Recurrent laryngeal nerve injury leading to vocal cord paralysis is a known complication of cardiothoracic surgery. Its occurrence during interventional catheterisation procedures has been documented in case reports, but there have been no studies to determine an incidence.

To establish the incidence of left recurrent laryngeal nerve injury leading to vocal cord paralysis after left pulmonary artery stenting, patent ductus arteriosus device closure and the combination of the procedures either consecutively or simultaneously.

Members of the Congenital Cardiovascular Interventional Study Consortium were asked to perform a retrospective analysis to identify cases of recurrent laryngeal nerve injury after the aforementioned procedures. Twelve institutions participated in the analysis. They also contributed the total number of each procedure performed at their respective institutions for statistical purposes.

Of the 1337 patients who underwent left pulmonary artery stent placement, six patients (0.45%) had confirmed vocal cord paralysis. 4001 patients underwent patent ductus arteriosus device closure, and two patients (0.05%) developed left vocal cord paralysis. Patients who underwent both left pulmonary artery stent placement and patent ductus arteriosus device closure had the highest incidence of vocal cord paralysis which occurred in 4 of the 26 patients (15.4%). Overall, 92% of affected patients in our study population had resolution of symptoms.

Recurrent laryngeal nerve injury is a rare complication of left pulmonary artery stent placement or patent ductus arteriosus device closure. However, the incidence is highest in patients undergoing both procedures either consecutively or simultaneously. Additional research is necessary to determine contributing factors that might reduce the risk of recurrent laryngeal nerve injury.

The PSP has been implemented in Catalonia in 2006 in an attempt to improve the Primary Care treatment of the most common mental disorders and addictions. It’s based on a collaborative model, made up between Primary Care and Mental Health professionals.

To identify the strengths and limitations of the PSP from the perspective of Primary Care and Mental Health professionals.

Qualitative, exploratory and interpretive study based on Grounded Theory, made between 2018 and 2019 with Primary Care and Mental Health professionals. Group interviews were conducted with triangulated analysis. The study got the approval from the Research Ethics Committee of the Sant Joan de Deu’s foundation.

11 group interviews were conducted in 6 primary care centers and 5 mental health centers in Barcelona. Intrinsic and extrinsic factors impacting the programme functioning were detected. Within the extrinsic factors, elements related to professionals, patients and public health system have been observed. All the professionals agree that the PCSP has a favorable impact on inter-professional relationships and patients, facilitating the management of cases. In contrast the heterogeneity implementation, the lack of training, and the health care burden in is considered to negatively influence an optimal development of the programme. Professionals suggest communication and inter-professional collaboration would be improved by creating more a horizontal structure that eliminates vertical lines of command and disagreements in clinical judgement, thus facilitating shared decisions.

PrimaryCare and MentalHealth professionals value the PSP positively, but conclude there are communication and organizative barriers that should be addressed in order to improve the overall programme’s efficiency.

Personality (according to Cloninger) responds to Biological aspects (temperamental) and Psychosocial (characterological), thereby forming the complex pattern of human behavior. High level of avoidance of harm and stiffness are factors associated with depressive disorders, closely linked to the Serotoninergic System. Melancholicus Typus (MT) is characterizes by its seriousness, scrupulousness of conscience, perfectionism, responsibility and order at all levels among other features.

Develop an inventory psychometrically to assess the influence of personality traits Melancholicus Typus in the appearance of resistant depression throughout life.

Retrospective observational study. We designed a questionnaire with a total of 70 items that shaped the personality of Melancholicus Typus. We explored the internal consistency using statistical factor analysis, as well as discriminate validity of these. This questionnaire was applied to the sample of 100 patients signed informed consent prior. They met criteria for inclusion/exclusion. The patient population is from the Institute of Psychiatry Rafael Coullaut. Madrid.

The existence of personality traits of Melancholicus Typus identifies a vulnerability to developing relevant resistant depression over the life of individuals. The inventory developed for this study is a useful test to assess personality traits such as Melancholicus Typus both clinical populations and general population.

The scale shows good construct validity, as well as good internal consistency through correlations Item/Total. The reliability of the scale is high.

This is a 380 heavy drinker patient's sample recruited from twelve primary care centers. The patients were screened using The Alcohol Use Disorders Identification Test (AUDIT > 8). Neuropsicological tests done at the base line and after the 4 years of the study were the Continous Performance Test (CPT) and the Barrat Impulsivity scale. The alcohol and cocaine consume accumulated along the four years was also study.

The two variables of the CPT (ommission and commission errors) had a significant correlation with the alcohol and cocaine use accumulated in these four years. The variable that was associated with a greater risk of making more commission and ommission errors was the cocaine risk consumption. The years of study were protective variable.

The most important conclusion of this study is that alcohol and cocaine use produces a modification in the conductual paradigm of impulsivity characterized by the inhibition difficulties measured by the CPT. Also, the cocaine use effects are added respect to the alcohol ones and finally that cocaine plus alcohol effects over the number of ommission and commission errors are more potent that the ones made only with alcohol.

Different neuropsychological studies have consistently found an attention, memory and executive function deficit in schizophrenic patients. The Positive and Negative Syndrome Scale (PANSS) evaluates different clinical aspects of schizophrenia. Factor analyses of this scale suggest the existence of a “cognitive factor”, constituted by several items pertaining to the different subscales. In order to have an acceptable concurrent validity, this “cognitive factor” should correlate with the execution of neuropsychological tasks. Our objective was to study the correlation between the PANSS “cognitive factor” and the execution of neuropsychological tasks evaluating attention, memory and executive functions.

Thirty-five schizophrenic patients were evaluated using the Continuous Performance Test (CPT), the Rey-Osterrieth Complex Figure Test (Rey CFT) and the Wisconsin Card Sorting Test (WCST). Bivariate partial correlation between the neuropsychological variables and the PANSS “cognitive factor” was examined. In order to obtain this cognitive component, and based on previous studies, items P2, N5, PG10 and PG11 were used.

The PANSS “cognitive factor” was significantly correlated to CPT omission errors (r=0.45; p=0.006), Rey CFT recall after 5 minutes (r=-0.34; p=0.049), Rey CFT recall after 30 minutes (r=-0.40; p=0.020), WCST perseverative responses (r=0.36; p=0.035), and WCST perseverative errors (r=0.35; p=0.041).

The existence of significant correlations between the PANSS “cognitive factor” and performance on neuropsychological tasks evaluating attention (CPT), memory (Rey CFT) and executive functions (WCST) supports the concurrent validity of this factor.

A high prevalence of childhood attention-deficit/hyperactivity disorder (ADHD) history has been found in alcoholic patients. Patients with this history have an earlier onset and greater intensity of alcohol use, more polysubstance use and a poorer prognosis. Our objective was to study differences in neuropsychological functioning in a group of alcoholic patients according to the presence or absence of a history of childhood ADHD.

A sample of 136 male alcoholic patients and 56 male control subjects were evaluated using the Continuous Performance Test (CPT); execution in both groups was compared. The sample of alcoholic patients was then divided into two subgroups according to the presence or absence of a history of childhood ADHD, namely the ADHD+ OH subgroup (61 patients with childhood ADHD history) and the ADHD- OH subgroup (75 patients without this history); CPT execution in these two subgroups was also compared.

The group of alcoholic patients made more omission (p=0.008) and commission (p=0.009) errors in the CPT than the control group. When comparing subgroups, ADHD+ OH patients made more omission and commission errors than ADHD- OH patients, although the differences did not reach statistical significance.

Alcoholic patients perform more poorly on the CPT than control subjects. In the sample of alcoholic patients, a history of childhood ADHD was not associated to significant differences in the execution of this test.

Different types of behavioural impulsivity have been associated with the development of substance use disorders but little is know about what type of impulsivity is provoked by the effect of chronic use of substances.

Determine what type of behavioural impulsivity was associated with the use of alcohol and cocaine.

A prospective cohort study was conducted to identify changes on behavioural impulsivity. Non-dependent heavy drinkers (N=471) were recruited from primary care centres. The following assessments were used at baseline and at the end of the 4-year follow-up period: The continuous performance test (CPT) and stop-signal task (SST) assessed behavioural inhibition. Differential reinforcement for low-rate responding (DRLR) was used to evaluate the delay discounting dimension. Diagnoses were rendered using the Structured Interview for DSM-IV.

Amounts on alcohol and cocaine consumption during follow-up correlated positively with changes on all impulsivity measures. Logistic regression analysis indicated that cocaine used was associated specifically with poor performance on CPT and SST and amount of alcohol used during follow-up was related to changes on DRLR.

Substances provoke different pattern of behavioural impulsivity: chronic cocaine use provokes changes mainly on behavioural inhibition dimension and alcohol use induces changes on delay discounting paradigm.

The Positive and Negative Syndrome Scale (PANSS) evaluates different psychopathological aspects of schizophrenic patients. Scores on the negative subscale of the PANSS have been associated with clinical and neuropsychological differences in these patients. Our aim was to study the relationship between PANSS negative scores and different clinical and neuropsychological variables in a sample of schizophrenic patients.

Our sample of 174 schizophrenic patients was split into two groups according to scores on the negative subscale of the PANSS: a group of 85 patients (55 male and 30 female; mean age 38.0 years, SD 9.3) with scores below the median (“low negative PANSS” group), and a group of 89 patients (58 male and 31 female; mean age 37.3, SD 8.4) with scores above the median (“high negative PANSS” group). The neuropsychological task used was the Wisconsin Card Sorting Test.

Significant clinical differences were found between both groups. In the “high negative PANSS” group a lower age of illness onset was found (p=0.030), as well as a lower age at first psychiatric admission (p=0.002) compared to the “low negative PANSS” group, without there being significant differences in current age (p=0.570). Regarding cognitive functions, “high negative PANSS” patients achieved fewer categories (p=0.005) and made more perseverative errors (p=0.031) than “low negative PANSS” patients.

Schizophrenic patients with higher scores on the negative subscale of the PANSS had an earlier age of onset of their illness and exhibited poorer cognitive functioning than patients with lower scores.

The link between impulsivity and alcohol use disorders has been established in longitudinal and cross-sectional studies, but little is know about the role of behavioural impulsivity in the development of substance use disorders.

Determine the role of behavioural measures of impulsivity in the development of alcohol use disorders.

A prospective cohort study was conducted to identify the risk factors associated with alcohol dependence. Non-dependent heavy drinkers (N=471) and healthy controls (N=149) were recruited from primary care centres. They were assessed at the end of the 4-year follow-up period. Diagnoses were rendered using the Structured Interview for DSM-IV. The continuous performance test (CPT) and stop-signal task (SST) assessed behavioural inhibition. Differential reinforcement for low-rate responding (DRLR) was used to evaluate the delay discounting dimension.

HD participants have significant impairments on all laboratory measures of impulsivity. In the logistic regression model, impairment on DRLR (delay discounting dimension) was the only measure that classified accurately HD. Baseline behavioural measures of impulsivity correlated positively with amount of alcohol consumption during the follow-up period. Logistic regression analysis indicated that performance on inhibitory control (SST) (behavioural inhibition dimension) was a significant predictor (odds=1.52[1.08-2.31]) for developing alcohol dependence.

Our data support the link between behavioural measures of impulsivity and alcohol use disorders. Delay discounting dimension may be a risk factor for begin alcohol use heavily and behavioural inhibition impairment is more involved in the development of dependence.

Impulsivity has been associated with alcohol dependence, but impulsivity in alcohol-dependent subjects has not been well characterized.

Using a variety of laboratory measures of impulsivity, we assessed whether alcohol-dependent patients (ADP) were more impulsive than control subjects, and the role of Cluster-B personality disorders in impulsivity measurements.

A cross-sectional patient survey with a community comparison group. Diagnoses were made using the Structured Interview for DSM-IV. Sustained attention and rapid-response impulsivity were assessed using the continuous performance test (CPT). Inhibitory control was measured by the stop-signal task (SST). Ability to delay reward task was assessed using differential reinforcement for low-rate responding (DRLR).

A final sample of 253 males with alcohol-dependence recruited from two alcoholism treatment centres was compared with a matched non-substance-abusing comparison group (n=96).

Patients with alcohol dependence were more impulsive across all behavioural tasks. Alcohol-dependent subjects without personality disorders showed lower efficiency in DRLR than control subjects. Patients with Cluster-B personality disorder performed worse in inhibitory control, but subjects with borderline personality disorder in particular demonstrated increased rates of omission and commission errors in CPT. Inability to delay gratification was associated with antisocial personality disorder.

Our findings support the suggestion of two paradigms in alcohol dependence. The first, based on inability to delay gratification, might be a vulnerability marker for alcohol dependence. The second was related to inhibitory control, and might be specific for antisocial and borderline personality disorders.

Different personality factors have been investigated in connection with addictive disorders such as pathological gambling. “Impulse control”, proposed as a dimension of personality in modern “Big Five” models, has been associated with pathological gambling. Pathological gamblers have a high prevalence of childhood attention-deficit/hyperactivity disorder (ADHD), which is also associated with high impulsivity. Based on a five-factor personality model, our objective was to compare different personality dimensions in a group of pathological gamblers with childhood ADHD history, a group of pathological gamblers without such history and a control group. Special emphasis was placed on the factor “emotional stability”, which includes the subdimensions “emotion control” and “impulse control”.

A sample of 30 pathological gamblers with childhood ADHD history (ADHD+PG group), 33 pathological gamblers without ADHD history (ADHD-PG group) and 42 control subjects were assessed using the Big Five Questionnaire (BFQ). The different BFQ dimensions and subdimensions were compared.

For the “emotional stability” factor, the T-scores obtained indicated statistically significant differences between groups (ADHD+PG group: 44.1; ADHD-PG group: 51.9; control group: 57.9; ANOVA, p<0.001). Scheffe´s post hoc analysis showed the ADHD+PG group to be less emotionally stable than both the ADHD-PG (p=0.002) and the control groups (p<0.001); the ADHD-PG group also scored lower on this “emotional stability” factor than the control group (p=0.015).

Pathological gamblers with a history of childhood ADHD exhibit differential personality traits. ADHD history is associated with a lower score on the “emotional stability” factor, which includes the subdimensions “emotion control” and “impulse control”.

Alcohol and cocaine are frequently used together. Little is known about which factors are related with the development of either cocaine or alcohol dependence in dually users.

To determine variables associated with the risk fro the development of either cocaine or alcohol dependence in non-dependent drinkers with recreational cocaine use during a 4 year-follow-up period.

A prospective cohort study was performed to establish the risk factors associated with alcohol and cocaine dependence. Subjects recruited (N=336), from primary care centres. At baseline were classified as heavy drinkers and cocaine users (HD+Co, N=227) and alcohol abusers with cocaine use (AA+Co, N= 109).

At 4-year follow-up assessment, AA+Co subjects had higher rates of prevalence for cocaine (55% vs. 32%, p<0.001)) and alcohol dependence (97.5% vs. 58.2%, p<0.001) than HD+Co participants. Being alcohol abuser and single were eight and three times, respectively, more likely to develop cocaine dependence. When impulse control disorders or alcohol abuse occurred the odds ratio of developing alcohol dependence was 9 and 5.7 respectively. Also, alcohol abuse at baseline was associated with shortened time between onset of abuse and dependence for cocaine use disorders and for alcohol use disorders.

Alcohol abuse in heavy drinkers with recreational cocaine use predicted alcohol and cocaine dependence at follow-up. Our findings agree with previous findings supporting the relationship between impulsivity and risk for substance use disorders.

Oestrogens may be a protective factor in psychosis. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD).

To evaluate gynaecological variables and psychopathology in women with DD.

To investigate the relationship between age of menarche and onset, and psychopathology in DD.

Forty-five outpatients with DD (DSM-IV-TR) were recruited at the Hospital Clinic of Barcelona, from 2008 to 2012. Twenty-five females underwent a demographic and gynaecological questionnaire. HRSD-17 for depression, PANSS for psychopathology, PSP for functionality and C-SSRS for suicide were assessed. The sample was divided into two groups according to the age of menarche: 12 years or less and more than 12.

Mean age of menarche (SD) was 12.6(1.4) years, mean age of menopause 49.1(3.15), mean age at onset of DD was 49.9(12.58). 33.3% of the sample did not receive gynaecological service in the last 3 years. The group with the earliest age of menarche was older [67.33(11.67) vs.56(9.6); p=0.026], presented an earlier age of menopause [46.80(2.84) vs.50.71(2.29) p=0.018] and latest onset of DD (53.50(14.32) vs.47.44(11.5); p=NS], than those with later age of menarche. No differences were found regarding psychopathology, suicidal behaviour or functionality.

Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. A low compliance rate in gynaecological service use was found. An earlier age of menarche was associated to an earlier age of onset of DD.

Although investigation have demonstrated that stimulants are effective medication for the treatment of the symptoms on the ADHD, a commonly described but quite slightly studied side effect of this type of medication, is the effect on the emotional expression of patients.

evaluate the effect of the treatment with Methylphenidate on the affective/emotional expression in children diagnosed with ADHD.

It's a descriptive study of several cases series, from a center and about a unique group, where 'n” will be 15 children diagnosed with ADHD at the University Hospital, who were required beginning treatment with methylphenidate, with a daily dose of at least 0,3mg/Kg. In this study it will be evaluated the emotional expression of the group, according to the scale Expression and Emotion Scale for Children (EESC) making a comparison between the previous moment to the treatment and a subsequent month from its beginning.

The evaluation of the total result of the EESC conducted by the parent didn't show statistically significant differences between scores previously of the treatment and results after a month with it. The dominions (positive emotions, emotional flatness and emotional lability) didn't show differences between both periods of time, nevertheless, the positive emotions showed a tendency of reduction more showy than the rest, without getting to be statistically significant (p=0.0638).

Statistically there haven't been significant changes in the emotional expression of the children caused by the treatment with methylphenidate. Nevertheless, the data show that there is a tendency to an improvement in it.

Suicide is one of the leading causes of premature death among people with psychotic disorders. However, little is known about treating suicide in delusional disorder.

To investigate effectiveness of PPLAI in delusional disorder (DD) patients.

To compare effectiveness of PPLAI vs,other atypical antipsychotics (OAA) in psychopathology and suicidality.

Prospective observational study including 45 DD outpatients (DSM-IV-RT) attended at the Department of Psychiatry (Hospital Clinic- BCN) from 2008 to 2012 and followed up for 6 months. Demographic and clinical variables were recorded. Hamilton Rating Scale for Depression-17 (HRSD-17), PANSS for psychopathology, Personal and Social Performance Scale (PSP) and Columbia Suicide Severity Rating Scale (C-SSRS) were assessed at baseline and after 6 months. The sample was divided into four groups according to which treatment they received: oral risperidone, Risperidone Long Acting Injection (RLAI), OAA and PPLAI. For comparisons, Kruskal-Wallis and Chi-square tests were used.

Eighty-two per cent were women. Mean age (SD) at onset: 46.9(11.8) years. 6 patients received oral risperidone, 23 OAA, 7 RLAI and 9 were treated with PPLAI. No statistically significant differences were found regarding demographic features, motives leading for consultation, depressive comorbidity and antidepressant prescription. After 6 months, patients treated with PPLAI presented lower frequency of ideation (0% vs.11.1%;p=0.027) and suicidal behaviour (0% vs.2.2%;p=NS). The group receiving PPILD presented a significant increase in functionality (PSP) (p=0.046) and an improvement in PANSS negative subscale scores (p=0.017).

Patients receiving PPLAI showed a decrease in suicidality, an improvement in psychotic symptoms and functionality.

It is hypothesized that in the etiology of schizophrenia genetic and environmental factors are involved. Between the environmental events linked to the causation of this condition an inmune dysfunction has been described. First degree biological relatives of people with schizophrenia also have an incrased incidence of autoimmune diseases.

The aim of this work was to examine the serum levels of proinflammatory cytokines (IL-1β, sIL-2R IL-6, IL-12p70, TNF-α and IFN-γ) as well as of anti-inflammatory cytokines (IL-4 and IL-10) in male patients with schizophrenia and in their first degree-biological relatives.

Blood samples were obtained from patients with a diagnosis of schizophrenia in a stable psychophatological condition (n = 36), first degree biological relatives of those patients and a healthy control group (n = 26). Serum interleukins were analyzed using a commercial ELISA preparation (Bender MedSystems). We used non-parametric test for statistical analysis.

Patients with schizophrenia showed significantly higher serum levels of proinflammatory cytokines (sIL-2R, IL-6, TNF-α, IFN-γ and IL12-p70) and lower serum levels of the anti-inflammatory cytokine IL-4 than in the healthy control group. The unaffected first-degree relatives showed changes in proinflammatory cytokines (sIL-2R, IL-6 and TNF-α,) in the same way as the corresponding schizophrenia patients, but at a lower level than the healthy control group.

Ours findings suggest that sIL-2R, IL-6 and TNF-a may be biologic vulnerability markers for psychiatric disorders and also these alterations might have an hereditably pattern.