Pablo González-Domenech

Introduction: The prevalence of tobacco smoking and high nicotine dependence (ND) in bipolar disorder (BD) is higher than in the general population but lower than in schizophrenia. This study aims to analyse the relationship of smoking behaviours, including age at onset of daily smoking (AODS), with age at onset of BD and course‐of‐illness variables –particularly recurrent suicide attempt– in a community sample of BD patients, also compared in their smoking behaviour variables with a sample of non‐psychiatric adults. Methods: Samples of 108 patients with BD and 290 non‐psychiatric adults were compared in their smoking habit. High ND was defined by a score of ≥ 6 on the Fagerström Test for Nicotine Dependence. Logistic regression analyses were employed to identify factors associated with daily smoking and high ND. Hazard curves were used to compare AODS between patients and controls and, among patients, age of BD onset between smokers and non‐smokers. Within‐subject survival times –AODS and the age at onset of BD symptoms– were compared with a multi‐state illness‐death model. Results: Compared with controls, BD patients showed higher prevalences of current daily smoking (44% vs. 34%) and high ND (25% vs. 9%); and lower smoking cessation rates (23% vs. 38%). Among BD patients, recurrent suicide attempt showed a strong independent association with both daily smoking and high ND. AODS was later in BD patients than the control group. Among patients, illness onset was earlier in smokers and AODS was earlier than illness onset. Conclusion: Addressing tobacco consumption should be an integral component of BD prevention and treatment strategies.

Introducción: El trastorno bipolar (TB) es una enfermedad mental crónica asociada a un mayor riesgo de mortalidad prematura. El consumo de tabaco es altamente prevalente en esta población y contribuye de forma relevante a la morbimortalidad física. Objetivo: Analizar críticamente la evidencia disponible sobre las intervenciones farmacológicas para el abandono del tabaco en pacientes con TB. Métodos: Se realizó una revisión narrativa estructurada en PubMed, The Cochrane Library y Web of Science, incluyendo estudios publicados entre enero de 1985 y marzo de 2025. Se incluyeron estudios originales que evaluaban tratamientos farmacológicos para la cesación tabáquica en pacientes con TB diagnosticado según criterios DSM o CIE. Debido a la heterogeneidad clínica y metodológica, no se realizó metaanálisis. Resultados: Se incluyeron 15 estudios. La mayoría evaluaron pacientes con TB dentro de cohortes psiquiátricas más amplias. La vareniclina mostró mayores tasas de abstinencia que el placebo, con odds ratios aproximadas entre 3,0 y 8,1, y fue superior al bupropión y a la terapia sustitutiva con nicotina (TSN) en varios estudios de gran tamaño. El bupropión y la TSN fueron generalmente más eficaces que el placebo, aunque con resultados menos consistentes. Los tratamientos fueron, en general, bien tolerados, sin aumento de eventos adversos neuropsiquiátricos graves. Conclusiones: Las intervenciones farmacológicas, especialmente la vareniclina, parecen efectivas y generalmente seguras para el abandono del tabaco en pacientes con TB. No obstante, la evidencia es heterogénea, lo que subraya la necesidad de estudios específicos en esta población.

Introduction : Attention-Deficit/Hyperactivity Disorder (ADHD) is a frequent neurodevelopmental condition in childhood. Although pharmacological treatments are effective for many patients, a substantial proportion show partial response or experience adverse effects. Nutritional strategies such as omega-3 supplementation and the Mediterranean diet have been proposed as complementary approaches to modulate symptoms and improve tolerability. Objectives : To evaluate the efficacy of omega-3 fatty acid supplementation and adherence to the Mediterranean diet on ADHD symptoms in children and adolescents. Methods: A systematic review was conducted in PubMed, Scopus, and Web of Science using the terms “Diet, Mediterranean”, “Fatty Acids, Omega-3”, and “Attention Deficit Disorder with Hyperactivity”. Studies published up to 2026 were included if they examined these interventions in participants under 18 with ADHD. Results : Twenty-three studies involving 1,838 participants met inclusion criteria. Most evaluated omega-3 supplementation, reporting mixed but generally favorable effects on attention, impulsivity, and hyperactivity. In several trials, combining omega-3 with pharmacotherapy reduced stimulant doses and adverse events. Only one randomized trial examined the Mediterranean diet, showing modest improvements limited by low adherence. Conclusion : Omega-3 supplementation may provide modest but meaningful benefits for core ADHD symptoms, particularly when combined with standard treatment. Evidence for the Mediterranean diet remains preliminary and requires further high-quality research.

Background: Several original studies have reported an inconsistent association between low meat consumption (e.g., vegetarian diets) and the risk of depression. The aim of this study was to quantify the relationship between low meat consumption and depression, identifying possible sources of heterogeneity and the potential role of psychosocial variables. Methods: A systematic review and meta-analysis were performed and reported according to PRISMA guidelines through a comprehensive search in Medline, Web of Science, Scopus, and PsychInfo databases from inception to January 2024 (PROSPERO registration ID: CRD42023405426). The exposures analyzed were (1) a meat-free diet and (2) a flexitarian (low-meat) diet. The outcome was depression. The meta-analysis included twenty longitudinal observational studies. Forest plots were designed, and heterogeneity was analyzed through I² statistic and subgroup analyses. Publication bias was assessed through funnel plots and Egger’s test. Results: The pooled overall analysis showed a protective association (HR: 0.74, 95%CI: 0.59–0.89, I² = 53.9%) between meat-free consumption and depression, which was consistent in the group of highest-quality studies. The main sources of heterogeneity identified were study quality, study design, year and country of publication, gender inequality in the country, and adjustment for certain variables (including social variables). The association between flexitarian diet and depression (HR: 0.90, 95%CI: 0.81–0.99, I² = 58.9%) was not consistent between subgroups. Conclusions: The results of this meta-analysis show a consistent protective association between meat-free diets and depression and an inconclusive association regarding flexitarian diet. Primary studies analyzing psychosocial variables are needed to explain these results.

Background: Neurodevelopmental disorders (NDDs) like intellectual disability (ID) are highly heritable, but the environment plays an important role. For example, endocrine disrupting chemicals (EDCs), including bisphenol A (BPA) and its analogues, have been termed neuroendocrine disruptors. This study aimed to evaluate the influence of different genetic polymorphisms (SNPs) on cognitive function in Spanish schoolchildren according to dietary bisphenol exposure. Methods: A total of 102 children aged 6–12 years old were included. Ten SNPs in genes involved in brain development, synaptic plasticity, and neurotransmission (BDNF, NTRK2, HTR2A, MTHFR, OXTR, SLC6A2, and SNAP25) were genotyped. Then, dietary exposure to bisphenols (BPA plus BPS) was estimated and cognitive functions were assessed using the WISC-V Spanish form. Results: BDNF rs11030101-T and SNAP25 rs363039-A allele carriers scored better on the fluid reasoning domain, except for those inheriting the BDNF rs6265-A allele, who had lower scores. Secondly, relevant SNP–bisphenol interactions existed in verbal comprehension (NTRK2 rs10868235 (p-int = 0.043)), working memory (HTR2A rs7997012 (p-int = 0.002), MTHFR rs1801133 (p-int = 0.026), and OXTR rs53576 (p-int = 0.030)) and fluid reasoning (SLC6A2 rs998424 (p-int = 0.004)). Conclusions: Our findings provide the first proof that exploring the synergistic or additive effects between genetic variability and bisphenol exposure on cognitive function could lead to a better understanding of the multifactorial and polygenic aetiology of NDDs.

Alcohol use disorder is considered a chronic and relapsing disorder affecting the central nervous system. The serotonergic system, mainly through its influence on the mesolimbic dopaminergic reward system, has been postulated to play a pivotal role in the underlying mechanism of alcohol dependence. The study aims to analyse the association of the rs6295 polymorphism of the 5HTR1A gene in women with alcohol use disorder and the association of personality traits with the development of alcohol dependence, as well as the interaction of the rs6295, personality traits, and anxiety with alcohol dependence in women. The study group consisted of 213 female volunteers: 101 with alcohol use disorder and 112 controls. NEO Five-Factor and State-Trait Anxiety Inventories were applied for psychometric testing. Genotyping of rs6295 was performed by real-time PCR. We did not observe significant differences in 5HTR1A rs6295 genotypes (p = 0.2709) or allele distribution (p = 0.4513). The AUD subjects scored higher on the anxiety trait (p < 0.0001) and anxiety state (p < 0.0001) scales, as well as on the neuroticism (p < 0.0001) and openness (p = 0134) scales. Significantly lower scores were obtained by the AUD subjects on the extraversion (p < 0.0001), agreeability (p < 0.0001), and conscientiousness (p < 0.0001) scales. Additionally, we observed a significant effect of 5HTR1A rs6295 genotype interaction and alcohol dependency, or lack thereof, on the openness scale (p = 0.0016). In summary, this study offers a comprehensive overview of alcohol dependence among women. It offers valuable insights into this complex topic, contributing to a more nuanced understanding of substance use among this specific demographic. Additionally, these findings may have implications for developing prevention and intervention strategies tailored to individual genetic and, most importantly, personality and anxiety differences.