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Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated.

Aims: To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; ‘third-wave’ psychotherapies vs. other types). Background: Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. Design: A systematic review of quantitative studies. Methods: A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. Results: The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents (‘third-wave’ psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 ‘third wave’ psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. Conclusion: The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and ‘third-wave’ psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions.

Research on the use of Acceptance and Commitment Therapy (ACT) for patients with degenerative lumbar pathology awaiting surgery are limited. However, there is evidence to suggest that this psychological therapy may be effective in improving pain interference, anxiety, depression, and quality of life. This is the protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of ACT compared to treatment as usual (TAU) for people with degenerative lumbar pathology who are candidates for surgery in the short term. A total of 102 patients with degenerative lumbar spine pathology will be randomly assigned to TAU (control group) or ACT + TAU (intervention group). Participants will be assessed after treatment and at 3-, 6-, and 12-month follow-ups. The primary outcome will be the mean change from baseline on the Brief Pain Inventory (pain interference). Secondary outcomes will include changes in pain intensity, anxiety, depression, pain catastrophizing, fear of movement, quality of life, disability due to low back pain (LBP), pain acceptance, and psychological inflexibility. Linear mixed models will be used to analyze the data. Additionally, effect sizes and number needed to treat (NNT) will be calculated. We posit that ACT may be used to help patients cope with the stress and uncertainty associated with their condition and the surgery itself.

La depresión es un problema de salud pública en todo el mundo reconocido por la OMS, cuya prevalencia en los servicios de Atención Primaria se estima en 19,5% a nivel mundial, y en 20% en España. Debido a la necesidad de diseñar nuevas estrategias terapéuticas que permitan hacer frente a este problema, en los últimos años se ha venido desarrollado una línea de investigación dirigida a la creación y evaluación de protocolos de intervención psicológica aplicados a través de las Tecnologías de la Información y la Comunicación, y especialmente las realizadas a través de internet. De hecho, la literatura científica disponible sugiere que estos tratamientos pueden ser alternativas eficaces para el tratamiento de la depresión. Por otro lado, las terapias de tercera generación, y concretamente las intervenciones basadas en mindfulness, han mostrado ser efectivas para el tratamiento de diferentes psicopatologías. Sin embargo, apenas se cuenta con estudios científicos llevados a cabo en España, en los que se evalúen programas de psicoterapia por ordenador para la depresión, en el ámbito de Atención Primaria. El objetivo principal de esta tesis es evaluar la eficacia de un protocolo de intervención psicológica breve basada en mindfulness y aplicada a través de internet para el tratamiento de la depresión leve-moderada, dentro del contexto sanitario español de Atención Primaria. El estudio de investigación que se presenta fue un ensayo clínico multicéntrico controlado y aleatorizado en dos grupos paralelos. Los pacientes con depresión leve o moderada, incluidos en el estudio, fueron asignados al azar entre las dos condiciones experimentales: a) tratamiento breve de psicoterapia por ordenador basado en mindfulness + tratamiento habitual mejorado (mindfulness + iTAU); b) tratamiento habitual mejorado (iTAU). La gravedad de la depresión, variable principal del estudio, se evaluó con el cuestionario sobre la salud del paciente, por sus siglas en inglés PHQ-9. Además, también se recogieron las siguientes variables: calidad de vida (SF-12), afecto positivo y negativo (PANAS); mindfulness (FFMQ); y bienestar (PHI). Las medidas de evaluación se llevaron a cabo en el pre-tratamiento (momento 1), en el post-tratamiento (momento 2), a los 6 meses (momento 3) y 12 meses del post-tratamiento (momento 4). Finalmente, de los 111 pacientes reclutados, 54 fueron asignados al grupo mindfulness y 57 al grupo control. El tratamiento breve de psicoterapia por ordenador basado en mindfulness mostró mejoras significativas en la gravedad de depresión, en comparación al grupo control, al finalizar el tratamiento (p = 0,001). Sin embargo, estas diferencias no se mantuvieron a los 6 meses de seguimiento, puesto que los sujetos de ambos grupos experimentaron el mismo perfil de mejoría en esta variable. Para las variables afecto negativo y calidad de vida mental se observó un patrón similar al seguido por la depresión, de manera que las diferencias halladas en el post-tratamiento no se mantenían en el seguimiento a los 6 meses. Por otro lado, las variables que mejor predecían una mejora en el nivel de depresión fueron: nivel de estudios, sexo, contrato de trabajo, tiempo de tratamiento, y días de repaso antes del post-test. La principal conclusión extraída a partir de los resultados obtenidos del estudio, es que el protocolo de intervención psicológico breve basado en mindfulness y aplicado a través de internet es eficaz, a corto plazo, en la mejora de la sintomatología depresiva leve-moderada, y que podría ser una adecuada estrategia de prevención secundaria en el ámbito de Atención Primaria de España.Abstract:Depression is, nowadays, a global health problem recognized by the World Health Organization. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. Due to the need to create new therapeutic strategies to address this problem, a line of research has been developed in recent years, whose objective is creating and evaluating psychological intervention protocols applied through Information and Communication Technologies, and especially those applied over the Internet. In fact, scientific literature suggests that these treatments may be effective alternatives for the treatment of depression. On the other hand, third generation therapies, and specifically mindfulness-based interventions, have been proven effective for the treatment of different psychopathologies. However, there is an absence of scientific studies carried out in Spain in which computer psychotherapy programs are evaluated for depression in Primary Care. The main objective of this thesis is to evaluate the efficacy of a brief psychological mindfulness-based intervention applied through the internet for the treatment of mild-moderate depression in Spanish Primary Care. A multicenter, two-arm, parallel, randomized controlled trial was carried out. Participants were randomized into two experimental conditions: a) brief online mindfulness-based intervention + improved usual treatment (mindfulness + iTAU); b) improved usual treatment (iTAU). The main outcome of the study was depression, which was evaluated with the Patient Health Questionnaire (PHQ-9). In addition, the following variables were also evaluated: quality of life (SF-12), positive and negative affect (PANAS); mindfulness (FFMQ); and well-being (PHI). The evaluations were collected from the pre-treatment (time 1) to the post-treatment (time 2), and up to 6 (time 3) and 12 months (time 4) follow up. Finally, of the 111 patients recruited, 54 were assigned to the mindfulness group and 57 to the control group. The mindfulness intervention showed significant improvements in the severity of depression compared to control at post-treatment (p = 0,001). However, these differences were not maintained at time 3, since both groups’ participants experienced the same improvement profile regarding this variable. For the negative affect and mental quality of life, the pattern was similar to that followed by depression, so that the differences found in the post-treatment were not maintained in the 6-month follow-up. On the other hand, the variables that best predicted an improvement in the depression levels were: level of studies, sex, employment contract, treatment time, and days of revision before the post-test. The main conclusion of the study is that the brief online mindfulness-based intervention is effective in the short term in the improvement of mild-moderate depressive symptomatology, and that it could be an appropriate secondary prevention strategy in the context of Spanish Primary Care.

La depresión es, desde hace ya unos años, un proble-ma de salud pública a nivel mundial reconocido por la OMS. La prevalencia actual de esta patología, en los servicios de Atención Primaria, se estima en 19,5% a nivel mundial y en 20,2% en España. Además, las políticas y protocolos de intervención actuales están suponiendo unos importantes costes, tanto personales como económicos, para las personas que padecen este trastorno, así como para la sociedad en ge-neral. Por otro lado, los índices de recaídas tras las interven-ciones farmacológicas que se aplican actualmente y la falta de una atención especializada eficaz en los servicios de salud mental, ponen de relieve la necesidad de desarrollar nuevas estrategias terapéuticas más accesibles y coste-efectivas. En esta línea, una de las propuestas que se están investigando en diferentes partes del mundo es el diseño y evaluación de protocolos terapéuticos aplicados a través de las Tecno-logías de la Información y la Comunicación, especialmente, a través de internet y de programas de ordenador. Por ello, el objetivo de este trabajo es presentar la situación actual de la atención en España respecto a la utilización de estas intervenciones para el tratamiento de la depresión en Atención Primaria. La conclusión principal es que, aunque existe evidencia científica sobre la eficacia de estos programas, to-davía existen barreras importantes que dificultan su implan-tación en el sistema público, y, por otro lado, la necesidad de desarrollar estudios de implementación que faciliten la transición de la investigación a la práctica clínica. Currently, depression is a global health problem recog-nized by the WHO. The prevalence of this pathology in Pri-mary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and eco-nomic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently ap-plied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profit-able. Therefore, one of the proposals that are being inves-tigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Infor-mation and Communication Technologies, especially through the Internet and computer programs. The objec-tive of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclu-sion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice.

Resumen Objetivo: El objetivo del estudio ha sido comparar la capacidad explicativa de dos instrumentos de medición del nivel de burnout (uno bajo la perspectiva tradicional y otro bajo la tipológica) en cuanto a la sintomatología somática y psicológica del síndrome se refiere. Método: Estudio descriptivo con un diseño transversal con una muestra aleatoria de trabajadores de la universidad (n=429), quienes completaron el MBI-GS (medida tradicional de burnout), el BCSQ-12 (medida de subtipos) y el HSCL-30 (síntomas psicológicos y somáticos derivados del estrés). Se construyeron modelos de regresión lineal multivariante entre los síntomas de estrés y las diferentes definiciones del síndrome de burnout. Resultados: Se encontró que la varianza de la sintomatología derivada del estrés era explicada un 40% (psicológica) y 31% (somática) por el MBI-GS y un 27% (psicológica) y 16% (somática) por el BCSQ-12 ambos con un nivel de significación de p

El objetivo de este trabajo fue evaluar la relación de los niveles de mindfulness (atención plena) con las siguientes variables psicológicas: afecto positivo-negativo, ansiedad estado-rasgo, estrés académico y satisfacción académica en una población universitaria (estudiantes de psicología) de N=28. Para ello se aplicaron los siguientes cuestionarios y escalas: FFMQ, PANAS, STAI, SISCO y UWES-S en sus versiones en castellano. Los resultados mostraron correlaciones significativas positivas entre mindfulness y afecto positivo y ansiedad-rasgo, y correlaciones significativas negativas entre mindfulness y el afecto negativo y ansiedad-estado. Palabras Clave: Mindfulness, afecto positivo-negativo, ansiedad estado-rasgo, estrés y satisfacción académica. The aim of this study was to analise an assessment of the relationship between levels of mindfulness (mindfulness) with the following psychological variables: positive-negative affect, state-trait anxiety, academic stress and academic satisfaction in a university population (psychology students) N = 28. To do this we applied the following questionnaires and scales: FFMQ, PANAS, STAI, SISCO and UWES-S in its versions in Spanisn. The results showed significant positive correlations between mindfulness and positive affect and trait anxiety and negative significant correlations between mindfulness and negative affect and state anxiety. Key Words: Mindfulness, positive-negative affect, state-trait anxiety, academic stress and satisfaction.