Biomedical subjects
Publications and source records attributed to M T Bascarán.
The aim is to investigate the association between apolipoprotein E (ApoE) and panic disorder (PD). Genotyping 92 PD patients [Diagnostic Statistic Manual IV (DSM IV) criteria] and 174 controls no differences were found between both groups. Variation in the ApoE-gene was not associated with the development of PD.
A report is presented of treatment of 156 patients (male 98%) with opioid dependence (ICD-10 criteria) using a maintenance programme with depot opioid antagonists (naltrexone) as subcutaneous implants, started after an outpatient rapid antagonization regimen. The retention index in the treatment was from 80% in the sixth month, and 65% after one year. The patients were followed-up for 1 year after discharge. For 6 months after discharge 55.4% were still returning for follow-up visits and 20.8% after 1 year, all of them remaining abstinent to opioids. It is concluded that the programme is safe for the patients and shows a better retention index than programmes using oral antagonists, with an improved compliance (negative urine analysis) compared to the latter.
AIM: To describe the prevalence of cocaine and other drug use in secondary school students in Oviedo (Asturias, Northern Spain) and determine the personality features and levels of sensation seeking in cocaine users. METHODS: 2,862 secondary school students (mean age +/- SD = 15.87+/-1.48 years; 50.6% males) were interviewed during the 1998-1999 academic year. For evaluation, the World Health Organization questionnaire for drug consumption, the Eysenck Personality Questionnaire (EPQ) for adults and the Zuckerman Sensation Seeking Scale were used. RESULTS: The prevalence of lifetime, previous year and previous month cocaine use among secondary school students was 6.1, 4.9 and 2.7%, respectively. Cocaine ranked sixth among illicit drugs ever used by this population. Once individuals had used cocaine for the first time, they were likely to use it again (44.8% of those who had ever used cocaine reported that they had done so in the previous month). Compared to students who had never used cocaine (but who may have used other substances), cocaine users had a more extensive drug abuse history. Students who had used cocaine at some point during their lifetime scored significantly higher on the EPQ psychoticism subscale and reported higher levels of sensation seeking. CONCLUSIONS: There is a significant rate of cocaine consumption amongst secondary school students of both sexes. Cocaine users are polyconsumers of other substances, both legal and illicit. Those who consume cocaine have a different psychological profile, characterized by high sensation seeking and high levels of psychoticism.
The technique of domiciliary rapid opiate detoxification (ROD) developed in Asturias since 1994 enables patients dependent on heroin and/or methadone (or other opiates) to start antagonist maintenance with a full dose of naltrexone (50 mg) and largely recover from the acute opiate withdrawal syndrome in a few hours at home without direct medical or nursing involvement. Detailed information on 1368 procedures is presented but in Asturias, over 3000 procedures have been completed to date without any deaths or serious medical or psychiatric complications. We also describe some recent modifications to the procedure involving the use of octreotide as an antidiarrhoeal and the insertion of subcutaneous naltrexone implants to prevent early relapse. Rather than domiciliary ROD, we think the procedure is more usefully conceptualized as domiciliary rapid antagonist induction (RAI), because treatment with well-supervised naltrexone is known to be effective in reducing relapse rates. Now that controlled studies uniformly describe greatly increased rates of transfer to naltrexone maintenance treatment following RAI, compared with conventional slower withdrawal and naltrexone induction procedures, it is important that the safety, acceptability and simplicity of this 'Asturian' RAI/ROD technique become more widely known.
AIM: To measure the prevalence of 3,4-methylenedioxymethamphetamine (MDMA) and other drug use in young males entering compulsory military service in Asturias (northern Spain) and to define trends in MDMA use in this group during the period from 1995 to 1999. We also sought to determine whether MDMA users have distinct personality features or higher levels of sensation seeking. METHODS: 3,634 conscripts [mean age (SD) = 20.19 years (2.52)] who entered military service during the period between 1995 and 1999 were evaluated using the World Health Organization (WHO) questionnaire for drug consumption, the Eysenck Personality Questionnaire-A (EPQ-A), and the Zuckerman Sensation Seeking Scale. RESULTS AND CONCLUSIONS: The prevalence of lifetime, previous year and previous month MDMA use among military recruits between 1995 and 1999 was 10.9, 7.8 and 4.5%, ranking fifth among illicit drugs ever used. Once individuals used MDMA for the first time, they were likely to use it again, with 71% of individuals who had ever used MDMA reporting that they had used it during the past year (ranking second only to hallucinogens), and 41% reporting having used it in the last month. Compared to recruits who had never used MDMA (but who may have used other illicit drugs), MDMA users had a more extensive drug abuse history. Recruits who had used MDMA during the year prior to study had significantly higher scores on the Neuroticism and Psychoticism Subscales of the EPQ-A, and reported higher levels of sensation seeking.
UNLABELLED: The aim of this study is to describe the situation of Spanish obsessive-compulsive disorder (OCD) patients and compare it to that of the general population and other patient groups. METHODS: Thirty-six OCD patients on maintenance treatment were evaluated using the Y-BOCS, SF-36, and DAS-S. Their SF-36 scores were compared to Spanish norms and to those obtained from U.S. OCD patients, schizophrenic outpatients, depressed outpatients, heroin dependents, patients on hemodialysis, and kidney transplant recipients. RESULTS: Sixty-one percent of the patients had severe or extremely severe symptoms. Their quality of life was worse when compared with the Spanish norms in all SF-36 areas, but especially with respect to mental health. In contrast to U.S. OCD patients, social functioning is more impaired in the Spanish OCD patients. OCD patients reported the same quality of life as schizophrenics in the areas of mental health, but better in the areas of physical health. Compared with heroin dependents and depressed patients, their quality of life was worse. On mental health scales, OCD patients scored worse than somatic patients. CONCLUSIONS: OCD in the Spanish population was shown to be associated with worse quality of life than for any other patient group (including physical groups), except schizophrenics.
Accurately evaluating alterations in sexual functioning requires a validated instrument that measures clinically relevant change over time. One-hundred one depressed patients from 15 Spanish out-patient clinics completed the Changes in Sexual Functioning Questionnaire (CFSQ; Clayton, McGarvey, & Clavet, 1997) at baseline and after 6 months of treatment with fluoxetine, nefazodone, paroxetine, or venlafaxine. Sexual desire/interest showed a nearly substantial floor effect (30% of patients indicated the maximum score) for women in the nefazodone group at baseline and in the paroxetine group at final visit. The percentage of dimensions recording change was greater for women (80%) than for men (20%) in the nefazodone group (improving changes) and greater for men (40%) than for women (20%) in the paroxetine group (worsening changes). Highest effect sizes were found on sexual desire/frequency with improvement in women in the nefazodone group (SES = 0.49), and on orgasm/ejaculation with worsening in men in the paroxetine group (SES = -1.45). In conclusion, the CSFQ is sensitive to bidirectional changes and is appropriate for measuring sexual dysfunction.
INTRODUCTION: The Social Adaptation Self-evaluation Scale (SASS) allows a very easy evaluation of the individual's perspective about himself and his environment, together with his behaviour and social motivation. Taking into account that social maladjustment is high prevalent and well documented for depressed subjects and it is one of the most limiting aspects of their global performance, the aim of the present work is to validate the Spanish version of SASS for its application in subjects diagnosed as suffering major depression (DSM-IV). METHODOLOGY: A cross sectional multicentre study was carried out by collecting information on 464 patients (34.7% men and 65.3% women range 18 to 65 years), which included their answers to the scale and relevant sociodemographic and clinical variables. RESULTS: The principal component analysis corroborated the identification of 4 main factors: the first one being extrafamily relationships (31.4% of inertia); the second, work and leisure (7.6% of inertia); the third, social and cultural interests (5.6% of inertia); and the fourth factor, family relationships and behavioral strategies (5.5% of intertia). The scale has provided adequate reliability and validity indexes as well as sensitivity to the severity of the depressive episode. CONCLUSIONS: The Spanish version of the SASS has proven to be an adequate instrument for evaluating social adjustment in depressive subjects. However, future studies must corroborate its sensitivity to the effects of antidepressant treatment and potential differences between the antidepressant agents employed.
AIM: To determine the psychometric properties of the Spanish versions of the following scales for assessing PTSD patients: TQ, CAPS-DX, DTS, TOP-8, and DGRP. METHODS: Data from 63 PTSD patients and 23 healthy subjects were analysed. Internal consistency and test-retest reliability (after 15 days) were calculated. Convergent validity was analysed by correlating subjects' scores with the number of symptoms (DSM-IV) and scores on the CGI scale. Discriminative capability was analysed by comparing TQ, CAPS-DX, DTS, TOP-8, and DGRP patients' scores with scores from healthy subjects, and between patients' subgroups according to the presence or absence of psychiatric comorbidity and to the degree of severity as determined by the CGI-S. RESULTS: CAPS-DX, DTS, TOP-8, and DGRP showed an adequate internal consistency (Cronbach alpha: 0.74-0.91) and all of them obtained ICC between 0.77 and 0.93. The five questionnaires were able to discriminate between patients and healty subjects, and between the patients' subgroups. CONCLUSIONS: The Spanish versions of the TQ, CAPS-DX, DTS, TOP-8, and DGRP have shown adequate reliability and validity for assessing PTSD patients in daily clinical practice. CAPS-DX seems to be more adequate a diagnostic and DTS a severity rating scale.
INTRODUCTION: There are no conclusive data on the effectiveness of antidepressant drugs in the treatment of comorbid cases of alcohol dependence and depression. OBJECTIVES: To determine the effectiveness of venlafaxine on depression and on severity (need of treatment) of alcohol dependence and related problems. METHODS: Observational, open-label, multicenter, 24-week follow-up study. PATIENTS: 90 outpatients with diagnosis of alcohol dependence and associated major depression disorder (DSMIV criteria). OUTCOMES MEASURES: the Hamilton Rating Scale for Depression (HAM-D17), European Addiction Severity Index (EuropASI) and Clinical Global Impression, severity and improvement subscales, (CGI-S and CGI-I). Evaluations were performed at baseline and at weeks 2, 4, 8 and 24. RESULTS: Mean age 44.94+/-9.74 years; 73.3 % man. HAM-D17 mean scores significantly decreased from baseline (24.85+/-5.94) to week 24 (5.976+/-4.68) and at each of the follow-up visits vs previous visit (p < 0.0005). Significant decreases from baseline to week 24 were obtained in four areas of EuropASI: medical status (2.12+/-2.45 to 1.07+/-1.68), alcohol use (5.29+/-2.24 to 3.04+/-2.35), family/ social relationships (3.68+/-2.36 to 1.71+/-2.06) and psychiatric status (5.61+/-1.81 to 2.67+/-2.03). Tolerance was excellent or good in 76.7% of the patients. CONCLUSIONS: Venlafaxine demonstrated to be effective in the treatment of depressive alcoholic patients. Furthermore, it seems to be useful to decrease the severity of problems related with the alcohol use.