Aim: The aim of this study was to determine if the problem-solving therapy (PST) helps control metabolic variables in patients with type 2 diabetes mellitus (T2DM) who show depressive and anxiety symptoms.Background: T2DM is a chronic-degenerative multifactorial disease. It is considered one of the main public health problems in the world, and it represents an important social and economic burden. It is frequently associated with major depression and anxiety disorders, which are related with high glycated hemoglobin (HbA1c) concentrations and poor metabolic control.Method: We initially included 123 patients diagnosed with T2DM from five primary care centers (PCC) in Mexico City. HbA1c, central glucose, and lipid profile were measured in each patient. In addition, the Kessler psychological distress scale (K-10), the Beck Depression Inventory, and the Beck Anxiety Inventory were applied at the beginning and, to those who continued, at the end of the PST, as well as four months later.Findings: In total, 36 patients completed the PST and the follow-up. There was a significant decrease in depressive and anxiety symptoms (P<0.001), as well as in total cholesterol (P=0.002), HbA1c(P=0.05), and low-density lipoprotein (LDL) (P=0.022). The PST helps reduce depressive and anxiety symptoms and may help stabilize glucose and cholesterol up to four months. Further studies on this area are recommended. If our findings are confirmed, the PST could help improve the quality of life of thousands of individuals with psychiatric-metabolic co-morbidity who only visit PCC.
In amnestic mild cognitive impairment (aMCI), neuroinflammation evolves during disease progression, affecting microglial function and potentially accelerating the pathological process. Currently, no effective treatment exists, leading to explorations of various symptomatic approaches, though few target the underlying physiological mechanisms. Modulating inflammatory processes may be critical in slowing disease progression. Cognitive stimulation (CS) and transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (l-DLPFC) show promise, but the results are heterogeneous. Thus, a randomized, double-blind, placebo-controlled clinical trial is currently underway. The first-stage results were examined after three weeks of intervention in two groups: active tDCS combined with CS and sham tDCS combined with CS. Twenty-two participants underwent two assessments: T0 (baseline) and T1 (after 15 sessions of tDCS, active or sham, and 9 sessions of CS). The results demonstrated that CS improved cognition, increased brain-derived neurotrophic factor (BDNF) levels, and reduced peripheral proinflammatory cytokine levels (interleukin IL-6 and chemokine CX3CL1) in serum. This decrease in IL-6 may promote microglial proliferation and survival as a modulatory effect response, while the increase in BDNF might suggest a regulatory mechanism in microglia–neuron interaction responses. However, tDCS did not enhance the cognitive or modulatory effects of CS, suggesting that longer interventions might be required to achieve substantial benefits.
Background. Abuse in early life stages has been proposed as an etiological risk factor for developing menstrually-related mood disorders (MRMDs). Objetive. To evaluate whether there is a relation between the occurrence of physical and/or sexual violence in childhood and/or adolescence and the development of MRMDs in adulthood. Method. A systematic search was conducted in PubMed, Web of Science, and ScienceDirect, with the route (“Premenstrual Syndrome”[Mesh]) OR (“Premenstrual Dysphoric Disorder”[MeSH]) AND (“Violence”[Mesh]) / (“menstrually-related mood disorders” AND “abuse”). Fifty-four articles were initially reviewed and 32 were excluded based on the criteria. Twenty-two articles were thoroughly reviewed. Finally, five articles (publication years 2014, 2013, 2012, 2007, and 2003) were included in the systematic review and submitted to a meta-analysis. Results. Results indicate that having been exposed to physical and/or sexual violence in childhood and/or adolescence increases 1.99 times the risk of experiencing MRMDs in adulthood in comparison with women who did not experience that type of violence (odds ratio [OR] = 1.99; 95% confidence interval [1.58, 2.51]). Discussion and conclusion. The present work provides evidence that a woman who experienced violence through physical and/or sexual abuse during childhood and/or adolescence has a greater risk of developing MRMDs in adulthood.
Los inhalables son sustancias ampliamente utilizadas como drogas recreativas: su potencial adictivo ha sido demostrado por numerosos estudios. No hay reportada evidencia medible del craving en usuarios de inhalables. El objetivo principal de este trabajo fue diseñar y obtener las evidencias de validez de las puntuaciones en un cuestionario para la evaluación del craving a sustancias inhalables (ICQ) en una muestra de población mexicana. El ICQ es un tipo de escala análoga visual de diez ítems. La validación de apariencia fue evaluada por un grupo de expertos en el campo de las adicciones. Los revisores consideraron la integridad, la semántica y la estructura de los enunciados, para garantizar una representación conceptual de los ítems. La versión final del ICQ fue aplicada a una muestra de 520 estudiantes mexicanos, 46% mujeres y 54% hombres, con edad comprendidas entre 12-19 años (M=15.18; SD=1.48), con años de escolaridad entre 7-12 años. La consistencia interna del ICQ mostró un Alfa de Cronbach de 0.947. Los 10 ítems se agruparon en un solo factor, con una carga factorial por encima de 0.74 para cada uno de ellos. El análisis ROC mostró que el punto de corte se localizó a 18.5 mm con una sensibilidad de 0.855 y especificidad de 0.753. El 33% (n=172) de la población de estudiantes evaluados reportó el uso de inhalables en algún momento de su vida, con un promedio de edad de inicio de 13.6 años. El ICQ mostró propiedades psicométricas adecuadas, lo que sugiere que el instrumento puede ser una herramienta útil para el tamizaje de craving en jóvenes usuarios de inhalables.
BACKGROUND: Cocaine use disorder (CUD) is a global condition lacking effective treatment. Repeated magnetic transcranial stimulation (rTMS) may reduce craving and frequency of cocaine use, but little is known about its efficacy and neural effects. METHODS: Using a double-blind placebo-controlled randomized clinical trial (RCT) [ NCT02986438 ], we sought to elucidate short- and long-term clinical benefits of 5-Hz rTMS as an add-on to standard treatment in CUD patients and discern underlying functional connectivity effects using magnetic resonance imaging. Forty-four randomly assigned CUD patients completed the 2-week double-blind acute phase [Sham (n=20, 2f/18m) and Active (n=24, 4f/20m)], in which they received 2 daily sessions of rTMS (5,000 pulses) on the left dorsolateral prefrontal cortex. Subsequently, n=20 CUD patients continued to open-label maintenance (2 weekly sessions for up to 6 months). Measures were acquired at baseline, 2 weeks, 3 months and 6 months. RESULTS: Overall, 5-Hz rTMS plus standard treatment for 2 weeks significantly reduced craving and impulsivity in the Active group; decreased impulsivity correlated with improvements in functional connectivity in executive control and default mode networks. Clinical and functional connectivity effects were maintained for 3 months but they dissipated by 6 months. We did not observe reduction of positive cocaine urine tests, however, self-reported frequency and grams consumed for 6 months were reduced. CONCLUSIONS: With this RCT we show that 5-Hz rTMS has potential promise as an adjunctive treatment for CUD and merits further research.