Psiquiatria Biologica最新文献

英文中文

Síndrome delirante en el contexto de consumo de cannabis 吸食大麻导致的妄想综合征

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-09 DOI: 10.1016/j.psiq.2024.100514

Mar González Testón, Elena Blanco Martín, Susana Macayo Villalobos, Marta Ramírez Bravo

引用次数: 0

Innovaciones en la cesación tabáquica: el papel de la citisiniclina 戒烟创新：胞二磷胆碱的作用

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-01 DOI: 10.1016/j.psiq.2024.100513

Miguel Angel Alvarez de Mon, Vanessa Herrera

Tobacco use is one of the leading causes of disease, disability, and death worldwide. Achieving smoking cessation without pharmacological assistance is extremely challenging due to the highly addictive nature of tobacco. The goal of pharmacotherapy for nicotine addiction is to reduce withdrawal symptoms and nicotine's reinforcing effects with minimal side effects. Several effective medications are available to help people quit smoking, including nicotine replacement therapy (NRT), bupropion, varenicline, nortriptyline, and cytisinicline, among others. Cytisinicline has gained popularity in Spain, supported by funding from the Ministry of Health, making it more accessible through the public health system. Cytisinicline is administered orally and does not undergo significant hepatic metabolism, reducing the risk of drug interactions. Its most common side effects are gastrointestinal symptoms, which usually resolve spontaneously. Clinical trials have demonstrated its efficacy in smoking cessation. A clinical trial in Australia compared cytisinicline with varenicline, showing similar abstinence rates but with better tolerability for cytisinicline. Other studies and meta-analyses have also demonstrated the superiority of cytisinicline over NRT and placebo. Given its effectiveness, favorable side effect profile, and low cost, cytisinicline is a promising option. Combining it with behavioral support, such as cognitive-behavioral therapy (CBT) and motivational interviewing, enhances outcomes.

吸烟是导致全球疾病、残疾和死亡的主要原因之一。由于烟草具有高度成瘾性，因此在没有药物辅助的情况下实现戒烟极具挑战性。尼古丁成瘾药物疗法的目标是减少戒断症状和尼古丁的强化作用，同时将副作用降到最低。目前有几种有效的药物可以帮助人们戒烟，包括尼古丁替代疗法（NRT）、安非他明、伐尼克兰、去甲替林和胞二磷胆碱等。胞二磷胆碱在西班牙很受欢迎，得到了卫生部的资助，使其更容易通过公共卫生系统获得。胞二磷胆碱口服给药，不会发生明显的肝脏代谢，从而降低了药物相互作用的风险。它最常见的副作用是胃肠道症状，通常会自行缓解。临床试验证明了它在戒烟方面的疗效。澳大利亚的一项临床试验对胞二磷胆碱和伐尼克兰进行了比较，结果显示戒烟率相似，但胞二磷胆碱的耐受性更好。其他研究和荟萃分析也表明，胞二磷胆碱的疗效优于 NRT 和安慰剂。鉴于其有效性、良好的副作用和低成本，胞二磷胆碱是一种很有前景的选择。将其与认知行为疗法（CBT）和动机访谈等行为支持相结合，可提高疗效。

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引用次数: 0

Risk of hospital readmission in patients with psychotic symptoms and a history of drug use 有精神病症状和吸毒史的患者再次入院的风险

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-01 DOI: 10.1016/j.psiq.2024.100509

Paula Mollà Roig

Introduction

Substance use is common in patients with psychotic symptomatology, especially in patients diagnosed with a first psychotic episode or schizophrenia. In both chronic psychosis and first psychotic episodes, substance abuse is associated with a worse outcome and a higher relapse rate.

Methods

For this study, a sample of n = 731 was collected, including all patients hospitalised in the Adult Hospitalisation Unit (AHU) of Psychiatry of the Hospital Clínico Universitario de Zaragoza between 1 January 2014 and 31 December 2017, with a discharge diagnosis of psychotic disorder or affective disorder with psychotic symptomatology.

Results

From the analysis of the sample, the results show that 52.19% of the patients in the sample studied have a history of drug use. And, the most frequently used substance among patients with psychotic pathology is cannabis (73.71%). Likewise, patients with a history of drug use were admitted at an earlier age (35.07 ± 12.72 years) than those without a history of drug use (50.74 ± 15.08 years). In addition, drug use was more frequent in males, with a ratio of 4:1.

Conclusions

It has also been observed that patients with a history of drug use have a higher risk of hospital readmission to a psychiatric unit. In the sample analysed, cannabis was the only substance that presented statistically significant differences with respect to the risk of hospital readmission.

引言吸毒在有精神病症状的患者中很常见，尤其是在被诊断为首次精神病发作或精神分裂症的患者中。在慢性精神病和首次精神病发作中，药物滥用都与较差的治疗效果和较高的复发率有关。方法本研究收集了 n = 731 个样本，包括萨拉戈萨大学医院精神病科成人住院部（AHU）在 2014 年 1 月 1 日至 2017 年 12 月 31 日期间住院的所有患者，出院诊断为精神病性障碍或伴有精神病性症状的情感障碍。结果通过对样本的分析，结果显示研究样本中52.19%的患者有吸毒史。在精神病患者中，最常使用的药物是大麻（73.71%）。同样，与无吸毒史的患者（50.74 ± 15.08 岁）相比，有吸毒史的患者入院年龄较早（35.07 ± 12.72 岁）。此外，男性使用毒品的频率更高，比例为 4:1。在分析的样本中，大麻是唯一一种在再次入院风险方面存在显著统计学差异的物质。

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引用次数: 0

Bioética en la salud mental. Dilemas actuales ante nuevas condiciones emergentes 精神卫生领域的生物伦理。面对新出现情况的当前困境

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-01 DOI: 10.1016/j.psiq.2024.100508

Francisco Angel Nente Chávez, Martha Díaz Rodríguez

引用次数: 0

Concordancia del autorreporte y la valoración clínica de la ideación suicida 自杀意念自我报告与临床评估的一致性

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-01 DOI: 10.1016/j.psiq.2024.100510

Constanza Vera-Varela , María Luisa Barrigón , Enrique Baca-García

Background

Thoughts of suicide and/or death usually precede suicide attempts and suicide deaths. We study the agreement in passive suicidal ideation between reports made by clinicians during an outpatient mental health service and patients’ online self-reports.

Methodology

Between 2014 and 2016, during routine psychiatric and psychological appointments in the outpatient mental-health facilities affiliated with the Fundación Jiménez Díaz Hospital in Madrid, wish of death was assessed in 25.358 patients.

Within 24 hours of this assessment, 648 patients completed a self-report in which they were asked about the presence of passive suicidal ideation. We used cluster analysis to determine the clinical profile of a population of patients according to the agreement between reports made by clinicians and self-reported information.

Results

A low level of agreement (kappa = 0.072) was found between clinicians and patients, as 56.4% (n = 366) of clinicians’ reports classified as containing no death-related ideas, although on self-report the patient did state that they had passive suicidal ideation. In this group, two clusters (cluster 2 y 4) were found to have shared characteristics: female sex, middle age, cohabitation, active employment, no history of suicidal behavior, and diagnosis of neurotic, stress-related, and somatoform disorders. Additionally, cluster 4 patients self-reported sleep disturbances, less appetite, poor treatment adherence, and aggressiveness.

Conclusions

We found low agreement between patients’ self-reports and clinician assessments regarding the passive suicidal ideation. Self-report may be useful in suicide risk assessment as a complementary method, that allows to generate a confidential space that could reduce the problem of underreporting of passive suicidal ideation.

背景在自杀未遂和自杀死亡之前，通常会有自杀和/或死亡的想法。我们研究了门诊精神卫生服务中临床医生报告与患者在线自我报告之间在被动自杀意念方面的一致性。方法2014年至2016年期间，在马德里希门尼斯-迪亚斯基金会医院附属门诊精神卫生机构的常规精神和心理咨询中，对25358名患者的死亡意愿进行了评估。在评估后24小时内，648名患者完成了自我报告，其中被问及是否存在被动自杀意念。我们使用聚类分析法，根据临床医生报告和患者自我报告信息之间的一致性来确定患者群体的临床特征。结果发现，临床医生和患者之间的一致性水平较低（kappa = 0.072），56.4%（n = 366）的临床医生报告被归类为不包含与死亡相关的想法，尽管患者在自我报告中确实表示他们有被动自杀意念。在这一群体中，有两个群组（群组 2 y 4）具有共同的特征：女性、中年、同居、积极就业、无自杀行为史，以及神经质、压力相关和躯体形式障碍诊断。此外，第 4 组患者还自我报告了睡眠障碍、食欲不振、治疗依从性差和攻击性强。自我报告作为一种补充方法，在自杀风险评估中可能是有用的，它可以产生一个保密空间，从而减少被动自杀意念报告不足的问题。

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引用次数: 0

Case report. Pregnancy in women with an eating disorder 病例报告。患有饮食失调症的妇女怀孕

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-10-01 DOI: 10.1016/j.psiq.2024.100511

Belén Resa-Pérez , Andrea Jiménez-Mayoral , Vanessa Gladys Velasquez-Acebey , Filip Damian Budny , Georgina Badia i Realp , Salvador Miret-Fallada , María Irigoyen-Otiñano

Introduction

Pregnancy has been described as a period of symptomatic stability for women diagnosed with eating disorder (ED). However, a poor control of alimentary symptoms before and during pregnancy is associated with higher risk of adverse effects during childbirth and the postpartum period. A case report is presented and a bibliographic review is carried out.

Methods

The authors take the case of a 33-year-old woman diagnosed with anorexia nervosa during adolescence, who becomes pregnant at the age of 30. A non-systematic review was carried out using the Pubmed database using keywords [eating disorder] AND [pregnancy]. Studies of more than 5 years were excluded. The patient's informed consent was obtained. This work complies with the agreements of the Declaration of Helsinki.

Results

Eutocic delivery was carried out without incidents. Currently, the baby is 5 months old, his weight is adjusted to his age and his neurodevelopment is normal. Although the patient denies restrictions or purgative behaviors, she has lost weight in postpartum and has recovered her pre-pregnancy body mass index. No major affective symptoms have been observed in this period.

Discussion/Conclusions

Pregnancy and postpartum period constitute periods of greater vulnerability in terms of eating symptoms in patients with EDs. Emphasis should be placed on a multidisciplinary approach with the aim of avoiding the appearance of associated risk factors both for the mother and the baby.

导言对于被诊断患有饮食失调症（ED）的女性来说，怀孕是一个症状稳定期。然而，妊娠前和妊娠期饮食症状控制不佳与分娩和产后不良反应的风险较高有关。作者以一名 33 岁的女性为例，她在青春期被诊断为神经性厌食症，30 岁时怀孕。作者使用 Pubmed 数据库中的关键词[饮食失调]和[怀孕]进行了非系统性综述。超过 5 年的研究被排除在外。已获得患者的知情同意。这项工作符合《赫尔辛基宣言》的协议。目前，婴儿已经 5 个月大，体重与年龄相符，神经发育正常。虽然患者否认有限制或排便行为，但她的体重在产后有所下降，并已恢复到怀孕前的体重指数。讨论/结论妊娠期和产后是 ED 患者更容易出现饮食症状的时期。重点应放在多学科方法上，以避免出现对母亲和婴儿相关的危险因素。

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引用次数: 0

Cognición y conducta suicida en psicosis y depresión 精神病和抑郁症患者的认知和自杀行为

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-09-26 DOI: 10.1016/j.psiq.2024.100512

Aina Sastre-Buades , Enrique Baca-Garcia , Maria Luisa Barrigon

引用次数: 0

Síntomas de ansiedad y depresión en los trabajadores de la salud durante la pandemia por COVID-19 en un centro de salud en Barranquilla, Colombia 哥伦比亚巴兰基亚一家医疗中心的医护人员在 COVID-19 大流行期间的焦虑和抑郁症状

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-09-03 DOI: 10.1016/j.psiq.2024.100505

Erika Arenas-Contreras , Laura Ariza-Teheran , Laura Borja-Egher , Omaira Diaz-Granados , Oriana Mora-Cartusciello , Lawren Thowinsson-Merizalde , Karina Cure-Aragón , Tania Acosta-Vergara , Edwin Guevara-Romero , Victor Florez-Garcia

Introduction

The spread of the pandemic in Colombian territory occurred heterogeneously, suggesting a potentially differential impact on the mental health of healthcare professionals who responded to the emergency.

Objective

To identify factors related to depressive and anxious symptoms in healthcare workers during the COVID-19 pandemic at a clinical center in the city of Barranquilla.

Methodology

We conducted a cross-sectional study involving 71 active healthcare workers in 2022. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were utilized to estimate the prevalence of these mental disorders.

Results

We estimated a prevalence of depressive and anxious symptoms, mild or higher, at 18.3% (CI95% 10.1–29.3) and 21.1% (CI95% 12.3–33.4), respectively. Work experience, glove usage, gastrointestinal discomfort, and appetite disturbance were significantly associated with depressive symptoms, while loss of libido and appetite disturbance were linked to mild or higher anxious symptoms.

Conclusions

Depressive and anxious symptoms are common in the mental health of healthcare workers in pandemic contexts. Factors associated with these symptoms, such as the use of personal protective equipment and work experience, could be addressed through organizational management.

导言大流行病在哥伦比亚境内的传播是异质性的，这表明对应对紧急情况的医护人员的心理健康可能会产生不同程度的影响。方法我们开展了一项横断面研究，涉及 2022 年的 71 名在职医护人员。结果我们估计，轻度或更严重的抑郁症状和焦虑症状的患病率分别为 18.3% (CI95% 10.1-29.3) 和 21.1% (CI95% 12.3-33.4)。工作经历、手套使用、胃肠道不适和食欲障碍与抑郁症状明显相关，而性欲减退和食欲障碍则与轻度或更严重的焦虑症状有关。与这些症状相关的因素，如个人防护设备的使用和工作经验，可以通过组织管理来解决。

{"title":"Síntomas de ansiedad y depresión en los trabajadores de la salud durante la pandemia por COVID-19 en un centro de salud en Barranquilla, Colombia","authors":"Erika Arenas-Contreras , Laura Ariza-Teheran , Laura Borja-Egher , Omaira Diaz-Granados , Oriana Mora-Cartusciello , Lawren Thowinsson-Merizalde , Karina Cure-Aragón , Tania Acosta-Vergara , Edwin Guevara-Romero , Victor Florez-Garcia","doi":"10.1016/j.psiq.2024.100505","DOIUrl":"10.1016/j.psiq.2024.100505","url":null,"abstract":"<div><h3>Introduction</h3><p>The spread of the pandemic in Colombian territory occurred heterogeneously, suggesting a potentially differential impact on the mental health of healthcare professionals who responded to the emergency.</p></div><div><h3>Objective</h3><p>To identify factors related to depressive and anxious symptoms in healthcare workers during the COVID-19 pandemic at a clinical center in the city of Barranquilla.</p></div><div><h3>Methodology</h3><p>We conducted a cross-sectional study involving 71 active healthcare workers in 2022. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were utilized to estimate the prevalence of these mental disorders.</p></div><div><h3>Results</h3><p>We estimated a prevalence of depressive and anxious symptoms, mild or higher, at 18.3% (CI95% 10.1–29.3) and 21.1% (CI95% 12.3–33.4), respectively. Work experience, glove usage, gastrointestinal discomfort, and appetite disturbance were significantly associated with depressive symptoms, while loss of libido and appetite disturbance were linked to mild or higher anxious symptoms.</p></div><div><h3>Conclusions</h3><p>Depressive and anxious symptoms are common in the mental health of healthcare workers in pandemic contexts. Factors associated with these symptoms, such as the use of personal protective equipment and work experience, could be addressed through organizational management.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efectos terapéuticos de las plantas medicinales en los trastornos de ansiedad. Revisión exploratoria 药用植物对焦虑症的治疗效果。探索性综述

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-09-02 DOI: 10.1016/j.psiq.2024.100495

Jose Luis Estela-Zape , Diana Carolina Libreros-Chica , Lizeth Dayana Noreña-Buitrón , Jose Miguel Sierra-Olea

Objective

Describe the therapeutic effects of medicinal plants in anxiety disorders.

Methods

Scoping review conducted by the guidelines (PRISMA-ScR). Scopus, Web of Science and PubMed were searched for original articles, clinical trials and case series that explained the effects of medicinal plants used as anxiolytic agents in English and without publication date restrictions.

Results

A total of 735 records were initially identified. After eliminating duplicates and applying eligibility criteria, 11 studies were included that described the neurobiological actions of medicinal plants in relation to anxiety. The studies highlighted the benefit of plants by regulating neurotransmitters and various neurobiological systems, influencing the modulation of neuronal and neurochemical responses associated with the disorder.

Conclusions

Studies support the effectiveness of herbal therapy in reducing anxiety, but further research is required to validate its effectiveness, clinical safety, and potential drug interactions.

方法根据指南（PRISMA-ScR）进行范围界定审查。方法根据指南（PRISMA-ScR）进行范围综述，在 Scopus、Web of Science 和 PubMed 上搜索用英文阐述药用植物作为抗焦虑药效果的原创文章、临床试验和系列病例，且无出版日期限制。在剔除重复内容并应用资格标准后，共纳入了 11 项研究，这些研究介绍了药用植物对焦虑症的神经生物学作用。这些研究强调了植物通过调节神经递质和各种神经生物系统、影响与焦虑症相关的神经元和神经化学反应的调节作用而带来的益处。结论研究支持草药疗法在减轻焦虑方面的有效性，但还需要进一步的研究来验证其有效性、临床安全性和潜在的药物相互作用。

{"title":"Efectos terapéuticos de las plantas medicinales en los trastornos de ansiedad. Revisión exploratoria","authors":"Jose Luis Estela-Zape , Diana Carolina Libreros-Chica , Lizeth Dayana Noreña-Buitrón , Jose Miguel Sierra-Olea","doi":"10.1016/j.psiq.2024.100495","DOIUrl":"10.1016/j.psiq.2024.100495","url":null,"abstract":"<div><h3>Objective</h3><p>Describe the therapeutic effects of medicinal plants in anxiety disorders.</p></div><div><h3>Methods</h3><p>Scoping review conducted by the guidelines (PRISMA-ScR). Scopus, Web of Science and PubMed were searched for original articles, clinical trials and case series that explained the effects of medicinal plants used as anxiolytic agents in English and without publication date restrictions.</p></div><div><h3>Results</h3><p>A total of 735 records were initially identified. After eliminating duplicates and applying eligibility criteria, 11 studies were included that described the neurobiological actions of medicinal plants in relation to anxiety. The studies highlighted the benefit of plants by regulating neurotransmitters and various neurobiological systems, influencing the modulation of neuronal and neurochemical responses associated with the disorder.</p></div><div><h3>Conclusions</h3><p>Studies support the effectiveness of herbal therapy in reducing anxiety, but further research is required to validate its effectiveness, clinical safety, and potential drug interactions.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Eficacia, seguridad y tolerabilidad de cariprazina en el trastorno depresivo mayor: una revisión sistemática y aspectos prácticos 卡哌嗪治疗重度抑郁障碍的疗效、安全性和耐受性：系统综述和实用性

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-08-29 DOI: 10.1016/j.psiq.2024.100494

Anna Giménez-Palomo , Lidia Ilzarbe , Eduard Vieta

Cariprazine is a new generation antipsychotic whose mechanism of action is based on partial agonism of dopamine D₂ and D₃ receptors, in addition to serotonin 5HT_1A receptors. Its use has been approved by the Spanish Agency of Medicines and Medical Devices for the treatment of schizophrenia. However, the available literature has demonstrated its efficacy in the treatment of manic, mixed, and depressive episodes of bipolar disorder, all them approved indication in the United Sattes and several other countries. Likewise, there is currently evidence regarding the clinical efficacy, safety, and tolerability of cariprazine as an adjunctive treatment in major depressive disorder, which has granted this compound the approval by the Food and Drug Administration (FDA). While three clinical trials have shown negative results, two others have observed a significant reduction in depressive and anxiety symptoms, which has also been confirmed in a long-term open-label trial. Despite presenting a favorable adverse effect profile compared to other antipsychotics, cariprazine has been associated with akathisia and restlessness. Based on current evidence, the use of cariprazine as an adjunctive treatment to antidepressants may be beneficial in major depressive disorder. Future studies may address its efficacy in monotherapy, and its role in the prevention of depressive recurrences.

卡利普嗪是一种新一代抗精神病药物，其作用机制是部分激动多巴胺 D2 和 D3 受体以及血清素 5HT1A 受体。西班牙药品和医疗器械管理局已批准将其用于治疗精神分裂症。不过，现有文献也证明了它在治疗双相情感障碍的躁狂、混合和抑郁发作方面的疗效，这些都是美国和其他一些国家批准的适应症。同样，目前也有证据表明卡培拉嗪作为重度抑郁障碍的辅助治疗药物具有临床疗效、安全性和耐受性，美国食品药品管理局（FDA）因此批准了这种化合物。虽然有三项临床试验显示了负面结果，但另外两项临床试验观察到抑郁和焦虑症状明显减轻，这一点也在一项长期开放标签试验中得到了证实。尽管与其他抗精神病药物相比，卡雷普嗪具有良好的不良反应特征，但它也与运动失调和躁动不安有关。根据目前的证据，使用开浦嗪作为抗抑郁药的辅助治疗可能对重度抑郁障碍有益。未来的研究可能会探讨其在单药治疗中的疗效及其在预防抑郁复发中的作用。

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引用次数: 0

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