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Hermida-Barros L, Primé-Tous M, García-Delgar B, Forcadell E, Lera-Miguel S, Fernández de la Cruz L, Vieta E, Radua J, Lázaro L, Fullana MA. Family accommodation in obsessive-compulsive disorder: An updated systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 161:105678. [PMID: 38621516 DOI: 10.1016/j.neubiorev.2024.105678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/12/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Family accommodation might play a crucial role in obsessive-compulsive disorder (OCD). Previous systematic reviews on family accommodation in OCD have focused on specific populations or variables or are outdated. We conducted a preregistered systematic review and meta-analysis on family accommodation in adults, children, and adolescents with OCD (CRD42021264461). We searched PubMed, Scopus, and Web of Science using the keywords "family accommodation" and "obsessive-compulsive disorder. One hundred-eight studies involving 8928 individuals with OCD were included. Our results indicate that levels of family accommodation in OCD are moderate, that there is a significant positive correlation between family accommodation and OCD severity (r = 0.42), that baseline family accommodation does not predict pre- to post-treatment change in OCD severity (g = -0.03), and that family accommodation decreases as a result of both individual and family-focused cognitive behavioral therapy for OCD (g = 2.00 and g = 1.17, respectively). Our findings highlight the relevance of family accommodation in OCD and may help guide assessment and treatment.
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Affiliation(s)
- Laura Hermida-Barros
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain
| | - Mireia Primé-Tous
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain
| | - Blanca García-Delgar
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain
| | - Eduard Forcadell
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain
| | - Sara Lera-Miguel
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm 10431, Sweden
| | - Eduard Vieta
- Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona 08036, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona 08036, Spain; University of Barcelona, Barcelona 08007, Spain
| | - Joaquim Radua
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona 08036, Spain.
| | - Luisa Lázaro
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona 08036, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona 08036, Spain; University of Barcelona, Barcelona 08007, Spain
| | - Miquel A Fullana
- Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona 08036, Spain.
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Galí D, Forcadell E, Primé-Tous M, Puig O, Lera-Miguel S. Cool Kids: Cognitive Behavioral Therapy in a Spanish Sample of Children and Adolescents with Anxiety Disorders. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01579-w. [PMID: 37672194 DOI: 10.1007/s10578-023-01579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 09/07/2023]
Abstract
Anxiety disorders (ADs) negatively impact functioning and life quality. Studies on cognitive behavioral therapy (CBT) have demonstrated its short- and long-term efficacy. Cool Kids (CK) is a 10-session CBT-based group program administered to participants with ADs aged 7-17 years and their parents, and it has demonstrated efficacy compared with control groups. This study analyzes the effectiveness of CK in a clinical cohort of Spanish children and adolescents with ADs. CK was offered to 57 patients with AD and their caregivers at the Hospital Clínic, Barcelona. In all global registered measures, the results demonstrated a reduction of symptoms and their interference in daily functioning. Moreover, a significant improvement was observed in participants who completed more sessions. Thus, CK reduced the severity of anxiety and its interference over individual and family functioning.
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Affiliation(s)
- Dafne Galí
- University of Barcelona, Barcelona, Spain.
| | - Eduard Forcadell
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Mireia Primé-Tous
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Olga Puig
- Departament of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona, 2021SGR01319, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Sara Lera-Miguel
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Forcadell E, Garcia-Delgar B, Nicolau R, Pérez-Vigil A, Cordovilla C, Lázaro L, Ibáñez L, Mir P, Madruga-Garrido M, Correa-Vela M, Morer A. Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents. Neurologia (Engl Ed) 2022:S2173-5808(22)00071-2. [PMID: 35820636 DOI: 10.1016/j.nrleng.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/19/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used. METHODS We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10). RESULTS The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item 1). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group. CONCLUSIONS The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.
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Affiliation(s)
- E Forcadell
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain.
| | - B Garcia-Delgar
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain
| | - R Nicolau
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain
| | - A Pérez-Vigil
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain
| | - C Cordovilla
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain
| | - L Lázaro
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Ibáñez
- Family Health Centers at NYU Langone, New York, USA
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Correa-Vela
- Sección de Neurología Pediátrica, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - A Morer
- Servicio de Psiquiatría y Psicológica Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Forcadell E, Garcia-Delgar B, Nicolau R, Pérez-Vigil A, Cordovilla C, Lázaro L, Ibáñez L, Mir P, Madruga-Garrido M, Correa-Vela M, Morer A. Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents. Neurologia 2020; 38:S0213-4853(20)30427-8. [PMID: 33317967 DOI: 10.1016/j.nrl.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used. METHODS We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10). RESULTS The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item one). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group. CONCLUSIONS The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.
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Affiliation(s)
- E Forcadell
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España.
| | - B Garcia-Delgar
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España
| | - R Nicolau
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España
| | - A Pérez-Vigil
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España
| | - C Cordovilla
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España
| | - L Lázaro
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - L Ibáñez
- Family Health Centers at NYU Langone, Nueva York, Estados Unidos de América
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - M Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España
| | - M Correa-Vela
- Sección de Neurología Pediátrica, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, España
| | - A Morer
- Servicio de Psiquiatría y Psicología Clínica Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic Universitari, Barcelona, España; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, España
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Forcadell E, Medrano L, Garcia-Delgar B, Fernández-Martínez I, Orgilés M, García C, Lázaro L, Lera-Miguel S. Psychometric Properties of the Children's Version of the Spence Children's Anxiety Scale (SCAS) in a Spanish Clinical Sample. Span J Psychol 2020; 23:e40. [PMID: 33079028 DOI: 10.1017/sjp.2020.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Spence Children's Anxiety Scale (SCAS) has demonstrated good psychometric properties in several countries and cultures. Nevertheless, most of the previous studies that explore these properties have combined clinical and community samples. We aimed to validate the Spanish version of the SCAS in a large clinical sample (N = 130) of children and adolescents. The Spanish adaptation of the SCAS showed good internal consistency for the total scale, and good test-retest reliability for all the subscales. Furthermore, its convergent and discriminant validity were supported by significant correlations with other anxiety questionnaires (Screen for Child Anxiety Related Emotional Disorders [SCARED], Youth Self-Report [YSR] subscales for anxiety disorders and internalizing symptomatology), and lower or non-significant correlations with depression symptoms and externalizing symptoms scales respectively. For the first time in a purely clinical sample, the original factor structure of the SCAS based on six correlated factors was confirmed. Future studies need to evaluate whether the factorial structure of the present instrument is the most suitable for use in clinical populations.
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Affiliation(s)
| | | | | | | | | | | | - Luisa Lázaro
- Hospital Clínic de Barcelona (Spain)
- CIBERSAM, Ministerio de Sanidad (Spain)
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Forcadell E, Torrents-Rodas D, Vervliet B, Leiva D, Tortella-Feliu M, Fullana MA. Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study. Int J Psychophysiol 2017; 121:63-71. [DOI: 10.1016/j.ijpsycho.2017.09.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/24/2017] [Accepted: 09/05/2017] [Indexed: 01/20/2023]
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Forcadell E, Torrents-Rodas D, Treen D, Fullana MA, Tortella-Feliu M. Attentional Control and Fear Extinction in Subclinical Fear: An Exploratory Study. Front Psychol 2017; 8:1654. [PMID: 29018384 PMCID: PMC5622961 DOI: 10.3389/fpsyg.2017.01654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/08/2017] [Indexed: 12/19/2022] Open
Abstract
Attentional control (AC) and fear extinction learning are known to be involved in pathological anxiety. In this study we explored whether individual differences in non-emotional AC were associated with individual differences in the magnitude and gradient of fear extinction (learning and recall). In 50 individuals with fear of spiders, we collected measures of non-emotional AC by means of self-report and by assessing the functioning of the major attention networks (executive control, orienting, and alerting). The participants then underwent a paradigm assessing fear extinction learning and extinction recall. The two components of the orienting network functioning (costs and benefits) were significantly associated with fear extinction gradient over and above the effects of trait anxiety. Specifically, participants with enhanced orienting costs (i.e., difficulties in disengaging attention from cues not relevant for the task) showed faster extinction learning, while those with enhanced orienting benefits (i.e., attention facilitated by valid cues) exhibited faster extinction recall as measured by fear-potentiated startle and Unconditioned Stimulus expectancies, respectively. Our findings suggest that, in non-emotional conditions, the orienting component of attention may be predictive of fear extinction. They also show that the use of fear extinction gradients and the exploration of individual differences in non-emotional AC (using performance-based measures of attentional network functioning) can provide a better understanding of individual differences in fear learning. Our findings also may help to understand differences in exposure therapy outcomes.
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Affiliation(s)
- Eduard Forcadell
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - David Torrents-Rodas
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Specialized Department in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Institut d'Investigació Biomèdica de Girona, Parc Hospitalari Martí i Julià, Salt, Spain
| | - Devi Treen
- Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain
| | - Miquel A Fullana
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Anxiety Unit, Institute of Neuropsychiatry and Addictions, Hospital del Mar, CIBERSAM, Barcelona, Spain.,IMIM, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Miquel Tortella-Feliu
- University Research Institute on Health Sciencies (IUNICS), Universitat de les Illes Balears, Mallorca, Spain.,PROMOSAM Red de Investigación en Procesos, Mecanismos y Tratamientos Psicológicos para la Promoción de la Salud Mental, Mallorca, Spain
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Treen D, Batlle S, Mollà L, Forcadell E, Chamorro J, Bulbena A, Perez V. Are there glutamate abnormalities in subjects at high risk mental state for psychosis? A review of the evidence. Schizophr Res 2016; 171:166-75. [PMID: 26803691 DOI: 10.1016/j.schres.2016.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/29/2015] [Accepted: 01/01/2016] [Indexed: 02/07/2023]
Abstract
New approaches to underlying alterations in psychosis suggest increasing evidence of glutamatergic abnormalities in schizophrenia and an association between these abnormalities and certain core psychopathological alterations such as cognitive impairment and negative symptoms. Proton magnetic resonance spectroscopy ((1)H MRS) is an MR-based technique that enables investigators to study glutamate function by measuring in vivo glutamatergic indices in the brain. In this article we review the published studies of (1)H MRS in subjects with an at-risk mental state (ARMS) for psychosis. The primary aim was to investigate whether alterations in glutamate function are present before the illness develops in order to expand our understanding of glutamatergic abnormalities in prodromal phases. Three databases were consulted for this review. Titles and abstracts were examined to determine if they fulfilled the inclusion criteria. The reference lists of the included studies were also examined to identify additional trials. Eleven final studies were included in this review. Significant alterations in glutamate metabolites across different cerebral areas (frontal lobe, thalamus, and the associative striatum) in subjects with an ARMS for psychosis are reported in six of the trials. A longitudinal analysis in two of these trials confirmed an association between these abnormalities and worsening of symptoms and final transition to psychosis. Considering that five other studies found no significant differences across these same areas, we can conclude that more research is needed to confirm glutamatergic abnormalities in subjects with an ARMS for psychosis. However, future research must overcome the methodological limitations of existing studies to obtain reliable results.
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Affiliation(s)
- Devi Treen
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Santiago Batlle
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Laia Mollà
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Eduard Forcadell
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Jacobo Chamorro
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Antonio Bulbena
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Autonomous University of Barcelona UAB, Department of Psychiatry and Forensic Medicine, Bellaterra, Spain
| | - Victor Perez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Autonomous University of Barcelona UAB, Department of Psychiatry and Forensic Medicine, Bellaterra, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain
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