Revista de psiquiatria y salud mental最新文献

英文中文

A clozapine's uncharted voyage: Five years and a pandemic after the end of mandatory haematological notifications to the Spanish medicines agency 氯氮平的未知航程:西班牙药品管理局强制血液学通报结束后的五年和大流行

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-10-01 DOI: 10.1016/j.rpsm.2022.04.001

Pilar Andres-Olivera , Concha Turrion , Emilio Fernandez-Egea , Jesus Perez

引用次数: 1

Validación y adaptación española de la Escala de Actitudes Estigmatizadoras hacia la Salud Mental entre Iguales (Peer Mental Health Stigmatization Scale, PMHSS-24) 同伴心理健康污名化量表(PMHSS-24)的西班牙验证和适应

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2020.06.004

Jesús de la Higuera-Romero , Andrea Candelas-Muñoz , Andrea Jiménez-González , Cristina Castañeda-Jiménez , Paula Fuica-Pereg , María Zurita-Carrasco , Eloísa Martínez-Fernandez-Repeto , Cristina Senín-Calderón

Introduction

There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24).

Material and methods

A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (M_age = 14.64; SD = .83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found.

Results

The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2 for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI>.95; NNFI>.95, SRMR<.08, RMSEA<.08). Factor loads ranged from .49 to .89, with α factor correlation between r=.53 and .45. Both subscales exhibited optimal alpha values (negative .94 and positive .81). The scale was invariant between the sexes.

Conclusions

The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.

目前，人们越来越关注旨在减少对青少年中有情绪困难的人的污名化的干预措施。不幸的是，西班牙语中可用来评估这些年龄段的病耻感的量表数量有限。本研究旨在调整和验证同伴心理健康污名化态度量表(PMHSS-24)。材料与方法共443名13 ~ 17岁青少年(女性46.6%，男性53.7%)参与研究(年龄= 14.64;SD = .83)。计算测试的内部一致性，对一半样本进行探索性析因分析(EFA)，对另一半样本进行验证性析因分析(CFA)，并发现量表通过性别测量的不变性。结果EFA在负性量表(解释53%的方差)和正性量表(解释62%的方差)上呈双因子结构。CFA用适当的拟合优度指标证实了因子结构(CFI>.95;NNFI>。95年,SRMR<。08年,RMSEA<。08)。因子负荷范围为0.49 ~ 0.89，α因子相关系数r=。53和。45。两个分量表均表现出最佳α值(负0.94和正0.81)。这一比例在两性之间是不变的。结论PMHSS-24可作为初步筛选青少年对精神疾病患者刻板印象的有效量表。

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引用次数: 2

Comparación de la discapacidad entre trastornos mentales graves y comunes usando la escala WHODAS 2.0 使用WHODAS 2.0量表比较严重和常见精神障碍的残疾情况

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2021.08.004

Elena Hernando-Merino , Enrique Baca-Garcia , Maria Luisa Barrigón

Introduction

Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility.

Material and methods

Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test.

Results

Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p < 0.001) and participation in society (p = 0.041).

Conclusions

In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.

精神障碍是全世界致残的主要原因之一。尽管严重精神障碍(SMD)与高度残疾相关，但普通精神障碍(CMD)的影响也不容忽视。在这项工作中，我们比较了在精神卫生护士设施的两个诊断组的WHODAS 2.0量表测量的残疾。资料与方法采用WHODAS 2.0量表收集马德里公主医院精神卫生专科护士就诊患者的社会人口学资料、临床诊断和残疾评分，并采用学生t检验比较SMD和CMD患者的残疾情况。结果我们的研究样本包括133例患者。与SMD患者相比，CMD患者表现出更大的残疾。据观察，与SMD相比，与CMD相关的残疾更高，这种差异在工作领域是显著的(p <0.001)和社会参与(p = 0.041)。在这项研究中，我们发现与CMD相关的残疾水平在某些领域比SMD更高，这种差异与“工作”和“参与”领域特别相关。这可能有助于调整针对这些人的干预措施，并改善他们的生活质量。

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引用次数: 4

Pedro Enrique Muñoz Rodríguez: un psiquiatra social en tiempos de confusión 佩德罗·恩里克munoz rodriguez:混乱时期的社会精神病学家

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2022.05.007

Luis Salvador-Carulla , Antonio Bulbena Vilarrasa

引用次数: 0

Towards a classification framework for patient safety incidents and adverse events for a mental health community-based model of service provision 建立病人安全事件和不良事件分类框架，以建立以社区为基础的精神卫生服务提供模式

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2021.11.007

Eva Frigola-Capell , René Morgan , Albert Nogué , Ingrid Thelen , Jordi Font , Begoña Gonzalvo , Pilar Oliveras , Eva Bacardí , Maria Dolors Malla , Alex Gimeno , Anna Pla , Domènech Serrano , Eduard Palomer , Glòria Trafach , Jose Luís Ignacio Sagredo , Margarita De Castro , Montse Gibernau , Roser Serrallonga , Maite Roger , Jordi Cid

引用次数: 0

Estimation of the epidemiology of dementia and associated neuropsychiatric symptoms by applying machine learning to real-world data 通过将机器学习应用于现实世界数据来估计痴呆和相关神经精神症状的流行病学

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2021.03.001

Javier Mar , Ania Gorostiza , Arantzazu Arrospide , Igor Larrañaga , Ane Alberdi , Carlos Cernuda , Álvaro Iruin , Mikel Tainta , Lorea Mar-Barrutia , Oliver Ibarrondo

Introduction

Incidence rates of dementia-related neuropsychiatric symptoms (NPS) are not known and this hampers the assessment of their population burden. The objective of this study was to obtain an approximate estimate of the population incidence and prevalence of both dementia and NPS.

Methods

Given the dynamic nature of the population with dementia, a retrospective study was conducted within the database of the Basque Health Service (real-world data) at the beginning and end of 2019. Validated random forest models were used to identify separately depressive and psychotic clusters according to their presence in the electronic health records of all patients diagnosed with dementia.

Results

Among the 631,949 individuals over 60 years registered, 28,563 were diagnosed with dementia, of whom 15,828 (55.4%) showed psychotic symptoms and 19,461 (68.1%) depressive symptoms. The incidence of dementia in 2019 was 6.8/1000 person-years. Most incident cases of depressive (72.3%) and psychotic (51.9%) NPS occurred in cases of incident dementia. The risk of depressive-type NPS grows with years since dementia diagnosis, living in a nursing home, and female sex, but falls with older age. In the psychotic cluster model, the effects of male sex, and older age are inverted, both increasing the probability of this type of symptoms.

Conclusions

The stigmatization factor conditions the social and attitudinal environment, delaying the diagnosis of dementia, preventing patients from receiving adequate care and exacerbating families’ suffering. This study evidences the synergy between big data and real-world data for psychiatric epidemiological research.

痴呆相关神经精神症状(NPS)的发病率尚不清楚，这阻碍了对其人口负担的评估。本研究的目的是获得痴呆症和NPS的人群发病率和患病率的大致估计。方法考虑到痴呆症人群的动态性，在2019年初和年底对巴斯克卫生服务数据库(真实数据)进行了回顾性研究。使用经过验证的随机森林模型，根据所有诊断为痴呆症的患者的电子健康记录中的存在情况，分别识别抑郁症和精神病性群集。结果在登记的60岁以上的631,949人中，28,563人被诊断为痴呆，其中15,828人(55.4%)表现为精神病症状，19,461人(68.1%)表现为抑郁症状。2019年痴呆症的发病率为6.8/1000人年。大多数抑郁症(72.3%)和精神病性NPS(51.9%)发生在痴呆患者中。患抑郁症型NPS的风险随着诊断为痴呆症、住在养老院和女性的年龄而增加，但随着年龄的增长而下降。在精神病群集模型中，男性性别和年龄的影响是相反的，两者都增加了这类症状的可能性。结论污名化因素影响了社会和态度环境，延误了痴呆症的诊断，使患者无法得到适当的护理，加剧了家庭的痛苦。本研究证明了大数据与现实世界数据在精神病学研究中的协同作用。

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引用次数: 7

De la modificación de la capacidad a la provisión de apoyos en personas con discapacidad 从能力的改变到为残疾人提供支持

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2021.12.005

Esperanza L. Gómez-Durán , Rosa María Méndez-Tomás , Carles Martin-Fumadó

引用次数: 0

El efecto de la ocupación laboral en la incidencia de demencia vascular: un estudio de cohortes de 12 años de seguimiento 职业对血管性痴呆发病率的影响:一项12年随访队列研究

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2020.05.002

Ana Cristina Gracia-Rebled , Raúl Lopez-Anton , Concepción Tomás , Elena Lobo , Guillermo Marcos , Antonio Lobo , Javier Santabárbara

Introduction

Vascular dementia (DV) is the second cause of dementia with 15.8-20% of cases. Previous studies of the effect of occupation in DV do not show conclusive results, therefore, the objective was to analyze if the type of occupation can vary the risk of developing DV in those older than 55 years.

Material and methods

In the ZARADEMP project, a community sample of 4,803 individuals were followed longitudinally in 4 waves. The occupation was classified following the National Classification of Occupations of 2011 and the International Standard Classification of Occupations of 2008. Different standardized instruments were used: the medical and psychiatric histories (History and Aetiology Schedule) and other risk factors (Mini-Mental Status Examination, Geriatric Mental State-AGECAT). For this study, we calculated incidence rates, incidence rate ratios and hazard ratios in multivariate Cox regression models, stratified by gender. For this study, we included 3,883 participants.

Results

In women, the risk of DV was doubled in blue-collar workers, with a moderate effect (Cohen's d = 0.54), and multiplying by 2.7 in homeworks respect to white-collar with a moderate effect (Cohen's d = 0.77), although they did not reach statistical significance. We did not observe the effect of occupation on the risk of DV in men.

Conclusions

We have found a moderate but non-significant effect between occupation and DV risk in women. We found no effect of occupation on the risk of VD in males while other clinical factors (age, diabetes or body mass index) presented a clearer effect than the occupation.

血管性痴呆(DV)是痴呆的第二大原因，占15.8-20%。先前关于职业对家庭暴力的影响的研究没有得出结论性的结果，因此，本研究的目的是分析职业类型是否会改变55岁以上家庭暴力的发生风险。材料和方法在ZARADEMP项目中，对4803人的社区样本进行了4波纵向随访。该职业按照2011年国家职业分类和2008年国际标准职业分类进行分类。使用不同的标准化工具:医疗和精神病史(病史和病因表)和其他危险因素(迷你精神状态检查，老年精神状态agecat)。在本研究中，我们计算了按性别分层的多变量Cox回归模型中的发病率、发病率比和风险比。在这项研究中，我们纳入了3883名参与者。结果在女性中，蓝领工人患家庭暴力的风险是中等影响的两倍(Cohen’s d = 0.54)，而白领工人患家庭暴力的风险是中等影响的2.7倍(Cohen’s d = 0.77)，尽管两者没有达到统计学意义。我们没有观察到职业对男性家庭暴力风险的影响。结论我们发现职业与女性家庭暴力风险之间存在中等但不显著的影响。我们发现职业对男性患VD的风险没有影响，而其他临床因素(年龄、糖尿病或体重指数)的影响比职业更明显。

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引用次数: 0

Is intensive home-treatment a real alternative to classical hospitalization for managing acute psychiatric processes? Insights from clinical practice 强化家庭治疗是治疗急性精神疾病的传统住院治疗的真正替代方案吗?临床实践感悟

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2021.11.001

Ana Martín-Blanco , Laura Calvo-Saiz , Jacopo Baccarin , Alba González-Fernández , Alejandro Keymer-Gausset , Sara Vieira-Costa , Núria Ribas-Fitó , Carles Garcia-Ribera

引用次数: 0

Validación de la versión española de la Escala de funcionamiento breve (FAST) en pacientes diagnosticados de esquizofrenia 西班牙版精神分裂症患者短功能量表(FAST)的验证

IF 9.2 3区医学 Q1 PSYCHIATRY

Revista de psiquiatria y salud mental

Pub Date : 2022-07-01 DOI: 10.1016/j.rpsm.2022.01.006

Eva Maria Lujan-Lujan , Maria Angeles Garcia-Leon , Elena Rodriguez-Cano , Sergi Huertas-Martinez , Juan Roldan-Merino , Montserrat Puig-Llobet , Maria Dolores Miguel-Ruiz , Raymond Salvador , Eduard Vieta , Edith Pomarol-Clotet

Introduction

Functional impairment in schizophrenia is one of the main features of the disorder and implies a great impact on the patient's quality of life. The brief functioning assessment scale (FAST), originally validated in bipolar disorder, has also been validated for its application in other mental disorders. However, we only found one study on the reliability and validity of the Brazilian version in schizophrenia. The purpose of this study was to analyze the psychometric properties of the Spanish version of the FAST in patients diagnosed with schizophrenia.

Material and methods

A total of 226 patients with a diagnosis of schizophrenia were evaluated by mean the FAST, the GAF and the self-care requirements scale (ERA). Scale properties were analyzed in terms of internal consistency, inter-observer agreement and test–retest reliability. Convergent validity with the GAF and ERA scales was also analyzed, as well as construct validity by means of a Confirmatory Factor Analysis (CFA).

Results

For the total scale, the results showed high internal consistency (Cronbach's Alpha of .87), as well as good inter-observer (ICC = .86) and test–retest (ICC = .77) agreement. Concurrent validity with the GAF scale was discrete (r = −.32; P < .001) and with the ERA scale was moderate (r = .50; P < .001). CFA showed an internal structure that matched the six factors proposed by the original scale, with a good level of item saturation for each factor.

Conclusions

The FAST scale showed good psychometric properties in terms of reliability and validity in its Spanish version for its application in patients with schizophrenia. It can be considered as a good tool to assess different areas of functional impairment in clinical practice and research.

精神分裂症的功能障碍是该疾病的主要特征之一，对患者的生活质量有很大影响。简短功能评估量表(FAST)最初在双相情感障碍中得到验证，也被证实可用于其他精神障碍。然而，我们只发现了一项关于巴西版精神分裂症的可靠性和有效性的研究。本研究的目的是分析精神分裂症患者的西班牙语版FAST的心理测量特性。材料与方法对226例精神分裂症患者采用FAST、GAF和自我护理要求量表(ERA)进行平均评估。量表性质从内部一致性、观察者间一致性和重测信度等方面进行分析。对GAF和ERA量表的收敛效度进行了分析，并通过验证性因子分析(CFA)对结构效度进行了分析。结果总量表结果具有较高的内部一致性(Cronbach’s Alpha = 0.87)、良好的观察者间一致性(ICC = 0.86)和重测一致性(ICC = 0.77)。与GAF量表的并发效度是离散的(r = - 0.32;P & lt;.001)，与ERA量表比较为中度(r = .50;P & lt;措施)。CFA显示了一个与原始量表提出的六个因素相匹配的内部结构，每个因素的项目饱和度都很好。结论FAST量表西班牙文版在精神分裂症患者中的应用具有良好的信度和效度。在临床实践和研究中，它可以被认为是评估不同领域功能损伤的一个很好的工具。

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