This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic.

Observational study of case series.

Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022.

CDI patients.

Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression.

We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals.

Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.

The concept of recovery is featured in the strategic plans of the World Health Organization as well as in other national mental health plans; however, there have been differing interpretations of what it means. This article aims to achieve a consensus on the key aspects of recovery in mental health from the perspective of movements of users and survivors of psychiatry at an international level. Four specific objectives were proposed in this study: (1) to identify what recovery in mental health means, (2) to identify the indicators that a person is progressing in their recovery, (3) to determine the factors that facilitate the recovery process, and (4) to determine the factors that hinder the recovery process.

A three-round e-Delphi study was conducted with the participation of 101 users and survivors of psychiatry, adhering to the CREDES checklist to ensure methodological rigour.

The results reveal 26 key aspects that define recovery, 31 indicating that a person is progressing in their recovery process, 8 that facilitate recovery and 12 that hinder recovery. The most agreed-upon statements for defining recovery highlight the importance of empowerment, leading a fulfilling life, ensuring safe-living conditions and acknowledging individuals as holders of rights. Similarly, empowerment and agency were highly agreed upon as relevant recovery indicators. Key findings underscore the significance of a supportive and respectful social environment in facilitating recovery, while coercion, discrimination and lack of support from significant others hinder recovery.

Despite cultural differences and recovery’s subjective nature, our results demonstrate that an international consensus on critical recovery aspects is attainable. Highlighting a significant shift, we emphasize the ‘Transition’ process to signify moving away from the biomedical model approach and advocating for collective rights. Our findings advocate for empowerment, users’ rights and the move towards person-centred care that integrates social, political and economic contexts. These consensus statements lay the groundwork for future research across diverse regions and cultures, offering insights into recovery’s meaning and potential for innovative approaches in diagnosis, intervention and evaluation.

Threatened preterm labor (TPL) represents an adverse prenatal event that can impact maternal mental health in the long term. Additionally, this prenatal event can disrupt fetal neurodevelopment, primarily during the third trimester of pregnancy when neuronal connections in the fetus are established. Indeed, infants born following TPL exhibit delayed communication and socio-individual skills at 6 months of age, regardless of prematurity. Furthermore, maternal mental health during the postpartum period can also influence the offspring’s psychomotor development.

The aim of this study is to examine the impact of maternal psychopathology on psychomotor development trajectories in infants born after a TPL from 6 to 30 months of age.

This prospective cohort study recruited 117 mother–child pairs who suffered from a TPL. Psychomotor assessment was performed at 6 and 30 months of age using the communication and socio-individual subscales of Ages & Stages Questionnaires for psychomotor development. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Increased communication delays were associated with higher maternal anxiety levels (p < 0.001), elevated maternal depression scores (p= .0003), and increased cortisol levels (p = .004) during postpartum. Similarly, elevated cortisol levels after 6 months postpartum were predictive of increased Personal-Social delays (p = .0018).

Maternal postpartum psychopathology was the main determinant of the course of psychomotor developmental disturbances. Therefore, infants born after TPL, whose mothers display postpartum psychopathology, should be identified and considered for psychological treatment to improve psychomotor delays in infants.

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The Choice giving birth by cesarean section when it is not biologically necessary implies a greater risk to the health of the mother and child Toral et al. Eletrônica Estácio Saúde 2018; 95(1) 27-30,refers the psychological relevance to identify perinatal effects of a good medical practice at birth. In this respect Poojari et al. Early Hum Dev 2019;115 93-98, state that a cesarean section as a surgical risk, causes decrease fetal oxygenation and an impairment release of stress-related hormones in the maternal-fetal binomial that does not favor neural connections at birth

Identify the neurodevelopmental lags in infant on children under 24 months of age born by cesarean section and vaginal delivery,

A cross-sectional descriptive correlational; Sample consisted of 100 children of a term gestation, 70 with spontaneous vaginal birth and 30 whose birth was by cesarean section, aged between one and twenty-four months; using the Abbreviated Development Scale, an instrument created and validated for the Colombian population (Cronbach’s alpha, 0.94). All parents signed the informed consent.

All test scales were applied (gross and fine motor, language and social personal), the results showed that children born by cesarean section had better development in areas of fine motor and language, while children born by vaginal delivery had better development of gross motor. See (graphic 1).

Graphic 1: Areas of development according to the type of delivery.

References

The influence of contextual variables such as age and educational level of the mother on language and social areas was also found

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Long-acting injectable antipsychotics (LAIs) offer advantages for schizophrenic patients compared to oral antipsychotics: less frequent dosing, lower relapse rates, better adherence, and lower healthcare costs. LAIs include paliperidone, aripiprazole, olanzapine, risperidone, and zuclopenthixol. Paliperidone palmitate is the only antipsychotic with two formulations with an administration interval longer than one month (3-monthly and 6-monthly), which could be better for the patient and help ensure treatment continuity, especially in cases of limited access to the health care system.

To assess the satisfaction of patients under treatment with 6-month paliperidone palmitate compared to other long-acting injectable antipsychotics with a higher frequency of administration.

We analyzed the satisfaction level of a sample of patients receiving treatment with LAIs at the Mental Health Center of El Escorial. All patients had a diagnosis of schizophrenia or other psychotic disorders (according to DSM-5). Patients who met the inclusion criteria completed the Treatment Satisfaction Questionnaire for Medication (TSQM), a generic questionnaire of treatment satisfaction that measures four dimensions: side effects, treatment efficacy, comfort of use, and overall satisfaction. Other clinical and socio-demographic variables were collected, as well as the type of injectable, dose, and frequency of administration.

Data from approximately 30 patients will be analyzed and discussed later.

Less frequent administration of LAIs may result in greater patient satisfaction and be just as beneficial clinically. Treatment satisfaction is positively associated with an improvement in psychotic symptoms and seems to be related to better adherence.

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Infants born preterm usually show a Preterm Behavioural Phenotype, which includes mixed symptomatology characterized by lack of attention, anxiety and social difficulties, with a 3-4 times greater risk of disorders in further childhood. Critically, this behavioural pattern is also observed in infants born after a threated preterm labour (TPL), regardless of the presence of prematurity. It is known that the course of this Preterm Behavioural Phenotype shows high variability. Nevertheless, the predictors of this Preterm Behavioural Phenotype prognosis remain unknown.

This study aimed to explore the predictors of change of Preterm Behavioural Phenotype symptomatology during preschool ages in order to improve prognosis.

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Preterm Behavioural Phenotype symptoms were assessed at age 2 and 6 using Child Behaviour Checklist. Gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress were included as predictors in a regression model.

Whereas increased internalizing problems were associated with a previous trauma history (p = .003), increased externalizing symptoms were linked to prenatal and postnatal maternal anxiety (p = .004 and p = .018, respectively).

Identifying modifiable risk factors, such as the history of maternal traumas and anxiety at TPL diagnosis and postpartum is recommendable to enhance better prognosis of Preterm Behavioural Phenotype in the offspring.

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Emotional dysregulation are considered early manifestations of neuropsychiatric disorders. Recent research has shown that a threatened preterm labour (TPL) represents an adverse prenatal event that involves temperament disturbances, even in absence of prematurity. Thus, full-term TPL infants at 6 months of age are characterized by lower positive affect, higher negative affect, and worse emotional regulation relative to a full-term non-TPL control group.

The aim of this study is to explore the predictors of change of emotional infant competences.

This prospective cohort study recruited mothers who suffered from a TPL. Infants’ temperament assessment was performed at 6 and 30 months of age using the Rothbart Behaviour Questionnaires, examining positive affectivity/surgency, negative emotionality, and orienting and emotional regulatory capacity. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Increased positive affectivity was related with lower paternal stress (p = .044). Maternal history of trauma and parenting stress was associated with increased negative emotionality (p = .037 and p = .045, respectively). Increased emotional regulation disturbance was linked to low gestational age at birth (p < .001), higher postnatal depression (p = .002), higher prenatal anxiety at TPL diagnosis (p = .039) and higher postnatal anxiety (p = .008).

Therefore, maternal previous traumas, maternal psychopathology from pregnancy to postpartum as well as parenting stress should be considered in psychological treatment to improve infant’s emotional competences and prevent subsequent neuropsychiatric disorders.

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Risky sexual relationships, reckless driving or initiating drug use are examples of health-related risk behaviours that are often related to poor emotional abilities (emotional identification, emotional understanding, facilitating thought and emotional regulation). However, the mechanisms by which this relationship operates have been relatively little studied. It is well known that certain personality traits such as impulsivity and sensitivity to reward are strongly related to risk-taking behaviour.

The aim of this work was to explore the role of these two traits in the relationship between each of the different abilities/ branches of emotional intelligence and health risk behaviour, as well as to identify the emotional ability that best predicts this relationship.

A community sample of 250 participants (Mage = 23.60; 72% women) was used to measure levels of emotional intelligence in each of its branches (through the performance-based ability test MSCEIT), and levels of health risk behaviour, impulsivity and sensitivity to reward.

The results supported the existence of a negative relationship between the four emotional abilities and health risk-taking. Mediation analyses that included all four MSCEIT branches as predictors revealed an indirect effect of the “managing” branch on risk-taking, being the most important branch in predicting health-related risk-taking, due to its effects through impulsivity and sensitivity to reward.

Our results suggest that a strong negative relationship exists between emotional management ability and health risk-taking, highlighting that the emotional components of impulsivity and levels of sensitivity to reward have been shown to be among the mediating factors underlying this relationship. Further experimental research is needed to confirm the role of emotional intelligence, and in particular emotional management, as a protective factor for risk-taking behaviour.

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Psychotic patients are a vulnerable population from a social and health point of view. The SARS Cov-2 pandemic affected millions of people around the world, however, its effects on psychotic patients in Avilés Spain, have not been analized.

The objective of this study was to determine and compare the mortality of patients with psychosis due to SARS Cov-2 in Avilés, Spain with others regions and countries in the European Union. Determine the influence of social condition and antipsychotic treatment on the condition of these patients.

This is a descriptive, observational study, in which patients diagnosed with psychosis in the period 2020-2021 who contracted SARS Cov-2 infection in Avilés, Spain, were studied to determine those who died from this cause. The influence of social status and antipsychotic medication, as well as sociodemographic factors (age, sex, marital status) were analyzed and compared with other regions and countries of the European Union.

Despite the high mortality rate in patients with psychosis, during the years of the pandemic SARS Cov-2 played an important role given the vulnerability of these patients.

The negative effects and deaths during the COVID-19 pandemic were at the time a major problem for public health worldwide. This study concluded that the morbidity and mortality of psychotic patients who contracted COVID-19 was lower than the rest of the population.

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Cannabinoid hyperemesis syndrome (CHS) is an underrecognized condition characterized by acute episodes of intractable nausea and vomiting, colic abdominal pain and restlessness related to chronic cannabis use. Antiemetics commonly fail to alleviate the severe nausea and vomiting. A very particular finding is the symptomatic relief with hot water. Antipsychotics (such as haloperidol), benzodiazepines and/or capsaicin cream appear to be the most efficacious in the treatment of this unique disorder. Precisely, it has been studied that transient relief of symptoms with topic capsaicin or hot water share the same pathophysiology. Nevertheless, abstinence from cannabis remains the most effective way of mitigating morbidity associated with CHS.

The objective is to study this phenomenom in our hospital and to alert of its existence in order to avoid a suspected misdiagnosis and overdiagnosis.

We report a case series of seven patients who attended the Emergency Room (ER) of a third level hospital located in Cantabria (Spain) where a psychiatric evaluation was demanded.

The reasons for consultation were agitation and/or compulsive vomit provocation and showers. They were all women, with a median age of 29 years (range 21 to 38), who all smoked cannabis and in probable high doses (seven to up to twenty joints per day, information was missing in three of the patients) and probable long duration of consumption (more than nine years up to twenty-three, information was missing in three of the patients).

One of the most striking findings is the time to diagnosis, being the median of years of more than eight (range from two to twenty-one). In all of the cases there is a hyperfrequentation to the ER for this reason (not counting other emergency centres we have in Cantabria which we don´t have access to), being the average of almost twenty-two times (thirteen up to thirty times), not diagnosing it until last visits. Another interesting fact is that Psychiatric evaluation is done approximately in a third of the visits, being the department that makes all of the diagnosis except in one case. In all of the cases there are a lot of diagnostic orientation doubts from different medical departments, being the two most common psychiatric misdiagnosis: Other Specified Anxiety Disorder and Other Specified Feeding or Eating Disorder. Two of the patients were hospitalized in an acute psychiatric unit for this reason, one of them nine times and the other patient, twice.

CHS has a very particular presentation which makes its recognition very simple. From our experience, it is an unknown entity for most of the doctors, something that needs to change in order to make a correct therapeutic management. Larger studies need to be done to make this findings more solid and for further information.

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Crisis resolution teams (CRTs) are a crucial component of mental health care, providing timely support to individuals experiencing acute mental health crises. This abstract delves into the concept of crisis and seeks to identify the patients who stand to benefit from these specialized services.

Defining crisis within the context of CRTs can be complex. It encompasses not only immediate emergencies but also broader mental health distress.

Research suggests that suitable candidates for CRT interventions are those facing acute mental health crises : This includes individuals experiencing suicidal ideation, severe agitation, or severe emotional distress.

La “Escala de Evaluación de Resolución de Crisis” (Crisis Resolution Team Assessment Tool, CRTAT) de Sonia Johnson es una herramienta diseñada para para medir la efectividad de los CRT y la duración de la intervención en crisis. Establece un límite de seis semanas como el período máximo durante el cual se debe ofrecer la atención en crisis.

Existen otras escalas de evaluación para medir la eficacia de la resolución de crisis:

1. 1. Escala de Intensidad de Crisis (CIS): se utiliza para medir la gravedad de la crisis y la necesidad de intervención inmediata.

2. 2. Escala de Evaluación de Crisis de Brage Hansen (BCES): se enfoca en la evaluación de crisis suicidas y evalúa la intensidad de la ideación suicida y la urgencia de la intervención.

3. 3. Escala de Evaluación de Crisis de Eriksson (ECAS): Diseñada para evaluar la intensidad de la crisis en pacientes psiquiátricos, la ECAS se centra en la agitación, la ansiedad y la angustia emocional.

- Studies have explored the effectiveness of CRTs and the perspectives of service users. Understanding how patients perceive crisis and CRT services is crucial for tailoring interventions effectively.

- CRTs play a vital role in mental health care, offering timely support to individuals experiencing crises. While defining crisis is complex, suitable candidates often include those in acute distress requiring immediate intervention. Understanding the perspectives of service users and the diverse nature of crisis experiences informs effective crisis resolution strategies.

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Men and women with psychosis have different courses and presentations of symptoms. Men with psychosis have an earlier onset of illness, more negative symptoms, and worse premorbid functioning. Women, on the other hand, have better social functioning and less substance abuse. Despite these evident differences, there are few studies that delve into these distinctions, especially from a subjective perspective.

The aim of this study is to understand the differences in the perception of psychosis between men and women.

Five women and five men diagnosed with schizophrenia participated in the study. They were matched so that the age difference between them was no more than 5 years, with ages ranging from 40 to 56 years. Participants had not experienced acute decompensation of their underlying illness and had not required admission to an Acute Care Unit in the 6 months prior to inclusion in the study. Data collection was conducted through the Spanish translation of the Indiana Psychiatric Illness Interview, consisting of five parts: a narrative about their life, a narrative about the illness, questions related to how the illness has changed their life and what has not changed, the overall influence of the illness on their life, and lastly, expectations for the future.

Men expressed more concerns about work (4 men versus 2 women), while women expressed more concerns about not having become mothers (3 out of 5 women, compared to one man). All participants shared experiences of isolation in intimate relationships, including romantic relationships. Regarding stigma, three women believed that people treated them like children and dismissed their opinions. However, two of them viewed this behavior from their loved ones positively. Two women discussed the impact that psychosis and medications had on their bodies and how others had reacted to these changes

The concerns and stigma associated with mental illness differ between genders. These differences should be taken into account when developing specific biopsychosocial treatment plans.

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