Actas espanolas de psiquiatria最新文献

Background: The pandemic caused by the SARS-CoV-2 virus led to a series of containment and mitigation measures through lockdowns, social distancing, and the closure of educational establishments, which have had a profound impact on the mental health of the adolescent population.

Objective: The main objective of the present study has been to identify the sociodemographic and mental health variables related to suicidal ideation, planning, and attempts in young people participating in outpatient intervention projects within the Chilean protection network since the onset of the pandemic and the strictest lockdowns.

Method: The study's sample consists of 125 young people aged 14 to 18 years (M = 15.65; SD = 1.22), participating in outpatient intervention projects within the National Service for Minors (SENAME)/Better Childhood protection network. Through a self-report survey, the young participants provided responses on sociodemographic variables and suicidal behaviour (ideation, planning, and attempts).

Results: 29.9% of the participants reported suicidal ideation during the onset of the pandemic and the established lockdowns; 29.2% reported having devised a plan to do so, and 18.2% indicated having attempted suicide during the evaluated period. A higher occurrence of suicidal behaviour was observed in females, sexual minorities, respondents over 15 years old, and respondents presenting depressive symptoms.

Conclusions: The Covid-19 pandemic has had a significant impact on suicidal behaviour among the adolescent population served by the protection network in Chile. The prior violation of their rights may have contributed to the issue, particularly affecting young females in late adolescence with indicators of depression, who require specialized intervention due to the high risk detected.

Background: This study aims to explore the clinical effect of psychotherapy based on five-element theory in traditional Chinese medicine (TCM) in improving the mental states of patients with post-stroke depression (PSD), to provide reference and guidance for clinical treatment.

Methods: A retrospective study was conducted on 163 PSD cases treated in The Second Affiliated Hospital, Hengyang Medical School, University of South China from January 2022 to January 2023. The patients treated with conventional treatment were included in the control group (n = 84), and patients receiving psychotherapy based on five-element theory in TCM and conventional treatment were classified as the observation group (n = 79). The anxiety levels, depression levels, TCM syndrome scores and sleep quality were compared in both groups. The enumeration data were tested by χ2 test. Kolmogorov-Smirnov method tested whether the measurement data met normal distribution, and those did not meet normal distribution were tested by Mann-Whitney method. The difference was statistically significant at p < 0.05.

Results: After 4-week and 8-week treatments, the observation group had significantly lower scores of Hamilton Anxiety Scale (z = -4.562, -6.765; p < 0.001), Hamilton Depression Scale (z = -7.588, -8.023; p < 0.001), TCM syndrome (z = -7.138, -10.946; p < 0.001), and Pittsburgh sleep quality index (z = -6.819, -8.240; p < 0.001) than the control group.

Conclusion: Psychotherapy based on five-element theory in TCM is beneficial to patients with PSD and can bring a certain clinical reference value.

Background: Depression is a common mental illness worldwide. Neuroimaging techniques, such as magnetic resonance imaging and functional magnetic resonance imaging, play an essential role in diagnosing and evaluating depression. This study is based on magnetic resonance imaging (MRI)-related research to explore the comparison of brain function and structure between patients with severe depression and normal individuals, and to conduct meta-analysis.

Methods: We conducted searches in various databases such as PubMed, Web of Science, Embase, and Cochrane Library to obtain research data on comparing brain function and structure between patients with severe depression and healthy individuals. The search keywords included "Major Depressive Disorder", "Brain Function", "Brain Structure", "Depression", "MRI", and "Magnetic Resonance". The quality assessment was conducted using the bias risk assessment tool recommended by the Cochrane Collaborative Network. Literature was screened following the predetermined inclusion and exclusion criteria, and Anisotropic Effect-Size Seed-Based Differential Mapping (AES-SDM) was used for systematic meta-analysis. Regression analysis was performed on age, gender, disease duration, years of education, and treatment status.

Results: After a thorough screening process, 10 documents were selected for subsequent analysis. These studies consisted of 477 study subjects, including 231 depression patients and 246 healthy individuals. The proportion of women was 36%-75%, and the disease duration was 3-60 months. The patients in 4 documents had first attacks, and the patients in the other 6 documents had multiple attacks. The baseline conditions of the 10 included documents were consistent and comparable. None of the studies reported blinding methods, and none of the results had incomplete data. The Regional homogeneity (ReHo) levels in the left precuneus (BA7), lentiform nucleus (BA48), and left prefrontal lobe (BA32) were significantly increased in the depression group, with voxel numbers of 358, 116, and 181, respectively. Conversely, the left postcentral gyrus (BA4), left cerebellar area (hemispheric lobule I, IV/V, lingual gyrus, fusiform gyrus), left fusiform gyrus (BA30), and right cingulate gyrus (BA23) were significantly reduced, with voxel numbers of 17, 50, and 124, respectively. Furthermore, regression analysis showed that gender, age, disease duration, years of education, and disease severity were potential influencing factors, and the disease duration demonstrated the most significant impact on the left cingulate gyrus (SDM = 2.777).

Conclusion: There are significant differences in brain function and structure between patients with major depression and healthy individuals. Furthermore, our findings reveal a substantial correlation between the severity of depressive symptoms and brain function and structure indicators. These findin

Background: Inflammatory bowel disease (IBD) is a chronic, lifelong disease, so IBD patients are highly susceptible to negative emotions, such as anxiety and depression, resulting in a reduced quality of life. Mindfulness-based intervention (MBI) is widely used to reduce stress, anxiety and depression in people. Therefore, this study conducted a systematic review of mindfulness-based intervention training on anxiety, depression, and quality of life in patients with IBD through meta-analysis.

Methods: Search papers in PubMed, Web of Science, Cochrane Library, Google Scholar, CNKI, Wanfang, and Embase databases. The search time limit was from the establishment of the database to May 2023. Randomized controlled trial studies of the effect of mindfulness intervention training on patients with IBD were screened, the included results were integrated and analyzed, and ReviewManager 5.4 was used for meta-analysis.

Results: A total of 14 studies with a total of 1030 IBD patients were included. A total of 10 studies showed that the anxiety of patients in the mindfulness intervention group was significantly reduced by (standard mean difference (SMD) = -0.73, 95% confidence interval (CI): -1.01 to -0.45) compared to the control group. 8 studies showed that the intervention group significantly reduced patients' depression (SMD = -0.60, 95% CI: -0.78 to -0.42). 7 studies showed that the patient's quality of life improved after mindfulness intervention (SMD = 0.66, 95% CI: 0.45-0.87).

Conclusion: Mindfulness-based intervention training can improve anxiety, depression, and quality of life in patients with inflammatory bowel disease in the short term, but the long-term effects need to be confirmed by more randomized controlled trials.

Background: Numerous observational studies have suggested a correlation between sarcopenia and depression, but the nature of this relationship requires further investigation.

Methods: This study employed bidirectional Mendelian randomization to explore this connection. Data from genome-wide association studies were used, encompassing measures of sarcopenia and mental factors, including depression and emotional states. The initial analysis concentrated on the impact of depression on sarcopenia, and then it examined the reverse relationship. The same methodology was applied to emotional data for validation.

Results: The results indicated a reciprocal causation between sarcopenia and depression, even when emotional state data were considered. Various emotions can impact sarcopenia, and in turn, sarcopenia can affect emotions, except subjective well-being. These findings highlight a cyclic deterioration between sarcopenia and depression, with a link to negative emotions and a partially ameliorative effect of subjective well-being on sarcopenia.

Conclusions: In summary, this study sheds light on the interplay between psychiatric factors and sarcopenia, offering insights into intervention and prevention strategies.

Background: Lung cancer is a significant health concern, and is often accompanied by comorbid depression, leading to worsened prognosis and decreased quality of life for patients. This study aimed to investigate the potential influence of a diet rich in Omega-3 fatty acids on the quality of life of patients with squamous cell lung cancer and comorbid depression.

Methods: A retroactive analysis of clinical information from patients with squamous cell lung cancer and comorbid depression admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University from June 2022 to June 2023 was conducted. The patients were classified into two groups on the basis of different dietary care approaches: the Routine Dietary Group and the Omega-3 Fatty Acids Group. Baseline characteristics, pulmonary function tests, dietary intake, depression scoring, and quality of life scores were compared between the two groups.

Results: 103 patients in total were included, with 51 in the Routine Dietary Group and 52 in the Omega-3 Fatty Acids Group. The Omega-3 Fatty Acids Group exhibited significantly higher ingestion of Omega-3 fatty acids in comparison with the Routine Dietary Group (3.15 ± 0.64 g/day vs. 2.93 ± 0.28 g/day, p = 0.022). Despite similar baseline pulmonary function tests, patients in the Omega-3 Fatty Acids Group showed significantly higher scores in physical (70.17 ± 4.81 vs. 68.18 ± 5.03, p = 0.043) and emotional (71.29 ± 4.58 vs. 69.38 ± 4.25, p = 0.030) functioning, as well as lower scores in insomnia (27.41 ± 4.51 vs. 29.34 ± 4.21, p = 0.027) and constipation (7.34 ± 1.66 vs. 8.43 ± 3.36, p = 0.040).

Conclusion: The study provided insights into the potential impact of a diet rich in Omega-3 fatty acids on the quality of life of patients with squamous cell lung cancer and complicating depression, suggesting that dietary interventions emphasizing Omega-3 fatty acids may be conducive to improving physical and emotional functioning, as well as symptom management, in this patient population.

Background and objective: Alzheimer's disease is a progressive neurodegenerative disorder characterized by cognitive decline, behavioral changes, and functional impairments. Apathy, a common symptom in Alzheimer's disease, refers to a lack of motivation, interest, and emotional responsiveness. It can significantly impact patients' quality of life and increase caregiver burden. This study aimed to determine the effects of a diversified rehabilitation program combined with donepezil on apathy, cognitive function, and family caregiver burden of Alzheimer's disease patients.

Methods: A total of 105 Alzheimer's disease patients treated at our hospital between January 2020 and January 2023 were selected and analyzed retrospectively. They were assigned to the control group (n = 50) or the observation group (n = 55). The two groups did not differ in terms of general data such as age and sex. All patients were treated with donepezil orally. The control group was given routine nursing, whereas the observation group was given a diversified rehabilitation program intervention, including cognitive training and emotional support. The Hasegawa's dementia scale, mini-mental state examination, and Montreal cognitive assessment scale were adopted to evaluate the cognitive function of the two groups before and after treatment. A caregiver burden scale, the Zarit Burden Interview (ZBI) and the Apathy Evaluation Scale Informant version (AES-I) were used to evaluate the caregiver burden and apathy of the two groups.

Results: A significantly higher overall response rate to treatment was found in the observation group (94.55%) than in the control group (80.00%) (p = 0.024). After treatment, scores on the Hasegawa's dementia scale, mini-mental state examination, and Montreal cognitive assessment scale of the two groups increased to varying degrees, with greater increases in the observation group than in the control group (p < 0.05). The ZBI and AES-I scores of the two groups decreased to different degrees after treatment, with greater decreases in the observation group than in the control group (p < 0.05).

Conclusion: A diversified rehabilitation program combined with donepezil can substantially alleviate the apathy of Alzheimer's disease patients, improve their cognitive function, and reduce the burden on their families.

Background: Readmission, defined as any admission after discharge from the same hospital, has negative implications for health outcomes. This study aims to identify the sociodemographic and clinical factors associated with hospital readmission among psychiatric patients.

Methodology: This case-control study analyzed 202 clinical records of patients admitted to a psychiatric hospital between 2019-2021. The sample was selected using simple random sampling. Qualitative variables were presented using frequencies, percentages, and chi-square tests for association. Quantitative variables were described using central tendency measures and dispersion of data, investigated with the Kolmogorov-Smirnov test, Student's t-test or Wilcoxon test as appropriate. Regression analysis was conducted to determine factors linked to readmission. p < 0.05 was considered.

Results: Women accounted for a higher readmission rate (59%). Patients diagnosed with schizophrenia had a higher readmission rate (63%), experienced longer transfer times to the hospital during readmissions, and had shorter hospital stays. Polypharmacy and pharmacological interactions were associated with readmission. Olanzapine treatment was identified as a risk factor for readmission (ExpB = 3.203, 95% CI 1.405-7.306, p = 0.006).

Conclusions: The findings suggest avoiding polypharmacy and medications with high side effect profiles to reduce readmissions. This study offers valuable insights for clinical decision-making from admission to discharge planning, aiming to enhance the quality of care.

Introduction: Current literature does not dispose from a widely accepted definition of recovery in alcohol use disorder (AUD), and most proposals originate from anglophone countries. This study introduces a pioneering consensus in Spain on the definition of recovery in AUD.

Method: The Delphi method was used. The expert panel, comprising 54 multidisciplinary professionals from the Community of Madrid.

Results: A high level of consensus (≥80% agreement) was reached for 45% of the items and majority (≥60%) for 84%. Recovery is understood as a dynamic, personalized, and voluntary process, potentially enduring throughout one's lifespan. It entails a transformative lifestyle shift aimed at achieving a significant improvement in overall quality of life, encompassing physical and mental health, interpersonal relationships, and environmental factors. The journey of recovery is marked by heightened psychological well-being, is characterized by empowerment, personal growth, existential purpose, and positive identity reconstruction. Recovery is supported by substance use management, requires proactive individual agency and involves both personal and societal responsibilities.

Conclusions: This study represents a milestone as it is the first consensus in the Community of Madrid on the meaning of recovery in AUD. The proposed definition of recovery could be a potential reference for similar regions within Spain or even for other countries with cultural similarities. The elucidation of a clear framework of recovery provides a solid basis for future research efforts and clinical interventions in the Spanish AUD landscape.

Background: The incidence of self-harm and suicidal behaviour in adolescents is increasing. Considering the great impact in this population, an actualization of the evidence of those psychological treatment's excellence for suicidal behaviour. Thus, the aim of this paper is to compile the available evidence on the effectiveness of cognitive behavioural therapy and dialectical behavioural therapy in preventing self-harm and suicidal behaviour in adolescents.

Methods: A umbrella review was carried out, different databases (PubMed, CINAHL, Cochrane Library, Psyinfo, Embase, Web of Science, Scopus and Google Scholar) were consulted. The 16-item measurement tool to assess systematic reviews-2 (AMSTAR-2) were performed by two independent reviewers and any discrepancies were resolved by consensus. The Rayyan-Qatar Computing Research Institute was used for the screening process.

Results: Nine systematic reviews were included. Cognitive Behavioural Therapy appears to reduce the incidence of suicide-related events compared with treatment as usual, compared to usual treatment (which usually consists of drugs and talk therapy) especially when combined with fluoxetine. Dialectical behavioural therapy seems to be associated with a reduction in suicidal ideation and self-harm.

Conclusions: Although the results found show results with high heterogeneity. The evidence on cognitive behavioural therapy and dialectical behavioural therapy for suicide prevention, self-harm and suicide ideation in adolescents seems to show positive results. Considering, the special population and great impact, further research is needed and comparable studies should be sought that allow to set up robust recommendations.