Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.03.004
Introduction and objectives
Selective serotonin reuptake inhibitors (SSRIs) are medications used in child and adolescent psychiatry mainly for the treatment of depression, anxiety and obsessive compulsive disorder. In general, these medications are safe and well tolerated. However, they can cause adverse effects such as activation syndrome, which if not identified can negatively affect adherence and response to treatment. Activation syndrome has received little attention and can be difficult to recognise due to the lack of a clear definition and objective diagnostic measures, and also because it can be confused with a worsening of the psychiatric disorder or mania triggered by the antidepressants. For all the above, it is important that professionals who prescribe antidepressants in the paediatric population are able to identify and manage activation syndrome when it occurs. Our aim was to carry out a narrative review of activation syndrome in children and adolescents treated with SSRIs in terms of definition, prevalence, pathophysiology, associated factors, relationship with suicide risk, management strategies and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population.
Methods
We performed a non-systematic narrative review of activation syndrome in children and adolescents which involved finding information in PubMed, Ovid, EBSCO, ProQuest and Embase. Review articles, prospective and retrospective investigations, systematic reviews, meta-analyses and other articles related to activation syndrome in children and adolescents were selected. The search was limited to studies published in English and Spanish that involved children and adolescents and no limits were applied to the publication date or study design.
Results
A total of 62 articles were included, 61 of them in English. The results were grouped into the following topics: definition; prevalence; pathophysiology; associated factors; relationship with suicide risk; management strategies; and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population. Activation syndrome refers to a set of symptoms consisting of impulsiveness, restlessness, increased activity, insomnia, irritability, disinhibition and agitation. This syndrome is poorly characterised in terms of its definition, prevalence, risk factors and pathophysiology, a situation that limits its recognition and evaluation. There are many factors that predispose the development of the syndrome such as age, differences in brain development in the paediatric population, the characteristics of the patient or the antidepressant, disorders of neurological development, and the doses and plasma levels of the medications. It has been thought that activation syndrome may be related to suicidal tendencies. However, the evidence in support of this link is inconsistent and further studies
{"title":"Activation syndrome in children and adolescents treated with selective serotonin reuptake inhibitors","authors":"","doi":"10.1016/j.rcpeng.2022.03.004","DOIUrl":"10.1016/j.rcpeng.2022.03.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Selective serotonin reuptake inhibitors (SSRIs) are medications used in child and adolescent psychiatry mainly for the treatment of depression, anxiety and obsessive compulsive disorder. In general, these medications are safe and well tolerated. However, they can cause adverse effects such as activation syndrome, which if not identified can negatively affect adherence and response to treatment. Activation syndrome has received little attention and can be difficult to recognise due to the lack of a clear definition and objective diagnostic measures, and also because it can be confused with a worsening of the psychiatric disorder or mania triggered by the antidepressants. For all the above, it is important that professionals who prescribe antidepressants in the paediatric population are able to identify and manage activation syndrome when it occurs. Our aim was to carry out a narrative review of activation syndrome in children and adolescents treated with SSRIs in terms of definition, prevalence, pathophysiology, associated factors, relationship with suicide risk, management strategies and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population.</p></div><div><h3>Methods</h3><p>We performed a non-systematic narrative review of activation syndrome in children and adolescents which involved finding information in PubMed, Ovid, EBSCO, ProQuest and Embase. Review articles, prospective and retrospective investigations, systematic reviews, meta-analyses and other articles related to activation syndrome in children and adolescents were selected. The search was limited to studies published in English and Spanish that involved children and adolescents and no limits were applied to the publication date or study design.</p></div><div><h3>Results</h3><p>A total of 62 articles were included, 61 of them in English. The results were grouped into the following topics: definition; prevalence; pathophysiology; associated factors; relationship with suicide risk; management strategies; and recommendations for reducing the risk of suicidal behaviours when using antidepressants in this population. Activation syndrome refers to a set of symptoms consisting of impulsiveness, restlessness, increased activity, insomnia, irritability, disinhibition and agitation. This syndrome is poorly characterised in terms of its definition, prevalence, risk factors and pathophysiology, a situation that limits its recognition and evaluation. There are many factors that predispose the development of the syndrome such as age, differences in brain development in the paediatric population, the characteristics of the patient or the antidepressant, disorders of neurological development, and the doses and plasma levels of the medications. It has been thought that activation syndrome may be related to suicidal tendencies. However, the evidence in support of this link is inconsistent and further studies ","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918285","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.03.003
Introduction
Different parameters of suicide attempts treated since the implementation of the Attention to Suicide Risk Program (ARSUIC) in 2012 at the Hospital Ramón y Cajal in Madrid Region are described in this paper.
Method
The sample was composed of 107 patients and the information was collected through a questionnaire created ad hoc with the following variables: type of suicidal ideation; drug use immediately prior to the attempt; method (in case of drug overdosing: drug/s used); location; accessibility to rescue; planning; intentionality; criticism; and brakes.
Results
Descriptive statistics were obtained and a comparison by gender was made through the χ2 and contingency coefficients tests. The data from the retrospective longitudinal study showed that the most common profile was of patients with unstructured ideas of death and no previous drug use who took an unplanned drug overdose in the family home, with the intention of self-harm or avoidance of discomfort, especially with benzodiazepines. Patients tend to ask for help afterwards and criticise the attempt, but potential restraints are often not recorded in the clinical report. Regarding the dissimilarities based on gender, statistically significant differences were found in prior alcohol consumption, in favour of men and in the overdose method, specifically with benzodiazepines, in favour of women.
Conclusions
Knowing the types of attempts at self-harm is essential for improving prevention, understanding and patient management.
{"title":"Proximal characteristics of suicide attempts: a study in a public hospital in Spain","authors":"","doi":"10.1016/j.rcpeng.2022.03.003","DOIUrl":"10.1016/j.rcpeng.2022.03.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Different parameters of suicide attempts treated since the implementation of the Attention to Suicide Risk Program (ARSUIC) in 2012 at the Hospital Ramón y Cajal in Madrid Region are described in this paper.</p></div><div><h3>Method</h3><p>The sample was composed of 107 patients and the information was collected through a questionnaire created <em>ad hoc</em> with the following variables: type of suicidal ideation; drug use immediately prior to the attempt; method (in case of drug overdosing: drug/s used); location; accessibility to rescue; planning; intentionality; criticism; and brakes.</p></div><div><h3>Results</h3><p>Descriptive statistics were obtained and a comparison by gender was made through the χ<sup>2</sup> and contingency coefficients tests. The data from the retrospective longitudinal study showed that the most common profile was of patients with unstructured ideas of death and no previous drug use who took an unplanned drug overdose in the family home, with the intention of self-harm or avoidance of discomfort, especially with benzodiazepines. Patients tend to ask for help afterwards and criticise the attempt, but potential restraints are often not recorded in the clinical report. Regarding the dissimilarities based on gender, statistically significant differences were found in prior alcohol consumption, in favour of men and in the overdose method, specifically with benzodiazepines, in favour of women.</p></div><div><h3>Conclusions</h3><p>Knowing the types of attempts at self-harm is essential for improving prevention, understanding and patient management.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918288","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2024.07.004
{"title":"Exposoma y biología en tiempos de geopsiquiatría","authors":"","doi":"10.1016/j.rcpeng.2024.07.004","DOIUrl":"10.1016/j.rcpeng.2024.07.004","url":null,"abstract":"","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076031","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2024.07.001
Introduction
Medical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE’s introduction in 2015.
Methods
An explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described.
Results
The mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0–5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups.
Conclusions
The OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process.
{"title":"Assessing skills in psychiatry. Experience and implementation of OSCE for medical students","authors":"","doi":"10.1016/j.rcpeng.2024.07.001","DOIUrl":"10.1016/j.rcpeng.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Medical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE’s introduction in 2015.</p></div><div><h3>Methods</h3><p>An explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described.</p></div><div><h3>Results</h3><p>The mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0–5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups.</p></div><div><h3>Conclusions</h3><p>The OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914773","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.03.002
Introduction
Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Telerehabilitation grew at this time as an alternative therapeutic tool. In this study we analysed remote cognitive rehabilitation in neurodevelopmental disorders.
Methods
This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months.
Results
After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorisation, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents.
Conclusions
Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.
{"title":"Telerehabilitation of subjects with neurodevelopmental disorders during confinement due to COVID-19","authors":"","doi":"10.1016/j.rcpeng.2022.03.002","DOIUrl":"10.1016/j.rcpeng.2022.03.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Telerehabilitation grew at this time as an alternative therapeutic tool. In this study we analysed remote cognitive rehabilitation in neurodevelopmental disorders.</p></div><div><h3>Methods</h3><p>This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months.</p></div><div><h3>Results</h3><p>After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorisation, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents.</p></div><div><h3>Conclusions</h3><p>Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914776","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.01.004
Introduction
It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society.
Objective
To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders.
Methods
A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015–2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions.
Results
Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight.
Conclusions
Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.
{"title":"Adherence to psychopharmacological treatment in patients with severe and persistent mental disorders: A systematic review","authors":"","doi":"10.1016/j.rcpeng.2022.01.004","DOIUrl":"10.1016/j.rcpeng.2022.01.004","url":null,"abstract":"<div><h3>Introduction</h3><p>It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society.</p></div><div><h3>Objective</h3><p>To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders.</p></div><div><h3>Methods</h3><p>A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015–2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions.</p></div><div><h3>Results</h3><p>Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight.</p></div><div><h3>Conclusions</h3><p>Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914772","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.02.005
Introduction
Worldwide, because of the demographic transition, the proportion of older adults has increased, which has been reflected in an increase in the prevalence of major neurocognitive disorder (MND). This phenomenon is especially important in low- and middle-income countries such as Colombia, given the high economic and social costs it entails. The objective was to analyse the association between socioeconomic variables with the presence of cognitive impairment in Colombian older adults.
Methods
The records of 23,694 adults over 60 years-of-age surveyed for SABE Colombia 2015, that took a stratified sample by conglomerates and were representative of the adult population over 60 years-of-age. This instrument assessed cognitive impairment using the abbreviated version of the Minimental (AMMSE) and collected information on multiple socioeconomic variables.
Results
19.7% of the older adults included in the survey were reviewed with cognitive impairment by presenting a score <13 in the AMMSE. There was a higher prevalence of cognitive impairment in women (21.5%) than in men (17.5%). The socioeconomic variables were shown to impact the prevalence of deterioration, especially being currently working (OR = 2.74; 95%CI, 2.43−3.09) as a risk factor and having attended primary school as a protective factor (OR = 0.30; 95%CI, 0.28−0.32), differentially according to gender.
Conclusions
An association between socioeconomic and sociodemographic factors with cognitive impairment in Colombian older adults was evidenced. Despite the above, a differential impact dependent on sex is suggested.
{"title":"Association between cognitive impairment and socioeconomic and sociodemographic factors in Colombian older adults","authors":"","doi":"10.1016/j.rcpeng.2022.02.005","DOIUrl":"10.1016/j.rcpeng.2022.02.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Worldwide, because of the demographic transition, the proportion of older adults has increased, which has been reflected in an increase in the prevalence of major neurocognitive disorder (MND). This phenomenon is especially important in low- and middle-income countries such as Colombia, given the high economic and social costs it entails. The objective was to analyse the association between socioeconomic variables with the presence of cognitive impairment in Colombian older adults.</p></div><div><h3>Methods</h3><p>The records of 23,694 adults over 60 years-of-age surveyed for SABE Colombia 2015, that took a stratified sample by conglomerates and were representative of the adult population over 60 years-of-age. This instrument assessed cognitive impairment using the abbreviated version of the Minimental (AMMSE) and collected information on multiple socioeconomic variables.</p></div><div><h3>Results</h3><p>19.7% of the older adults included in the survey were reviewed with cognitive impairment by presenting a score <13 in the AMMSE. There was a higher prevalence of cognitive impairment in women (21.5%) than in men (17.5%). The socioeconomic variables were shown to impact the prevalence of deterioration, especially being currently working (OR = 2.74; 95%CI, 2.43−3.09) as a risk factor and having attended primary school as a protective factor (OR = 0.30; 95%CI, 0.28−0.32), differentially according to gender.</p></div><div><h3>Conclusions</h3><p>An association between socioeconomic and sociodemographic factors with cognitive impairment in Colombian older adults was evidenced. Despite the above, a differential impact dependent on sex is suggested.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914774","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2022.03.001
Introduction
Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes.
Case report
We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 h, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 h after the infusion.
Discussion
Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis.
Conclusions
Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.
{"title":"Successful treatment for serious depression with suicidal risk in a heart transplant patient","authors":"","doi":"10.1016/j.rcpeng.2022.03.001","DOIUrl":"10.1016/j.rcpeng.2022.03.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes.</p></div><div><h3>Case report</h3><p>We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 h, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 h after the infusion.</p></div><div><h3>Discussion</h3><p>Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis.</p></div><div><h3>Conclusions</h3><p>Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914775","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}
Pub Date : 2024-04-01DOI: 10.1016/j.rcpeng.2024.08.001
Introduction
Problematic Internet use has become a growing problem worldwide; several factors, including personality, play an essential role in understanding this disorder. The Big Five personality traits and their association with problematic Internet use were examined in a large and diverse population.
Methods
A survey was applied to a total of 1,109 adults of working age. Each answered the Big Five Inventory and the Internet Addiction Test.
Results
Problematic Internet use was found in 10.6% of them (n = 112). The personality traits extraversion and openness to experience were significantly associated with those with the disorder. With adjustment models, a positive association was found between these traits and being single and higher education.
Conclusions
This study represents the largest of its kind in the Spanish-speaking population, highlighting the importance of recognising the factors involved in problematic Internet use.
{"title":"Problematic Internet Use and Personality Traits: Results in Working Age Adults","authors":"","doi":"10.1016/j.rcpeng.2024.08.001","DOIUrl":"10.1016/j.rcpeng.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Problematic Internet use has become a growing problem worldwide; several factors, including personality, play an essential role in understanding this disorder. The Big Five personality traits and their association with problematic Internet use were examined in a large and diverse population.</p></div><div><h3>Methods</h3><p>A survey was applied to a total of 1,109 adults of working age. Each answered the Big Five Inventory and the Internet Addiction Test.</p></div><div><h3>Results</h3><p>Problematic Internet use was found in 10.6% of them (n<!--> <!-->=<!--> <!-->112). The personality traits extraversion and openness to experience were significantly associated with those with the disorder. With adjustment models, a positive association was found between these traits and being single and higher education.</p></div><div><h3>Conclusions</h3><p>This study represents the largest of its kind in the Spanish-speaking population, highlighting the importance of recognising the factors involved in problematic Internet use.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142077495","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}
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