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Substance use related problems, clinical features, and addiction severity reported by treatment seekers are important characteristics to take into account when planning treatment as they facilitate tailoring treatment to meet patients' needs.

IntroductionEvidence shows a lag in adoption of evidence-based practices (EBPs) for substance abuse treatment and supports the need for studying the factors involved in this worldwide problem.

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.

Background and aims: A worldwide increase in childhood overweight (OW) and obesity (OB) has been reported. OB is an inflammatory state which affects iron metabolism and the sensibility of the tests to detect iron deficiency (ID). Our aim was to evaluate the adequacy of current ferritin cut-offs to define ID in children with OW/OB. Methods: This cross-sectional study included 152 children (54% girls) aged (median [Q1-Q3]) 11 (8-13) years with OW/OB. Complete blood count and iron metabolism were evaluated. Low ferritin, transferrin saturation (TSat), and anemia were defined by age- and sex-specific cut-offs recommended by National Guidelines. Iron intake was assessed in a subgroup (n = 80) by a 24-hour dietary recall. Analyses were made according to pubertal development and ferritin tertiles. Results: The overall prevalence of low ferritin, TSat, and anemia was 2.6%, 23.8%, and 5.2%, respectively. Among pre-pubertal children (n = 87), the frequency of low TSat rose across ferritin tertiles ( P < .05), whereas it decreased among pubertal children (n = 65; P < .005). Cases of anemia among pre-pubertal children were found in the highest ferritin tertile, whereas 4/6 anemia cases in pubertal children were found in the lowest ferritin tertile (<39 µg/L). Pubertal children within the lowest ferritin tertile + low TSat (n = 11) showed lower hemoglobin (–9%; P < .005) and hematocrit (–8%, P < .01) than those in the same tertile + normal TSat (n = 16). The overall prevalence of children with ferritin < 39 µg/L + low TSat was 9.2%. Conclusions: Higher ferritin cut-off values are required to define ID in children with OW/OB. Such cut-off remains to be validated in larger, multi-ethnic cohorts of children with OW/OB.

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According to the treatment plan from the motivational interviewing model, we have worked with a 25-year-old male, single and childless. He is currently unemployed and he lives with his grandparents. His parents divorced about 20 years ago, he has a paternal brother of two years and his mother lives in Barcelona. He went to the USMC Huelva for the first time in 2014.The patient and the family reported emotional and behavioral disorders for several years, which were getting worse since 4 months. He has been convicted for rash driving and he resisted to police officers for several times. The patient was also abusing of several substances like cigarettes, cannabis, MDMA and cocaine.In order to work with the motivational interviewing with this patient, we proposed five clinical principles: express empathy, create discrepancy, avoid discussion, put a spin on his strength and promote self-efficacy.The clinical evolution of the proposed patient was positive. As we could see, the motivation for change occurred when the patient perceived a discrepancy between the place where he was and the place he wanted to get. As we saw, the important thing was to define acceptable and accessible targets that represented the progress toward recovery.In this style, we avoid the persuasion based on the discussion with the patient, instead we assume the validity of the experiences and the subjective perspectives of the patient. The motivational interview represents an alternative to unleash the change, instead of direct persuasion and aggressive confrontation.Disclosure of interestThe authors have not supplied their declaration of competing interest.