Spanish Journal of Psychiatry and Mental Health最新文献

Introduction: Antipsychotic (AP) prescription has risen across Europe, but updated data on prescribing trends and treatment intensity in youth remain limited. This study describes AP prescription patterns among children and adolescents in the region of Valencia, Spain, with 5 million inhabitants.

Methods: Population-based, cross-sectional study using the Valencia Health System's Integrated Database (VID) including all AP drugs prescribed to individuals aged 0-19 years from 2015 through 2023. APs were categorized by active substance, and yearly trends in prescription volume, patient numbers, and chlorpromazine equivalent doses (CED) per patient were presented. Results were stratified by age and sex.

Results: A total of 570,238 AP prescriptions were dispensed to 30,704 patients, increasing 1.61-fold over the study period. Risperidone and aripiprazole accounted for 60.5% of all prescriptions, while lurasidone experienced the highest growth (13-fold increase), followed by olanzapine (3.1-fold), aripiprazole (2.3-fold), and quetiapine (2.1-fold). The number of treated patients increased by 50%, with the highest relative increase in young children (0-4 years old) and adolescents (15-19 years old). AP use was higher in males but rose more sharply among females (1.4-fold vs 2.1-fold, Overall, CED per patient slightly declined.

Conclusions: AP prescriptions and patients treated among Spanish youth increased significantly between 2015 and 2023, with notable differences by age and sex. While total CED rose, treatment intensity per patient remained relatively stable. Future studies should investigate the clinical indications for these prescriptions as well as the outcomes associated with AP use in children and adolescents.

Introduction: Stressful life events significantly influence the development and course of mental disorders in children and adolescents. The Stressful Life Events Schedule (SLES) is an instrument designed to evaluate these events. This study aims to validate the Spanish version of the SLES (Spanish SLES) for children, adolescents and parents by analysing its psychometric properties and discriminant validity.

Methods: Participants were recruited from two cohorts. Cohort I comprised 188 offspring aged 6-17 years (50.0% female), including 114 offspring of patients with bipolar disorder or schizophrenia (high-risk group) and 74 offspring of control subjects (control group). Cohort II included 35 adolescents aged 14-18 years with a first-episode psychosis (FEP group) (62.9% female). The psychometric properties of the SLES were assessed, including internal consistency (IC) and test-retest reliability, discriminant validity across groups, and concurrent validity.

Results: The Spanish SLES demonstrated robust psychometric properties. In adolescents, IC was 0.87 for the total event count and 0.88 for interference with intraclass correlation coefficients (ICCs) of 0.74 and 0.70, respectively. In children, IC was also high (α = 0.83 for events and α = 0.85 for interference) with ICCs of 0.61 for both measures. In parents, IC was 0.78-0.86 for events and 0.78-0.87 for interference with ICCs of 0.80-0.84 and 0.75-0.82, respectively. Adolescents in the FEP group reported significantly more stressful events (p < 0.001, ηp² = 0.156) and greater interference (p < 0.001, ηp² = 0.190) compared with both the high-risk and control groups. Additionally, moderate correlations were found between parent and adolescent reports, with lower concordance observed in the child sample. These findings underscore the importance of integrating multiple informants when assessing stressful life events in clinical practice.

Conclusions: The Spanish SLES is a valid and reliable instrument for assessing stressful life events in children, adolescents and their parents. It is an accessible and easy-to-administer tool, suitable for use in both clinical practice and research settings.

Non-suicidal self-injury (NSSI) in adolescents is a common and concerning thing, as it is associated with suicide risk. In this study, we propose a memetic framework to understand its social spread among the young populations (as well as among peers and on social media). Furthermore, we explore how to design and disseminate, with the help of AI, 'protective memes' with a Papageno effect that mitigate the potential Werther effect of NSSI in at-risk adolescents.

Objectives: This study aimed to examine the association between the inflammatory biomarkers-C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR), and monocyte-lymphocyte ratio (MLR)-and metabolic status in a sample of patients with schizophrenia. We tested the hypothesis that individuals with schizophrenia exhibit a high prevalence of metabolic alterations, and that these inflammatory biomarkers are associated with a greater number of metabolic risk factors and the presence of metabolic syndrome (MetS), after adjusting for potential confounders.

Methods: A total of 541 participants with a DSM-5 diagnosis of a schizophrenia spectrum disorder at any illness phase were included. We analyzed inflammatory markers and receiver operating characteristic (ROC) curves were used to determine their predictive utility for MetS.

Results: Patients with higher NLR and CRP levels and lower PLR values exhibited a more severe metabolic profile. ROC analysis identified CRP and PLR as the most effective predictors of MetS, with optimal cut-off points of 2.87mg/L for CRP (sensitivity, 70%; specificity, 54%) and 80.7 for PLR (sensitivity, 71%; specificity, 60%).

Conclusions: Screening CRP levels and inflammatory ratios is a cost-effective and easily implementable practice that may facilitate the early identification of patients with schizophrenia spectrum disorders at risk of developing metabolic complications.

Background: Traditional approaches treat depression as unidimensional constructs rather than neurobiologically informed symptom clusters. The objective to investigate how Research Domain of Criteria-informed depression assessment enhances phenotype identification compared to traditional factor structures using nationally representative Peruvian data.

Methods: A cross-sectional analysis of Peru's National Health Survey (2015-2024) included confirmatory factor analysis, comparing five competing models (n=318,681), and latent profile analysis to identify depression phenotypes among clinically significant cases (n=22,339; PHQ-9 score≥10). Models were estimated using maximum likelihood with robust standard errors and entropy-based class selection criteria.

Results: The four-factor model demonstrated a superior fit (RMSEA=0.019) compared to traditional approaches (RMSEA=0.050-0.055), representing an 89% improvement in model fit. Seven distinct phenotypes emerged with unique factor score patterns: Mild Cross-Domain Depression (39.4%), High Negative Valence Internalizing Depression (15.1%), Primary Negative Valence Externalizing Depression (12.5%), High Negative Valence with Preserved Cognitive Systems Depression (12.1%), High Arousal-Regulatory Systems Depression (9.1%), Severe Cross-Domain Depression (8.7%), and Severe Dual Negative Valence Depression (3.1%).

Conclusions: Depression functions as a multidimensional neurobiological system with distinct phenotypic presentations across Peruvian populations. The High Negative Valence Internalizing Depression-characterized by suicide risk independent of mood severity-necessitates phenotype-specific rather than symptom-severity-based clinical protocols.