3 results
A descriptive case-register study of delusional disorder
- Enrique de Portugal, Nieves González, Josep M. Haro, Jaume Autonell, Jorge A. Cervilla
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- Journal:
- European Psychiatry / Volume 23 / Issue 2 / March 2008
- Published online by Cambridge University Press:
- 16 April 2020, pp. 125-133
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Objective
A few empirically based studies' data on delusional disorder (DD) exist. We aim to describe sociodemographic and clinical correlates of DD and to identify clinical profiles associated to DD and its subtypes.
MethodsThis is a case-register study based on all those subjects attending community mental health services within a geographically well-defined area. Four hundred and sixty-seven patients had been diagnosed as DD cases at psychiatric services serving a catchment area of some 607,494 inhabitants living in South Barcelona (Spain) during a three-year period (2001–2003). A thorough systematic review of computerised medical records was used to establish DSM-IV diagnosis, rendering a valid sample of 370 patients who fulfilled DSM-IV criteria for DD. Independent variables gathered include sociodemographic data, family and personal psychiatric history, and comorbid diagnoses on all DSM-IV axes (including GAF). We used descriptive and univariate statistical methods to explore sample frequencies and correlates across DD types.
ResultsThe mean age of the patients was 55 years and the sample had a mean GAF score of 51 suggesting a poor functionality; 56.5% of the patients were female. The most frequent DD types were persecutory (48%), jealous (11%), mixed (11%) and somatic (5%), whilst 23% qualified for the NOS type. Most frequent symptoms identified were self-reference (40%), irritability (30%), depressive mood (20%) and aggressiveness (15%). Hallucinations were present in 16% of the patients (6% tactile; 4% olfactory). Nearly 9% had a family history of schizophrenia (higher among those with the jealous subtype) and 42% had a comorbid axis II diagnosis (mostly paranoid personality disorder). Depression was significantly more frequent among the persecutory and jealous types. Finally, global functioning was significantly better among jealous and mixed types and worse amongst erotomanic and grandiose cases (p = 0.008).
ConclusionsIn the absence of other similar empirical data, this modest study provides unique empirical evidence of some clinical and risk correlates of DD and its subtypes.
Burden of chronic physical conditions and mental disorders in primary care
- Anna Fernández, Juan Ángel Bellón Saameño, Alejandra Pinto-Meza, Juan Vicente Luciano, Jaume Autonell, Diego Palao, Luis Salvador-Carulla, Javier García Campayo, Josep Maria Haro, Antoni Serrano, the Dasmap investigators
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- Journal:
- The British Journal of Psychiatry / Volume 196 / Issue 4 / April 2010
- Published online by Cambridge University Press:
- 02 January 2018, pp. 302-309
- Print publication:
- April 2010
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Background
The World Health Organization (WHO) has stated that the three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depression and ischaemic heart disease.
AimsTo estimate health-related quality of life (HRQoL) and quality-adjusted life-year (QALY) losses associated with mental disorders and chronic physical conditions in primary healthcare using data from the diagnosis and treatment of mental disorders in primary care (DASMAP) study, an epidemiological survey carried out with primary care patients in Catalonia (Spain).
MethodA cross-sectional survey of a representative sample of 3815 primary care patients. A preference-based measure of health was derived from the 12-item Short Form Health Survey (SF–12): the Short Form–6D (SF–6D) multi-attribute health-status classification. Each profile generated by this questionnaire has a utility (or weight) assigned. We used non-parametric quantile regressions to model the association between both mental disorders and chronic physical condition and SF–6D scores.
ResultsConditions associated with SF–6D were: mood disorders, β =−0.20 (95% CI −0.18 to −0.21); pain, β = −0.08 (95%CI −0.06 to −0.09) and anxiety, β =−0.04 (95% CI −0.03 to −0.06). The top three causes of QALY losses annually per 100 000 participants were pain (5064), mood disorders (2634) and anxiety (805).
ConclusionsEstimation of QALY losses showed that mood disorders ranked second behind pain-related chronic medical conditions.
Estudio descriptivo de un registro de casos de trastorno delirante
- Enrique de Portugal, Nieves González, Josep M. Haro, Jaume Autonell, Jorge A. Cervilla
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- Journal:
- European Psychiatry (Ed.Española) / Volume 15 / Issue 5 / June 2008
- Published online by Cambridge University Press:
- 12 May 2020, pp. 228-236
- Print publication:
- June 2008
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Objetivo.
Hay pocos datos publicados de estudios empíricos sobre el trastorno delirante (TD). Intentamos describir las correlaciones sociodemográficas y clínicas del TD e identificar los perfiles clínicos asociados con el TD y sus subtipos.
Métodos.Éste fue un estudio de registro de casos basado en todos los sujetos que acudían a los servicios de salud mental de la comunidad en un área geográficamente bien definida. Cuatrocientos sesenta y siete pacientes habían sido diagnosticados de TD en los servicios psiquiátricos de un área de 607.494 habitantes, aproximadamente, que vivían en el Sur de Barcelona (España) durante un período de tres años (2001-2003). Se hizo una revisión sistemática cuidadosa de historias médicas computarizadas para establecer el diagnóstico de DSM-IV, obteniéndose una muestra válida de 370 pacientes que cumplieron los criterios de TD del DSM-IV. Las variables independientes recogidas fueron datos sociodemográficos, historia psiquiátrica personal y familiar, y diagnósticos de enfermedades coexistentes en todos los ejes del DSM-IV, incluido el GAF. Usamos métodos estadísticos descriptivos y univariantes para explorar las frecuencias de la muestra y las correlaciones a través de los tipos de TD.
Resultados.La edad media de los pacientes era 55 años y la muestra tenía una puntuación media de GAF de 51 que indicaba baja funcionalidad; el 56,5% de los pacientes eran mujeres. Los tipos de TD más frecuentes eran persecutorio (48%), celotípico (11%), mixto (11%) y somático (5%), mientras que el 23% era del tipo no especificado (NOS). Los síntomas más frecuentes identificados fueron autorreferencia (40%), irritabilidad (30%), ánimo depresivo (20%) y agresividad (15%). Sufrían alucinaciones el 16% de los pacientes (el 6% táctiles; el 4% olfativas). Casi el 9% tenía antecedentes familiares de esquizofrenia (mayor en los del subtipo celotípico) y el 42% tenían otro diagnóstico coexistente del eje II (trastorno de personalidad, sobre todo, paranoide). La depresión era significativamente más frecuente en los tipos persecutorio y celotípico. Finalmente, el funcionamiento global era significativamente mejor en los tipos celotípicos y mixtos y peor en los tipos erotomaníaco y grandioso (p=0,008).
Conclusiones.En ausencia de otros datos empíricos similares, este estudio limitado proporciona evidencias empíricas únicas de algunas correlaciones clínicas y de riesgo del TD y sus subtipos.