Actas espanolas de psiquiatria最新文献

Background: Personality Disorders (PDs) are a critical public health issue frequently misdiagnosed and underdiagnosed in mental health services. The purpose of this study is to demonstrate the reliability, validity and repeatability of the Spanish version of the Standardised Assessment of Personality - Abbreviated Scale (SAPAS), a short and self-administered scale for PD diagnosis and screening.

Methods: This longitudinal study was performed using a 107-patient sample who attended community mental health services and outpatient clinics. A Receiver Operating Characteristic (ROC) curve was utilized to determine concurrent validity by comparing the SAPAS with the International Personality Disorder Examination (IPDE), thus establishing sensitivity, specificity, and predictive value for several cut-off points. Repeatability was measured by calculating an Intraclass Correlation Coefficient (ICC) between an initial SAPAS administration and a second one carried out 30 days later.

Results: The Area Under the Curve (AUC) was found to be 0.84. A cut-off point of 3 provided 90% sensitivity and 52% specificity and correctly classified 71% of the cases. The ICC for the two SAPAS measures was 0.88.

Conclusion: Our Spanish translation for the SAPAS proves to be a reliable, valid and consistent PD screening tool in mental health settings.

Background: Recent developments have highlighted the importance of separation anxiety across the lifespan, positioning it as a longitudinal psychopathological dimension. Few studies in the past decade, have explored this correlation within the context of other psychiatric disorders. This study aims to assess the presence of childhood and adulthood separation anxiety in a sample of adults with personality disorders, and its potential contribution to specific personality domains.

Methods: A sample of 102 patients (39% male, 61% female) with a principal diagnosis of "Unspecified Personality Disorders" according to the Diagnostic and Statistical Manual of Mental Disorders - 5° edition - text revision (DSM-5-TR) was recruited. The patients were assessed using the following instruments: the Structured Clinical Interview for Separation Anxiety Symptoms and the Personality Inventory for DSM-5-Brief Form (PID-5-BF). Correlation and linear regression analyses were performed.

Results: Both childhood and adulthood separation anxiety were positively correlated with all PID-5 domains except "Antagonism" (p = 0.352/0.067). The linear regression analysis showed that only adult separation anxiety was a direct predictor of the personality domains "Negative Affectivity" (p = 0.002), "Detachment" (p = 0.008), and "Psychoticism" (p = 0.028).

Conclusions: Our study is the first to highlight the potentially crucial role of adult separation anxiety levels in personality disorders. Unexpectedly, childhood separation anxiety did not predict personality domains. The presence of separation anxiety should be considered a potential developmental obstacle to a healthy transition toward a well-rounded adult personality organization.

Background: Comorbidity between substance use disorders and other mental health conditions is common, yet existing treatments often fail to address its full spectrum. Opportunities for integrated treatment are limited, and the effects of such treatment remain relatively unexplored. This study explores the experiences of individuals with substance use disorders who successfully completed a four-month integrated intensive program at an outpatient addiction-care clinic in western Sweden.

Method: An anonymous survey combining quantitative measures and qualitative open-ended questions was used to evaluate the experiences of 65 clients (out of 117) who completed the program between 2015 and 2021.

Results: The findings revealed that most clients expressed high levels of satisfaction with the program. The mean scores for the questions ranged from 9.17 to 9.35, indicating a generally positive experience. The standard deviations were relatively low (1.17 to 1.34), suggesting consistency in responses. The median scores for all questions were 10, with ranges indicating that most participants rated their experiences at the highest level. The analysis identified three key categories of clients' experiences: (1) strong relationships and a comprehensive treatment approach; (2) engaged, knowledgeable staff who lead with warmth; and (3) opportunities for self-development through novel experiences.

Conclusion: Clients who successfully completed the four-month integrated intensive program reported high satisfaction levels, positive relationships with staff, and valuable self-development insights. However, the high dropout rate limited gaining an understanding of the barriers to program completion, highlighting the need for further research aimed at enhancing retention rates and developing more effective integrated treatment interventions for individuals with substance use disorders.

Background: Anxiety, depression, and sleep disorders, as psychological and emotional diseases, have serious impact on people's physical and mental health, and receive increasing academic attention. This study aimed to examine anxiety, depression, and sleep disorder of staff in a district of Shenzhen and to provide the basis for the development of targeted intervention measures to improve the psychological status of cadres.

Methods: Based on the psychological evaluation data of staff cadres in a district of Shenzhen City obtained from January to December 2020, a stratified sampling method was adopted to randomly select two streets and three communities in each street. A total of six communities were selected as investigation units. All participants filled out the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI). Chi-square test and multiple logistic regression analysis were performed using R4.2.0 statistical software.

Results: A total of 705 effective psychological assessment questionnaires were matched, and there were 71 (10.13%) positive results on SAS, 156 (22.13%) positive results on SDS, and 264 (37.45%) positive results on PSQI. Chi-square test results showed that the detection rates of anxiety and depression were significantly different among the staff cadres of different genders and different educational levels (p < 0.05). The detection rate of sleep disorder of government officials significantly differed among different age groups (p < 0.05). The logistic regression analysis showed that the detection rates of anxiety, depression, and sleep disorder of female cadres and workers were significantly higher than those of male cadres and workers (p < 0.05). The detection rates of anxiety and depression of the staff with bachelor's degree and graduate degree were significantly lower than those of the staff with a college degree or below (p < 0.05).

Conclusion: The detection rates of anxiety and depression are different among staff of different genders and different education levels in a district of Shenzhen, where female staff and those with lower education levels have higher detection rates.

Background: Endometriosis often causes chronic pain and fertility issues, exacerbating the risk of depression and complicating conditions like rheumatoid arthritis, which further impacts quality of life. This study aimed to explore the detection rate of depression in patients with endometriosis and rheumatoid arthritis by using different diagnostic criteria, and to analyze the occurrence and influencing factors.

Method: A total of 108 patients with endometriosis combined with rheumatoid arthritis in the First Hospital of Lanzhou University from July 2021 to July 2023 were selected as samples. The internationally accepted Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the new depression assessment tool Hamilton Depression Scale (HAMD), and the Self-rating Depression Scale (SDS) were used to detect the incidence of depression in patients with endometriosis and rheumatoid arthritis. On the basis of the DSM-5 results, patients with concurrent depression were categorized into the observation group, and those without depression were categorized into the control group. The patients' clinical data were collected, and the impact factors were analyzed through binary logistic regression.

Results: DSM-5 detected 20 patients with depression, with a detection rate of 18.52%. HAMD detected 21 patients with depression, with a detection rate of 19.44%. SDS detected 18 patients with depression, with a detection rate of 16.67%. The difference in the detection rate of depression in patients with endometriosis combined with rheumatoid arthritis among the three methods was not statistically significant (p = 0.865). Binary logistic regression analysis showed that dysmenorrhea (odds ratio (OR) = 3.589, p = 0.005), dyspareunia (OR = 2.964, p = 0.012), Visual Analog Scale score (OR = 2.545, p = 0.001), Disease Activity Score-28 score (OR = 3.828, p = 0.004), Pittsburgh Sleep Quality Index score (OR = 3.942, p = 0.004), and Health Assessment Questionnaire-Disability Index score (OR = 3.527, p = 0.008) were significant influencing factors for depression.

Conclusion: DSM-5, HAMD, and SDS can be used to detect depression in patients with endometriosis and rheumatoid arthritis as effective tools for depression screening. Dysmenorrhea, dyspareunia, Visual Analog Scale (VAS), Rheumatoid arthritis disease activity (DAS28), Pittsburgh Sleep Quality Index (PSQI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) are influencing factors of depression in these patients.

Background: Mental contamination (MC) refers to feelings of internal filthiness associated with contamination obsessions. Ego-dystonic memories and thoughts can trigger MC, although it can also be activated by trauma, which is associated with the onset of post-traumatic stress disorder (PTSD). Research shows that MC, negative emotions and PTSD can occur simultaneously. Despite considerable interest from researchers and clinicians, to the best of our knowledge, no systematic review has been carried out on the relationship between disgust and other negative emotions with MC and PTSD. Therefore, we conducted this systematic review to summarise and synthesise the current understanding of these constructs in PTSD. The main objective of this study was to review the association between MC, post-traumatic stress disorder and trauma; the role of disgust and other negative emotions in these associations; and whether the relationship between MC and trauma is limited to traumatic sexual experiences.

Method: We searched PsycINFO, Psychology and Behavioural Sciences Collection, Scopus, Web of Science, Medline, PubMed, ProQuest Dissertations and Theses, Cochrane Library, APA PsycNet, and the Online Library of the University of Algarve. We also included grey literature published in Google Scholar. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the included studies.

Results: Twenty studies met the inclusion criteria for the review. Among these, six studies used a randomised methodology, nine used a non-randomised methodology, and five used a descriptive methodology. The results showed that MC is associated with all types of interpersonal trauma, although the relationship with sexual trauma was the strongest. Both basic emotion and disgust sensitivity appear to be significantly associated with MC and the severity of PTSD symptoms. Similarly, other negative emotions are positively associated with MC, although the experience and reappraisal of negative emotions may potentially attenuate the experience of MC.

Conclusions: Based on the findings, MC, disgust and negative emotions are important clinical constructs associated with trauma and PTSD. These results may contribute to our understanding and treatment of PTSD.

Background: Depression is a common comorbidity in patients with Parkinson's disease (PD) and can significantly impact their overall well-being. The combination of venlafaxine and pramipexole is a standard treatment approach for depression in PD. However, the effects of incorporating psychological care into the treatment regimen remain unclear. This study aimed to investigate the impact of psychological intervention in the treatment of depression in Parkinson's disease, using a combination of venlafaxine and pramipexole.

Methods: The clinical data of 151 patients with both Parkinson's disease (PD) and depression, treated in Geriatric Hospital of Hainan from May 2021 to May 2023, were analyzed retrospectively. Among the 151 patients, 71 received routine nursing care and were allocated to the control group, while the remaining 80 patients received psychological nursing care based on routine nursing care and were assigned to the study group. The Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Scale (HAMA) were used to evaluate the degree of depression and anxiety in both groups before and after care. The MOS 36-Item Short-Form Health Survey (SF-36) was employed to assess the quality of life of both groups before and after care. The efficacy and adverse reactions in both groups were also analyzed.

Results: Before care, the HAMD and HAMA scores did not significantly differ between the two groups (p > 0.05). However, after care, both groups exhibited a significant reduction in HAMD and HAMA scores (p < 0.0001), with a more pronounced decrease observed in the study group (p < 0.0001). Prior to care, there was no significant difference in SF-36 scores between the two groups (p > 0.05). However, following care, the SF-36 scores markedly increased in both groups (p < 0.0001), with a more pronounced increase in the study group (p < 0.0001). Additionally, a significantly lower overall response rate was noted in the control group compared to the study group (p = 0.013), while no significant difference was observed in the total incidence of adverse reactions between the two groups (p = 0.273).

Conclusion: Utilizing venlafaxine combined with pramipexole in the treatment of depression in PD, supplemented by psychological nursing care, significantly enhances therapeutic efficacy. This combined approach effectively alleviates symptoms of depression and anxiety in patients without introducing additional side effects. Hence, it emerges as a valuable clinical treatment option.

Background: Traumatic fractures are common orthopedic injuries with higher incidence globally, leading to acute stress disorder (ASD). Therefore, this study aimed to analyze the clinical outcomes of mindfulness-based stress reduction (MBSR) therapy in patients with traumatic bone fractures suffering from ASD.

Methods: This study included 135 patients who underwent trauma and fracture treatment at The 305th Hospital of the PLA between August 2021 and August 2023. Based on their participation in MBSR therapy, they were categorized into a conventional group (n = 62) and a combined group (n = 73). We comparatively analyzed the ASD Scale (ASDS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Self-Rating Sleep Status Scale (SRSS), and World Health Organization Quality of Life (WHOQOL) measurement-BREF (WHOQOL-BREF) scores between these two experimental groups. Furthermore, we assessed the incidence of ASD after treatment between these two groups.

Results: There were no significant differences in gender, age, body mass index, education, income, type of expense, trauma type, marital status, fracture site, diabetes status, hypertension status, and the pain visual analog scale (VAS) score, activities of daily living (i.e., modified Barthel index) score, and Social Support Rating Scale score between the two experimental groups (p > 0.05). Moreover, no significant differences were found in the prevalence of ASDS before treatment between these two groups (p > 0.05). However, after treatment, the ASDS score was significantly lower in the combined group than in the conventional group (p < 0.05). Furthermore, post-management analysis revealed that the incidence rate of ASD was 24.19% in the conventional group and 8.22% in the combined group. Moreover, the incidence of ASD was significantly lower in the combined group compared to the conventional group (p < 0.05). Before intervention, the difference in the SAS or SDS between patients was not statistically significant (p > 0.05). However, following treatment, the SAS and SDS scores of patients were significantly lower in the combined group than in the conventional group (p < 0.05). Similarly, after treatment, the SRSS scores of patients were substantially lower in the combined group than in the conventional group (p < 0.05). Furthermore, the WHOQOL-BREF score of patients was significantly greater in the combined group than in the conventional group (p < 0.05).

Conclusion: MBSR therapy can significantly alleviate ASD in trauma and fracture patients. Furthermore, this approach can alleviate the incidence of ASD and reduce anxiety, depression, and negative emotions in patients. These positive effects collectively improve sleep quality and overall well-being of patients.

No abstract present.

Background: With the advancement of blood purification technology, there is increasing attention to the mental health of hemodialysis patients, particularly concerning depression. This study aims to determine the effect of psychological interventions on anxiety and depression in hemodialysis patients through a meta-analysis.

Methods: A computerized search was conducted to identify randomized controlled trial (RCT) studies published in PubMed, Embase, Web of Science, ScienceDirect, and Cochrane Library databases from their inception to October 2023, focusing on the effects of psychological interventions on improving depression in hemodialysis patients. Data extraction, quality evaluation, and cross-checking were performed independently by two researchers. The methodological quality of the included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews and the meta-analysis was performed using RevMan 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark). The effect of psychological interventions on anxiety and depression in hemodialysis patients was determined by combining effect sizes and I2 statistics.

Results: Fifteen studies were included, encompassing a total of 929 hemodialysis patients: 468 in the intervention group and 461 in the control group. The results indicated that psychological interventions could improve depressive moods [mean difference (MD) = -4.91, 95% confidence intervals (CI) (-6.56, -3.26), p < 0.001] and anxiety status [MD = -5.11, 95% CI (-6.97, -3.25), p < 0.001]. A subgroup analysis based on the intervention duration (more or less than 8 weeks) revealed that patients experienced significant improvements in depression and anxiety regardless of the intervention length. Additionally, subgroup analyses focusing on quality of life demonstrated that psychological interventions significantly improved the psychological aspects of patients' quality of life [MD = 7.31, 95% CI (1.06, 13.56), p = 0.001]. Sensitivity analysis, which excluded sources of heterogeneity, indicated that psychological interventions significantly enhanced both the psychological [odds ratios (OR) = 4.14, 95% CI (1.08, 7.20), p = 0.008] and physical [MD = 2.52, 95% CI (0.10, 4.95), p = 0.04] aspects of patients' quality of life.

Conclusion: Psychological interventions can significantly alleviate depression and anxiety in hemodialysis patients and improve their quality of life. Psychotherapy holds promise as an effective method for improving depression in dialysis patients.