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The use of long-acting treatments is a common clinical practice in psychiatry. No disease insight and the risk of treatment discontinuation in a significant portion of our patients, increase the demand for psychiatric emergency and hospital admissions. Treatment adherence must be facilitated, taking into account possible side effects and patient´s subjective satisfaction.
-Evaluate the type of long-acting intramuscular treatment in selected patients. -Evaluate the differences in treatment satisfaction between different types of long-acting intramuscular treatments as well as frequency of psychiatric emergency and hospital admissions in the last year.
We select patients with different severe mental disorders who stay in a Medium Stay Unit, Sociosanitary Community Residence, Supervise house and Residence for the elderly in Albacete (Spain); all of them, with intramuscular neuroleptic treatment (zuclopenthixol dihydrochloride, aripiprazole long acting, palmitate paliperidone monthly, 3-monthly and 6-monthly) at least 1 year.
We evaluate their sociodemographic characteristics, the satisfaction questionnaire with the treatment (TSQM-9) and the rate of psychiatric emergencies and admissions after current intramuscular treatment in last year.
We have selected 57 patients with an average age of 45.86. 78.94% with a diagnosis of schizophrenia, 12.28% with schizoaffective disorder, 5.26% bipolar disorder and 3.5% unspecified psychotic disorder.
We can see in the graphics below that the longer duration of the intramuscular treatment, the greater satisfaction in all the items of the TSQM-9 questionnaire.
31% of the patients with zuclopenthixol dihydrochloride treatment, have gone to psychiatric emergencies and 28% of psychiatric admissions in the last year.18% of the patients with aripiprazole long acting, 17% with paliperidone palmitate long acting-monthly and 12% de 3-monthly have gone to psychiatric emergencies and 15%, 12% and 12% needed psychiatric admissions respectively. Patients with palmitate long acting-monthly have not emergencies or psychiatric admissions in the last year.
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- The longer long acting of the intramuscular treatments, the better patient satisfaction.
- With the longer duration treatment (Palmitate paliperidone LD 6 month), we have lower psychiatric emergencies and hospital admissions.
None Declared
Generalized anxiety disorder (GAD) is one of the most common mental disorders in adults. Psychotherapies are among the most recommended treatment choices for GAD, but which should be considered as first-line treatment still needs to be clarified.
To examine the most effective and accepted psychotherapy for GAD both in the short and long-term, via a network meta-analysis.
We searched MEDLINE, Embase, PsycINFO, and the Cochrane Register of Controlled Trials – CENTRAL, from database inception to January 1st, 2023, to find randomized controlled trials (RCTs) of psychotherapies for GAD. Eight psychotherapies (behaviour therapy, cognitive-behaviour therapy, cognitive restructuring, psychoeducation, psychodynamic therapy, relaxation therapy, supportive psychotherapy, and third-wave CBTs) were compared with each other and two control conditions (treatment as usual, waiting list). We followed Cochrane standards when extracting data and assessing data quality and used PRISMA guidelines for the reporting. We conducted random-effects model pairwise and network meta-analyses. We assessed risk of bias of individual studies through the second version of the Cochrane’s Risk of Bias tool and used the Confidence in Network Meta-Analysis (CINeMA) to rate certainty of evidence for meta-analytical results. Severity of GAD symptoms and acceptability of the psychotherapies were our outcomes of interest.
We analysed data from 66 RCTs. Effect size estimates on data from 5,597 participants suggest third wave cognitive-behavioural therapies (standardized mean differences [SMDs] =-0.78; 95%CI=-1.19 to -0.37; certainty=moderate), cognitive-behavioural therapy (CBT) (SMD=-0.68; 95%CI=-1.05 to -0.32 certainty=moderate), and relaxation therapy (SMD=-0.54; 95%CI=-1.04 to -0.05; certainty=low) reduced generalized anxiety symptoms more than treatment as usual (TAU). Relative risks for all-cause discontinuation signalled no differences compared with TAU for all psychotherapies. When excluding studies at high risk of bias, relaxation therapy lost its superiority over TAU. When considering anxiety severity at three to twelve months after completion of the intervention only CBT remained significantly more efficacious than TAU (SMD=-0.58; 95%CI=-0.93 to -0.23).
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Given the evidence for both acute and long-term efficacy, CBT may represent the reasonable first-line psychological treatment for GAD. Third-wave CBT and relaxation therapy have short-term efficacy and may also be offered. Results from this investigation should inform patients, clinicians, and guidelines. This project is funded by the European Union’s HORIZON EUROPE research programme under grant agreement No 101061648.
None Declared
The aim of this paper is to study supersoluble skew braces, a class of skew braces that encompasses all finite skew braces of square-free order. It turns out that finite supersoluble skew braces have Sylow towers and that in an arbitrary supersoluble skew brace B many relevant skew brace-theoretical properties are easier to identify: For example, a centrally nilpotent ideal of B is B-centrally nilpotent, a fact that simplifies the computational search for the Fitting ideal; also, B has finite multipermutational level if and only if 
$(B,+)$ is nilpotent.
Given a finite presentation of the structure skew brace 
$G(X,r)$ associated with a finite nondegenerate solution of the Yang–Baxter equation (YBE), there is an algorithm that decides if 
$G(X,r)$ is supersoluble or not. Moreover, supersoluble skew braces are examples of almost polycyclic skew braces, so they give rise to solutions of the YBE on which one can algorithmically work on.
Palygorskite in Miocene mudstones, palustrine limestones and calcretes from the Esquivias locality (Madrid Basin, Spain) has been analyzed by X-ray diffraction, infrared spectroscopy, scanning electron microscopy, transmission electron microscopy and analytical electron microscopy to determine its characteristics and chemical composition. Other palygorskites from the literature are used as references. The mean structural formula obtained from the analysis of isolated particles is (Si7.87Al0.13)O20(
)(OH)2(OH2)4(Ca0.02K0.05Na0.08). This palygorskite has the largest Mg content reported in the literature, and it seems that, chemically, it fills the ‘compositional gap’ existing between sepiolite and palygorskite. Infrared spectroscopy reveals the absence of trioctahedral Mg and therefore the possibility of the existence of magnesic clusters in the ribbons is discounted. An homogeneous distribution of the octahedral cations (Al, Fe3+ and Mg) along the ribbons is proposed.
