Especialidad sanitaria de psicología clínica de la infancia y la adolescencia: Una propuesta razonada

Clinical child and adolescent psychology is a healthcarespecialty of psychology that is recognized with its own identity in many countries. In the Spanish National Health System, its institutionalization runs parallel to that of Clinical Psychology, mainly after the psychiatric reform law, which has resulted in its gradual consolidation in the different health structures and ways of doing of clinical psychologists.The objective of this article is to make a reasoned reflection on some of the most relevant issues of the Clinical Psychology of Children and Adolescents that allows the necessary debate for the training of the specialists in this field.For this, a review is carried out on its history, competencies, areas of action and future development that enables its consolidation through the Spanish internship specialist training model for clinical psychology.Health-care specialty in clinical child and adolescent psychology: A reasoned proposal Abstract: Clinical child and adolescent psychology is a health care specialty in psychology that is recognized with its own identity in many countries. In the Spanish National Health System, its institutionalization runs parallel to the one related to clinical psychology, mainly after the psychiatric reform law, which has led to its gradual consolidation in the different health structures and ways of doing of clinical psychologists. The objective of this article was to make a reasoned reflection on some of the most relevant issues concerning clinical child and adolescent psychology that allows the debate necessary for the training of specialists in this field. After a brief review of its history, competencies and areas of action that enables its consolidation, as well as the future development of this specialty through the Spanish internship specialist training model for clinical psychology are described. Keywords: Clinical child and adolescent psychology, internship training in clinical psychology, specialized training, psychological treatments. Resumen: La psicología clínica de la infancia y adolescencia (PCIA) es una especialidad sanitaria de la psicología que está reconocida con identidad propia en muchos países. En el Sistema Nacional de Salud (SNS) de España, su institucionalización corre paralela a la de la psicología clínica, principalmente tras la reforma psiquiátrica, lo que ha dado lugar a su paulatino afianzamiento en las diferentes estructuras sanitarias y formas de hacer de los psicólogos clínicos. El objetivo de este artículo fue realizar una reflexión razonada sobre algunos de los aspectos más importantes de la PCIA, que permita el debate necesario para la formación del especialista en este ámbito. Después de una breve reseña sobre su historia, se describen las competencias y áreas de actuación que posibilitan su consolidación, así como el futuro desarrollo de esta especialidad, a través del modelo español de residencia para la formación sanitaria especializada en psicología clínica. Palabras clave: Psicología clínica de la infancia y adolescencia, PIR, formación especializada, tratamientos psicológicos

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality