Baquero Escribano, Abel

The technological revolution has led to the birth of new diagnoses, such as gaming disorder. When any addiction, including this one, is associated with other mental disorders, it is considered a dual diagnosis. The objectives of this current work were to estimate the prevalence of dual diagnoses in the adolescent general population while also considering the problematic use of video games and substance addiction and assessing its psychosocial risk factors. Thus, we carried out a cross-sectional study with a sample of 397 adolescents; 16.4% presented problematic videogame use and 3% presented a dual diagnosis. Male gender increased the probability of both a dual diagnosis (OR [95% CI] = 7.119 [1.132, 44.785]; p = 0.036) and problematic video game use (OR [95% CI] = 9.85 [4.08, 23.77]; p < 0.001). Regarding personality, low conscientiousness, openness, and agreeableness scores were predictors of a dual diagnosis and problematic videogame use, while emotional stability predicted a dual diagnosis (OR [95% CI] = 1.116 [1.030, 1.209]; p = 0.008). Regarding family dynamics, low affection and communication increased both the probability of a dual diagnosis (OR [95% CI] = 0.927 [0.891, 0.965]; p < 0.001) and problematic video game use (OR [95% CI] = 0.968 [0.945, 0.992]; p = 0.009). Regarding academic performance, bad school grades increased the probability of a dual diagnosis. In summary, male gender, certain personality traits, poor communication, and poor affective family dynamics should be interpreted as red flags that indicate an increased risk of a dual diagnosis in adolescents, which could require early intervention through specific detection programs.

Background: Synthetic cannabinoids (SC) are difficult to detect in urine samples, and therefore an appropriate strategy is required to investigate its potential consumption. In this work, we have designed a study to investigate SCs consumption by minors in juvenile offenders’ centres. Methods: 127 minors were selected from five juvenile offenders’ centres in the Valencian Autonomous Community (Spain). 667 urine samples were collected after their therapeutic permits with stay at home. We studied the active molecules from 7 herbal blends available at the smartshop frequented by minors. Both, the herbal blends and urine samples were analysed by liquid chromatography coupled to hybrid quadrupole time-of-flight mass spectrometry. Results: Regarding cannabis consumption, 40.2% (N=51) of the subjects reported using organic or synthetic cannabis: 5.9% of them reported only to consume synthetic cannabis, 37.2% synthetic and organic cannabis and 56.9% only organic cannabis. The urine samples analysis revealed the absence of the parent SCs investigated, but the presence of the main metabolites from two SCs (XLR-11, UR-144): N-pentanoic acid and N-(5-hydroxypentyl). The 16 individual urine samples positives to the XLR-11 metabolites could be assigned to 6 minors, 2 of which recognize consumption whereas the remaining 4 adolescents did not recognize consumption of SCs. Conclusions: Synthetic cannabinoids, specifically, XLR-11, are consumed in juvenile offenders’ centres in the Autonomous Valencian Community. Preventive and therapeutic interventions in minors housed in those centres must be implemented to reduce the consumption of new psychoactive substances and to improve the risk-perception of these substances.

The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.

Checking whether changes in the perception of the quality of life related to health, after the nursing intervention, influence these patients’ motivation to change. This was a two‐staged study undertaken in entertainment‐sector workers in Spain: the first part was transversal and observational, and the second was semi‐experimental. First part undertook in 284 entertainmentsector workers, selected by non‐probabilistic sampling, while second part undertook in 50 entertainment‐business workers, selected by consecutive sampling from those who consumed substances. A short group‐based motivational intervention session was implemented by nursing staff, and a before and after evaluation was completed. The EuroQol‐5D and Test for the Evaluation of the Quality of Life in Addicts to Psychoactive Substances (TECVASP) were used. The patients’ motivation to change was evaluated through the Stages of Change Readiness and Treatment Eagerness Scale. The results analysis showed that the nursing intervention reduced the participants’ perceptions of their health‐related quality of life (t = 4.23; P = 0.00009) and of their quality of life in addicts to psychoactive substances (t = 3.38; P = 0.00140). There was an increase in the motivation of 6 workers (12%) to seek treatment of their addiction (χ = 13.02; P = 0.0091). The post‐test contemplation stage score was predicted (F = 6.56; P = 0.003; R = 0.46) with post‐test TECVASP score and pre–post difference in TECVASP score. By reducing the patients’ perception of their quality of life, this brief nursing intervention facilitated a favourable increase in the motivation for change among these workers and was effective in 12% of cases.

This study reports experimental results from a clinical sample of patients with a cocaine-related disorder and dual diagnosis: Schizophrenia and Anti-Social Personality Disorder. Both types of patients as well as a non-clinical group of students performed two incentivized decision-making tasks. In the first part of the experiment, they performed a lottery-choice task in order to elicit their degree of risk aversion. In the second part, they decided in two modified dictator games aimed at eliciting their aversion to advantageous and disadvantageous inequality. It is found that the Anti-Social Personality Disorder group exhibits no significant differences from the non-clinical sample in either task. However, compared with the students’ sample, subjects from the group with schizophrenia show more risk aversion and exhibit more aversion towards disadvantageous inequality.

Little data are available for women diagnosed with a dual diagnosis. However, dual diagnosis in women presents increased stigma, social penalties, and barriers to access to treatment than it does for men. Indeed, it increases the probability of suffering physical or sexual abuse, violent victimization, gender-based violence, unemployment, social exclusion, social-role problems, and physical and psychiatric comorbidities. Thus, a transversal sex and gender-based perspective is required to adequately study and treat dual diagnosis. For this, sex and gender factors should be included in every scientific analysis; professionals should review their own prejudices and stereotypes and train themselves specifically from a gender perspective; administrations should design and provide specific treatment resources for women; and we could all contribute to a structural social transformation that goes beyond gender mandates and norms and reduces the risk of abuse and violence inflicted on women.

The objective of the study was to evaluate the efficacy of an animal-assisted-therapy (AAT) program in patients diagnosed with schizophrenia-spectrum disorders and substance-use disorders in residential treatment in order to intervene in the remission of negative and positive symptoms and improve quality of life and adherence to treatment, favouring the clinical stabilization of patients who participate in the AAT program, within the context of a mental-illness-treatment device. This was a quasi-experimental prospective study with intersubject and intrasubject factors. The sample comprised 36 patients (21 in the experimental group and 15 in the control group) who were evaluated at three time points (in the 3rd, 6th, and 10th sessions). The program lasted 3 months and consisted of 10 sessions that were implemented once a week, with a maximum participation of 10 patients per group. The participants were evaluated with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Life Skills Profile-20 (LSP-20) questionnaire. We observed a decrease in the positive symptoms of psychosis (F: 27.80, p = 0.001) and an improvement in functionality (F: 26.70, p < 0.001) as the sessions progressed. On the basis of these results, we concluded that AAT seems to be valid as a coadjuvant therapy as part of the rehabilitation processes of patients diagnosed with schizophrenia and addiction-spectrum disorders (dual diagnosis).

Objective:Schizophrenia, cocaine-related disorder, antisocial personality disorder, andpsychopathy share biological bases, but few studies discriminate between these disordersby means of prepulse inhibition. This work studies the phenotype of patients with cocaine-related disorders who are vulnerable to presenting a dual diagnosis of schizophrenia orantisocial personality disorder, by evaluating their prepulse inhibition, impulsivity and psych-opathy personality traits.Methods:The sample (n¼38) was divided into three groups: (1)cocaine-related disorder (8 individuals diagnosed with cocaine-related disorder who did notpresent any other mental disorder), (2) cocaine-related disorder and schizophrenia (n¼14),and (3) cocaine-related disorder and antisocial personality disorder (n¼16).Results:Theprepulse inhibition in the two groups with dual diagnosis was lower than that in thecocaine-related disorder group,F(2, 35)¼6.52,p¼.004, while there was no significant differ-ences between the two dual-diagnosis groups. Psychopathy was evaluated with the revisedHare Psychopathy Checklist and showed no correlation with the prepulse inhibition.Secondary psychopathy (impulsivity and poor behavior control), as evaluated with LevensonSelf-Report Psychopathy Scale, was related to the prepulse inhibition. Two discriminating functions were obtained that allowed prediction of patient inclusion in the groups usingthe prepulse inhibition and the revised Hare Psychopathy Checklist with a success rate of81.6% (cocaine-related disorder¼62.5%; cocaine-related disorder and schizophrenia¼78.6%;cocaine-related disorder and antisocial personality disorder¼93.8%). These results are dis-cussed in regard to the neurobiological implications of prepulse inhibition in dual diagnosis.Conclusions:The results suggest that the prepulse inhibition is a promising dual-diagnosisvulnerability marker in individuals with cocaine addiction, because prepulse inhibition defi-cits are related both to schizophrenia and antisocial personality disorder. In addition, pre-pulse inhibition, which is considered a good endophenotype for studies on the genetic andneurobiological basis of cocaine-related disorder and schizophrenia, could be used in thesame way in studies on antisocial personality disorder.