Revista de Psiquiatría y Salud Mental (English Edition)最新文献

英文中文

Suicidal behaviour recurrence in psychiatric emergency departments of patients without a prior suicide attempt, index and reattempters: A prospective study 精神科急诊科无自杀企图患者的自杀行为复发、指数和再企图者:一项前瞻性研究

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2018.07.002

José Javier López-Goñi , Adriana Goñi-Sarriés , Leire Azcárate-Jiménez , Pablo Sabater-Maestro

Introduction

There has been little change in the incidence of suicidal behaviour and reattempts in recent years. Evidence is needed on the incidence of suicidal behaviour in the psychiatric population and its follow-up.

Material and method

A prospective multi-centre case–control study. The sample covered the cases of 440 patients seen as psychiatric emergencies. For this purpose, we used the Vital Adverse Event Scale by Brugha and screening with the Columbia Scale. The sample was divided into three groups: patients without prior suicide attempts, patients with an index attempt and patients with more than one attempt. At two years, the clinical histories of these patients were reviewed, assessing for suicidal behaviour.

Results

A total of 49.1% (n = 216) of the patients required urgent psychiatric care during the follow-up period, and 2.7% eventually committed suicide. The data shows a differential profile between the three groups analysed. Among them, the group of reattempters required the highest number of interventions regarding suicide behaviour (11.0%; χ² = 30.3; d.f. = 2; p < .001). Eventually, 6.1% of the patients without prior suicide attempts tried to commit suicide for the first time, and 21.7% (n = 60) of the remaining sample repeated their prior attempts. The highest risk of attempt was in the thirty days following the urgent intervention. After this period, risk distribution varied for each group. Three items from the Columbia Scale predict suicide behaviour.

Conclusions

The results show the need for assessing suicidal behaviour for all patients who receive psychiatric urgent care, including during the follow-up period. A more thorough control should be performed during the first months for patients without prior suicide attempts, and longer periods for those patients who have already tried to commit suicide.

近年来，自杀行为和再企图的发生率几乎没有变化。需要关于精神科人群自杀行为发生率及其随访的证据。材料与方法前瞻性多中心病例对照研究。样本涵盖了440名被视为精神紧急情况的患者。为此，我们采用Brugha的严重不良事件量表，并采用Columbia量表进行筛选。样本被分为三组:没有自杀企图的患者，有过多次自杀企图的患者和有过多次自杀企图的患者。两年后，对这些患者的临床病史进行回顾，评估其自杀行为。结果共有49.1% (n = 216)的患者在随访期间需要紧急精神科护理，其中2.7%最终自杀。数据显示了被分析的三组之间的差异。其中，再企图者对自杀行为干预的要求最高(11.0%;χ2 = 30.3;d.f = 2;p & lt;措施)。最终，6.1%之前没有自杀企图的患者第一次尝试自杀，21.7% (n = 60)的剩余样本重复了他们之前的自杀企图。在紧急干预后的30天内，企图自杀的风险最高。在此之后，每个组的风险分布有所不同。哥伦比亚量表中的三个项目可以预测自杀行为。结论对所有接受精神科紧急护理的患者，包括随访期间，都需要评估自杀行为。对于之前没有自杀企图的患者，应在头几个月内进行更彻底的控制，而对于那些已经试图自杀的患者，应进行更长的时间控制。

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引用次数: 0

Suicide and dementia: Systematic review and meta-analysis 自杀和痴呆:系统回顾和荟萃分析

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2020.04.006

Francisco Javier Álvarez Muñoz , María Rubio-Aparicio , Pedro Gurillo Muñoz , Ana María García Herrero , Julio Sánchez-Meca , Fernando Navarro-Mateu

Introduction

To analyze the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and/or completed suicides.

Methods

Systematic review and meta-analysis. Selection criteria: studies that analyzed the relationship between dementia and suicide. Search strategy: (i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; (ii) manual search of the bibliography of selected articles; (iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I² index. Assessment of publication bias using funnel plots (“trim-and-fill” method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model.

Results

37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR = 1.37 (95% CI: .78–2.39); Suicide Attempt: OR = 2.24 (95% CI: 1.01–4.97); and Completed Suicide: OR = 1.28 (95% CI: .77–2.14). Possible publication bias was ruled out.

Conclusions

A trend toward suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events.

目的:分析老年人痴呆与随后发展的自杀意念、自杀企图和/或自杀未遂之间的可能关系。方法系统回顾和荟萃分析。选择标准:分析痴呆和自杀之间关系的研究。检索策略:(i) 2018年12月前在PubMed、EMBASE、CINAHL、IME和Lilacs中检索;(ii)人工检索选定文章的参考书目;(iii)与主要作者联系。根据预先确定的方案进行文章选择和数据提取，包括偏倚风险评估，由独立的同行审稿人进行。效应大小指数采用比值比(OR)及其95%置信区间(随机效应模型)计算。采用森林样地、Cochran’s Q和I2指数评价异质性。使用漏斗图(“修剪-填充”方法)和Egger检验评估发表偏倚。在混合效应模型下，采用多元元回归分析调节变量。结果共纳入37项研究，47个基本研究单元。痴呆与自杀意念相关的效应量OR = 1.37 (95% CI: 0.78 - 2.39);自杀企图:OR = 2.24 (95% CI: 1.01-4.97);完成自杀:OR = 1.28 (95% CI: 0.77 - 2.14)。排除了可能的发表偏倚。结论痴呆患者存在自杀倾向，尤其是自杀未遂。在最近诊断出痴呆后，建议给予更多的关注和护理，特别是对可能影响自杀事件发生和结果的合并症进行充分评估。

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引用次数: 4

Suicide. The post-COVID era: A time for action 自杀。后covid时代:行动的时刻

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2020.10.001

Alicia Padron-Monedero , Isabel Noguer-Zambano , Teresa Gómez García , Rodrigo Sarmiento Suárez , Julio Bobes , Margalida Gili , Victor Pérez , Miquel Roca , Jeronimo Saiz-Ruiz

引用次数: 0

Emotional and behavioural difficulties and prosocial behaviour in adolescents: A latent profile analysis 青少年的情绪和行为困难与亲社会行为:一个潜在的特征分析

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2020.01.003

Eduardo Fonseca-Pedrero , Javier Ortuño-Sierra , Alicia Pérez-Albéniz

Introduction

The purpose of this study was to identify homogenous subgroups of adolescents with emotional and behavioural difficulties using latent profile analysis. The relationship between the latent profile classes and socio-emotional and school adjustment was also analysed.

Materials and methods

A total of 1506 students, 667 men (44.3%) were selected by random cluster sampling. The mean age was 16.15 years (SD = 1.36). The instruments used were the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Version, The 10-item Positive and Negative Affect Schedule for Children, the Prodromal Questionnaire-Brief, the Paykel Suicide Scale, the Cyberbullying-Brief Questionnaire, the Penn Matrix Reasoning Test, and the school performance assessment.

Results

A total of 7.7% of adolescents obtained risk scores for mental health difficulties. We identified 3 mental health subgroups named: Low risk, Externalizing, and Internalizing. These 3 latent classes demonstrated a differential pattern in terms of socio-emotional adjustment and academic performance.

Conclusions

To identify and validate risk groups of youths for emotional and behavioural problems allows implementing measures to promote emotional well-being and prevent mental health problems. Future studies should continue to analyse young people with emotional and behavioural problems longitudinally and to incorporate new forms of assessment and intervention.

本研究的目的是利用潜在特征分析来确定具有情绪和行为困难的青少年的同质亚组。分析了潜型班级与社会情绪适应和学校适应的关系。材料与方法采用随机整群抽样的方法，抽取学生1506人，其中男性667人，占44.3%。平均年龄16.15岁(SD = 1.36)。使用的工具有优势与困难问卷、个人幸福指数-学校版、10项儿童积极与消极影响量表、前驱行为问卷-简要、佩克尔自杀量表、网络欺凌简要问卷、佩恩矩阵推理测验和学校绩效评估。结果7.7%的青少年获得心理健康困难风险评分。我们确定了3个心理健康亚组:低风险、外化和内化。这三个潜在阶层在社会情绪适应和学业表现方面表现出不同的模式。结论识别和验证青少年情绪和行为问题的风险群体有助于实施促进情绪健康和预防心理健康问题的措施。今后的研究应继续对有情绪和行为问题的年轻人进行纵向分析，并纳入新的评估和干预形式。

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引用次数: 7

Divergent trends in suicide mortality by Autonomous Community and sex (1980–2016) 自治区、性别自杀死亡率差异趋势(1980-2016年)

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2019.07.003

Lucía Cayuela , Francisco José Pilo Uceda , Agustín Sánchez Gayango , Susana Rodríguez-Domínguez , Antonio Andrés Velasco Quiles , Aurelio Cayuela

Objectives

To analyse the changes in mortality trends by suicide according to Autonomous Community and sex in Spain during the period 1980–2016 using Joinpoint regression models.

Methods

Mortality data were obtained from the Instituo Nacional de Estadística. For each Spanish autonomous community and sex, crude and standardised rates were calculated. The joinpoint analysis was used to identify the best-fitting points where a statistically significant change in the trend occurred.

Results

The joinpoint analysis allows to differentiate areas in which the rates remain stable in men (Cantabria, Castilla-La Mancha) and women (Canary and Cantabria) throughout the study period and others with a continued decline (Extremadura in both men and women and Castilla-La Mancha in women). In those communities where changes in the trend are observed, in almost all of them, there is a first period of increase in rates in both men and women. The most recent trends show divergences between the different autonomous communities and, in men, Andalusia, the Canary Islands, Castilla-León, the Valencian Community, Galicia, Murcia, the Basque Country and La Rioja show significant downward trends, while Catalonia and Madrid show significant increases (2007–2016: 2.4% and 2010–2016: 18.7% respectively). Something similar is observed in women where Andalusia, Castilla y León, Valencian Community, Galicia, Murcia, País Vasco and La Rioja show downward trends while in the Balearic Islands, Catalonia and Madrid the trend is upward (2001–2016: 5.0%; 2006–2016: 4.2% and 2010–2016: 18.7% respectively).

Conclusions

Suicide mortality varies widely among the Spanish autonomous communities, both in terms of mortality level and trends. Little is known about the determinants of observed trends and, therefore, more studies are needed.

目的采用Joinpoint回归模型，分析1980-2016年西班牙自治区和性别自杀死亡率的变化趋势。方法死亡率数据来自国立卫生研究院Estadística。对每个西班牙自治区和性别，计算了粗比率和标准化比率。联结点分析用于确定趋势发生统计学显著变化的最佳拟合点。结合点分析可以区分在整个研究期间，男性(坎塔布里亚、卡斯蒂利亚-拉曼查)和女性(加那利和坎塔布里亚)的发病率保持稳定的区域，以及其他持续下降的区域(男女均为埃斯特雷马杜拉，女性为卡斯蒂利亚-拉曼查)。在观察到趋势发生变化的社区中，几乎所有这些社区的男女发病率都出现了第一个时期的上升。最近的趋势显示了不同自治区之间的差异，在男性方面，安达卢西亚、加那利群岛、Castilla-León、瓦伦西亚社区、加利西亚、莫尔西亚、巴斯克地区和拉里奥哈显示出显著的下降趋势，而加泰罗尼亚和马德里则显示出显著的增长(2007-2016年:2.4%，2010-2016年:18.7%)。在安达卢西亚、卡斯蒂利亚León、瓦伦西亚社区、加利西亚、穆西亚、País瓦斯科和拉里奥哈的妇女中也观察到类似的情况，而在巴利阿里群岛、加泰罗尼亚和马德里，这一趋势呈上升趋势(2001-2016年:5.0%;2006-2016年:4.2%，2010-2016年:18.7%)。结论西班牙各自治区的自杀死亡率在死亡率水平和趋势上差异很大。人们对所观察到的趋势的决定因素知之甚少，因此需要进行更多的研究。

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引用次数: 0

Prevention over prediction: The psychiatrist challenge of suicide risk assessment in the emergency department 预防胜于预测:精神病学家对急诊科自杀风险评估的挑战

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2019.12.001

Daniel Hernández-Calle , Gonzalo Martínez-Alés , Eva Román-Mazuecos , Beatriz Rodríguez-Vega , María Fe Bravo-Ortiz

引用次数: 0

Transitioning from the child and adolescent to the adult mental health services: An unresolved challenge and an opportunity 从儿童和青少年过渡到成人心理健康服务:一个未解决的挑战和机遇

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2020.06.002

Alberto Segura-Frontelo , Raquel Alvarez García , Violeta López de Lerma Borrué , Fabiola Rincón de los Santos , Enrique Baca-García

引用次数: 0

Stance of the Spanish Society of Psychiatry regarding the United Nations Convention on the Rights of Persons with Disabilities 西班牙精神病学学会对《联合国残疾人权利公约》的立场

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-10-01 DOI: 10.1016/j.rpsmen.2020.11.002

引用次数: 0

Effects of an integrative approach to bipolar disorders combining psychoeducation, mindfulness-based cognitive therapy and functional remediation: Study protocol for a randomized controlled trial 结合心理教育、正念认知疗法和功能修复的双相情感障碍综合治疗方法的效果:一项随机对照试验的研究方案

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-07-01 DOI: 10.1016/j.rpsmen.2020.05.001

Èlia Valls, José Sánchez-Moreno, C. Mar Bonnín, Brisa Solé, Mireia Prime-Tous, Imma Torres, Mercè Brat, Patricia Gavin, Ivette Morilla, Laura Montejo, Esther Jiménez, Cristina Varo, Carla Torrent, Diego Hidalgo-Mazzei, Eduard Vieta, Anabel Martínez-Arán, María Reinares

Introduction

Bipolar disorder is related to a high level of personal, familial, social and economic burden. There is a need for feasible adjunctive psychological interventions easy to implement in clinical practice in order to enhance aspects that medication alone cannot achieve. This study aims to evaluate the impact of a 12-session adjunctive integrative program designed for patients with bipolar disorder.

Methods

This is a single-blind prospective, randomized controlled trial involving a total of 132 outpatients with bipolar disorder who will be recruited from the Hospital Clinic of Barcelona. All participants will be randomly assigned to two arms. All the patients will receive treatment as usual (TAU) but in addition the experimental group will receive an integrative approach consisting of 12-sessions of 90 min each in which contents of psychoeducation for patients have been combined with a session for family members, and complemented with aspects related to health promotion, mindfulness training, and strategies for cognitive and functional enhancement. The whole sample will be assessed at baseline, after completion (3-months) and at 12 months from baseline regarding demographic and clinical variables, psychosocial and cognitive functioning, wellbeing and quality of life. The primary outcome measure will be improvement in psychosocial functioning.

Conclusions

If the integrative approach is effective, it would allow clinicians to cover different areas that may be affected by bipolar disorder, by means of a brief intervention that can therefore be easily generalized to clinical practice.

Trial registration

NCT04031560. Date registered July 24, 2019.

双相情感障碍与高水平的个人、家庭、社会和经济负担有关。有必要在临床实践中易于实施的可行的辅助心理干预措施，以增强药物单独无法实现的方面。本研究旨在评估为双相情感障碍患者设计的12期辅助综合治疗方案的影响。方法:这是一项单盲、前瞻性、随机对照试验，共纳入132名来自巴塞罗那医院诊所的双相情感障碍门诊患者。所有参与者将被随机分配到两组。所有患者将接受常规治疗(TAU)，但实验组将接受一种综合方法，包括12个疗程，每次90分钟，其中对患者的心理教育内容与对家庭成员的心理教育内容相结合，并辅以与健康促进、正念训练以及认知和功能增强策略相关的方面。整个样本将在基线、完成后(3个月)和基线后12个月进行人口统计学和临床变量、社会心理和认知功能、健康和生活质量的评估。主要的结果测量将是社会心理功能的改善。结论:如果综合方法有效，它将允许临床医生覆盖可能受双相情感障碍影响的不同领域，通过简短的干预，因此可以很容易地推广到临床实践中。registrationNCT04031560审判。注册日期2019年7月24日。

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引用次数: 0

El destino del diagnóstico de síndrome de Asperger. ¿Qué le depara el futuro al síndrome de Asperger? 阿斯伯格综合症诊断的命运。阿斯伯格综合症的未来是什么?

Revista de Psiquiatría y Salud Mental (English Edition)

Pub Date : 2020-07-01 DOI: 10.1016/j.rpsmen.2019.05.002

Mara Parellada

引用次数: 0

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