Spanish Journal of Psychiatry and Mental Health最新文献

{"title":"Legal requirements for admission of children and adolescent patients to in-home mental health services: The case of the Niño Jesús Hospital at home unit in Madrid, Spain","authors":"Luciana Miguel-Alhambra , María Goretti Morón-Nozaleda , Raquel Chacón-Campollo , Silvia Yañez-López , Mar Faya Barrios , Monserrat Graell Berna","doi":"10.1016/j.sjpmh.2023.03.001","DOIUrl":"10.1016/j.sjpmh.2023.03.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 55-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950285323000066/pdfft?md5=b731c476e69615941724fa6f6832e173&pid=1-s2.0-S2950285323000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90904005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High persistence in Spanish transgender minors: 18 years of experience of the Gender Identity Unit of Catalonia","authors":"Clara De Castro ,&nbsp;Mireia Solerdelcoll ,&nbsp;Maria Teresa Plana ,&nbsp;Irene Halperin ,&nbsp;Mireia Mora ,&nbsp;Laura Ribera ,&nbsp;Camil Castelo-Branco ,&nbsp;Esther Gómez-Gil ,&nbsp;Angela Vidal","doi":"10.1016/j.rpsm.2022.02.001","DOIUrl":"10.1016/j.rpsm.2022.02.001","url":null,"abstract":"<div><h3>Introduction</h3><p>An increasing number of transgender minors are seeking help during the development of their gender identity and transitioning. Understanding their characteristics and the impact of transitioning on their mental health would be of help in the development of protocols to offer a better assistance to this population. The aim of this study was to examine the socio-demographic characteristics and clinical data related to gender identity, transitioning and persistence of transgender minors who were seen at the Gender Identity Unit (GID) of Catalonia, Spain.</p></div><div><h3>Material and methods</h3><p>All underage applicants who requested clinical assistance at the specialized GID from 1999 until 2016 were retrospectively evaluated using the minors’ medical records.</p></div><div><h3>Results</h3><p>124 out of 140 minors were confirmed as being transgender, 83.1% of them were adolescents. The assigned male/female ratio was 1:1.2. 97.6% persisted in their transgender identity after a median follow-up time of 2.6 years. Prior to the first meeting, 48.5% were living in their affirmed role and, by the end of the study, this percentage rose to 87.1%. Yearly, the number of referrals exponentially grew whereas the age at referral decreased (<em>rs</em> <!-->=<!--> <!-->−0.2689, <em>p</em> <!-->=<!--> <!-->0.0013). Child consultations rose to a significant percentage (23.5%) over the last 6 years.</p></div><div><h3>Conclusions</h3><p>Over the 18-year period, the number of referrals increased considerably, more assigned natal female minors and children were seen, and more minors made the decision to go through social transition at a younger age. In contrast with other epidemiological studies conducted in this field, a consistently high rate of persistence was observed.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 35-40"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888989122000283/pdfft?md5=5b57157b29a40d337d9f47b6c9e486a4&pid=1-s2.0-S1888989122000283-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83164414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of postpartum depression in threatened preterm labour: Importance of psychosocial factors","authors":"Julia Buesa ,&nbsp;Laura Campos-Berga ,&nbsp;Marta Lizaran ,&nbsp;Belén Almansa ,&nbsp;Farah Ghosn ,&nbsp;Pilar Sierra ,&nbsp;Julia Andreu ,&nbsp;Máximo Vento ,&nbsp;Vicente Diago ,&nbsp;Ana García-Blanco","doi":"10.1016/j.sjpmh.2023.06.004","DOIUrl":"10.1016/j.sjpmh.2023.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Postpartum depression (PPD) is more common in high-risk pregnancies. One of the main causes of high-risk pregnancy is threatened preterm labour (TPL), a stressful event which involves psychological consequences for the mother. The objective of this study was to identify those psychosocial factors that may imply a greater risk of PPD in TPL women.</p></div><div><h3>Material and methods</h3><p>A prospective cohort study was carried out, consisting of a sample of 149 pregnant women who suffered from a TPL during pregnancy, and 61 controls. At the time of inclusion, demographic, obstetric, biological, and psychosocial variables were collected. At 3 months postpartum, depressive symptoms were evaluated along with their predictive factors.</p></div><div><h3>Results</h3><p>Women who suffered TPL showed higher scores in depressive symptomatology (<em>F</em> (1, 208)<!--> <!-->=<!--> <!-->7.46, <em>p</em> <!-->=<!--> <!-->.007), as well as higher probability of PPD diagnosis than controls (<em>χ</em>² (1)<!--> <!-->=<!--> <!-->8.05, <em>p</em> <!-->=<!--> <!-->005). Higher maternal age (+.335), lower educational level (−2.15), history of trauma (+.28) and higher trait anxiety scores (+.314) were the main predictors of PPD after TPL.</p></div><div><h3>Conclusions</h3><p>Experiencing TPL during pregnancy, carries a higher risk of PPD. This risk is mediated by sociodemographic and psychological factors related to chronic stress. The detection of these potentially modifiable risk factors in pregnant women after experiencing TPL would help prevent PPD and improve the maternal–infant prognosis.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 51-54"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950285323000339/pdfft?md5=9ffc9b4b4aacb41ddc768f0a1416f43f&pid=1-s2.0-S2950285323000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the pathophysiological mechanisms associated with the onset and course of neurodevelopmental disorders in preterm infants (the PeriSTRESS-PremTEA study): Rationale, objectives, design and sample description","authors":"Pablo Navalón ,&nbsp;Jéssica Merchan-Naranjo ,&nbsp;Farah Ghosn ,&nbsp;Belén Almansa ,&nbsp;Consuelo Chafer-Pericas ,&nbsp;Javier González-Peñas ,&nbsp;Elisa Rodríguez-Toscano ,&nbsp;Susana Zeballos ,&nbsp;María Arriaga ,&nbsp;Pedro Castro Castro ,&nbsp;Dorotea Blanco Bravo ,&nbsp;Máximo Vento ,&nbsp;Laura Pina-Camacho ,&nbsp;Ana García-Blanco","doi":"10.1016/j.rpsm.2021.02.002","DOIUrl":"10.1016/j.rpsm.2021.02.002","url":null,"abstract":"<div><h3>Background</h3><p>There are few studies exploring the pathophysiological pathways that may condition differentially the emergence/course of neurodevelopmental disorders (ND) in very preterm and extremely preterm newborns (VPTN/EPTN). Furthermore, there are no established biological markers predictive of ND in this population. The aim of this study is four-fold: in two cohorts of VPTN/EPTN (i) to characterize the emergence/course of ND up to corrected-age 6 years, (ii) to identify those factors (from prenatal stages up to age 6 years) that explain the interindividual differences related to emergence/course of ND, (iii) to identify in the first hours/days of life a urinary metabolomic biomarker profile predictive of ND, and (iv) to determine longitudinally variations in DNA methylation patterns predictive of ND.</p></div><div><h3>Methods</h3><p>Observational, longitudinal, prospective, six-year follow-up, multicentre collaborative study. Two cohorts are being recruited: the PeriSTRESS-Valencia-cohort (<em>n</em> <!-->=<!--> <!-->26 VPTN, 18 EPTN, and 122 born-at-term controls), and the PremTEA-Madrid-cohort (<em>n</em> <!-->=<!--> <!-->49 EPTN and <em>n</em> <!-->=<!--> <!-->29 controls).</p></div><div><h3>Results</h3><p>We describe the rationale, objectives and design of the PeriSTRESS-PremTEA project and show a description at birth of the recruited samples.</p></div><div><h3>Conclusions</h3><p>The PeriSTRESS-PremTEA project could help improve early identification of clinical, environmental and biological variables involved in the physiopathology of ND in VPTN/EPTN. It could also help to improve the early identification of non-invasive ND biomarkers in this population. This may allow early ND detection as well as early and personalised intervention for these children.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 19-27"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888989121000288/pdfft?md5=141d44430ae250cf504ff85f71f2f768&pid=1-s2.0-S1888989121000288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25394313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADHD Rating Scale (ADHD-RS): Validation in Spanish in adult population according to the DSM-5","authors":"Aldo Pereira ,&nbsp;Vanesa Richarte ,&nbsp;Christian Fadeuilhe ,&nbsp;Montse Corrales ,&nbsp;Estela García ,&nbsp;Josep Antoni Ramos-Quiroga","doi":"10.1016/j.sjpmh.2023.06.002","DOIUrl":"10.1016/j.sjpmh.2023.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Attention deficit hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder, with an estimated prevalence in adulthood of 2.5–3.4%. The Attention Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS) is an 18-item self-administered scale that assesses attention deficit and hyperactivity/impulsivity symptoms of ADHD in adults. This study aims to validate the ADHD-RS in Spanish according to the diagnostic criteria established by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).</p></div><div><h3>Materials and methods</h3><p>A sample of 441 adult patients (mean age 33.34<!--> <!-->±<!--> <!-->11.37 years) was included, 396 subjects were diagnosed with ADHD (mean age 33.17<!--> <!-->±<!--> <!-->11.18 years), and 45 were controls (mean age 35.40<!--> <!-->±<!--> <!-->12.33 years). The clinical diagnosis of ADHD was established according to the DSM-5 criteria. The ADHD-RS was subsequently administered to all participants.</p><p>A logistic regression study evaluated the model in terms of sensitivity, specificity, positive predictive value, and negative predictive value. The Kaiser-Meyer-Olkin (KMO) measure was performed to assess the adequacy of the data set, and to determine whether factor analysis was applicable, Bartlett's sphericity test was performed.</p><p>Principal component analysis was used, using the Varimax orthogonal rotation method, which minimizes the number of variables with high loads on each factor, obtaining two factors and thus, simplifying their interpretation.</p></div><div><h3>Results</h3><p>The cut-off point that best discriminates the combined presentation of ADHD was 24 points, with a sensitivity of 94.78%, a specificity of 84.79%, a PPV (positive predictive value) of 93.74%, and an NPV (negative predictive value) of 78.33, with an area under the curve (AUC) of 0.85, and a kappa coefficient of 0.86.</p><p>Regarding inattentive ADHD, the cut-off point that best discriminates was 21 points, with a sensitivity of 92.56%, a specificity of 76.26%, a PPV of 92.01%, an NPV of 78.33%, an AUC of 0.90, and a kappa coefficient of 0.87.</p><p>Different cut-off values in the two subgroups suggests that a differentiated cut-off point for the inattentive and combined presentations may be an adequate assessment strategy for ADHD in adulthood.</p></div><div><h3>Conclusions</h3><p>The Spanish version of the ADHD-RS is a valid instrument to evaluate ADHD in adults according to the diagnostic criteria established by the DSM-5.</p><p>Differentiated cut-off points for the inattentive and combined presentations discriminate more accurately than a single cut-off point.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 46-50"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950285323000145/pdfft?md5=aa4f589b5a4eac98d0edcc5fcce930a2&pid=1-s2.0-S2950285323000145-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134995340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New units for perinatal mental health disorders: Description of the first 150 dyads attended at Mother Baby Day Hospital CLINIC-BCN","authors":"Alba Roca-Lecumberri ,&nbsp;Anna Torres ,&nbsp;Susana Andrés ,&nbsp;Carmen Naranjo ,&nbsp;Ester Roda ,&nbsp;Cristina Lopez ,&nbsp;Barbara Sureda ,&nbsp;Eva Solé ,&nbsp;María Luisa Imaz ,&nbsp;Sara Lera ,&nbsp;Andrea Mallorquí ,&nbsp;Lluisa García-Esteve","doi":"10.1016/j.rpsm.2022.06.004","DOIUrl":"10.1016/j.rpsm.2022.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Perinatal Mental Disorders are considered a public health problem due to the impact on both, the maternal health and the children, in the short and long term. During 2018, at the Hospital Clínic of Barcelona, the first Mother Baby Day Hospital (MBDH) in Spain was developed and implemented.</p></div><div><h3>Method</h3><p>The first 150 dyads (mother and baby) attended from January 2018 to October 2021 were selected. The sociodemographic and clinical characteristics were described. The clinical variables studied were anxious and depressive symptoms, mother–baby relationship and maternal functionality.</p></div><div><h3>Results</h3><p>The mean age of mothers was 34 years and of babies 3.7 months. 80% had a psychiatric background and 30.7% had required some psychiatric inpatient admission. 48.7% of the patients were diagnosed with a major depressive episode and a half had some psychiatric comorbidity (54.7%). One in 3 patients admitted had a moderate–high suicidal risk and 10.7% had attempted suicide in the current episode. At discharge, significant improvements were observed in the scales of depression (EPDS), anxiety (STAI-E), mother–baby relationship (PBQ) and functionality (HoNOS).</p></div><div><h3>Conclusions</h3><p>The MBDH allows us a comprehensive, intensive and multidisciplinary care for postpartum mothers with a mental disorder with good results and containment of risk behaviours. Likewise, MBDH allows us to detect and to intervene in bonding difficulties and maternal care giving.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 41-45"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888989122000751/pdfft?md5=bdfb0d41664565f04ed88bc1e739e8e0&pid=1-s2.0-S1888989122000751-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74799704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child and adolescent psychiatry in the context of disease prevention","authors":"Celso Arango","doi":"10.1016/j.sjpmh.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.sjpmh.2024.01.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950285324000012/pdfft?md5=b6f34e0427862f3f3305accdccc51598&pid=1-s2.0-S2950285324000012-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and management of individuals consulting for a suicidal crisis: A European Delphi method-based consensus guidelines.","authors":"Aiste Lengvenyte, Lucas Giner, Vincent Jardon, Emilie Olié, Victor Perez, Pilar Saiz, Ana Gonzalez Pinto, Philippe Courtet","doi":"10.1016/j.sjpmh.2023.12.001","DOIUrl":"10.1016/j.sjpmh.2023.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>Managing patient with suicidal thoughts and behaviours presents significant challenges due to the scarcity of robust evidence and clear guidance. This study sought to develop a comprehensive set of practical guidelines for the assessment and management of suicidal crises.</p><p><strong>Materials and methods: </strong>Utilizing the Delphi methodology, 80 suicide clinician and research experts agreed on a series of recommendations. The process involved two iterative rounds of surveys to assess agreement with drafted recommendations, inviting panellists to comment and vote, culminating in 43 consensus recommendations approved with at least 67% agreement. These consensus recommendations fall into three main categories: clinical assessment, immediate care, and long-term approaches.</p><p><strong>Results: </strong>The panel formulated 43 recommendations spanning suicidal crisis recognition to continuous long-term care. These guidelines underscore systematic proactive suicide risk screening, in-depth medical and toxicological assessment, and suicide risk appraisal considering personal, clinical factors and collateral information from family. The immediate care directives emphasize a secure environment, continuous risk surveillance, collaborative decision-making, including potential hospitalization, sensible pharmacological management, safety planning, and lethal means restriction counselling. Every discharge should be accompanied by prompt follow-up care incorporating proactive case management and multi-modal approach involving crisis lines, brief contact, and psychotherapeutic and pharmacological interventions.</p><p><strong>Conclusions: </strong>This study generated comprehensive guidelines addressing care for individuals in suicidal crises, covering pre- to post-discharge care. These practical recommendations can guide clinicians in managing patients with suicidal thoughts and behaviours, improve patient safety, and ultimately contribute to the prevention of future suicidal crises.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072534","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":"Second victim experience in Spanish psychiatrists coping with patient suicide: A call for postvention.","authors":"Víctor Pérez-Solà, José Luis Ayuso, Cecilia Borrás-Murcia, Matilde Elices, Maite Campillo, Lucas Giner, Ana González-Pinto, Julio Antonio Guija, Mercedes Navío, Diego Palao, Pilar Saiz","doi":"10.1016/j.sjpmh.2023.11.004","DOIUrl":"10.1016/j.sjpmh.2023.11.004","url":null,"abstract":"<p><strong>Background: </strong>Losing a patient by suicide may lead to psychological distress and mid/long-term personal and professional consequences for psychiatrists, becoming second victims.</p><p><strong>Material and methods: </strong>The validated Spanish version of the Second Victim Experience and Support Tool (SVEST-E) questionnaire and a 30-item questionnaire created ad-hoc was administered online to psychiatrists from all over Spain to evaluate how patient suicide affects mental health professionals.</p><p><strong>Results: </strong>Two hundred ninety-nine psychiatrists participated in the survey, and 256 completed the SVEST-E questionnaire. The results of the SVEST-E questionnaire revealed a negative impact of suicide on emotional and physical domains, although this seemed not to lead to work absenteeism. Most respondents desired peer support from a respected colleague and considered institutional support, although desirable, lacking. Almost 70% of surveyed stated that an employee assistance program providing free counseling to employees outside of work would be desirable. The ad-hoc questionnaire showed that up to 88% of respondents considered some suicides unavoidable, and 76% considered the suicide unexpected. Almost 60% of respondents reported no changes in the approach of patients with suicidal ideation/behavior, after losing a patient. However, up to 76% reported performing more detailed clinical evaluations and notes in the medical record. Up to 13% of respondents considered leaving or changing their job or advancing retirement after losing a patient by suicide.</p><p><strong>Conclusions: </strong>After a patient's suicide, psychiatrists often suffer the feelings of second victim, impacting personal and professional areas. The study results indicate the need for postvention strategies to mitigate the negative impact of patient suicide.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441955","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":"Improved estimation of the risk of manic relapse by combining clinical and brain scan data","authors":"Pol Palau ,&nbsp;Aleix Solanes ,&nbsp;Merce Madre ,&nbsp;Naia Saez-Francas ,&nbsp;Salvador Sarró ,&nbsp;Noemí Moro ,&nbsp;Norma Verdolini ,&nbsp;Manel Sanchez ,&nbsp;Sílvia Alonso-Lana ,&nbsp;Benedikt L. Amann ,&nbsp;Anna Romaguera ,&nbsp;Marta Martin-Subero ,&nbsp;Lydia Fortea ,&nbsp;Paola Fuentes-Claramonte ,&nbsp;Maria A. García-León ,&nbsp;Josep Munuera ,&nbsp;Erick Jorge Canales-Rodríguez ,&nbsp;Paloma Fernández-Corcuera ,&nbsp;Paolo Brambilla ,&nbsp;Eduard Vieta ,&nbsp;Joaquim Radua","doi":"10.1016/j.rpsm.2023.01.001","DOIUrl":"10.1016/j.rpsm.2023.01.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Estimating the risk of manic relapse could help the psychiatrist individually adjust the treatment to the risk. Some authors have attempted to estimate this risk from baseline clinical data. Still, no studies have assessed whether the estimation could improve by adding structural magnetic resonance imaging (MRI) data. We aimed to evaluate it.</p></div><div><h3>Material and methods</h3><p>We followed a cohort of 78 patients with a manic episode without mixed symptoms (bipolar type I or schizoaffective disorder) at 2–4–6–9–12–15–18 months and up to 10 years. Within a cross-validation scheme, we created and evaluated a Cox lasso model to estimate the risk of manic relapse using both clinical and MRI data.</p></div><div><h3>Results</h3><p>The model successfully estimated the risk of manic relapse (Cox regression of the time to relapse as a function of the estimated risk: hazard ratio (HR)<!--> <!-->=<!--> <!-->2.35, <em>p</em> <!-->=<!--> <!-->0.027; area under the curve (AUC)<!--> <!-->=<!--> <!-->0.65, expected calibration error (ECE)<!--> <!-->&lt;<!--> <!-->0.2). The most relevant variables included in the model were the diagnosis of schizoaffective disorder, poor impulse control, unusual thought content, and cerebellum volume decrease. The estimations were poorer when we used clinical or MRI data separately.</p></div><div><h3>Conclusion</h3><p>Combining clinical and MRI data may improve the risk of manic relapse estimation after a manic episode. We provide a website that estimates the risk according to the model to facilitate replication by independent groups before translation to clinical settings.</p></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"16 4","pages":"Pages 235-243"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888989123000022/pdfft?md5=b98803d376e7eb52f2d91340a66ac9d4&pid=1-s2.0-S1888989123000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}