Adolescent psychopathological profiles and the outcome of the COVID-19 pandemic: Longitudinal findings from the UK Millennium Cohort Study

Background: According to cross-sectional studies, public health measures to contain the spread of COVID-19 are associated with adverse effects, including high level of psychological distress, anxiety, and depression. Aims: This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19. Methods: The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis. Results: Four psychopathological profiles were identified: “low-symptom class” (60.17% of participants), “high-symptom class” (23.01% of participants), “substance/behavioural addictions class” (12.03% of participants), and “emotion-dysregulation class” (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period. Conclusion: Adolescent psychopathological profiles predicted the mental health impacts of the COVID-19 outbreak.Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaTRUEpu

The course of depression in late life: A longitudinal perspective

Depression in old age deserves special attention in view of the fact of progressive population ageing, because of the way in which depression and risk factors interact in this period of life and the particularly negative impact of late-life depression on health and quality of life. This editorial aims to provide some insight into longitudinal aspects of depression in old age. Depression may follow varying trajectories (e.g. episode emergence, recurrence) across the lifespan. Late-life depression is not an exception. A symptom-based approach is presented as an appropriate research method to study the predictors and course of affective syndromes in old age. Findings from our studies on depressive symptom trajectories in old age revealed that participants with a course of unremitting elevated symptoms showed the highest levels of loneliness across the trajectory groups and that participants with subclinical symptoms also showed higher levels of loneliness than their counterparts with a minimal-symptom course trajectory. This highlights the need to address loneliness as a way of dealing with depression in old age.This work was supported by the 5-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. The ATHLOS project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 635316; Instituto de Salud Carlos III-FIS under grant number PI16/00218; and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)

La evitación experiencial en un caso de trastorno obsesivo-compulsivo tratado con Terapia de Aceptación y Compromiso

Exposición powerpoint de la comunicación.El sufrimiento es un fenómeno inherente a la naturaleza humana. En este sentido, se ha observado la existencia del llamado Trastorno de Evitación Experiencial (TEE) como uno de los factores que perpetúan este sufrimiento. El TEE está presente en multitud de cuadros psicopatológicos; entre ellos en el trastorno obsesivo-compulsivo (TOC). En este estudio, se pretende analizar la eficacia de la Terapia de Aceptación y Compromiso (ACT), para eliminar las evitaciones constantes asociadas al trastorno y dirigirse a los valores personales. Así, se aplicó un tratamiento basado en ACT para un caso de TOC con profundas compulsiones cognitivas y encubiertas, relacionadas con el orden y la comprobación. En concreto, el tratamiento estuvo formado por 18 sesiones de terapia individual y seguimientos hasta los 12 meses. Se midieron aspectos psicopatológicos asociados al TOC, ansiedad y depresión; así como acercamiento hacia direcciones valiosas. Como resultado, se introdujeron cambios significativos en el individuo que llevaron a un cambio en el foco de atención conductual desde la evitación a las situaciones ansiogénicas hasta el seguimiento de los valores personales. Ello repercutió en una disminución de la sintomatología psicopatológica. En conclusión, ACT promueve buenos resultados terapéuticos en pacientes con TOC, dado que moviliza a la persona hacia direcciones que realmente importan, desechando las conductas de control del problema que suelen conducir al sufrimiento personal.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Sociedad SAVECC y UNE

Calidad subjetiva de sueño en pacientes con trastornos de la conducta alimentaria

El presente estudio se centra en analizar la calidad de sueño de pacientes con trastornos de la conducta alimentaria (TCA). Para ello se compararon las puntuaciones de 13 pacientes con dichos diagnósticos y 15 controles en el Inventario de Calidad de Sueño de Pittsburg (PSQI), la Escala de Somnolencia de Epworth (ESS), la Escala de Creencias y Actitudes Disfuncionales sobre el Sueño (DBAS-18) y un diario de sueño. Se encontraron diferencias significativas con respecto a calidad subjetiva de sueño, consumo de medicación hipnótica y problemas durante el sueño, en los niveles de somnolencia diurna en la ESS y con respecto a creencias disfuncionales sobre el sueño. En conclusión, los pacientes con TCA manifiestan peor calidad de sueño y más problemas de sueño que los controles sanos. Estos resultados ponen de manifiesto la conveniencia de atender a los problemas de sueño en los programas terapéuticos con este tipo de pacientes.The present research focuses on the analysis of the quality of sleep in eating disorder patients (EDs). For this purpose, scores of 13 EDs patients and 15 controls on the Pittsburg Sleep Quality Inventory (PSQI), the Epworth Somnolence Scale (ESS), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-18) and a sleep diary were compared. Significant differences were found with regard to subjective quality of sleep, hypnotic medication use, and sleep problems in the PSQI; in addition significant differences were shown on daytime sleepiness levels in the ESS, and in relation to several dysfunctional beliefs about the sleep. In conclusion, EDs patients show less quality of sleep and more sleep problems than controls. These results show the need to be aware into to sleep problems in ED therapeutic interventions

Trayectorias de policonsumo y diferencias en impulsividad entre adolescentes

Background/Objective: Although alcohol, tobacco and cannabis are the most widely consumed drugs, sparse data exist regarding polydrug use in adolescents and its relationship with impulsivity. This study aims to identify trajectories of polydrug use and analyze differences in impulsivity between them. Method: A total of 1,565 adolescents (54.4% males; mean age = 13.02, SD = 0.57) were annually assessed over three years using the Barratt Impulsiveness Scale, the Zuckerman Impulsive Sensation Seeking Scale, a Stroop Test and a Delay Discounting Task. Frequency of alcohol, tobacco, and cannabis use, intoxication episodes and problem drinking were also assessed. Polydrug trajectories were identified using latent class mixed modelling. To examine differences in self-reported and behavioral impulsivity two mixed multivariate analyses of covariance were used. Results: Three trajectories of substance use were found. The ‘Experimental use’ and the ‘Early use’ trajectories presented the lowest and highest impulsivity, respectively. Substance use increases in the ‘Telescoped used’ trajectory were associated with parallel increases in impulsivity. Conclusions: individuals with divergent patterns of substance use during adolescence differ in their impulsiveness, primarily in general impulsivity and sensation seeking. Present findings suggest the relevance of these facets as possible targets for interventions preventing the onset and escalation of substance use.This work was supported by the Spanish Ministry of Health, Social Services and Equality [grant number MSSSI-12-2012/131] and by the Ministry of Economy and Competitiveness [grant number BES-2015-073327

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women’s psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic

Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies

There is growing evidence that loneliness is associated with mild cognitive impairment (MCI) and dementia. However, the extent of this association remains unclear. A systematic review and meta-analysis of longitudinal studies examining this association was conducted. Six electronic databases were searched from inception to November 15th 2018. A random-effects meta-analysis was performed to obtain pooled estimates and 95% CIs. Studies were also assessed for heterogeneity, methodological quality and publication bias. A total of 4270 hits were retrieved based on the initial search strategy and ten studies met the eligibility criteria involving 37339 individuals (mean age from 64.9 to 83.1 years). Variation between studies was present for the measurement of loneliness as well as for the case ascertainment of MCI and dementia. Loneliness was positively associated with increased risk of dementia (overall RR = 1.26; 95% CI = 1.14, 1.40; n = 8). Due to lack of sufficient data, we could not explore the association between loneliness and risk of MCI through a meta-analysis, but limited evidence suggests a potential effect of loneliness on MCI. A further understanding of the deleterious effects of loneliness on MCI and dementia may assist the design of environmental and psychological interventions to prevent or delay the onset of these neuropsychiatric condition