Revista de psiquiatria y salud mental最新文献

英文中文

Clinical symptoms and social functioning in schizophrenia 精神分裂症的临床症状和社会功能

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.2020.05.009

Maria Jose Escandell , Gemma Prat , Mar Garcia-Franco , Jose Ramón Martín-Martínez , Susana Ochoa , Ingrid Tortades , Sonia Vilamala , Marina Verdaguer-Rodríguez , Emma Casas-Anguera

Introduction

The aim of the present study was to assess the relationship between social functioning and clinical symptoms in people with schizophrenia, analyzing the influence of both global social functioning and the specific aspects of social functioning, assertiveness and communication skills in the explanation of type of symptoms.

Material and methods

A cross-sectional descriptive study composed of 125 people diagnosed with schizophrenia was performed. Patients were assessed with the Communication Skills Questionnaire (CSQ), the Gambrill and Richey Assertiveness Inventory (GR), the Global Assessment of Functioning Scale (GAF) and the Global Assessment of Social Functioning Scale (SOFAS), Social Functioning Scale (SFS), Life Skills Profile (LSP) scale and the Clinical Global Impression scale for Schizophrenia (CGI-S).

Results

SOFAS, LSP and GR are related to each of the subscales and total scores of symptoms (p < 0.05–0.001). The multiple regressions show that SOFAS and GR explained 59% of the total symptoms. SOFAS and GR, accounting for 65% of the variance, explain positive symptoms. GR and SOFAS explained 34% of the variance of negative symptoms. SOFAS, CSQ and LSP, accounting for 20% of the variance, explain depressive symptoms. SOFAS explained 46% of the variance of cognitive symptoms.

Conclusions

Our findings suggest the usefulness of social functioning assessment in the explanation of clinical symptoms in people with schizophrenia. Moreover, our results point out that not only negative and cognitive symptoms, but also positive and depressive symptoms, should be taken into account in the rehabilitation process in order to improve patient adaptation in the community.

本研究的目的是评估精神分裂症患者的社会功能与临床症状之间的关系，分析整体社会功能以及社会功能、自信和沟通技巧的特定方面对症状类型的解释的影响。材料与方法对125例精神分裂症患者进行横断面描述性研究。采用沟通技巧问卷(CSQ)、Gambrill和Richey自信量表(GR)、整体功能评估量表(GAF)和整体社会功能评估量表(SOFAS)、社会功能量表(SFS)、生活技能量表(LSP)和精神分裂症临床整体印象量表(CGI-S)对患者进行评估。结果sofas、LSP和GR与各分量表及症状总分相关(p <0.05 - -0.001)。多重回归分析显示，SOFAS和GR解释了总症状的59%。SOFAS和GR占方差的65%，可以解释阳性症状。GR和SOFAS解释了34%的阴性症状方差。SOFAS、CSQ和LSP占方差的20%，可以解释抑郁症状。SOFAS解释了46%的认知症状差异。结论社会功能评估有助于解释精神分裂症患者的临床症状。此外，我们的研究结果指出，在康复过程中，不仅应考虑阴性和认知症状，还应考虑阳性和抑郁症状，以提高患者在社区中的适应能力。

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引用次数: 0

Valproate, obesity and other causes of clozapine poor metabolism in the context of rapid titration may explain clozapine-induced myocarditis: A re-analysis of a Turkish case series 丙戊酸盐、肥胖和其他氯氮平代谢不良的原因在快速滴定的背景下可以解释氯氮平诱导的心肌炎:对土耳其病例系列的重新分析

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.2021.10.003

Aygün Ertuğrul , A. Elif Anıl Yağcıoğlu , Esen Ağaoğlu , Ahmet Alp Karakaşlı , Sertaç Ak , M. Kâzım Yazıcı , Jose de Leon

Introduction

Clozapine-induced myocarditis or any clozapine-induced inflammation may be a hypersensitivity reaction due to titration that was too rapid for the patient's clozapine metabolism. Clozapine metabolism is influenced by ancestry, sex, smoking and the presence of confounders including obesity, infections, and inhibitors (e.g., valproate) causing the patient to behave as a clozapine poor metabolizer (PM). A published study in a Turkish hospital identified 1 case of clozapine-induced pancreatitis and hepatitis and 9 cases of clozapine-induced myocarditis. To explore the hypothesis that the 10 patients were clozapine PMs, their serum clozapine concentrations were investigated using concentration-to-dose (C/D) ratios and their titrations carefully reviewed.

Methods

Dividing the trough serum concentration by the dose produces the clozapine C/D ratio. The dose required to reach 350 ng/ml was considered the minimum therapeutic dosage and was used to classify patients according to clozapine PM status. Titration speed was assessed.

Results

All 10 patients were possibly clozapine PMs (3 of them had as minimum therapeutic doses: 72, 82 or 83 mg/day). Nine of the 10 patients may have behaved as clozapine PMs due to obesity and/or valproate co-prescription during titration. One also had an undiagnosed infection. Of the 10 patients, 9 had at least 1 of 3 factors: too-rapid titration in the first or second weeks, or a final dosage that was too high.

Conclusions

Future studies using clozapine levels and considering the role of clozapine PM status should explore whether or not all cases of clozapine-induced inflammation could be explained by lack of individualized titration.

氯氮平引起的心肌炎或任何氯氮平引起的炎症都可能是一种超敏反应，因为滴定速度太快，患者的氯氮平代谢跟不上。氯氮平代谢受血统、性别、吸烟和混杂因素(包括肥胖、感染和抑制剂(如丙戊酸))的影响，导致患者表现为氯氮平代谢不良者(PM)。土耳其一家医院发表的一项研究发现了1例氯氮平诱发的胰腺炎和肝炎，9例氯氮平诱发的心肌炎。为了探讨这10例患者是否为氯氮平pm的假设，我们使用浓度剂量比(C/D)调查了他们的血清氯氮平浓度，并仔细审查了他们的滴定法。方法用谷血药浓度除以剂量得到氯氮平C/D比。需要达到350 ng/ml的剂量被认为是最低治疗剂量，并根据氯氮平PM状态对患者进行分类。测定滴定速度。结果10例患者均可能为氯氮平经前综合征，其中3例患者最小治疗剂量分别为72、82、83 mg/d。10例患者中有9例可能表现为氯氮平经前综合症，原因是在滴定期间肥胖和/或丙戊酸共处方。其中一人还患有未确诊的感染。在这10例患者中，9例至少有3个因素中的1个:第一或第二周滴药过快，或最终剂量过高。结论未来使用氯氮平水平并考虑氯氮平PM状态的研究应该探讨是否所有氯氮平诱导的炎症病例都可以通过缺乏个体化滴定来解释。

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引用次数: 11

A Covid-19 outbreak in a Spanish long-term psychiatric hospital led to infections in 6 clozapine patients: elevations in their plasma clozapine levels 西班牙一家长期精神病院爆发的Covid-19疫情导致6名氯氮平患者感染:血浆氯氮平水平升高

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.2022.06.001

Manuel Arrojo-Romero , Maria Rosario Codesido-Barcala , Jose de Leon

引用次数: 10

Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI) 精神病人群中不同的幻听测量方法。西班牙语版听觉幻听评定量表(AVHRS)和积极有用声音问卷(PUVI)的验证

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.2020.03.002

Esther Lorente-Rovira , Eva Grasa , Susana Ochoa , Iluminada Corripio , Trinidad Peláez , Raquel López-Carrilero , Ángela Gutiérrez-Gea , María Morano-Guillén , José M. Villagrán , Agna A. Bartels-Velthuis , Jack A. Jenner , Julio Sanjuán

Introduction

An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI).

Materials and methods

A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire.

Results

The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test–retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test–retest reliability.

Conclusions

The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.

一份最新的评估精神病患者幻听的最常用仪器的总结，使我们能够强调西班牙语版本重要仪器的稀缺和需求。本研究的目的是检验两种不同的、互补的评估幻听的工具的心理测量特征，西班牙语版的听觉幻觉量表(AVHRS)和西班牙语版的积极和有用的声音调查(PUVI)。材料和方法来自四个不同中心的68例患者样本，均被诊断为精神分裂症或分裂情感性障碍，并伴有幻听。除AVHRS和PUVI外，还对所有患者进行精神病症状评定量表-幻听子量表(PSYRATS-AH)和阳性和阴性综合征量表(PANSS)，并进行可接受性问卷调查。结果西班牙语版AVHRS具有较好的内部一致性、中至高的量表间信度、中至中等的重测信度、较好的收敛效度和判别效度。西班牙语版本的PUVI表现出良好的内部一致性和异质性，但总体上中等，重测信度。结论西班牙语版AVHRS和PUVI具有良好的心理测量性能，为患者所接受。

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引用次数: 2

Clozapine-induced myocarditis in Russia: Animal studies but no clinical studies 氯氮平引起的心肌炎在俄罗斯:动物研究但没有临床研究

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.2021.09.001

Oleg O. Kirilochev , Carlos De las Cuevas , Jose de Leon

引用次数: 2

Here we go again! Subtyping diagnosis and refining treatments 又来了!分型诊断和细化治疗

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.2022.11.001

Javier Vázquez-Bourgon

引用次数: 0

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。

{"title":"Validación y adaptación española de la Escala de Actitudes Estigmatizadoras hacia la Salud Mental entre Iguales (Peer Mental Health Stigmatization Scale, PMHSS-24)","authors":"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","doi":"10.1016/j.rpsm.2020.06.004","DOIUrl":"10.1016/j.rpsm.2020.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>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).</p></div><div><h3>Material and methods</h3><p>A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (<em>M</em><sub>age</sub>  =.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.</p></div><div><h3>Results</h3><p>The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2for 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 <em>r</em>=.53 and .45. Both subscales exhibited optimal alpha values (negative .94 and positive .81). The scale was invariant between the sexes.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 3","pages":"Pages 176-184"},"PeriodicalIF":9.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38198560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

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

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

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