Spanish Journal of Psychiatry and Mental Health最新文献

{"title":"Clinical profile of patients with eating disorders attending emergency services after suicide attempt.","authors":"Wala Ayad-Ahmed, Marina Diaz-Marsa, María Dolores Saiz-Gonzalez, Marta Navas, Jorge Andreo-Jover, Teresa Bobes-Bascarán, María Ángeles Botí, Manuel Canal-Rivero, Ana Isabel Cebrià Meca, Benedicto Crespo-Facorro, Matilde Elices, Adriana García-Ramos, Ana Gonzalez-Pinto, Iria Grande, Luis Jiménez-Treviño, Angela Palao-Tarrero, Diego J Palao Vidal, Juan Manuel Pastor, Anna Pedrola-Pons, Natalia Roberto, Miguel Ruiz-Veguilla, Pilar Alejandra Sáiz, Alejandro de la Torre-Luque, Víctor Pérez","doi":"10.1016/j.sjpmh.2026.04.001","DOIUrl":"10.1016/j.sjpmh.2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Suicidal behaviour is a major public health issue, particularly among individuals with eating disorders (EDs), who exhibit elevated risks of suicidal ideation and attempts. EDs, including anorexia nervosa and bulimia nervosa, are associated with significant psychological distress and psychiatric comorbidities, contributing to higher suicide rates.</p><p><strong>Objective: </strong>This study aimed to explore the clinical characteristics and suicidal behaviour in patients with EDs following a suicide attempt. Specifically, we sought to analyse the influence of sociodemographic factors, psychiatric comorbidities, impulsivity, and childhood trauma on suicide-related outcomes.</p><p><strong>Methods: </strong>A total of 1441 adults were included, of whom 131 (9.1%) had an ED diagnosis. Participants were categorized into ED and no-ED groups. Group comparisons were conducted using χ² and ANOVA tests. Linear and logistic regression models explored the influence of sociodemographic and clinical variables (e.g., comorbidities, impulsivity, trauma) on suicidal ideation intensity, number of suicide behaviours, and medical damage from the index attempt.</p><p><strong>Results: </strong>The ED group was younger, predominantly female, and had higher educational attainment. Clinically, they showed greater psychopathology, higher rates of non-suicidal self-injury (NSSI), emotional and sexual abuse, and more previous suicide attempts. They also exhibited a higher number of suicidal behaviours (d=0.70), but only slightly greater ideation intensity (d=0.28). Regression models identified psychiatric comorbidities, depression, acquired capability, and past attempts as key predictors of ideation; suicide behaviours were associated with ED (binging-purging subtype), comorbidities, psychotic symptoms, NSSI, and prior attempts.</p><p><strong>Conclusions: </strong>EDs, particularly those with binging-purging patterns, are linked to repeated suicidal behaviour. Suicide risk assessments in ED patients should consider comorbidities, trauma, NSSI, and impulsivity to guide targeted interventions.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267735","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":"Suicide as a cause of maternal mortality in the postpartum period in Spain.","authors":"María Del Mar Martin-Moya, María Luisa de la Cruz-Conty, Rosa Vila-Hernández, Ivanna Llordella-Sarmiento, Sara Tameish, Elena Jiménez-Belio, Hilario Blasco-Fontecilla, Manuel Martín-González, Óscar Martínez-Pérez","doi":"10.1016/j.sjpmh.2026.03.005","DOIUrl":"10.1016/j.sjpmh.2026.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>The postpartum period carries a high risk of suicide, one of the leading causes of maternal death in Europe. This study analyzes the incidence of suicide as a cause of maternal mortality within the first postpartum year in Spain.</p><p><strong>Materials and methods: </strong>Data were obtained from the National Institute of Statistics. Suicide records in Spain (2016-2023) were linked to birth and birth-loss certificates. Suicides during pregnancy or after losses <22 weeks were excluded due to lack of national registration data. Variables included year of death, maternal age, and time from delivery to death. Analyses were descriptive. The study was approved by the Research Ethics Committee of Almería (June 26, 2024; SUICIDE_POSPARTO 37/2024).</p><p><strong>Results: </strong>Thirty women died by suicide during the first postpartum year between 2016 and 2023. Eighty percent of cases involved women aged 30-40 years. Half of the suicides occurred within the first five months postpartum, with 83.3% classified as late maternal mortality (between day 43 postpartum and the end of the first year). The highest maternal mortality ratio due to suicide was recorded in 2017, at 0.76 per 100,000 live births (three cases), followed by 2022 with 0.61 (two cases). In contrast, late maternal mortality due to suicide was highest in 2016, with a ratio of 1.70 per 100,000 live births.</p><p><strong>Conclusions: </strong>This is the first study to publish data on suicide in the first postpartum year in Spain, contributing to the national maternal mortality registry. Research on suicidal behavior and prevention strategies during pregnancy and postpartum remains a priority.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960397","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":"Air pollution exposure and mental health disorders in Catalonia: A population-based cross-sectional study.","authors":"Ruth Voltà I Solerdelcoll, María Jesús Perdomo Alonso, Clàudia Valenzuela-Pascual, Ariadna Mas, Marta Korniyenko, Clara Escala, Daniel Ilzarbe, Gerard Anmella, Michele De Prisco, Giovanna Fico, Vincenzo Oliva, Miquel Bioque, Josep Llorca-Bofí, Diego Hidalgo-Mazzei, Eduard Vieta, Vicent Llorca-Bofí","doi":"10.1016/j.sjpmh.2026.03.004","DOIUrl":"10.1016/j.sjpmh.2026.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Air pollution is a global health threat increasingly linked to mental disorders. Exposure to particulate matter (PM₁₀), nitrogen dioxide (NO₂), and ozone (O₃) has been linked to higher risk of these conditions. Evidence is strongest for NO₂, while findings for PM₁₀ and O₃ remain inconsistent, particularly in Southern Europe.</p><p><strong>Methods: </strong>We conducted a cross-sectional study geolinking 2019 mental health diagnoses from the PADRIS-PRESTO cohort (n=1,415,944) with air pollution data from 30 health districts in Catalonia, Spain. Annual mean concentrations of NO₂, O₃, and PM₁₀ were estimated. Logistic regression models, adjusted for age, sex, socioeconomic status, and health district, examined associations between pollutant exposure tertiles and the prevalence of major depressive disorder (MDD), anxiety disorder (AD), bipolar disorder, schizophrenia (SCZ), attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).</p><p><strong>Results: </strong>NO₂ exposure showed the strongest associations, including a moderate effect for ADHD (OR=2.04, 95%CI: 1.94-2.15) and small positive associations with ASD, SCZ, and AD (OR range: 1.27-1.31). O₃ demonstrated a small positive association with ADHD (OR=1.41, 95%CI: 1.36-1.46) but showed no substantive associations with other disorders. PM₁₀ showed mostly null or inverse associations, including a small inverse association with ADHD (OR=0.76, 95%CI: 0.73-0.79).</p><p><strong>Conclusions: </strong>This large population-based study found consistent associations between NO₂ exposure and neurodevelopmental and psychotic disorders, whereas O₃ and PM₁₀ showed weaker or inconsistent relationships. These findings highlight the need for longitudinal research to clarify causality.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959413","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":"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":"New interventions for schizophrenia: Navigating the treatment landscape","authors":"Emilio Fernandez-Egea,&nbsp;Robert A. McCutcheon","doi":"10.1016/j.sjpmh.2026.02.004","DOIUrl":"10.1016/j.sjpmh.2026.02.004","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 127-131"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences and substance use in the onset of psychosis: Implications for early intervention","authors":"Esther Hesline Palandi,&nbsp;Amândio de Araújo Sarmento,&nbsp;Muhammad Iqbal Fajri,&nbsp;Asep Setiawan,&nbsp;Gilbert Rely,&nbsp;Ardi Azhar Nampira,&nbsp;Yurika,&nbsp;Zeth Parinding,&nbsp;Erfan Ramadhani","doi":"10.1016/j.sjpmh.2025.07.003","DOIUrl":"10.1016/j.sjpmh.2025.07.003","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 132-133"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025028","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":"Navigating schizophrenia treatment: Challenges in pharmacogenetic counseling","authors":"Ivan Martin da Silva,&nbsp;Mar Panisello-Cardona,&nbsp;David Almenta,&nbsp;Alexandra Roldán,&nbsp;Sara Bernal,&nbsp;Narcís Cardoner,&nbsp;María Gámez-Lechuga,&nbsp;Pau Riera","doi":"10.1016/j.sjpmh.2025.12.005","DOIUrl":"10.1016/j.sjpmh.2025.12.005","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 79-81"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145151","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":"From premorbid adjustment dimensions to clinical outcomes: Exploring environmental stress and epigenetic influences on first-episode schizophrenia phenotypes","authors":"Anaid Pérez-Ramos,&nbsp;Àlex Gonzalez-Segura,&nbsp;Laura Julià,&nbsp;Clemente García-Rizo,&nbsp;Ana Sánchez-Torres,&nbsp;Vito Cavone,&nbsp;Iñaki Zorrilla,&nbsp;Anna Mané,&nbsp;Roberto Rodriguez-Jimenez,&nbsp;Alexandra Roldan,&nbsp;Edith Pomarol-Clotet,&nbsp;Angela Ibañez,&nbsp;Judith Usall,&nbsp;Antonio Lobo,&nbsp;Miquel Bioque,&nbsp;Miquel Bernardo,&nbsp;Manuel J. Cuesta,&nbsp;Mara Parellada,&nbsp;Ana González-Pinto,&nbsp;Esther Berrocoso,&nbsp;Maria Paz García-Portilla","doi":"10.1016/j.sjpmh.2025.08.002","DOIUrl":"10.1016/j.sjpmh.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Schizophrenia is a complex and multifaceted mental disorder characterized by cognitive, emotional, and behavioral dysfunctions that significantly impact the patients’ daily lives. Premorbid adjustment (PA) is a multidimensional framework, the severity of which has been associated with more severe phenotypic traits and unfavorable outcomes, offering insights into the development of this disorder. This study aims to characterize a group of first-episode schizophrenia (FES) patients based on academic (PAA) and social (PSA) PA, explore the overlap across these dimensions, and examine their associations with early clinical, environmental, and epigenetic factors, through methylation profile scores (MPS).</div></div><div><h3>Material and methods</h3><div>A total of 218 FES subjects were included. K-means clustering identified “poor” and “good” groups for PAA and PSA. Clusters overlaps were explored using multiple correspondence analysis and were characterized by sociodemographic, clinical, functional, and cognitive features. Associations with clinical, environmental factors and MPS were examined using multivariable models adjusted for key covariates.</div></div><div><h3>Results</h3><div>Poor-PAA individuals showed worse cognitive performance (working memory, attention, and executive function), lower educational level, and higher cannabis use. Poor-PSA individuals had more severe negative symptoms. MPS for early-life adversity and cannabis use were associated with PSA clusters, while MPS for birth weight and tobacco use were linked to PAA clusters.</div></div><div><h3>Conclusions</h3><div>PAA and PSA dimensions show distinct clinical, cognitive, functional, and epigenetic profiles. These findings support the use of premorbid functioning subtypes for identifying early markers and tailoring interventions.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 99-110"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535196","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":"Use of antipsychotics in children and adolescents in Spain, 2015–2023: A real-world, population-based study","authors":"Isabel Hurtado,&nbsp;Celia Robles-Cabaniñas,&nbsp;Anibal García-Sempere,&nbsp;Rafael Tabarés-Seisdedos,&nbsp;Inmaculada Baeza,&nbsp;Fran Llopis-Cardona,&nbsp;Verónica Gamón,&nbsp;Clara Rodríguez-Bernal,&nbsp;Salvador Peiró,&nbsp;Gabriel Sanfélix-Gimeno","doi":"10.1016/j.sjpmh.2026.01.002","DOIUrl":"10.1016/j.sjpmh.2026.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Antipsychotic (AP) prescription has risen across Europe, but updated data on prescribing trends and treatment intensity in youth remain limited. This study describes AP prescription patterns among children and adolescents in the region of Valencia, Spain, with 5 million inhabitants.</div></div><div><h3>Methods</h3><div>Population-based, cross-sectional study using the Valencia Health System's Integrated Database (VID) including all AP drugs prescribed to individuals aged 0–19 years from 2015 through 2023. APs were categorized by active substance, and yearly trends in prescription volume, patient numbers, and chlorpromazine equivalent doses (CED) per patient were presented. Results were stratified by age and sex.</div></div><div><h3>Results</h3><div>A total of 570,238 AP prescriptions were dispensed to 30,704 patients, increasing 1.61-fold over the study period. Risperidone and aripiprazole accounted for 60.5% of all prescriptions, while lurasidone experienced the highest growth (13-fold increase), followed by olanzapine (3.1-fold), aripiprazole (2.3-fold), and quetiapine (2.1-fold). The number of treated patients increased by 50%, with the highest relative increase in young children (0–4 years old) and adolescents (15–19 years old). AP use was higher in males but rose more sharply among females (1.4-fold vs 2.1-fold). Overall, CED per patient slightly declined.</div></div><div><h3>Conclusions</h3><div>AP prescriptions and patients treated among Spanish youth increased significantly between 2015 and 2023, with notable differences by age and sex. While total CED rose, treatment intensity per patient remained relatively stable. Future studies should investigate the clinical indications for these prescriptions as well as the outcomes associated with AP use in children and adolescents.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 111-118"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138167","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":"Expanding therapeutic and clinical horizons in psychosis","authors":"Benedicto Crespo-Facorro","doi":"10.1016/j.sjpmh.2026.06.001","DOIUrl":"10.1016/j.sjpmh.2026.06.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"19 2","pages":"Pages 73-74"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321473","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}