Spanish Journal of Psychiatry and Mental Health最新文献

{"title":"Palliative psychiatry and euthanasia in refractory obsessive-compulsive disorder: A case report.","authors":"Sergi López-Rodríguez, Sara Lakis-Granell, Jesús González-Barboteo, Eva Real, Sara Bertolín, J M Menchón, Mª Del Pino Alonso, Cinto Segalàs","doi":"10.1016/j.sjpmh.2026.03.002","DOIUrl":"10.1016/j.sjpmh.2026.03.002","url":null,"abstract":"<p><strong>Background: </strong>Spain's Organic Law 3/2021 regulates euthanasia or medical aid in dying (MAiD) for individuals with serious and incurable disease or chronic incapacitating conditions causing intolerable suffering. Psychiatric MAiD remains exceptional; decisions depend on well-documented refractoriness, preserved decision-making capacity, and intolerable mental suffering within a safeguarded legal process.</p><p><strong>Case presentation: </strong>We report the clinical and legal course of a 24-year-old woman with childhood-onset obsessive-compulsive disorder (OCD) dominated by contamination/washing rituals, treated at a national reference center. Over several years, she completed multiple maximally dosed SSRI and clomipramine trials with antipsychotic augmentation and more than 100 therapist-guided exposure and response prevention sessions. Bilateral deep brain stimulation of the anterior limb of the internal capsule/ventral striatum was performed without durable benefit after 18 months of systematic programming. During a prolonged inpatient admission, harm-reduction and palliative psychiatry measures were implemented while 2 senior psychiatrists, independent of daily care, conducted repeated ability-based capacity evaluations confirming intact decision-making, absence of psychosis, delirium, or major depressive episode, and a consistent distinction between a sustained MAiD request and suicidality. After reiterated written requests made with full information about prognosis and alternatives, an independent psychiatric consultation, and the regional commission's ex ante authorization, MAiD was performed in hospital by the responsible psychiatrist through direct administration, without complications.</p><p><strong>Conclusions: </strong>Even after exhaustive, guideline-concordant, and neurosurgical interventions, a small subset of patients with OCD may experience persistent, irremediable suffering. Transparent documentation of refractoriness, longitudinal capacity assessment, and proportional palliative psychiatry care are essential to ethically and legally sound MAiD practice in Spain.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694613","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}

{"title":"The value of innovation: Challenges and perspectives in mental health.","authors":"Marina Díaz-Marsá","doi":"10.1016/j.sjpmh.2026.03.003","DOIUrl":"10.1016/j.sjpmh.2026.03.003","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679897","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}

{"title":"Economic stigma in mental health: When burden and investment diverge.","authors":"Lucas Giner, Diego de la Vega, Philippe Courtet","doi":"10.1016/j.sjpmh.2026.02.005","DOIUrl":"10.1016/j.sjpmh.2026.02.005","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505878","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}

{"title":"Blood-based immune biomarkers and functional outcomes in acute schizophrenia: A retrospective cohort study.","authors":"Vicent Llorca-Bofí, Miquel Bioque, Samuel Pàmpols-Pérez, Esther Buil-Riné, Marina Adrados-Pérez, Eugènia Nicolau-Subires, Lucia Ibarra-Pertusa, Carla Albert-Porcar, Andrea Jiménez-Mayoral, Belén Resa-Pérez, Maria Font, Maria Mur","doi":"10.1016/j.sjpmh.2026.02.006","DOIUrl":"10.1016/j.sjpmh.2026.02.006","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a chronic psychiatric disorder characterized by acute relapses and significant functional impairment. While antipsychotic medications are effective in managing acute episodes, many patients fail to achieve functional remission. Recent research suggests that immune mechanisms may influence treatment outcomes, yet studies focusing on the relationship between immune biomarkers and functional recovery are limited.</p><p><strong>Objective: </strong>This study aims to evaluate whether blood-based immune biomarkers can predict functional response and remission in patients with acute schizophrenia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with 354 inpatients diagnosed with schizophrenia, admitted to an acute psychiatric unit between January 2010 and December 2020. Sociodemographic, clinical, and immune biomarker data were extracted from electronic records. Functional outcomes were measured using Global Assessment of Functioning (GAF) scores at admission and discharge. Immune biomarkers assessed included white blood cell counts, ratios and C-reactive protein. Functional response was defined as a GAF score improvement >40 points, while functional remission was defined as a GAF score ≥70 at discharge.</p><p><strong>Results: </strong>Higher leukocyte counts increased the risk of non-functional response, while a higher platelet-lymphocyte ratio (PLR) was a protective factor. Additionally, Higher lymphocyte and platelet counts were protective against non-functional remission. However, the predictive performance for both functional response and remission was limited, with an AUC ranging from 0.53 to 0.61.</p><p><strong>Conclusion: </strong>Immune biomarkers, particularly leukocyte counts, PLR, and lymphocyte counts, show significant associations with functional outcomes in acute schizophrenia. However, their predictive value for clinical practice remains limited.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505840","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}

{"title":"New interventions for schizophrenia: Navigating the treatment landscape.","authors":"Emilio Fernandez-Egea, Robert A McCutcheon","doi":"10.1016/j.sjpmh.2026.02.004","DOIUrl":"10.1016/j.sjpmh.2026.02.004","url":null,"abstract":"<p><p>For over half a century, antipsychotic efficacy for schizophrenia treatment has been tied to dopamine D2 receptor antagonism, with predictable trade-offs: limited impact on negative and cognitive symptoms, and substantial metabolic, endocrine, and motor adverse effects. In the past few years, schizophrenia drug development has re-accelerated, including the first US approval of a non-D2 antipsychotic mechanism (xanomeline-trospium), and several late-stage programmes aiming to treat symptom domains that matter most to long-term functioning. At the same time, several high-profile \"dopamine-sparing\" agents have failed in phase 2 and 3 trials, underscoring that mechanistic novelty alone is insufficient. Successful translation requires alignment among biological targets, trial design, and patient phenotypes. In this review, we examine emerging interventions and propose a pragmatic translational framework centered on domain-specific prescribing, earlier implementation of measurement-based care, and biomarker-informed stratification.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367959","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}

{"title":"Associations between social cognition and inflammatory markers in eating disorders and borderline personality disorder.","authors":"Carla da Vila, Karina MacDowell, Jorge Álvarez, Pablo Mola, Álvaro Carrasco, Juan Carlos Leza, José Luis Carrasco, Celia Hernández, Alejandro de la Torre-Luque, Marina Díaz Marsá","doi":"10.1016/j.sjpmh.2026.02.003","DOIUrl":"10.1016/j.sjpmh.2026.02.003","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Eating disorders (EDs) and borderline personality disorder (BPD) are severe psychiatric conditions characterized by emotional dysregulation and impairments in social cognition. Growing evidence suggests that inflammatory and oxidative stress pathways may contribute to their pathophysiology. The present study aimed to explore the association between social cognition performance and immune-inflammatory and oxidative stress biomarkers in individuals with BPD, restrictive ED (EDR), and purging ED (EDP) vs healthy controls (HC), using a pathway-based psychoneuroimmunological approach.</p><p><strong>Methods: </strong>We studied a total of 100 adult women (EDR, EDP, BPD, and HC) using the Movie for the Assessment of Social Cognition (MASC) and a comprehensive clinical battery. Blood samples were drawn to quantify inflammatory, oxidative stress, and antioxidant biomarkers, including intracellular signaling pathways. Group comparisons and group-specific Bayesian Lasso regression analyses were conducted to examine within-group associations between biomarkers and social cognition outcomes, controlling for relevant clinical and demographic covariates.</p><p><strong>Results: </strong>Participants with BPD and EDP showed greater psychological dysregulation, higher impulsivity, and increased activation of pro-inflammatory and oxidative stress pathways vs HC. The EDR group displayed an intermediate biological and clinical profile. Social cognition impairments were observed across clinical groups, with BPD participants exhibiting the highest hypomentalization. Exploratory regression analyses revealed diagnosis-specific associations between social cognition performance and immune-inflammatory pathways, particularly involving markers related to p38 MAPK, JNK, COX-2, and oxidative stress, with no significant associations observed in healthy controls.</p><p><strong>Conclusions: </strong>The findings support a psychoneuroimmunological model in which social cognition impairments are associated with diagnosis-specific interactions between immune-inflammatory regulation and clinical phenotype in EDs and BPD. Because of the exploratory and cross-sectional design, these results should be considered hypothesis-generating and warrant replication in longitudinal studies.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367963","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}

{"title":"Association of depressive symptoms with all-cause, cardiovascular, and cancer mortality: A population-based study in Spain.","authors":"Teresa López-Cuadrado, Cristina Ortiz, Roberto Pastor-Barriuso, Iñaki Galán","doi":"10.1016/j.sjpmh.2026.02.002","DOIUrl":"10.1016/j.sjpmh.2026.02.002","url":null,"abstract":"<p><strong>Introduction: </strong>Depression affects 4.4% of the global population and is associated with an increased risk of disability and premature mortality. Below we evaluate the association between depression and mortality in the adult population of Spain.</p><p><strong>Material and methods: </strong>We conducted a longitudinal study using data from the 2014 European Health Interview Survey for Spain, including participants aged ≥15 years (N=22,652), associated with the national mortality registry up to December 2023. Depression was self-reported using the 8-item Patient Health Questionnaire (PHQ-8) and measured once at baseline, with a score ≥10 being indicative of moderate-to-severe depressive symptoms. We explored the effect of a prior physician-diagnosis of depression and antidepressant treatment received within the previous two weeks. Age-standardized rate ratios (SRR) and differences (SRD) for all-cause, cardiovascular, and cancer mortality were estimated using Poisson regression.</p><p><strong>Results: </strong>Compared with individuals with no or mild depressive symptoms, those with a PHQ-8 score ≥10 had an SRR of 1.33 (95%CI, 1.16, 1.54), with an estimated SRD of 3.94 per 1000 person-years (95%CI, 1.78, 6.11). For cardiovascular and cancer mortality, the SRR was 1.30 (95%CI, 1.00, 1.67) and 1.09 (95%CI, 0.79, 1.50), respectively. Among individuals with PHQ-8 ≥10, those with a prior diagnosis had an SRR for all-cause mortality of 1.18 (95%CI, 0.92, 1.50) vs 1.60 (95%CI, 1.31, 1.95) in those with no prior diagnosis (P=.006). Similarly, participants with PHQ-8 ≥10 who had received pharmacotherapy showed lower mortality risk than untreated individuals (P=.044).</p><p><strong>Conclusions: </strong>Individuals with moderate-to-severe depressive symptoms, particularly those undiagnosed and/or not receiving treatment, have an increased risk of all-cause and cardiovascular mortality.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367938","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}

{"title":"Francesc Tosquelles: Pioneer of institutional psychotherapy.","authors":"Antonio Labad","doi":"10.1016/j.sjpmh.2026.02.001","DOIUrl":"10.1016/j.sjpmh.2026.02.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230236","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}

{"title":"Prevalence of suicidal ideation and suicide attempts among medical professionals in Argentina: A cross-sectional, observational study.","authors":"Julieta Ramirez, Ricardo Corral, Alejo Corrales, Federico Rebok","doi":"10.1016/j.sjpmh.2026.01.004","DOIUrl":"10.1016/j.sjpmh.2026.01.004","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230275","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}

{"title":"Disruption in Access to Essential Drugs: The Anafranil Shortage in Spain.","authors":"Carolina Donat-Vargas, Emilio Pol-Yanguas, Carlos Chiclana","doi":"10.1016/j.sjpmh.2025.12.006","DOIUrl":"10.1016/j.sjpmh.2025.12.006","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151693","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}