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Suicide attempts (SA) leading to highly lethal consequences have been associated with heightened suicide planning (Barker et al., 2022), along with deficits in social cognition (Levi-Belz et al., 2022). Hypomentalizing, characterized by excessive uncertainty regarding mental states, may contribute to heightened social withdrawal and an increased risk of SA (Nestor & Sutherland, 2022). Although certain studies have identified a connection between hypomentalizing profiles and self-harm (Badoud et al., 2015), research into the lethality of SA remains limited.
Objectives
This study aimed to explore the association between hypomentalizing and SA lethality.
Methods
Our study encompassed a cohort of 1,371 patients who committed a SA. We conducted assessments of mentalizing using the RFQ-8 instrument, and evaluations of suicidal ideation and behavior employing the CSRSS questionnaire. Demographic and clinical characteristics were compared using the T-student and Chi-square tests. To investigate the relationship between hypomentalizing and the SA lethality, we employed logistic regression models.
Results
Descriptive date are presented in Table 1. Our results show that hypomentalizing do not predict a higher SA lethality. Additionally, hypomentalizing increased the risk of SA planning (p≤0.001, B=-0.182), and SA planning predicted a higher SA lethality (see Table 2).Table 1.
Means Comparison for low and high lethality (N=1371)
Low lethality N=539
High lethality N=832
p value
Effect size
Age, mean (SD)
38.65 (15.65)
41.91 (15.37)
≤0.001
-0.209a
Female sex, N (%)
392 (72.7)
571 (68.6)
0.116
0.044b
Educational years, mean (SD)
12.45 (2.99)
12.43 (3.41)
0.890
0.0076a
Employed, N (%)
220 (41.2)
332 (40)
0.692
0.012b
Suicide Ideation, N (%)
475 (88.1)
742 (89.2)
0.541
0.016b
Suicide Planning, N (%)
159 (39.2)
400 (58.1)
≤0.001
0.183b
Number of attempts, mean (SD)
3.28 (5.48)
3.63 (5.74)
0.269
-0.169a
RFQ, mean (SD)
4.68 (1.27)
4.56 (1.32)
0.087
0.095a
Table 2.
Logistic regression analyses for high SA lethality (N=1371).
Univariate analysis
Multivariate analysis
OR
p value
OR
p value
Age
1.014 (1.007-1.021)
≤0.001
1.014 (1.005-1.022)
0.001
Female sex
0.820 (0.646-1.042)
0.105
Educational years
0.998 (0.965-1.031)
0.890
Employed
0.952 (0.763-1.187)
0.660
Suicide ideation
1.111 (0.790-1.562)
0.545
Suicide planning
2.150 (1.674-2.761)
≤0.001
2.183 (1.697-2.808)
≤0.001
Number SA
1.012 (0.990-1.034)
0.277
RFQ
0.929 (0.854-1.011)
0.088
Conclusions
While the association between hypomentalizing and high SA lethality was not significant, a discernible trend toward such relationship can be noted. Further studies examining the moderating effects of planning in the association between hypomentalizing and SA lethality are required.
A commonly used confrontation naming task used in the United States is The Boston Naming Test (BNT). Performance differences has been found in Caucasian and ethnic minorities on the BNT. The Cordoba Naming Test (CNT) is a 30-item confrontation naming task developed in Argentina. Past research has shown acculturation levels can influence cognitive performance. Furthermore, one study evaluated geriatric gender differences on CNT performance in Spanish. Researchers reported that older male participants outperformed female participants on the CNT. To our knowledge, researchers have not evaluated ethnic differences on the CNT using a geriatric sample. The purpose of the present study was to examined CNT performance and acculturation in a Latinx and Caucasian geriatric sample. It was predicted the Caucasian group would outperform the Latinx group on the CNT. Moreover, the Caucasian group would report higher acculturation levels on the Abbreviated Multidimensional Acculturation Scale (AMAS) compared to the Latinx group.
Participants and Methods:
The sample consisted of 9 Latinx and 11 Caucasian participants with a mean age of 66.80 (SD =6.10), with an average of 14.30 (SD = 2.00) years of education. All participants were neurologically and psychologically healthy and completed the CNT and the AMAS in English. Acculturation was measured via the AMAS English subscales (i.e., English Language, United States. Identity, United States, Competency). A series of ANCOVAs, controlling for years of education completed and gender, was used to evaluate CNT performance and acculturation.
Results:
The ethnic groups were not well demographically matched (i.e., years of education and gender).We found that the Caucasian group outperformed the Latinx group on CNT performance p = .012, ηp 2 = .34. Furthermore, the Caucasian group reported higher acculturation levels (i.e., English Language, United States, Identity, United States, Competency) compared to the Latinx group p’s < .05, ηps2 = .42-.64.
Conclusions:
To our knowledge, this is the first study to evaluate CNT performance between ethnic groups with a geriatric sample. As expected the Caucasian group outperformed the Latinx group on the CNT. Also, as expected the Caucasian group reported higher English acculturation levels compared to the Latinx group. Our findings are consistent with past studies showing ethnic differences on confrontational naming performance (i.e., The Boston Naming Test), favoring Caucasians. A possible explanation for group differences could have been linguistic factors (e.g., speaking multiple languages) in our Latinx group. Therefore, since our Latinx group reported lower levels of English Language, United States identity, and United States competency the Latinx group assimilation towards United States culture might of influence their CNT performance. Future studies with different ethnic groups (e.g., African-Americans) and a larger sample size should examine if ethnic differences continue to cross-validate in a geriatric sample.
More than one-third of American adults fail to achieve the 7–9 hours of sleep recommended by the American Academy of Sleep Medicine and the Sleep Research Society needed for optimal health and well-being. In addition to primary sleep disorders, such as sleep apnea, insomnia, and restless legs syndrome, many modern societal factors are also thought to contribute to chronic sleep deficiency, such as technology and work-related factors. Interruptions in the natural sleep–wake cycle can be associated with shift work and numerous chronic health conditions. A few studies have investigated the impact of nonstandard shift work on male reproductive health, and a compelling association between sleep and male urogenital health has been demonstrated. This chapter will review the literature on the effect of sleep and shift work on ED, LUTS, hypogonadism, male infertility, and how improved sleep quality can possibly improve common men’s health conditions.
To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.
Methods
This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).
Results
Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.
Conclusions
TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.
Objectives
The aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.
Methods
A sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.
Results
Two classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).
Image:
Conclusions
We found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.
The SARS-CoV-2 pandemic has produced an unprecedented clinical situation, causing a direct and indirect impact on the physical and mental health of the population. In Spain, between March 15 and June 21 of 2020, it was decreed a home confinement that caused the interruption of the daily life of millions of people. However, there are few studies that analyze the changes produced in psychiatric care in the Emergency Department (ED).
Objectives
To analyze the changes produced in psychiatric emergencies, subanalysing paediatric population, during the first year of the pandemic (COV1/Y-COV1) compared to the previous year (NOCOV/Y-NOCOV1). To analyze the clinical features of patients attended during the lockdown period of the pandemic (LOCK) and compare it to the period of the pandemic after the lockdown (NOLOCK).
Methods
Through the registry of computerized medical records, patients who attended the psychiatric hospital emergency department between 03/01/2019 and 02/28/2021 were identified. We also identified all attendances from 15/03 to 21/06 in 2019 and in 2020 to obtain variables from the lockdown period.
Results
During period of this study, 2694 psychiatric visits made in the ED (1744 patients - 54.3% women, and 69.5% were between 25 and 64 years-), 1537 in NOCOV and 1157 in COV1. Significant differences were found between COV1 and NOCOV in sociodemographic variables, such as employment status and number of offspring. At a clinical level, in COV1, we observed an increase in attendance due to heteroaggressive behaviors, mania, insomnia and problems due to substance use. An increase in the prescription and/or modification of treatment was observed (59.3% vs 54.3%). During COV1, in terms of discharge follow-up in the month following the ED visit, telematic assistance increased (11.4% vs. 5.3%). During the period of study, 282 ED attendances were performed, 153 in Y-NOCOV and 129 in Y-COV1. At a clinical level, during Y-COV1, a decrease in attendances related to substance use was found significant. The sub-analysis carried out for LOCK and NOLOCK yields similar data to those obtained in the COV1 vs. NOCOV1 comparison. During lockdown, the face-to-face follow-up in the month following the ED was significantly lower (39,5% vs 57,1%) regarding telematic follow-up (24,4% vs 5,8%) In this period, an increase of adolescents without previous mental health follow-up was observed (44% LOCK vs. 22% NOLOCK).
Conclusions
Our work supports the hypothesis that the COVID-19 pandemic caused a change in psychiatric care in the ED. It also shows how lockdown changed the attendance in psychiatric emergencies, and also in the later community care attendance. Changes are detected in emergency care for adolescents during the pandemic compared to the previous year. Strikingly, our study does not reflect a quantitative increase in the demand. It would be of interest to continue collecting data after the time of the present project.
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods
8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results
4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
Conclusions
Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
The aim of this research communication was to examine and report the current situation of dairy farms in the province of Lugo (Galicia, Spain) regarding facility problems. We assessed the facilities of 168 free-stall dairy farms, housing in total 9228 Holstein cows in milk. Housing factors related to the resting area, circulation area, feeding area, ventilation area and milking area, as well as animal-handling features, were evaluated. Distance measurements were performed using a laser metre or a roll metric tape. A survey was conducted to gather information about cleaning and preventive protocols. Our results showed that most farms do not comply with the objective for cubicle measurements, width of the crossovers, type of flooring and presence of a quarantine pen, which may have a negative impact on the health and productivity of the animals. Therefore, to maximise the profits of the farm, the recommendations given in this study may be useful as a guide when building a new farm or remodelling the existing ones.
Suicidal behaviour and cognition: A systematic review with special focus on prefrontal deficits Introduction: Suicide is a major health concern worldwide, thus, identifying risk factors would enable a more comprehensive understanding and prevention of this behaviour. Neuropsychological alterations could lead to difficulties in interpreting and managing life events resulting in a higher risk of suicide.
Objectives
Objective: Bibliographic review about the influence of neuropsychological deficits on suicidal behaviour.
Methods
Method: A systematic literature search from 2000 to 2020 was performed in Medline (Pubmed), Web of Science, SciELO Citation Index, PsycInfo, PsycArticles and Cochrane Library databases regarding studies comparing cognition of attempters versus non-attempters that share same psychiatric diagnosis. Results: 1.885 patients diagnosed with an Affective Disorder (n = 1512) and Schizophrenia/ Schizoaffective Disorder (n = 373) were included.
Results
In general comparison, attention was found to be clearly dysfunctional. Regarding diagnosis, patients with Schizophrenia and previous history of suicidal behaviour showed a poorer performance in executive function. Patients with current symptoms of an Affective Disorder and a previous history of suicidal attempt had poorer performance in attention and executive function. Similarly, euthymic affective patients with history of suicidal behaviour had worse decision-making, attention and executive function performance compared to euthymic non-attempters.
Conclusions
Patients who have attempted suicide have a poorer neuropsychological functioning than non-attempters with a similar psychiatric disorder in attention and executive function. These alterations increase vulnerability for suicide.
Conflict of interest
Jessica Fernández-Sevillano is beneficiary of the Pre-PhD Training Programme of the Basque Government. Dr. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers
In Spain, consumption of psychotropic drugs is high and benzodiazepines represent 74% of the total. His prescription in primary care is very common and their use continues to grow. They are safe and effective drugs, but patients with prolonged use are elaborating the most adverse effects, particularly the dependency.
Desing
Descriptive ans cross-sectional.
Scope
Primary Health Care.
Subjects
We seleted 202 patients treated with benzodiazepines, consecutive sample, belonging to the health center Los Barrio who were seen in consultation during 2009.
Methods
We conducted through a questionnaire that cointained the treatment and demographic characteristics.
Results
We detect a frequency of use of benzodiazepines 9% (95% CI 4,7-12,1%). The profile of the consumer responds to middle-aged woman, with primary and housewives. Somatic diseases were associated in 72.6% (CI 67,2-77,5%) and had mental pathology at 59.7% (CI 53,9-65,3%). 35% (95% 29,6-40,6%) of prescribed benzodiazepines were clorazape dipotassium. Consumption was constant for over a year. The prescription from primary care represents 81% (95% 76,3-85,4%) and in 65% (CI 59,3-70,3%) is associated with other psychoactive drug.
Conclusions
In our area, highlights the prescription of benzodiazepines from primary care on demand and consumption during prolonged time. Interventions should be conducted on the prescription of benzodiazepines in medical and other interventions for patient support.
Course and outcome in schizophrenia are heterogeneous. Numerous studies have shown an association between the presence of negative symptoms and psychosocial and occupational functioning of patients.
Objectives
To analyse the prevalence of negative symptoms in the course of illness in first episode psychosis and chronic schizophrenia and to establish its relation with the functional outcome.
Methods
43 patients with a first-episode psychosis (FEP) from our area were compared with 43 chronic schizophrenic patients and 43 normal controls from a parallel area. They were matched one on one for age, gender and years of education. All subjects were compared regarding psychopathology and functional outcome terms. Patients were examined with Positive and Negative Syndrome Scale (PANSS) for clinical symptom. Longitudinal functionality was prospectively assessed with the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) rating scales.
Results
We found significant differences between FEP and chronic patients in negative symptom severity (t = -4.97, p< 0.001) and global assessment of functioning (t = 7.58, p< 0.001). There was no statistically significant difference between the two groups in PANSS positive and general components or Clinical Global Impression. Negative symptom severity was associated with poorer GAF ratings in first episode psychosis and chronic schizophrenia.
Conclusions
Negative symptoms appear to be persistent. In our study negative symptom severity was associated with social and functional impairment, defined as Global Assessment of Functioning Scale score of less than or equal to 60.
It is well stablished that therapeutic compliance is a fundamental predictive factor in the outcome of first-episode psychosis. Risperidone long-acting injection has demonstrated high remission rates and improvements in treatment adherence.
Objective
1- To analyse the efficacy of risperidone long-acting injection vs oral atypical antipsychotics in first-episode psychosis.
2- To describe in both groups the evolution of clinical and cognitive symptoms, functional outcome, quality of life, insight and treatment adherence.
Method
18 patients with a first-episode psychosis treated with long-acting risperidone were compared with 21 first-episode psychosis treated with oral atypical antipsychotic medication. They were matched one on one for age, gender and years of education. All subjects were compared regarding psychopathology and functional outcome terms. Patients were examined with Positive and Negative Syndrome Scale (PANSS) for clinical symptoms. Longitudinal functionality was prospectively assessed with the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) rating scales.
Results
We found significant differences between both groups in negative symptom severity and global assessment of functioning. There was no statistically significant difference between the two groups in PANSS positive and general components. Negative symptom severity was associated with poorer GAF ratings.
Conclusions
Our data suggest that risperidone long-acting injection assures treatment compliance and therefore could improve clinical and functional outcome.
CYP2D6 and CYP2C19 are involved in the metabolism of widely used antidepressants and other drugs with psychotropic activity. They also participate in the metabolism of endogenous substrates, and are expressed in the brain.
Objectives and Aims
This study examined, for the first time, whether a high CYP2D6-CYP2C19 metabolic capacity combination increases the likelihood of suicidal intent severity in a large study cohort.
Methods
Survivors of a suicide attempt (n=587; 86.8% women) were genotyped for CYP2C19 (*2, *17) and CYP2D6 (*3, *4, *4xN, *5, *6, *10, wtxN) genetic variation and evaluated with the Beck Suicide Intent Scale (SIS).
Results
Patients with a high CYP2D6-CYP2C19 metabolic capacity showed an increased risk for a severe suicide attempt (P<0.01) as measured by the SIS-objective circumstance subscale (odds ratio (OR)=1.37; 95% confidence interval (CI)=1.05-1.78; P=0.02). Importantly, the risk was greater in those without a family history of suicide (OR=1.82; CI=1.19-2.77; P=0.002).
Conclusions
Further research is warranted to evaluate whether the observed relationship is mediated by the role of CYP2D6 and CYP2C19 involvement in the endogenous physiology or drug metabolism or both.
Acknoledgments
This work was supported in part by Union Europea Fondo Social Europea (FEDER/FSE), Instituto de Salud Carlos III-FIS (PI10/02758) and Gobierno de Extremadura Consejería de Economía, Competitividad e Innovación (IB13186 and PD10199). CHU Montpellier (PHRC UF 7653), Agence Nationale de la Recherche (ANR NEURO 2007 'GENESIS').
Those suicide attempters that choose violent methods dramatically diminish the possibility of survival. Completed suicide using violent means, which appears common among first-time suicide attempters, was recently found to be more likely among T allele carriers in the three most common ABCB1SNPs, encoding for P-gp.
Objectives and Aims
This study examined, for the first time, whether the ABCB1(C1236T, G2677T/A, C3435T) SNPs were associated with the use of violent means among survivors of a suicide attempt.
Methods
Suicide attempters (n=578, 87.4% women; of whom 16.6% committed a violent intent) were genotyped for ABCB1C1236T, G2677T/A, C3435T. The relations of the three genotypes and of the TTT haplotype with the use of a violent suicide method were evaluated separately. The impact of confounds on these variables was controlled.
Results
A higher frequency (p=0.02) of suicide attempters using violent methods was found among those carrying the ABCB1haplotype (1236TT-2677TT-3435TT). Since gender and number of previous suicide attempts were identified as confounds, the relation was tested in the subset of women who were first-time attempters or second- and more-time attempters. The ABCB1 haplotype increased the risk more than three times in those women attempting a violent suicide for the first time (OR=3.6; CI95%:1.08-12.09; p=0.04).
Discussion
The ABCB1haplotype (1236TT-2677TT-3435TT) was related to the use of a violent suicide attempt method. Genotyping for these three ABCB1SNPs may be helpful to detect people at risk of first suicide intents using violent methods.
Acknowledgments
FEDER/FSE-GOBEX Consejería Economía, Competitividad e Innovación IB13186 and PD10199.
The Eiffel study is a longitudinal, naturalistic study of patients with first episode psychosis (FEP) designed to evaluate the predictive value of defective insight on treatment adherence and global functioning.
Methods
Five hundred seventy-seven patients with FEP were assessed at baseline and at a 1-year follow-up. They were compared in terms of sociodemographic factors, psychopathology, insight, treatment adherence and functional outcome. Longitudinal functionality was prospectively assessed with the clinical global impression (CGI) and global assessment of functioning (GAF) rating scales.
Results
At baseline, up to 50% of our sample presented with a lack of insight. Most clinical symptoms, including insight, improved over the follow-up period. Insight, education and social withdrawal significantly predicted CGI and GAF at follow-up. Insight and level of education were predictive of treatment adherence.
Conclusions
Insight significantly predicted the general clinical course, treatment adherence and functional outcome in our FEP sample after 1 year. Only education additionally accounted for the longitudinal course. Since our results suggest that better insight improves treatment adherence and consequently clinical course and functional outcome, insight could be a specific target of treatment in early intervention programs.
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
Methods
In the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
Results
Fifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
Conclusion
Results show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
Quality tools for the assessment of social and functional participation in patients suffering from fibromyalgia are few and far between. The Fibromyalgia Participation Questionnaire (FPQ) achieves reliable results in its original version in German and this project aims to achieve a translated, culturally adapted and validated version of it in Spanish.
The questionnaire has been translated according to the FACIT methodology and tested at the Unidad de Gestión Clínica de Salud Mental (mental health department) in North Almería. Once the preliminary tests were carried out, the final version of the questionnaire was created. The final version underwent a validation process, during which its psychometric properties were analysed, and its reliability evaluated through internal consistency and test-retest, Cronbach's alpha and Pearson's correlation coefficient. Several different types of validity were also analysed including external validity, construct and convergent validity estimated using correlation coefficients, content validity using empirical evaluation and discriminant validity using a DIF analysis. Floor and ceiling effects were also evaluated. The process in its entirety has been approved by the Comité Ético de Investigación Clínica (research ethics committee for clinical investigation) in Almería.
The validation of the FPQ into different languages will provide medical professionals with a new tool for the assessment of patients with fibromyalgia, which will allow for improved treatment methods based on results.
When cognitive decline (CD) is present, attention is one of the impaired mental functions. CD is also associated with anxious/depressive symptoms and with some demographic variables, particularly, age.
Objectives
Investigate the associations between selective attention (Stroop Test: Stroop_Word, Stroop_Color, Difference between Stroop_Word and Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color and Difference between Stroop Ratio_Word and Stroop Ratio_ Color) and CD (Montreal Cognitive Assessment/MoCA) in institutionalized elders; explore the predictive value of Stroop variables for CD, controlling anxious/depressive symptoms and sociodemographic variables.
Methods
140 institutionalized elders (mean age, M = 78.4, SD = 7.48, range = 60-97) voluntarily answered to sociodemographic questions, the MoCA, the Geriatric Anxiety Inventory/GAI, the Geriatric Depression Scale/GDS and Stroop test.
Results
73 elders (52, 1%) had CD. Dichotomized MoCA was associated with Stroop_Word, Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color, GDS and the sociodemographic variable schooling × profession. Age and education were not tested, since MoCA was stratified according to those variables. GDS, Stroop Ratio_Word and Stroop Ratio_Color showed to predict CD.
Conclusions
There was an association between Stroop_Word, Stroop_Color, Stroop Ratio_Word and Stroop Ratio_Color and CD, confirming that selective attention is smaller when the elderly reveal CD. GDS and CD were, also, associated. However, there was no association between MoCA dichotomized and differences between the correct answers (Stroop_Word and Stroop_Color) and Ratios (Stroop Ratio_Word and Stroop Ratio_Color). Selective attention and depressive symptoms predicted CD. It would be important to intervene through cognitive rehabilitation with the elders to improve their attention.
Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples.
Objectives
To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n = 97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome.
Method
The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45 minutes each. Data on patients’ personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis.
Results
The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence.
Conclusion
Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients’ sex, comorbid symptom levels and the personality-trait profiles play a central role.