Cognitive deficits are known to be present in psychotic patients even before psychosis has been diagnosed. Those deficits show poor response to antipsychotics and seem to be responssible of functional impairment.Several trials point out cognitive remediation interventions may improve these neuropsychological deficits and therefore functioning.Our aim is to evaluate if a computerized cognitive remediation program (Rehacom®) improves cognition, and therefore insight, functioning and quality of life in early stages of psychosis.A randomized open label prospective study comparing 21 first psychotic outpatients doing RehaCom with 21 first psychotic patients doing non specific computer work. All 42 patients have done 24 one hour sessions, twice a week during 12 consecutive weeks. The trial was conducted between january 1st and december 31st, 2013. All patients were evaluated using the Matrics Cognitive Consensus Battery (MCCB), the Scale Unawarness of Mental Disorders (SUMD), the Global Assessment of Functioning (GAF) and the Quality of Life Scale (QLS) at basal time, 6 and 12 months later.Basal differences between groups were analized using Chi2 and U-Man Whitney. STATA v.11 was used for the analysis.MCCB total score were 32, 34 and 38 at basal time, midtime and endpoint. All patients show neuropsicological improvement after a year but no statistical differences were found between groups. Education was associated with better scores after cognitive remediation, The RehaCom group did show better scores in insight (p<0.041) but not in functioning or quality of life.

Objective: Naltrexone is an opioid antagonist used for the treatment of patients with opioid use disorder and alcohol use disorder. This population often presents problems of follow-up and therapeutic efficacy related to adherence to treatment. The purpose of our study is to provide an exhaustive summary of the current evidence regarding naltrexone adherence in people with substance use disorders and to identify possible variables that may influence adherence to naltrexone. Methods: Two searches were performed in bibliographic databases (PubMed, Embase), and studies included in the systematic review were those published from January 1, 2011 to September 2020, with participants over 18 years of age, evaluating treatment with naltrexone in alcohol use disorder and opioid use disorder. From the total of 133 articles initially selected, 36 were included and analyzed in the systematic review. Results: Naltrexone has not demonstrated superiority over other available treatments in terms of adherence and abstinence, although reinforcement systems have obtained favorable results as an additional strategy to improve adherence. Conclusion:It is necessary to study other psychosocial variables involved in improving adherence, in addition to taking patient preferences into account in order to improve the external validity of the results.