AUCTORES
Globalize your Research
Chat with us
Research Article | DOI: https://doi.org/10.31579/2690-1919/284
Professor of Psychology at the Faculty of Psychology/ Havana University
*Corresponding Author: Humberto Garcia Penedo. Professor of Psychology at the Faculty of Psychology/ Havana University.
Citation: Humberto Garcia Penedo. (2023). Emotional comorbidities in drug addictions. Recount and thematic review, J. Journal of Clinical Research and Reports, 12(3) DOI:10.31579/2690-1919/284.
Copyright: © 2023 Humberto Garcia Penedo. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 19 December 2022 | Accepted: 28 December 2022 | Published: 06 January 2023
Keywords: Emotional comorbidities; complicated grief; anxiety; depression; testimonials; drug addiction; psychotherapy; psychotrauma; Bibliotherapy
It is a thematic review where the author's path in scientific research focused on enhancing the effectiveness of psychotherapeutic treatment of people with alcoholism or any other drug addiction and the results of published studies are exposed. The thematic review focuses on the neurotic level affective spectrum comorbidities in drug addictions from the progressive understanding of this author in the professional practice with Cuban and Latin American patients. The logic followed in scientific research and its outcome towards an effective professional practice in psychotherapy in this area of clinical psychology is narrated. The state of the art in the Cuban user population of these services is reported, the value of resources and psychotherapeutic strategies that give prestige to the work with the emotional area of users of the addiction service is based, since they seem to contain a greater potential for effectiveness to fulfill psychotherapeutics objectives.
Delving into the professional practice of assisting people with drug and alcohol addiction is a challenge given the complexity of these problems. After a 12-year work experience in the Rogelio Paredes Teaching Psychiatry ward of the Psychiatric Hospital of Havana as a clinical psychologist and under the direction of Ph.D. Ricardo Á. González Menéndez, starting in 1995, it was possible to assist people with varied drug addictions and of different nationalities, especially from Cuba and Latin America. At the beginning, I was instructed to carry out didactic groups that would have the objective of reinforcing the instructional part of the assistance program of the service; since its contents or methodology to implement it weren’t developed yet at that time, work was done to define which instructional contents would emerge from the needs felt and expressed by the service users themselves.
These demands were also nourished by the very logic of the care process, issues that were published [1,2,3], so that they contributed to Psychoeducation in this area. However, although this complementary assistance modality was developed by this author, its effects would be restricted to the cognitive area of the problem and, although useful, it was obvious that it would be necessary to continue looking for other procedures that would contribute to strengthening the assistance program of these people, since it is proposed that drug addictions are essentially an emotionally based problem [4,5].
Affective comorbidities in addictions are very frequent, more than 65% in a Spanish study in which patients with mood, psychotic anxiety, ADHD and personality predominated [6]. Anxiety and depression are the rule in these people [7,8], anger is also very common [9,10]. The Unpleasant Affect factor declared by several authors and which consists of a significant group of negative emotions has the greatest weight in its association with the craving for consumption [11].
Effective treatment in people with addictions becomes more complex to the extent that different types of comorbidities appear, although the most frequent are neurotic, in addition to the fact that in some cases elements of drug-induced psychosis appear. Care programs for this problem have been characterized by being multimodal [12], which means that different types of psychotherapy are used because each one provides benefits to meet certain psychotherapeutic objectives of proven efficacy.
For years the slogan has been heard that says: "What is effective is what is affective" but even when there was an intuition about the veracity of this maxim, at the beginning there wasn't a sufficient idea that would allow the implementation of interventions that would be effective in the treatment of people with drug addiction. It was noteworthy that many individuals upon admission to the psychiatric service declared that they had made that decision after having suffered an event of high social and personal significance resulting from their negligent behavior associated with drug use. A patient, for example, decided to enter after having pushed his pregnant wife and having lost the child for that reason, another patient was admitted after being sentenced to non-conviction correctional work because under the influence of alcohol while transporting his mother in the back seat of his bicycle collided with a vehicle on a slope and she died days later.
After the compilation of reference anecdotes was elaborated, it had to be tested while studying the best way to use it in assistance. Professional practice has shown that nothing is better than the confession of anecdotes of patients presents for psychotherapeutic work, while anecdotes compiled whose protagonists were patients who were no longer present and whose anonymity was reserved, would be better used as a complement in case of not obtaining immediate confessions that would serve to “emotionally warm up” a psychotherapeutic environment [16]; procedure that proved to be effective in the treatment of these people.
Once the effective potential of an approach centered on “the affective” was certain, it continued to be thought of adding other intervention procedures that would contribute to further reinforcing the care program. The integration of contributions from Neuroscience and studies on trauma would be key pieces that would be integrated into the intervention system. In 2006 two patients suffering from chronic alcoholism were treated but they had in common that they both suffered from a complicated mourning.
Patient “A”, a farmer who began his career of binge drinking after losing his father who suffered from alcoholism and committed suicide in front of him and his mother by drinking a pesticide. Patient "B" also began abusing alcohol from the moment his little brother, under eight years old, was accidentally crushed to death by the collapse of an old building where he was playing. As his mother was taking a nap, "B" blamed her for being responsible and for 21 years he mistreated and humiliated her a lot, he denied her all affection; while "A" imitated the embarrassing behavior of his father in life, both alcohol consumption and pathological gambling.
A mourning technique was applied to both patients, managing to overcome it despite the chronicity of this disorder (18 years in "A" and 21 in "B"); miraculously, the latter never drank alcohol again, he reconciled with his mother whom he kissed after 21 years without kissing her and called her "mom"; although forgiveness was a required step in this therapy; while "A", on the other hand, despite having overcome the mourning, relapsed six months later for a typical reason that explains the relapse of many patients with alcoholism, but his recovery was very fast and his relapse was free from the onslaught of the previous complicated mourning.
Grief turned out to be primary in both cases with respect to alcoholism, a typical example of a Mental Illness Substance Abuse (MISA) case; this solution was decisive in the recovery from alcoholism. How many psychiatric pathologies associated with addictions as comorbidities are influencing the chronicity of the latter? It is obvious that the comprehensive treatment of comorbidities contributes to enhancing the effectiveness of treatments, in fact the DSM in its most current version registers the category "Disorders related to traumas and stress factors" where very relevant disorders are reflected from their symptomatic composition due to the impact of traumas, but clinicians have to deal with a myriad of traumas that, due to their peculiar composition and expression of the psychopathological frame, are not classified as well in the disorders included in the reference diagnostic category, but are included within the trauma model as stated [17].
From this approach, it is known that there are dissimilar modalities of trauma experienced by people in very personal ways, attenuated clinical forms of what could be a Post-Traumatic Stress Disorder (PTSD), suitable for people who learned to live badly with these traumas and they establish interpersonal relationships that reflect social dysfunction as an expression of sequelae of events perceived by them as psychotraumatic.
From the aforementioned approach, by identifying affective comorbidities and treating them appropriately, the chances of successful treatment are high. Now the diagnosis that clarifies the entire affective spectrum is of great value to fine-tune the psychotherapeutic strategy, since by personalizing the diagnosis it also allows treatment to be individualized [6]. Although this premise is not new, it has gone through a defect that has been affecting the effectiveness and efficiency of assistance programs; even when the psychopathological categories are diagnosed from the categorical paradigm that doesn’t dictate enough about the patient. Depression, for example, is identified and ruled generically in around 50% of patients, but its character as a trait is not always judged, nor is the treatment always completely consistent with this fact, nor is it usually described emotional composition of that disorder, something that doesn’t help to personalize the treatment.
When focusing attention on depression, especially trait one, it is logical to think that the person has incorporated attitudes, beliefs, and behaviors that perpetuate the disorder into their usual way of being, and this already leads us to think about their synaptic connectivity substrate. Taylor [19] calls it "automatic or pre-programmed reactivity of the limbic system", meanwhile Maté [20] names it "brain patterns" or “programs of early painful experiences”, while Lewis [21] calls this "neural habits".
On the other hand, although depression has shared symptoms and signs, people often suffer from their anguish or discomfort personally, hence the need to identify which negative emotions are part of its composition, since some people are sad with feelings of guilt, of frustration, of a low self-esteem, while others feel hatred, resentment towards other people and expectations of harm that place them in defensive and even offensive attitudes towards others. Therefore, there is a group of negative emotions that do not in themselves constitute a psychopathological diagnosis, but that acquire a high social significance for those who suffer from an addiction. In the article by Von Hammerstein et al. [11], it can be seen that these authors name "Unpleasant affect" to a factor composed of dissimilar emotions including stress, shame, disappointment, anxiety, frustration, among others, which they declare that are associated with the craving; this means that these emotional experiences precede craving and enhance it.
These differences in emotional composition that individuals suffers are originally related to events perceived as traumatic that engendered negative predispositions in these people, which are what explain social dysfunctionality, according to Shapiro [17] and which was verified by this author in investigative practice [18]. This emotional pattern expresses the set of preconceived responses of these people to new situations that are perceived as a potential repetition of very unpleasant past experiences and that they intend to prevent from happening again. This is how a psychological trauma operates in its composition and functionality, which is found in many people with addiction in clinical practice [3]. This belief repeatedly observed by Maté was what led him to consider addiction as a secondary disorder with respect to its importance and rescue the harmful impact of traumas when he stated: “The question will never be: why addiction? Otherwise why the pain? (p.43) [20].
The addictive cycle according to Volkow [22] includes a very important component that is that of negative emotions, this reaches its maximum influence when the individual pauses in drug use and is emotionally knocked down, at the same time, that the same emotional state, being perceived as unbearable, contributes to enhancing the craving for consumption and drags the patient towards the next phase of preoccupation-anticipation before entering the binge. In this emotional component, a very valuable gateway is distinguished to enhance psychotherapeutic assistance, either when solving a complicated mourning, or when treating depression from a trait perspective in which trauma is conceived in the genesis of a large part of the psychopathological alterations of the patients.
The various negative emotions are designed to be experienced in a transitory and not permanent way. Nothing is more normal than a person feeling anger at a well-justified person and circumstance, which does not mean that the person should remain under anger all the time as happens with feelings. The same can be said of other negative emotions that must be transitory and circumstantial.
On the other hand, there are people who have incorporated negative emotions into their usual way of perceiving and reacting, which makes them vulnerable to a high number of social experiences; hence the basis for designing a psychometric instrument that allows trait emotionality to be identified based on its frequency and magnitude, both of which make up what has been called its clinical significance. Anger, being very frequent in addicted people [9], led to the design of a program for its treatment [10]; however, Alcoholics Anonym ous themselves state the following: “The greatest enemies of us alcoholics are resentment, jealousy, envy, frustration and fear.” (A.A. Blue Book p. 108). These emotions, reflecting a notable level of clinical significance, become the focus of the therapist's interest and lead to the identification of which traumatic experiences they are originally associated with. To diagnose this entire set of aforementioned emotions, an instrument was designed that has proven to be very relevant, the Modified Grau's Experiential Self-Report [23,24] (See appendix 1).
This instrument records a total of 25 emotions, of these 22 are negatives and three positives, those that obtain clinical significance will be worked on in psychotherapy with the patients. To complement this instrument, a Rotter (a sentence completion) was designed that focuses on questions that explore emotionality so that it is possible to identify which specific topics these emotions are associated with in order to clarify which past events they are originally linked to. Together with these two instruments, an interview guide is used to conclude the investigation about the psychotraumatic event or events that the patient must have gone through.
The strategy to follow for the treatment of this unhealthy emotional composition, although it is based on Shapiro's theory about its origin and shares with this author to meet the same specific objectives, is based on the Corrective Emotional Experience of Alexander and French (1949) with elements in addition to Greenberg and Watson [25]. Therapy Focused on Emotions for being very effective for these cases. The psychopathological diagnosis should not be restricted to the categorical paradigm but should include the report of dimensions that facilitate the understanding of each case; in particular, the negativity composed of negative emotions identified against the positivity composed of qualities such as optimism, good humor and happiness reported by individuals. Both dimensions are very relevant to work on the emotional area of these patients. The positivity deficit bases the need to promote emotional health that contributes to psychological well-being, while the removal of negativity will be a goal of the therapist with the conviction of suppressing the source that potentiated the anxiety. These bases demonstrated therapeutic effectiveness [24].
The follow-up of a part of the patients who were assisted with this approach showed that they have remained abstinent for a long time, some for four years after this study was carried out. This perspective shows that assistance programs are perfected in the growing integration of good practices; classic psychotherapeutic methods together with the somewhat newer ones and the gradual conviction of seeing emotional comorbidities more as an opportunity than as a stumbling block. An important implication of this approach favors combating the stigma that seeks to delegitimize addiction as a disease, the less it is shown that it is one more way of expressing affective spectrum disorders. It also shows that, although this addictive structure and dynamic is not fulfilled in all patients, in those in whom it is fulfilled they are suitable creditors to be benefited from this perspective, their resources and strategies predicting effectiveness in treatment, in addition, although addictions are they settle on a peculiar neuroconnectivity although of social origin, it is modifiable with psychotherapy.
Appendix No.1
Grau's Modified Emotional Self report
Instructions: To the left column there are a series of emotions that you could feel. To the right of each one there is a horizontal line whose left end indicates the weakest grade in that you feel these emotions, while the right end corresponds to the biggest intensity in that you may has felt them.
1.- You should check only one box per row where you think best reflects the intensity with which you have been feeling each emotion during the last few months. Please make sure to match the chosen intensity with the frequency in which it occurs.
Affective comorbidities in drug addictions represent a major challenge in treatment but at the same time, understanding how negative emotions become traits are formed and operate and the role of traumas in their origin, their treatment also represents a path that predicts the effectiveness of therapeutic assistance, since when affective comorbidities are resolved, patients reach a more favorable health condition to initiate and sustain abstinence in consumption for a longer time. Focusing on trait emotionality and trauma seems to add greater effectiveness to care; also, the more detailed psychopathological diagnosis allows to personalize the treatment, both conditions contribute to the effectiveness of the treatment.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
