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Gerardo Flórez,1,2 Ana López-Durán,3 Yolanda Triñanes,4 Jesús Osorio,5 Jaime Fraga,5 José Manuel Fernández,5 Elisardo Becoña,3 Manuel Arrojo5 1Addictive Disorders Assistance Unit, Complejo Hospitalario, Ourense, Spain; 2Center for Biomedical Research in Mental Health (CIBERSAM), Oviedo, Spain; 3Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain; 4Galician Agency for Health Technology Assessment, Directorate General for Innovation and Management of Public Health, Galicia, Spain; 5Directorate General of Health Assistance, Galician Health Service, Galicia, Spain Background: The purpose of this study was to gain an understanding of the profiles of the new treatment demands posed by opioid addicts between 2005 and 2010 at the addictive disorders assistance units in Galicia, Spain. Methods: A cluster analysis was performed using data from 1,655 treatment entrants. Clusters were constructed using sociodemographic and medicolegal variables. A cluster analysis was also conducted according to age. Once clusters were defined, their association with the following variables was analyzed: age at first use of opioids, years of use, frequency of opioid use in the previous month, psychiatric treatment, cocaine use, existence of a drug-dependent partner, and source of referral. Results: Four clusters were obtained in the main analysis. Cluster 1 (34.01%) consisted of young males, cluster 2 (16.19%) consisted of not-so-young males, cluster 3 (32.62%) consisted mainly of older males and a small group of females, and cluster 4 (17.18%) was made up entirely of women. With regard to age-related clusters, two clusters were obtained in those under the age of 30 years: cluster 1 (73%) without medicolegal complications and cluster 2 (27%) with medicolegal complications. For those over the age of 30 years, two clusters were obtained: cluster 1 (53.92%) with hardly any medicolegal complications and cluster 2 (46.08%) with medicolegal complications. Conclusion: Cluster analysis suggests that there have been no substantial changes in variables indicating greater severity in this new group of patients. Women are likely to seek help earlier, which reduces their duration of opioid use. The younger the patient, the shorter the duration of opioid use and the greater the likelihood of cessation of intravenous use. Public health systems should use a two-pronged treatment strategy of short but intense cessation therapies for women and younger treatment entrants and longer maintenance and replacement therapies for older treatment entrants with more psychosocial and medical complications. Keywords: opioid dependence, cluster analysis, treatment-seeking, sex, age

Aims: Gene x environment (G×E) interactions, i.e. genetic modulation of the sensitivity to environmental factors and/or environmental control of the gene expression, have not been reliably established regarding aetiology of psychotic disorders. Moreover, recent studies have shown associations between the polygenic risk scores for schizophrenia (PRS-SZ) and some risk factors of psychotic disorders, challenging the traditional gene v. environment dichotomy. In the present article, we studied the role of GxE interaction between psychosocial stressors (childhood trauma, stressful life-events, self-reported discrimination experiences and low social capital) and the PRS-SZ on subclinical psychosis in a population-based sample. Methods: Data were drawn from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, in which subjects without psychotic disorders were included in six countries. The sample was restricted to European descendant subjects (n = 706). Subclinical dimensions of psychosis (positive, negative, and depressive) were measured by the Community Assessment of Psychic Experiences (CAPE) scale. Associations between the PRS-SZ and the psychosocial stressors were tested. For each dimension, the interactions between genes and environment were assessed using linear models and comparing explained variances of 'Genetic' models (solely fitted with PRS-SZ), 'Environmental' models (solely fitted with each environmental stressor), 'Independent' models (with PRS-SZ and each environmental factor), and 'Interaction' models (Independent models plus an interaction term between the PRS-SZ and each environmental factor). Likelihood ration tests (LRT) compared the fit of the different models. Results: There were no genes-environment associations. PRS-SZ was associated with positive dimensions (β = 0.092, R 2 = 7.50%), and most psychosocial stressors were associated with all three subclinical psychotic dimensions (except social capital and positive dimension). Concerning the positive dimension, Independent models fitted better than Environmental and Genetic models. No significant GxE interaction was observed for any dimension. Conclusions: This study in subjects without psychotic disorders suggests that (i) the aetiological continuum hypothesis could concern particularly the positive dimension of subclinical psychosis, (ii) genetic and environmental factors have independent effects on the level of this positive dimension, (iii) and that interactions between genetic and individual environmental factors could not be identified in this sample. [ABSTRACT FROM AUTHOR]

The research focuses on how new communicative designs in the digital environment influence the perception and engagement of communicative content. The study proposes two main objectives: 1) analyze how the support itself (telephone, computer, television) conditions the perception and engagement of fiction series; and 2) how these technological supports can condition the consumption. To carry out the research, the fiction "The 100" was chosen, and the differences in perception were analyzed according to the distribution channel -subject to a schedule or not- and the impact of the level of consumption according to the technological support used. The scientific method employed is the Neuromarketing Research Methodology applied to the study of communicative phenomena. The results corroborate the hypothesis that the support and the transmission device condition both the level of attention and the active follow-up (engagement) that is developed with the audiovisual content. [ABSTRACT FROM AUTHOR]

Background: Obsessive Compulsive Disorder (OCD) is characterized by the presence of executive dysfunctions. As organizational strategies may play an important role as a possible endophenotype of the disorder, we decided to investigate non-verbal memory and organizational abilities in OCD. We also investigated how organization and non-verbal memory differ between responder and non-responder patients to pharmacological treatment, to test whether cognitive functions can predict the response to pharmacological treatment.Methods: In Study 1, executive and clinical functioning measures were applied to 162 OCD and 95 controls. In Study 2, clinical, intelligence and executive functioning measures were applied to 72 OCD responders and 63 OCD non-responder patients.Results: OCD patients and controls from Study 1 differed in copy organization (p < 0.01) and delayed recall (p = 0.048). In Study 2, the OCD responders displayed better copy organization (p = 0.013) and lower depressive, anxious and OCD symptoms (p < 0.01 in the three cases). Scores in the following instruments were found to predict the response to pharmacological treatment: HDRS, Y-BOCS, Raven progressive matrices, and Direct digit subtest from the Wechsler's scale (p < 0.01 in all four cases).Limitations: In Study 1, the imbalance of the sample can be considered a limitation, whilst in Study 2, some of the levels of pharmacological resistance were not represented.Conclusions: In this study, non-verbal memory and organization was affected in OCD. Responder patients also displayed better executive functioning and fluid intelligence. Organizational ability is a predictor of pharmacological response to SSRI monotherapy in a predictive model controlling for anxious symptoms. [ABSTRACT FROM AUTHOR]

Introduction Tobacco use has been associated with more excitement and agitation symptoms, greater severity of global psychopathology as measured by the Clinical General Impression (CGI) Scale, and psychotic symptoms in patients with schizophrenia. Aim To assess the effects of nicotine abstinence versus nicotine maintenance on the clinical symptoms of a sample of outpatients smokers diagnosed with schizophrenia. Methods Sample: 81 outpatients with schizophrenia [72.8% males; mean age (SD) = 43.35 (8.82)] currently smoking tobacco [no. of cigarettes (SD) = 27.96 (12.29)]. Desing: non-randomized, open-label, 6-month follow-up and multi-center study conducted at 3 sites in Spain (Oviedo, Santiago de Compostela and Orense). Instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression for Schizophrenia (CGI-SCH), Hamilton Depression Rating Scale (HDRS). Antropometric measures: Body mass index (BMI) and waist circumference. Vital sings: heart rate. Procedure: Patients were assigned to 2 conditions: – control group = patients continuing their tobacco use; – experimental group = patients participated in vareniclina or nicotine patches treatment for smoking cessation. Patients were evaluated at baseline (all patients smoking) and after 3 and 6 months. Results No significant differences ( P >.05) were found between groups at baseline evaluation. Likewise, there were no significant differences between smokers and non-smokers after treatment (3 and 6 months follow-up) in their clinical symptomatology (according to PANSS, HDRS and CGI-SCH), anthropometric measures and heart rate. Conclusions No significant differences were found in the clinical symptoms after a period of nicotine abstinence. Therefore, clinicians should motivate and help their patients to quit smoking (CIBERSAM - FIS PI11/01891). [ABSTRACT FROM AUTHOR]

Introduction Spatial patterns of mortality could help us to focus research to achieve prevention. On the other hand, recent research has shown an association between unemployment and suicide, but the mediating factors in this relationship are still unknown. Objectives We investigated the provincial spatial patterns of suicide mortality in Spain, and the effect of unemployment and economic recession on suicide mortality rates in the Spanish region of Galicia that has high suicide rates. Method To describe regional suicide mortality in Spain and to assess its association with recession and unemployment in Galicia, we calculated age-standardized suicide rates in men and women throughout 1975–2012 by region and performed a time-trend Generalized Additive Model using mortality data provided by National Statistics Institute and employment data collected from Statistics Institute of Galicia. Results In Spain, during the study period, there were 105,134 suicides with an age-adjusted rate of 10.2 and 3.02 per 100,000 population in men and women, respectively. There is a high variability in mortality rates across Spanish provinces. Madrid had the lower rates and Asturias and Galicia the higher ones. In Galicia, suicide rates were 13.7 in men and 4.3 in women per 100,000 and we found that economic recession and unemployment interacted with regards to suicide rates ( P = 9.80E-4) and after stratifying by sex, the effect was confirmed only among men ( P = 8.70E-3). Conclusions In Spain, suicide mortality varies greatly by region and in Galicia that is one of Spanish regions with higher suicide rates, unemployment was related with suicide during economic recession periods. [ABSTRACT FROM AUTHOR]

Introduction The self-medication hypothesis suggests that patients diagnosed with schizophrenia might smoke as an attempt to self-medicate theirsymptoms. As a consequence, smoking cessation could worsen their clinical status. Objectives To assess the clinical changes associated with tobacco cessation in a sample of smoking outpatients with schizophrenia. Methods Sample: 63 smoking outpatients with DSM-IV Schizophrenia from three Mental Health Centers located in Northern Spain [77.0% males; mean age (SD) = 43.90 (8.72); average daily cigarette use (SD) = 27.99 (12.55)]. Instruments: (1) Clinical symptoms: Positive and Negative Symptoms Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression (CGI). (2) Pattern of tobacco use: n° cigarettes/day; Expired carbon monoxide (CO ppm). Design: A quasi-experimental design with two groups was implemented: control group (GC − 18 patients not willing to stop smoking), and treatment group [TG − 45 patients in smoking cessation supported by nicotine patches or vareniclina (12 weeks)]. Patients were evaluated at baseline and at week 11 (end of program). Paired sample t-test was used to detect changes in clinical symptoms from baseline to follow-up. Results 23.1% stopped smoking (from TG). No significant differences were found between baseline and follow-up scores (p>.05) among smokers and abstinent in PANSS subscales, HDRS and CGI. Conclusions Tobacco cessation did not have a significant effect on the clinical symptoms of this group of patients. Further studies should analyze the stability of these outcomes at longer follow-ups to confirm our results. [ABSTRACT FROM AUTHOR]