Spanish Journal of Psychiatry and Mental Health最新文献

{"title":"EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial","authors":"Bridget Hogg ,&nbsp;Joaquim Radua ,&nbsp;Itxaso Gardoki-Souto ,&nbsp;Marta Fontana-McNally ,&nbsp;Walter Lupo ,&nbsp;María Reinares ,&nbsp;Esther Jiménez ,&nbsp;Mercè Madre ,&nbsp;Laura Blanco-Presas ,&nbsp;Romina Cortizo ,&nbsp;Anna Massó-Rodriguez ,&nbsp;Juan Castaño ,&nbsp;Isabel Argila ,&nbsp;José Ignacio Castro-Rodriguez ,&nbsp;Mercè Comes ,&nbsp;Cristina Macias ,&nbsp;Roberto Sánchez-González ,&nbsp;Estanislao Mur-Mila ,&nbsp;Patricia Novo ,&nbsp;Adriane R. Rosa ,&nbsp;Benedikt L. Amann","doi":"10.1016/j.sjpmh.2023.11.005","DOIUrl":"10.1016/j.sjpmh.2023.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen </span>disease course, but this study is the first multicentre </span>randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.</div></div><div><h3>Materials and methods</h3><div><span><span><span>This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused </span>Eye Movement Desensitization and Reprocessing<span><span> (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and </span>cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in </span></span>clinical trials (</span><span><span>NCT02634372</span><svg><path></path></svg></span>) and carried out in accordance with CONSORT guidelines.</div></div><div><h3>Results</h3><div>There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (<em>p</em> <!-->=<!--> <!-->0.0006, <em>d</em> <!-->=<!--> <!-->0.969), manic symptoms (<em>p</em> <!-->=<!--> <!-->0.027, <em>d</em> <!-->=<!--> <!-->0.513), and improving functioning (<em>p</em> <!-->=<!--> <!-->0.038, <em>d</em> <!-->=<!--> <!-->0.486). There was no significant difference in dropout between treatment arms.</div></div><div><h3>Conclusions</h3><div>Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 203-214"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625613","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":"Persons first: staying close to the roots of psychiatry","authors":"Rafael Tabarés-Seisdedos ,&nbsp;Vicent Balanzá-Martínez","doi":"10.1016/j.sjpmh.2024.10.001","DOIUrl":"10.1016/j.sjpmh.2024.10.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 179-180"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640543","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":"Spanish validation of the Empirically Developed Clinical Staging Model (EmDe-5) for patients with bipolar disorder","authors":"Lorena de la Fuente-Tomás ,&nbsp;Belén Arranz ,&nbsp;Pilar Sierra ,&nbsp;Mónica Sánchez-Autet ,&nbsp;Ana García-Blanco ,&nbsp;Luis Gutiérrez-Rojas ,&nbsp;Vicent Balanzá-Martínez ,&nbsp;Sonia Vidal-Rubio ,&nbsp;Eduard Vieta ,&nbsp;Esther Jiménez ,&nbsp;Carla Hernández ,&nbsp;Manuel Arrojo ,&nbsp;Jesús Gómez-Trigo ,&nbsp;Yolanda Zapico-Merayo ,&nbsp;Jose María Pelayo-Terán ,&nbsp;Victor Pérez-Solà ,&nbsp;Estanislao Mur ,&nbsp;Narcís Cardoner ,&nbsp;Ana González-Pinto ,&nbsp;Iñaki Zorrilla ,&nbsp;Maria Paz García-Portilla","doi":"10.1016/j.rpsm.2021.09.005","DOIUrl":"10.1016/j.rpsm.2021.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Bipolar disorder (BD) has been reconceptualised as a progressive disorder that develops from mild to severe presentations. An empirical staging model – the Empirically Developed Clinical Staging Model for BD (EmDe-5) – was developed in a previous study. This study aims to further validate that model using a larger and more representative Spanish sample.</div></div><div><h3>Material and methods</h3><div>183 BD outpatients were recruited at 11 sites in Spain. Assessment included clinical characteristics of the BD (number of hospitalisations, number of suicide attempts, comorbid personality disorders), physical health (BMI, metabolic syndrome<span><span>, number of physical illnesses), cognition (SCIP), functioning (permanently disabled due to BD, FAST), and quality of life (SF-36). The CGI-S, VAS-S, and </span>psychopharmacological treatment pattern were used as external validators.</span></div></div><div><h3>Results</h3><div>Ten patients (51.5%) were classified as stage 1, 33 (18%) as stage 2, 93 (50<!--> <!-->8%) as stage 3, 37 (20<!--> <!-->2%) as stage 4, and 10 (5<!--> <!-->5%) as stage 5. All profilers, other than number of suicide attempts (<em>p</em> <!-->=<!--> <!-->0.311) and comorbid personality disorder (<em>p</em> <!-->=<!--> <!-->0.061), exhibited worse scores from stage 1 to 5. As expected, VAS-S and CGI-S scores were worse in the later stages. Regarding treatment, early stages (1–2) were associated with the use of one to three drugs while late stages (4–5) were associated with four or more drugs (<em>p</em> <!-->=<!--> <!-->0.002).</div></div><div><h3>Conclusions</h3><div>We confirm the EmDe-5 staging model's construct validity. The ease of obtaining the profilers, together with the operational criteria provided to quantify them, will facilitate the use of the EmDe-5 staging model in daily clinical practice.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 215-221"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79934665","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":"Pharmacological treatment for challenging behavior in adults with intellectual disability: Systematic review and meta-analysis","authors":"Rodrigo Campos-Jara ,&nbsp;Cristian Martínez-Salazar ,&nbsp;Christian Campos-Jara ,&nbsp;José María Fernández ,&nbsp;Darío Martínez-García ,&nbsp;Falonn Contreras-Osorio","doi":"10.1016/j.rpsm.2023.01.003","DOIUrl":"10.1016/j.rpsm.2023.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Few evidence on the use of antipsychotics in people with intellectual disabilities and challenging behaviors, generates the need to develop studies that contribute to collect, compare and synthesize the available information. The present systematic review and meta-analysis aims to determine the clinical efficacy of antipsychotic medication in reducing critical episodes in this population.</div></div><div><h3>Methods</h3><div>We searched Web of Science, Scopus, EBSCO, Embase, and PubMed for randomized controlled trials of antipsychotic medication versus placebo. Preliminarily yielded 1354 abstracts and citations; six studies with 274 subjects met the inclusion criteria of studies with experimental design, longitudinal type, with pre- and post-intervention measurements.</div></div><div><h3>Results</h3><div>There is evidence for the use of psychotropic drugs in the acute management of challenging behaviors in patients with intellectual disability (SMD<!--> <!-->=<!--> <!-->−0.85; 95% CI<!--> <!-->=<!--> <!-->−1.69 to −0.01; <em>p</em> <!-->=<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>Our results coincide with the recommendations on the efficacy of the use of antipsychotics. Although our study provides evidence, the limited number of studies included in this research does not allow us to obtain totally conclusive results, although it can be considered as a guide for future studies.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 231-238"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238292","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":"Meta-analysis of the effects of adjuvant drugs in co-occurring bipolar and substance use disorder","authors":"Joaquim Radua ,&nbsp;Lydia Fortea ,&nbsp;José Manuel Goikolea ,&nbsp;Iñaki Zorrilla ,&nbsp;Miquel Bernardo ,&nbsp;Manuel Arrojo ,&nbsp;Ruth Cunill ,&nbsp;Xavi Castells ,&nbsp;Elisardo Becoña ,&nbsp;Ana López-Durán ,&nbsp;Marta Torrens ,&nbsp;Judit Tirado-Muñoz ,&nbsp;Francina Fonseca ,&nbsp;Belén Arranz ,&nbsp;Marina Garriga ,&nbsp;Pilar A. Sáiz ,&nbsp;Gerardo Flórez ,&nbsp;Luis San ,&nbsp;Ana González-Pinto","doi":"10.1016/j.rpsm.2023.01.005","DOIUrl":"10.1016/j.rpsm.2023.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with bipolar disorder<span> (BD) often have co-occurring substance use disorders (SUDs), which substantially impoverish the course of illness. Despite the importance of this dual diagnosis, the evidence of the efficacy and safety of adjuvant treatments is mostly unknown.</span></div></div><div><h3>Objective</h3><div>To perform a meta-analysis to evaluate the efficacy and safety of adjuvant drugs in patients with co-occurring BD and SUD.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, and Web of Knowledge until 30th April 2022 for randomized clinical trials<span> (RCT) evaluating the efficacy and safety of adjuvant drugs compared to placebo in patients with a dual diagnosis of BD and SUD. We meta-analyzed the effect of adjuvant drugs on general outcomes (illness severity, mania, depression, anxiety, abstinence, substance craving, substance use, gamma-GT, adherence, and adverse events) and used the results to objectively assess the quality of the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. For completeness, we also report the specific effects of specific adjuvant drugs in patients with specific substance disorders.</span></div></div><div><h3>Results</h3><div>We included 15 RCT studies (9 alcohol, 3 cocaine, 2 nicotine, and 1 cannabis) comprising 628 patients allocated to treatment and 622 to placebo. There was low-quality evidence that adjuvant drugs may reduce illness severity (<em>g</em> <!-->=<!--> <!-->−0.25, 95% CI: −0.44, −0.06), and very-low quality evidence that they may decrease substance use (<em>g</em> <!-->=<!--> <!-->−0.23, 95% CI: −0.44, −0.02) and increase substance abstinence (<em>g</em> <!-->=<!--> <!-->0.21, 95% CI: 0.04, 0.38).</div></div><div><h3>Discussion</h3><div>There is low-quality evidence that adjuvant drugs may help reduce illness severity, probably via facilitating abstinence and lower substance use. However, the evidence is weak; thus, these results should be considered cautiously until better evidence exists.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 239-250"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10181957","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":"Functional Remediation for Older Adults with Bipolar Disorder (FROA-BD): Study protocol for a randomized controlled trial","authors":"Laura Montejo ,&nbsp;Esther Jiménez ,&nbsp;Carla Torrent ,&nbsp;Caterina del Mar Bonnín ,&nbsp;Brisa Solé ,&nbsp;Anabel Martínez-Arán ,&nbsp;Eduard Vieta ,&nbsp;Jose Sánchez Moreno","doi":"10.1016/j.rpsm.2022.01.004","DOIUrl":"10.1016/j.rpsm.2022.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Older Adults with Bipolar Disorder (OABD) show cognitive impairments with a negative impact on psychosocial functioning and quality of life. However, to date any intervention for the improvement of functioning has been developed for OABD. The current project aims to demonstrate the efficacy of the Functional Remediation program (FR) specifically adapted to OABD, over 60 years old, for improving functional outcome.</div></div><div><h3>Methods</h3><div>This is an experimental, randomized-controlled trial. Two groups will be included: the experimental group (<em>n</em> <!-->=<!--> <!-->42) will receive a 4-month intervention consisting of 32 sessions of treatment and the control group which will receive treatment as usual (TAU) (<em>n</em> <!-->=<!--> <!-->42). The intervention will result from the adaptation of the Functional Remediation program for OABD (FROA-BD), that has already proven its efficacy at improving psychosocial functioning in patients with bipolar disorder. Clinical, neuropsychological and functional evaluations will be carried out at baseline, post-intervention and follow-up (one year after baseline evaluation). We hypothesized that patients who have undergone the intervention FROA-BD will improve their psychosocial functioning, cognitive performance, quality of life and well-being. We also hypothesized that all these changes will remain stable after eight month follow-up.</div></div><div><h3>Conclusions</h3><div>The results will provide evidence of the efficacy in improving psychosocial functioning, cognitive performance and quality of life applying the FROA-BD. This project consists in the first attempt to adapt the FR program to OABD population who needs specific needs and approaches. The novelty of this contribution represents an advance in the framework of psychological treatment in later-life bipolar disorder.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 181-189"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91349231","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":"Empowering the future of psychiatry: The development of the young psychiatrists section of the Spanish Society of Psychiatry and Mental Health.","authors":"Gonzalo Salazar de Pablo, Claudia Aymerich, Justo Pinzón-Espinosa","doi":"10.1016/j.sjpmh.2024.09.003","DOIUrl":"10.1016/j.sjpmh.2024.09.003","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335938","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":"Luis Martín-Santos: A multidimensional psychiatrist.","authors":"José Lázaro","doi":"10.1016/j.sjpmh.2024.09.002","DOIUrl":"10.1016/j.sjpmh.2024.09.002","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305506","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":"Individualized pretest risk estimates to guide treatment decisions in patients with clinical high risk for psychotic disorders.","authors":"Elodie Sprüngli-Toffel, Erich Studerus, Logos Curtis, Caroline Conchon, Luis Alameda, Barbara Bailey, Camille Caron, Carmina Haase, Julia Gros, Evelyn Herbrecht, Christian G Huber, Anita Riecher-Rössler, Philippe Conus, Alessandra Solida, Marco Armando, Afroditi Kapsaridi, Mathieu Mercapide Ducommun, Paul Klauser, Kerstin Jessica Plessen, Sébastien Urben, Anne Edan, Nathalie Nanzer, Ana Liso Navarro, Maude Schneider, Davina Genoud, Chantal Michel, Jochen Kindler, Michael Kaess, Dominic Oliver, Paolo Fusar-Poli, Stefan Borgwardt, Christina Andreou","doi":"10.1016/j.sjpmh.2024.09.001","DOIUrl":"10.1016/j.sjpmh.2024.09.001","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical high risk for psychosis (CHR) states are associated with an increased risk of transition to psychosis. However, the predictive value of CHR screening interviews is dependent on pretest risk enrichment in referred patients. This poses a major obstacle to CHR outreach campaigns since they invariably lead to risk dilution through enhanced awareness. A potential compensatory strategy is to use estimates of individual pretest risk as a 'gatekeeper' for specialized assessment. We aimed to test a risk stratification model previously developed in London, UK (OASIS) and to train a new predictive model for the Swiss population.</p><p><strong>Method: </strong>The sample was composed of 513 individuals referred for CHR assessment from six Swiss early psychosis detection services. Sociodemographic variables available at referral were used as predictors whereas the outcome variable was transition to psychosis.</p><p><strong>Results: </strong>Replication of the risk stratification model developed in OASIS resulted in poor performance (Harrel's c=0.51). Retraining resulted in moderate discrimination (Harrel's c=0.67) which significantly differentiated between different risk groups. The lowest risk group had a cumulative transition incidence of 6.4% (CI: 0-23.1%) over two years.</p><p><strong>Conclusion: </strong>Failure to replicate the OASIS risk stratification model might reflect differences in the public health care systems and referral structures between Switzerland and London. Retraining resulted in a model with adequate discrimination performance. The developed model in combination with CHR assessment result, might be useful for identifying individuals with high pretest risk, who might benefit most from specialized intervention.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305507","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":"A psychiatrist in the court of Philip II of Spain: Mental medicine in the work of Francisco Valles (1524-1592).","authors":"David Fraguas","doi":"10.1016/j.sjpmh.2024.08.001","DOIUrl":"10.1016/j.sjpmh.2024.08.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074922","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}