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Background: Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. Aim: To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. Methods: A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide). Results: Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. Conclusion: To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well., Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Introduction: Borderline personality disorder (BPD) is characterized by intense affective reactions with underlying social and interpersonal cognitive deficits. Oxytocin has largely been associated with both stress regulation and social cognition in psychiatric patients and in non-clinical populations in previous studies. Finally, abnormal oxytocin levels have been preliminary reported in BPD patients. Methods: 53 patients with moderate-severe BPD and 31 healthy control subjects were investigated for plasma levels of oxytocin and protein expression of oxytocin receptor in blood mononuclear cells. Clinical assessments were made for severity, functionality, and comorbidity with axis I and II conditions. Results: Oxytocin plasma levels were significantly lower in BPD patients compared with controls. In addition, protein expression of oxytocin receptor was significantly reduced in the BPD group. A positive correlation was found between plasma oxytocin levels and the activity index score of the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Oxytocin receptor protein expression, on the contrary, had a negative correlation with the ZKPQ sociability index score. Conclusions: Results support the evidence of a dysfunction of the oxytocin system in borderline personality disorder, which could be involved in emotional dysregulation and interpersonal disturbances in these patients., Instituto de Salud Carlos III, FEDER, Depto. de Farmacología y Toxicología, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

In recent years we have witnessed a great deal of media interest in climate change, echoing the growing public concern about a complex phenomenon with daunting consequences. This pa­per examines the impact of concepts such as “eco-anxiety” and “solastal­gia” in the Spanish and Latin American written and digital press. These neolo­gisms attempt to explain the emotion­al effects of climate change on men­tal health. Between 2015 and 2019 the words “solastalgia” and “Nature Deficit Disorder (NDD)” slowly made their way into the media, until 2019, when the term “eco-anxiety” became relatively successful in the newspapers. In addition to analysing the factors in­volved in the birth and evolution of this concept, the study describes the most frequently cited emotions, such as fear, anguish, stress, sadness and guilt. The results obtained indicate, on the one hand, that eco-anxiety is still a vague idea and not very present in the media, too often linked to negative emotions, in contradiction of clinical psycholo­gy advice. Meanwhile, emotions such as anger or indignation, which would enable a collective response to climate change, are often neglected., Depto. de Ciencias de la Comunicación Aplicada, Fac. de Ciencias de la Información, TRUE, pub

The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were “conceptual disorganization”, “emotional withdrawal”, “lack of spontaneity and flow of conversation”, “delusions”, “unusual thought content”, “dealing with strangers” and “poor rapport”. Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this population., Depto. de Psicobiología y Metodología en Ciencias del Comportamiento, Fac. de Psicología, TRUE, pub

Background: The contents of traditional communication media and new internet social media reflect the interests of society. However, certain barriers and a lack of attention towards mental disorders have been previously observed. Objective: The objective of this study is to measure the relevance of influential American mainstream media outlets for the distribution of psychiatric information and the interest generated in these topics among their Twitter followers. Methods: We investigated tweets generated about mental health conditions and diseases among 15 mainstream general communication media outlets in the United States of America between January 2007 and December 2016. Our study strategy focused on identifying several psychiatric terms of primary interest. The number of retweets generated from the selected tweets was also investigated. As a control, we examined tweets generated about the main causes of death in the United States of America, the main chronic neurological degenerative diseases, and HIV. Results: In total, 13,119 tweets about mental health disorders sent by the American mainstream media outlets were analyzed. The results showed a heterogeneous distribution but preferential accumulation for a select number of conditions. Suicide and gender dysphoria accounted for half of the number of tweets sent. Variability in the number of tweets related to each control disease was also found (5998). The number of tweets sent regarding each different psychiatric or organic disease analyzed was significantly correlated with the number of retweets generated by followers (1,030,974 and 424,813 responses to mental health disorders and organic diseases, respectively). However, the probability of a tweet being retweeted differed significantly among the conditions and diseases analyzed. Furthermore, the retweeted to tweet ratio was significantly higher for psychiatric diseases than for the control diseases (odds ratio 1.11, CI 1.07-1.14; P<.001). Conclusions: American m, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Mental health stigma is a relevant phenomenon with implications for the people who suffer from it. Despite its importance, no studies have been carried out in Spain at national level with a representative sample of the population. Aims: The aim of this research is to analyze the stigma associated with MHPs in a representative sample of the Spanish population for the first time. Method: A cross-sectional quantitative descriptive study was carried out with a representative sample of the population (N = 2746). Descriptive analyses and regressions are carried out on the different dimensions of stigma such as attitude, attribution and intention of social distance. Results: Medium levels of stigma are obtained in stigmatizing attitudes and attributions, and medium-low levels in the intention of social distance. The best predictors of stigma in its different dimensions are attitudes, attributions and intention of social distance themselves. Progressive political ideology is related to less stigma in all dimensions. Knowing someone with mental health problems and talking openly about it together with higher education are also relevant protectors. Mixed results are obtained regarding age, gender and help-seeking. Conclusion: National programs and campaigns focused on attitudes, attributions and behavioral intentions are necessary to reduce the stigma still present in Spanish society., Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Although alterations in the gut microbiota have been linked to the pathophysiology of major depressive disorder (MDD), including through effects on the immune response, our understanding is deficient about the straight connection patterns among microbiota and MDD in patients. Male and female MDD patients were recruited: 46 patients with a current active MDD (a-MDD) and 22 in remission or with only mild symptoms (r-MDD). Forty-five healthy controls (HC) were also recruited. Psychopathological states were assessed, and fecal and blood samples were collected. Results indicated that the inducible nitric oxide synthase expression was higher in MDD patients compared with HC and the oxidative stress levels were greater in the a-MDD group. Furthermore, the lipopolysaccharide (an indirect marker of bacterial translocation) was higher in a-MDD patients compared with the other groups. Fecal samples did not cluster according to the presence or the absence of MDD. There were bacterial genera whose relative abundance was altered in MDD:Bilophila(2-fold) andAlistipes(1.5-fold) were higher, whileAnaerostipes(1.5-fold) andDialister(15-fold) were lower in MDD patients compared with HC. Patients with a-MDD presented higher relative abundance ofAlistipesandAnaerostipes(1.5-fold) and a complete depletion ofDialistercompared with HC. Patients with r-MDD presented higher abundance ofBilophila(2.5-fold) compared with HC. Thus, the abundance of bacterial genera and some immune pathways, both with potential implications in the pathophysiology of depression, appear to be altered in MDD, with the most noticeable changes occurring in patients with the worse clinical condition, the a-MDD group., Spanish Ministry of Science and Innovation, CIBERSAM, Catalan Intensification Programme, Instituto de Salud Carlos III, Depto. de Farmacología y Toxicología, Depto. de Microbiología y Parasitología, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Regulatory agencies encourage computer modeling and simulation to reduce the time and cost of clinical trials. Although still not classified in formal guidelines, system biology-based models represent a powerful tool for generating hypotheses with great molecular detail. Herein, we have applied a mechanistic head-to-head in silico clinical trial (ISCT) between two treatments for attention-deficit/hyperactivity disorder, to wit lisdexamfetamine (LDX) and methylphenidate (MPH). The ISCT was generated through three phases comprising (i) the molecular characterization of drugs and pathologies, (ii) the generation of adult and children virtual populations (vPOPs) totaling 2,600 individuals and the creation of physiologically based pharmacokinetic (PBPK) and quantitative systems pharmacology (QSP) models, and (iii) data analysis with artificial intelligence methods. The characteristics of our vPOPs were in close agreement with real reference populations extracted from clinical trials, as did our PBPK models with in vivo parameters. The mechanisms of action of LDX and MPH were obtained from QSP models combining PBPK modeling of dosing schemes and systems biology-based modeling technology, i.e., therapeutic performance mapping system. The step-by-step process described here to undertake a head-to-head ISCT would allow obtaining mechanistic conclusions that could be extrapolated or used for predictions to a certain extent at the clinical level. Altogether, these computational techniques are proven an excellent tool for hypothesis-generation and would help reach a personalized medicine., Takeda, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Background: This study aimed at depicting the course of depression symptoms over the old age, with a special interest in a) uncovering its relationships with sociodemographic and health-related factors; b) analysing its predictive role on healthy-ageing outcomes later in life. Methods: The sample comprised 8317 older adults (46.02% men) from the English Longitudinal Study of Ageing. Robust structural equation modelling was used to identify symptom trajectories and their relationships with time-varying factors. Trajectory class and covariates were used to predict outcomes (quality of life, satisfaction with life, and daily living functioning) in a 2-year follow-up. Results: Three trajectory classes (so-called, normative, subclinical, chronic symptom trajectories) were identified for both sexes. Rising hearing difficulties and history of psychiatric problems were consistently associated with the chronic symptom trajectory. Lower education level, history of psychiatric problems, and increasing visual difficulties were connected with the subclinical trajectories. Finally, participants with either a subclinical or a chronic symptom trajectory showed worse outcomes than the remaining participants in the follow-up. Conclusion: This study highlighted the presence of varying courses of depression symptoms (each showing some distinctive features from other another) over the old age, pointing to some relevant implications for clinical assessment and treatment prescription., Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Se trata de un estudio de posibles relaciones familiares entre individuos datados en el periodo conocido como Cogotas I (>2900YBP), enterrados colectivamente empleando marcadores genéticos y software de uso forense convencional. La metodología empleada constituye una manera de objetivar los resultados., Background: This study relies on the discovery of two pit burials (LTA and LTB) of the Bronze Age Cogotas I archaeological culture (circa 3600–2950BP) in Spain. LTA was a single burial and LTB con- tained three skeletal remains of two adults and a newborn or foetus at term. Aim: The central question posed by this find was whether the LTB tomb constituted a traditional nuclear family (father, mother and son or daughter). Methods: Ancient and forensic DNA protocols were employed to obtain reliable results. Autosomal, X-STR markers and mitochondrial DNA were amplified. Subsequently, different kinship probabilities were estimated by means of LR values calculated using the Familias 3 software. Furthermore, an allelic dropout sensitivity test was developed in order to evaluate the influence of allelic dropout phenomena on the results. Results: It was possible to determine the molecular sex of all individuals and to establish a maternal relationship between the perinatal individual and one of the adults. Conclusion: The remains in the LTB tomb were not a traditional nuclear family (father, mother and son/daughter) and it was probably a tomb where two women, one of them pregnant, were buried., Antecedentes: Este estudio se basa en el descubrimiento de dos entierros en fosas (LTA y LTB) de la cultura arqueológica Cogotas I de la Edad del Bronce (alrededor de 3600-2950 a. C.) en España. LTA fue un entierro único y LTB contenía tres restos esqueléticos de dos adultos y un recién nacido o un feto a término. Objetivo: La pregunta central planteada por este hallazgo fue si la tumba de LTB constituía una familia nuclear tradicional (padre, madre e hijo o hija). Métodos: Se emplearon protocolos de ADN antiguos y forenses para obtener resultados confiables. Se amplificaron marcadores autosómicos, X-STR y ADN mitocondrial. Posteriormente se estimaron diferentes probabilidades de parentesco mediante valores de LR calculados mediante el software Familias 3. Además, se desarrolló una prueba de sensibilidad al abandono alélico para evaluar la influencia de los fenómenos de abandono alélico en los resultados. Resultados: Se logró determinar el sexo molecular de todos los individuos y establecer una relación materna entre el individuo perinatal y uno de los adultos. Conclusión: Los restos en la tumba de LTB no eran un núcleo familiar tradicional (padre, madre e hijo/hija) y probablemente se trataba de una tumba donde fueron enterradas dos mujeres, una de ellas embarazada., Ministerio de Economía y Competitividad, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Background: Substance use disorders (SUD) represent one of the most important public health problems which has an onset in adolescence. Although substantial data exist on adolescent substance use, studies examining the role of parental psychopathological profiles on adolescent offspring SUD are lacking. Thus, this study aimed to identify parental psychopathological profiles, and to examine the extent to which these profiles predict the presence of SUD in their offspring. Method: Data comes from the National Comorbidity Survey – Adolescent Supplement, a nationally representative survey of adolescents. This study examined data of 5887 adolescents (48.60% boys; M = 15.07 years, SD = 1.46) whose biological parents responded to the Parent Self-Administered Questionnaire. Parental psychopathological profiles were identified by means of latent class analysis. Profile class membership was used to predict offspring SUD in adolescence. Results: Different psychopathological profiles were identified in fathers and mothers. Among fathers, two psychopathological profiles were found: “normative class” (i.e., low psychopathological symptoms) and “high psychopathology class” (i.e., high psychopathological symptoms). Among mothers, three psychopathological profiles were found: “normative class” (i.e., low psychopathological symptoms), and “high psychopathology class” (i.e., high psychopathological symptoms), and “suicide class” (i.e., low psychopathological symptoms and drug use, but high on suicidal ideation or attempting to commit suicide). Father’s high psychopathological profile significantly predicted adolescent’s drug abuse. Mother’s high psychopathological profile significantly predicted adolescent’s nicotine dependence, alcohol or illicit drug abuse. Conclusions: Family-based interventions should include skills training in reducing parental SUD and other mental health problems., Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Several hypotheses involving alterations of the immune system have been proposed among etiological explanations for psychotic disorders. The endocannabinoid system (ECS) has a homeostatic role as an endogenous neuroprotective and anti-inflammatory system. Alterations of this system have been associated with psychosis. Cannabis use is a robust risk factor for these disorders that could alter the ECS signalling. In this study, 95 patients with a first episode of psychosis (FEP) and 90 healthy controls were recruited. Protein expression of cannabinoid receptor 2 (CB2), the protein levels of the main endocannabinoid synthesizing enzymes N-acyl phosphatidylethanolamine phospholipase (NAPE) and diacylglycerol lipase (DAGL), and of degradation enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL) were determined by western blot analysis in peripheral blood mononuclear cells (PBMCs). Patients with a FEP showed a decreased expression of CB2 and of both endocannabinoids synthesizing enzymes (NAPE and DAGL) in comparison to healthy controls. After controlling for age, gender, body mass index, and cannabis use, NAPE and DAGL expression remained significantly decreased, whereas FAAH and MAGL expression were increased. On the other hand, FEP subjects with history of severe cannabis use showed a larger ECS dysregulation compared with healthy controls. These results indicate an ECS dysregulation in PBMC of FEP patients. The alteration of the ECS presented at the initial phases of psychosis could be contributing to the pathophysiology of the disease and constitutes a possible biomarker of psychotic disorders and an interesting pharmacological target to take into account for therapeutic purposes., Spanish Ministry of Economy and Competiveness, CIBERSAM, Instituto de Salud Carlos III, Comunidad de Madrid, Government of Catalonia, Esther Koplowitz Center, Depto. de Farmacología y Toxicología, Depto. de Medicina Legal, Psiquiatría y Patología, TRUE, pub

Background: In Spain, there has been great effort by lawmakers to put Advance Directives (ADs) into practice since 2002. At the same time, the field of bioethics has been on the rise, a discipline that has spurred debate on the right of patients to exercise their autonomy. Despite all this, the implementation of ADs can be said to have failed in Spain, because its prevalence is very low, there is a great lack of knowledge about them and they have very little impact on clinical decisions. The purpose of this article is to analyze and discuss the main reasons for the failure of ADs in Spain. Main body: The main reasons why ADs have no impact on clinical practice in Spain have been fundamentally four: (1) the training of health professionals about the end of life and AD is lacking; (2) there has been no public process to increase awareness about AD, and therefore people (with the exception of specific highly sensitized groups) know little about them; (3) the bureaucratic procedure to document and implement ADs is excessively complex and cumbersome, creating a significant barrier to their application; (4) in Spain, the remnants of a paternalistic medical culture continue to exist, which causes shared decision-making to be difficult. Conclusion: Due to the four reasons mentioned above, AD have not been a useful tool to help honor patients' autonomous decisions about their future care and, therefore, they have not achieved their objective. However, despite the difficulties and problems identified, it has also been observed that health care professionals and the Spanish public have a very positive view of AD. Having identified the problems which have kept AD from being successful, strategies must be developed to help improve their implementation into the future., Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Loneliness is considered a prognostic factor for poorer health status in the elderly. It is proposed to analyze the role of loneliness in health status in terms of various factors. A total of 1747 individuals from the pilot survey of the Aging in Spain Longitudinal Study (ELES-PS) were reviewed. ELES is a cross-sectional study for collecting health variables, food habits, socioeconomic data, and cognitive and functional capacities, which was carried out on a Spanish representative sample of noninstitutionalized persons of 50 years of age or older. Moreover, since telomere shortening is associated with cellular senescence, 35 telomere-related SNPs and cognitive impairments were analyzed. The results characterize the “solos” as males of 50–60 years, who were overweight and had lower levels of hemoglobin and neutrophils. There is also an association between five SNPs related to telomere length and BDNF. A group of people with loneliness and depression was identified with poorer health and cognitive status, poorer perception of their quality of life, poorer quality of sleep, and lower physical activity. Therefore, it follows that telomeres and BDNF play a role as intermediaries between loneliness and depression and their relationship with a worse state of health., UCM-SANTANDER, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Background: Down syndrome (DS) is considered the most frequent cause of early-onset Alzheimer’s disease (AD), and the typical pathophysiological signs are present in almost all individuals with DS by the age of 40. Despite of this evidence, the investigation on the pre-dementia stages in DS is scarce. In the present study we analyzed the complexity of brain oscillatory patterns and neuropsychological performance for the characterization of mild cognitive impairment (MCI) in DS. Materials and methods: Lempel-Ziv complexity (LZC) values from restingstatemagnetoencephalography recordings and the neuropsychological performance in 28 patients with DS [control DS group (CN-DS) (n = 14), MCI group (MCI-DS) (n = 14)] and 14 individuals with typical neurodevelopment (CN-no-DS) were analyzed. Results: Lempel-Ziv complexity was lowest in the frontal region within the MCI-DS group, while the CN-DS group showed reduced values in parietal areas when compared with the CN-no-DS group. Also, the CN-no-DS group exhibited the expected pattern of significant increase of LZC as a function of age, while MCI-DS cases showed a decrease. The combination of reduced LZC values and a divergent trajectory of complexity evolution with age, allowed the discrimination of CN-DS vs. MCI-DS patients with a 92.9% of sensitivity and 85.7% of specificity. Finally, a pattern of mnestic and praxic impairment was significantly associated in MCI-DS cases with the significant reduction of LZC values in frontal and parietal regions (p = 0.01). Conclusion: Brain signal complexity measured with LZC is reduced in DS and its development with age is also disrupted. The combination of both features might assist in the detection of MCI within this population., Ministerio de Economía y Competitividad (Instituto de Salud Carlos III), Jérôme Lejeune Foundation, Ministerio de Ciencia, Innovación y Universidades, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Se trata del estudio genético de relaciones familiares más antiguo hasta la fecha en la Península Ibérica, mediante la utilización de marcadores genéticos y software forenses de uso convencional. Igualmente, se aporta información relevante sobre el aspecto físico de los neolíticos del Pirineo, cosa no realizada hasta el momento (2020). Es el resultado de una intensa colaboración nacional e internacional con el Grupo de Genética Forense y Genética de Poblaciones de la Facultad de Medicina de la Universidad Complutense, dirigido por los Drs. Eduardo Arroyo-Pardo y la Dra. Ana M. López-Parra., One of the most important Neolithic necropolises in the north-east of the Iberian Peninsula is La Feixa del Moro (3975-3790 cal. BC), located at 1335 mamsl in the Pyrenees (Juberri, Sant Julia de Lòria, Andorra). Within the scarcity of multiple simultaneous Neolithic burials, the main importance of La Feixa del Moro lies in the fact that it is one of the very few cases to suggest a biological family burial, comprising two adults and a newborn baby. Accordingly, the purpose of the present work was the multidisciplinary interpretation of the necropolis in the Neolithic context of the Pyrenees, on a potential route between the Iberian Peninsula and Europe. Therefore, kinship and biogeographic analyses were performed, as well as external visible characteristics phenotyping. Our results suggest the possibility of a traditional nuclear family, pointing to a very probable relation between the newborn and both adults. First, two mitochondrial haplotypes and two lineages were determined: H1, for the presumable mother and newborn, and U5, for the presumed father. Second, regarding their physical appearance, they all had brown eyes, the adult female and the neonate had dark brown hair, while the adult male's hair was dark red-brown. Finally, it was possible to confirm the sex of two of the individuals, as the newborn baby gender was also confirmed by the High Troughoutput Sequencing analysis. The multidisciplinary analysis of the La Feixa del Moro burial place envisions a very probable familial burial. Not only does the genetic evidence point to biological kinship, but also the archaeological record indicates a habitational area surrounding the burial site. The similar artefacts and the care shown during the funerary ritual suggest a probable biological Neolithic family., Una de las necrópolis neolíticas más importantes del noreste de la Península Ibérica es La Feixa del Moro (3975-3790 cal. a. C.), situada a 1335 m sobre el nivel del mar en los Pirineos (Juberri, Sant Julià de Lòria, Andorra). Dentro de la escasez de múltiples enterramientos neolíticos simultáneos, la principal importancia de La Feixa del Moro reside en que es uno de los pocos casos que sugiere un entierro familiar biológico, compuesto por dos adultos y un recién nacido. En este sentido, el objetivo del presente trabajo fue la interpretación multidisciplinar de la necrópolis en el contexto neolítico del Pirineo, en una potencial ruta entre la Península Ibérica y Europa. Para ello, se realizaron análisis de parentesco y biogeográficos, así como fenotipado de características externas visibles. Nuestros resultados sugieren la posibilidad de una familia nuclear tradicional, apuntando a una relación muy probable entre el recién nacido y ambos adultos. En primer lugar se determinaron dos haplotipos mitocondriales y dos linajes: H1, para la presunta madre y el recién nacido, y U5, para el presunto padre. En segundo lugar, en cuanto a su apariencia física, todos tenían ojos marrones, la hembra adulta y el neonato tenían cabello castaño oscuro, mientras que el cabello del macho adulto era marrón rojizo oscuro. Finalmente, fue posible confirmar el sexo de dos de los individuos, ya que el sexo del recién nacido también fue confirmado mediante el análisis de secuenciación de alto rendimiento. El análisis multidisciplinar del lugar de enterramiento de La Feixa del Moro vislumbra un enterramiento familiar muy probable. No sólo la evidencia genética apunta a un parentesco biológico, sino que también el registro arqueológico indica un área habitacional que rodea el sitio de enterramiento. Los artefactos similares y el cuidado mostrado durante el ritual funerario sugieren una probable familia biológica neolítica., Santander-Universidad Complutense de Madrid, Ministerio de Ciencia, Innovación y Universidades, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Background: The concept of European psychologisation of depression versus somatisation in non-European populations has been the basis of several studies of cultural psychopathology in the general population. Little is currently known about cross-cultural differences and similarities in late-life depression symptom reporting. We cross-culturally compared symptom reporting in the context of Major Depressive Disorder (MDD) among community-dwelling older adults from Spain and Nigeria. Methods: We relied on data from two household multistage probability samples comprising 3,715 persons aged 65 years or older in the Spanish and Nigerian populations. All participants underwent assessments for MDD using the World Mental Health Survey version of the Composite International Diagnostic Interview. Cross-cultural comparison of broad somatic and psychological categories as well as relationship and influence of individual symptoms were analysed using the Symptom Network Analysis approach. Results: Current MDD was diagnosed in 232 and 195 older persons from Spain and Nigeria, respectively. The symptom network of the two samples were invariant in terms of global strength, S(GSPAIN , GNIGERIA ) = 7.56, P = .06, with psychological and somatic symptoms demonstrating centrality in both countries. However, country-specific relationships and influence of individual symptoms were found in the network structure of both samples, M(GSPAIN , GNIGERIA ) = 2.95, P < .01. Conclusion: Broad somatic and psychological symptoms categories contributed to the structural network of older Africans and their peers from the Spanish population. Variations in the relationship and influence of individual symptoms suggests that the functional and "communicative" role of individual symptoms may be differentiated by context specific imperatives. J Am Geriatr Soc 68:-, 2020., Wellcome Trust, Unión Europea, Ministerio de Economía y Competitividad, Instituto de Salud Carlos III, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Psychopathology networks consist of aspects (e.g., symptoms) of mental disorders (nodes) and the connections between those aspects (edges). This article aims to analyze the research literature on network analysis in psychopathology and mental health for the last ten years. Statistical descriptive analysis was complemented with two bibliometric techniques: performance analysis and co-word analysis. There is an increase in publications that has passed from 1 article published in 2010 to 172 papers published in 2020. The 398 articles in the sample have 1,910 authors in total, being most of them occasional contributors. The Journal of Affective Disorders is the one with the highest number of publications on network analysis in psychopathology and mental health, followed by the Journal of Abnormal Psychology and Psychological Medicine stand out. The present study shows that this perspective in psychopathology and mental health is a recent field of study, but with solid advances in recent years from a wide variety of researchers, mainly from USA and Europe, who have extensively studied symptom networks in depression, anxiety, and post-traumatic stress disorders. However, gaps are identified in other psychological behaviors such as suicide, populations such as the elderly, and gender studies., Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Background: The cortico-cerebellar-thalamic-cortical circuit has been implicated in the emergence of psychotic symptoms in schizophrenia (SZ). The kynurenine pathway (KP) has been linked to alterations in glutamatergic and monoaminergic neurotransmission and to SZ symptomatology through the production of the metabolites quinolinic acid (QA) and kynurenic acid (KYNA). Methods: This work describes alterations in KP in the post-mortem prefrontal cortex (PFC) and cerebellum (CB) of 15 chronic SZ patients and 14 control subjects in PFC and 13 control subjects in CB using immunoblot for protein levels and ELISA for interleukins and QA and KYNA determinations. Monoamine metabolites were analysed by high-performance liquid chromatography and SZ symptomatology was assessed by Positive and Negative Syndrome Scale (PANSS). The association of KP with inflammatory mediators, monoamine metabolism and SZ symptomatology was explored. Results: In the PFC, the presence of the anti-inflammatory cytokine IL-10 together with IDO2 and KATII enzymes decreased in SZ, while TDO and KMO enzyme expression increased. A network interaction analysis showed that in the PFC IL-10 was coupled to the QA branch of the kynurenine pathway (TDO-KMO-QA), whereas IL-10 associated with KMO in CB. KYNA in the CB inversely correlated with negative and general PANSS psychopathology. Although there were no changes in monoamine metabolite content in the PFC in SZ, a network interaction analysis showed associations between dopamine and methoxyhydroxyphenylglycol degradation metabolite. Direct correlations were found between general PANSS psychopathology and the serotonin degradation metabolite, 5-hydroxyindoleacetic acid. Interestingly, KYNA in the CB inversely correlated with 5-hydroxyindoleacetic acid in the PFC. Conclusions: Thus, this work found alterations in KP in two brain areas belonging to the cortico-cerebellar-thalamic-cortical circuit associated with SZ symptomatology, with a possible impact across a, MINECO-FEDER, Instituto de Salud Carlos III, ERDF, CIBERSAM, Depto. de Farmacología y Toxicología, Fac. de Medicina, TRUE, pub

Up to 30% of patients with attention-deficit hyperactivity disorder (ADHD) treated with psychostimulants discontinue the treatment because of intolerance or lack of therapeutic response. Therapeutic alternatives are needed for such patients. In the present case series, we study the effectiveness of reboxetine over a period of 6 months in a sample of 14 children diagnosed with ADHD according to DSM-IV-TR criteria, who had responded only partially or had presented poor tolerance to conventional treatment with methylphenidate. Clinical efficacy was evaluated through the application of the 18-item Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS-IV) and the Clinical Global Impressions-Global Improvement Scale (CGI-I). Percentages of responders (ADHD-RS ≥ 25%) and improvers (CGI-I absolute value < 4) were 90.9 and 72.7%, respectively. No serious side-effects were observed during treatment, the most frequent effects being headaches and insomnia. The initial findings of our study show that reboxetine may constitute an effective tool for long-term treatment of children with ADHD who present poor response or poor tolerance to initial treatment with methylphenidate., Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Auditory hallucinations (AHs) are one of the most distressing symptoms of schizophrenia (SZ) and are often resistant to medication. Imaging studies of individuals with SZ show hyperactivation of the default mode network (DMN) and the superior temporal gyrus (STG). Studies in SZ show DMN hyperconnectivity and reduced anticorrelation between DMN and the central executive network (CEN). DMN hyperconnectivity has been associated with positive symptoms such as AHs while reduced DMN anticorrelations with cognitive impairment. Using real-time fMRI neurofeedback (rt-fMRI-NFB) we trained SZ patients to modulate DMN and CEN networks. Meditation is effective in reducing AHs in SZ and to modulate brain network integration and increase DMN anticorrelations. Consequently, patients were provided with meditation strategies to enhance their abilities to modulate DMN/CEN. Results show a reduction of DMN hyperconnectivity and increase in DMNsingle bondCEN anticorrelation. Furthermore, the change in individual DMN connectivity significantly correlated with reductions in AHs. This is the first time that meditation enhanced through rt-fMRI-NFB is used to reduce AHs in SZ. Moreover, it provides the first empirical evidence for a direct causal relation between meditation enhanced rt-fMRI-NFB modulation of DMNsingle bondCEN activity and post-intervention modulation of resting state networks ensuing in reductions in frequency and severity of AHs., Depto. de Psicobiología y Metodología en Ciencias del Comportamiento, Fac. de Psicología, TRUE, pub

Introduction: Women have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender. Methods: A cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables. Results: Women in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma. Conclusion: Being female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested., Real Colegio Complutense, Banco Santander, Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Plasma acylethanolamides (NAEs), including the endocannabinoid anandamide (AEA), have been proposed as circulating biomarkers of substance use disorders. However, the concentration of these lipid transmitters might be influenced by the use of drugs prescribed for either the treatment of addiction or the associated psychiatric co-morbidities such as psychosis. As an example, neuroleptics, used for attenuation of psychotic symptoms and sedation, might theoretically interfere with the monoamine-mediated production of NAEs, obstructing the interpretation of plasma NAEsasclinical biomarkers. To solve the lack of information on the impact of neuroleptics on the concentration of NAEs, we evaluated the concentrations of NAEs in a control group and compared them to those present in (a) substance use disorders (SUD) patients that are not prescribed with neuroleptics, and (b) SUD patients (both alcohol use disorder and cocaine use disorder patients) using neuroleptics. The results demonstrate that SUD patients exhibited greater concentrations of NAEsthan the control population, affecting all species with the exception of stearoylethanolamide (SEA) and palmitoleoylethanolamide (POEA). Neuroleptic treatment enhanced the concentrations of NAEs, especially those of AEA, linoleoylethanolamide (LEA), and oleoylethanolamide (OEA). This effect of neuroleptic treatment was observed independently of the drug addiction that motivated the demand for treatment (either alcohol or cocaine). This study remarks the need to control the current use of psychotropic medication as a potential confounding variable when considering the use of NAEsasbiomarkers in SUD., Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación (España), European Commission, Ministerio de Sanidad, Junta de Andalucía, Depto. de Psicobiología y Metodología en Ciencias del Comportamiento, Fac. de Psicología, TRUE, pub, Descuento UCM

Department of Nursing, University of Jaen, 23071 Jaen, Spain Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain European University of Valencia, 46010 Valencia, Spain Department of Obstetrics and Gynecology, Delivery Ward, Hospital Antequera, 29200 Malaga, Spain Mental Health Unit, Virgen del Rocio University Hospital, 41013 Seville, Spain English Language Department, University of Seville, 41004 Seville, Spain Department of Nursing, The University of Granada, 18071 Granada, Spain Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, CIBERSAM ISCIII, 28040 Madrid, Spain, The coronavirus SARS-CoV-2 generated an alert that became a state of emergency in health issues worldwide, a situation that affected the entire population, including pregnant women. The present study aims to understand the effect of the psychopathological profile of a sample of pregnant women at the time of the COVID-19 pandemic on themselves during childbirth (Phase 1) and after childbirth and the anthropometric measures of the neonate at birth (Phase 2). The total sample comprises 81 pregnant women aged 32.07 years (SD = 5.45) and their neonates. Sociodemographic and obstetric data of the sample were collected. During pregnancy, psychopathology was measured by means of the SCL-90, as well as other psychological measures on stress and social support. Cluster k-means techniques were used to uncover the heterogeneous profiles of psychopathology in Phase 1. Two main psychopathological profiles were found (Cluster 1: High psychopathological symptoms; Cluster 2: Low psychopathological symptoms). The clusters generated show significant differences in all the SCL-90-R subscales used and in the general index at Phase 1. After childbirth, high psychopathology profile membership was associated with a greater probability of having a non-eutocic delivery. On the other hand, the low psychopathological symptoms cluster shows higher levels of depressive symptoms, hostility, paranoid ideation, and psychotic symptoms in Phase 2. In conclusion, there seemed to exist two heterogeneous profiles of psychopathology in pregnant women during the pandemic; the stress related to the pandemic seemed uninfluential on the development of a profile of high psychopathological symptoms and the psychopathology profile may influence delivery and postpartum outcomes., Department of Nursing, University of Jaen, Instituto de Investigación Biosanitaria (ibs.GRANADA), European University of Valencia, Department of Obstetrics and Gynecology, DeliveryWard, Hospital Antequera, Mental Health Unit, Virgen del Rocio University Hospital, English Language Department, University of Seville, Department of Nursing, The University of Granada, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Suicide is a serious global public health problem, with a worrying recent increase in suicide rates in both adolescent and adult populations. However, it is essential to recognize that suicide is preventable. A myriad of factors contributes to an individual’s vulnerability to suicide. These factors include various potential causes, from psychiatric disorders to genetic and epigenetic alterations. These changes can induce dysfunctions in crucial systems such as the serotonergic, cannabinoid, and hypothalamic–pituitary–adrenal axes. In addition, early life experiences of abuse can profoundly impact an individual’s ability to cope with stress, ultimately leading to changes in the inflammatory system, which is a significant risk factor for suicidal behavior. Thus, it is clear that suicidal behavior may result from a confluence of multiple factors. This review examines the primary risk factors associated with suicidal behavior, including psychiatric disorders, early life adversities, and epigenetic modifications. Our goal is to elucidate the molecular changes at the genetic, epigenetic, and molecular levels in the brains of individuals who have taken their own lives and in the plasma and peripheral mononuclear cells of suicide attempters and how these changes may serve as predisposing factors for suicidal tendencies., Red de investigación en atención primaria de adicciones, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub, Descuento UCM

El amplío uso en la ínvestigación psicopatológica de paradigmas experimentales derivados del procesamiento de información exige el desarrollo de estímulos experimentales con adecuadas propiedades psicométricas. En el presente artículo se presentan dos conjuntos de estímulos verbales en español desarrollados para la investigación de constructos cognitivos relacionados con los trastornos de ansiedad social y depresión (p. ej., los autoesquemas depresivos y ansiosos, los nodos cognitivos de depresión y ansiedad, etc.), mediante tareas experimentales como la tarea Stroop, de anticipación semántica, de codificación autorreferente, o de decisión léxica. Estos dos conjuntos están formados por grupos de adjetivos de personalidad de valencia positiva y negativa cuyo contenido está específicamente relacionado con la depresión, la ansiedad social, con ambos trastornos (adjetivos mixtos) y con ninguno de ellos (adjetivos control). Además, los grupos de adjetivos que componen tales conjuntos no difieren entre sí en dimensiones tales como frecuencia objetiva de uso, frecuencia subjetiva de uso, imaginabilidad, emocionalidad y longitud en número de letras, lo que asegura en futuras investigaciones el control de los posibles efectos como variables extrañas de dichas dimensiones., The proliferatíon of experimental paradigms imported from information processing in psychopathological research calls for the development of experimental stimuli with appropríate psychometric properties. This paper presents two sets of Spanish verbal stimuli developed for the research of cognítive constructs related to social anxiety and depression (e.g., depressíve and anxious self-schemata, depression and anxíety cognitive nodes, etc.) with experimental tasks such as the Stroop, priming, self-referent encoding, or lexical decísion tasks. These two sets are composed of groups of personality trait adjectives with positive and negative valence, and with content specifically related to depressive, anxious, both depressíve and anxious (mixed adjectives), and normal themes (control adjectives). In addition, the groups of adjectíves do not díffer among them on dimensions such as objective frequency of use, subjectíve frequency of use, imagery, emotionality, and word length. Thís absence of differences warrants the control of possible effects as strange variables of those dimensíons in future studies., Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Growing evidence supports the hypothesis that temperamental traits are not static throughout adolescence. The known links between both reactive and regulatory temperament and anxiety symptoms should be investigated bearing this hypothesis in mind. This study collected self-reported data on behavioral inhibition system (BIS) sensitivity, attentional control (AC), and anxiety symptomatology, from 296 adolescents (64.2% girls; M = 12.96 years at the first assessment, SD = 0.47) every six months, four times over eighteen months. The relationships between temperament factors (AC and BIS sensitivity), considered longitudinally (by means of their trajectories) and anxiety symptoms were investigated using Multigroup Latent Growth Modeling (MLGM), as well as the mediating effect of sex on trajectories and anxiety. BIS sensitivity decreased over time and showed differential patterns across sexes. AC remained relatively stable and we found no sex influence on its trajectory. On the other hand, we observed that the BIS sensitivity trajectory was a significant predictor of anxiety symptomatology at age 15. In conclusion, temperamental changes between the ages of 13 and 15 seem to play a relevant role in explaining subsequent anxiety symptomatology, under the mediating influence of sex., Unión Europea, Ministerio de Economía y Competitividad (España), Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub