Sistemas de activación e inhibición conductual en los trastornos depresivos atendidos en la atención primaria en salud : un estudio de seguimiento a 6 meses /

Consultable des del TDXTítol obtingut de la portada digitalitzadaEstudio 1 En los últimos años se ha sugerido que la evaluación telefónica de la salud mental es igual de válida que la realizada cara a cara. Sin embargo, pocos instrumentos se encuentran validados específicamente para este propósito. El objetivo de este estudio fue evaluar la validez del procedimiento de la administración telefónica de dos instrumentos que fueron empleados en el Estudio 2: la escala para valorar sintomatología depresiva Patient Health Questionnaire 9-items depression module (PHQ-9) y el cuestionario de personalidad Sensibilidad al Castigo/ Sensibilidad a la Recompensa (SCSR) como medida de la actividad de los sistemas de activación e inhibición conductual. Los resultados obtenidos permiten establecer que la administración telefónica de la escala PHQ-9 y del cuestionario SCSR es fiable y genera resultados muy similares a los obtenidos en formato auto-administrado. Estudio 2 Una serie de estudios recientes sugieren que las personas con depresión presentan hipoactividad del sistema de activación conductual (SAC) y/o hiperactividad del sistema de inhibición conductual (SIC). Estas alteraciones han sido relacionadas con el curso y el pronóstico de la depresión. El objetivo de este estudio longitudinal, con seguimiento durante 6 meses, fue evaluar las diferencias individuales respecto de la actividad del SAC y SIC en un grupo de personas con trastornos depresivos que recibía tratamiento farmacológico antidepresivo en la atención primaria y compararlas con las de un grupo de personas sin historia de trastornos del ánimo (control). Los resultados sugieren que las personas con depresión mayor presentan, de manera estable e independiente del estatus clínico, hipoactividad del SAC al compararlas con personas con depresión menor, personas con trastorno depresivo no especificado y personas sin historia de trastornos del ánimo. Además, estos últimos tres grupos no presentaron diferencias ente sí respecto de la actividad del SAC. La hipoactividad del SAC también estaría relacionada con el cumplimiento terapéutico y tanto la actividad del SAC como la del SIC no sería diferente entre las personas que toman o no un inhibidor selectivo de la recaptación de serotonina.Study 1 In the last years, it has been suggested that telephone assessment of mental health is as valid as face-to-face assessment. However, few instruments have been specifically validated for this purpose. The aim of this study was to evaluate procedural validity of the telephone-administered Patient Health Questionnaire 9-items depression module (PHQ-9) and Sensitivity to Punishment/ Sensitivity to Reward Questionnaire (SPSRQ). The PHQ-9 is a depression severity measure and the SPSRQ a measure of the activity of the behavioural activation and inhibition systems. Both instruments were used in the second study. Results suggest that telephone administration of the PHQ-9 and SPSRQ is reliable as it yields results very close to the self-administered versions. Study 2 Several recent studies suggest that participants suffering from depression show hipoactivity of the behavioral activation system (BAS) and/or hyperactivity of the behavioral inhibition system (BIS). These alterations have been related to the course and prognosis of depression. The aim of this longitudinal 6 month follow-up study, was to assess individual differences regarding BIS and BAS activity of depressed participants receiving antidepressant treatment at primary care, and to compare them to a control group (participants without personal history of mood disorders). Results suggest that participants with major depression (MD) show BAS hipoactivity when compared to participants with minor depression (MiD), participants with depressive disorder not otherwise specified (DDNOS) or control participants. BAS hipoactivity was found to be stable and independent of clinical state. Additionally, participants with MD, MiD or DDNOS did not show differences regarding BAS activity. BAS hipoactivity was related to treatment compliance, and both BIS and BAS activity were similar between participants taking or not a selective serotonin reuptake inhibitor

Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys

Louisa Degenhardt and colleagues report an international survey of 17 countries that finds clear differences in drug use across different regions of the world

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Behavioural Inhibition and Behavioural Activation Systems in current and recovered major depression participants

A number of theorists have proposed that the Behavioural Inhibition System (BIS) and the Behavioural Activation System (BAS) could be abnormal in subjects with depression. Subjects with major depression (MD) could show a hyperactive BIS and a hypoactive BAS. Individual differences in BIS and BAS activity were examined among depressed, recovered and non-depressed participants. Using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire, 15 participants with current MD, 35 participants recovered from MD, and 30 non-psychiatric controls were assessed. Compared to non-psychiatric controls, participants with current MD showed a hyperactive BIS and a hypoactive BAS, while participants recovered from MD showed similar BIS activity and a hypoactive BAS. Overall, results suggest that a hypoactive BAS could be a trait–vulnerability marker for MD even after recovery

Evaluation of behavioural activation and inhibition systems by telephone

Introduction and objectives: The activity of behavioral inhibition and activation systems (BIS and BAS) has been related to several mental disorders. The availability of a validated questionnaire to assess BIS and BAS over the telephone could aid research. The objective of the present study was to evaluate the procedural validity of telephone administration of the sensitivity to punishment/sensitivity to reward questionnaire (SPSRQ) as a measure of BIS and BAS activity (by means of its two scales: the sensitivity to punishment [SP] scale and the sensitivity to reward [SR] scale). Methods: A total of 231 participants were assessed with the SPSRQ twice (over the telephone and in a self-administered format). Intraclass correlation coefficients and kappa indices were calculated. Additionally, possible differences between the mean scores obtained with the two assessment procedures and internal consistency were explored. Results: Telephone and self-assessment of BIS and BAS, by means of the SPSRQ, provided similar results, supporting the procedural validity of telephone administration. A slight but statistically significant tendency (estimated betha = 0.62; 95% CI, 0.33-0.92; p < 0.001) toward lower scores was observed for the telephone-administered SP scale and for the interaction “first or second assessment/telephone or self-administered SPSRQ” for the SR scale (p = 0.023). Conclusions: The results of the present study support the reliability of telephone assessment of BIS and BAS by means of the SPSRQ

Evaluación telefónica de los sistemas de activación e inhibición conductual

INTRODUCTION AND OBJECTIVES: The activity of behavioral inhibition and activation systems (BIS and BAS) has been related to several mental disorders. The availability of a validated questionnaire to assess BIS and BAS over the telephone could aid research. The objective of the present study was to evaluate the procedural validity of telephone administration of the sensitivity to punishment/sensitivity to reward questionnaire (SPSRQ) as a measure of BIS and BAS activity (by means of its two scales: the sensitivity to punishment [SP] scale and the sensitivity to reward [SR] scale). METHODS: A total of 231 participants were assessed with the SPSRQ twice (over the telephone and in a self-administered format). Intraclass correlation coefficients and kappa indices were calculated. Additionally, possible differences between the mean scores obtained with the two assessment procedures and internal consistency were explored. RESULTS: Telephone and self-assessment of BIS and BAS, by means of the SPSRQ, provided similar results, supporting the procedural validity of telephone administration. A slight but statistically significant tendency (estimated betha = 0.62; 95% CI, 0.33-0.92; p<0.001) toward lower scores was observed for the telephone-administered SP scale and for the interaction "first or second assessment/telephone or self-administered SPSRQ" for the SR scale (p=0.023). CONCLUSIONS: The results of the present study support the reliability of telephone assessment of BIS and BAS by means of the SPSRQ