Miguel Jiménez Blázquez , María Parrondo Pérez-Olivares
{"title":"Evaluación de la capacidad de hecho en interconsulta psiquiátrica","authors":"Miguel Jiménez Blázquez , María Parrondo Pérez-Olivares","doi":"10.1016/j.psiq.2024.100519","DOIUrl":"10.1016/j.psiq.2024.100519","url":null,"abstract":"<div><div>The evaluation of a possible inability to make decisions must be careful to respect the principle of patient autonomy and to preserve the ethical principle of non-maleficence. The presumption that the patient retains his de facto capacity must always prevail. The Aid to Capacity Evaluation is the most appropriate tool for assessment in Liaison Psychiatry.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 1","pages":"Article 100519"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697928","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":"Síndrome de encefalopatía posterior reversible tras la terapia electroconvulsiva","authors":"Andrea Jiménez-Mayoral , Emilio Ruiz-Fernández , Aurora Torrent-Seto , Iolanda Batalla-Llordes","doi":"10.1016/j.psiq.2024.100515","DOIUrl":"10.1016/j.psiq.2024.100515","url":null,"abstract":"<div><h3>Introduction</h3><div>Electroconvulsive therapy (ECT) is a safe technique in which adverse effects are usually mild and self-limited. Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity characterized by encephalopathy, headache, seizures and visual alterations of acute evolution, caused by noxas that produce endothelial damage with vasogenic edema in the cerebral vessels. PRES has been described as a rare neurological complication associated of ECT. A case report is proposed to facilitate PRES recognition and management.</div></div><div><h3>Material and methods</h3><div>We present a clinical case report of a young woman with diagnosis of obsessive-compulsive disorder and eating disorder who was admitted due to a torpid evolution, who in the context of an ECT trial, suffered a PRES. Informed consent was obtained for every test performed, and for the use of their results in this publication. This publication complies with the agreements of the Declaration of Helsinki.</div></div><div><h3>Results</h3><div>The patient presented a spontaneous and complete recovery within a week, with no alterations on the MRI and no new neurological symptoms during admission or in the months after discharge. Even so, it was decided to suspend the ECT sessions.</div></div><div><h3>Discussion</h3><div>Patient’s symptoms were highly suggestive of PRES. MRI findings were unremarkable, which we attribute to the characteristic reversibility of the syndrome and the patients’ rapid clinical recovery after discontinuation of ECT.</div></div><div><h3>Conclusion</h3><div>Despite its reversibility and good prognosis, it is important to know this entity as a possible complication of ECT to facilitate its early recognition and improve the management and prognosis of our patients.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 2","pages":"Article 100515"},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661802","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":"Innovaciones en la cesación tabáquica: el papel de la citisiniclina","authors":"Miguel Angel Alvarez de Mon, Vanessa Herrera","doi":"10.1016/j.psiq.2024.100513","DOIUrl":"10.1016/j.psiq.2024.100513","url":null,"abstract":"<div><div>Tobacco use is one of the leading causes of disease, disability, and death worldwide. Achieving smoking cessation without pharmacological assistance is extremely challenging due to the highly addictive nature of tobacco. The goal of pharmacotherapy for nicotine addiction is to reduce withdrawal symptoms and nicotine's reinforcing effects with minimal side effects. Several effective medications are available to help people quit smoking, including nicotine replacement therapy (NRT), bupropion, varenicline, nortriptyline, and cytisinicline, among others. Cytisinicline has gained popularity in Spain, supported by funding from the Ministry of Health, making it more accessible through the public health system. Cytisinicline is administered orally and does not undergo significant hepatic metabolism, reducing the risk of drug interactions. Its most common side effects are gastrointestinal symptoms, which usually resolve spontaneously. Clinical trials have demonstrated its efficacy in smoking cessation. A clinical trial in Australia compared cytisinicline with varenicline, showing similar abstinence rates but with better tolerability for cytisinicline. Other studies and meta-analyses have also demonstrated the superiority of cytisinicline over NRT and placebo. Given its effectiveness, favorable side effect profile, and low cost, cytisinicline is a promising option. Combining it with behavioral support, such as cognitive-behavioral therapy (CBT) and motivational interviewing, enhances outcomes.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"31 4","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586847","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":"Risk of hospital readmission in patients with psychotic symptoms and a history of drug use","authors":"Paula Mollà Roig","doi":"10.1016/j.psiq.2024.100509","DOIUrl":"10.1016/j.psiq.2024.100509","url":null,"abstract":"<div><h3>Introduction</h3><div>Substance use is common in patients with psychotic symptomatology, especially in patients diagnosed with a first psychotic episode or schizophrenia. In both chronic psychosis and first psychotic episodes, substance abuse is associated with a worse outcome and a higher relapse rate.</div></div><div><h3>Methods</h3><div>For this study, a sample of <em>n</em> <!-->=<!--> <!-->731 was collected, including all patients hospitalised in the Adult Hospitalisation Unit (AHU) of Psychiatry of the Hospital Clínico Universitario de Zaragoza between 1 January 2014 and 31 December 2017, with a discharge diagnosis of psychotic disorder or affective disorder with psychotic symptomatology.</div></div><div><h3>Results</h3><div>From the analysis of the sample, the results show that 52.19% of the patients in the sample studied have a history of drug use. And, the most frequently used substance among patients with psychotic pathology is cannabis (73.71%). Likewise, patients with a history of drug use were admitted at an earlier age (35.07<!--> <!-->±<!--> <!-->12.72 years) than those without a history of drug use (50.74<!--> <!-->±<!--> <!-->15.08 years). In addition, drug use was more frequent in males, with a ratio of 4:1.</div></div><div><h3>Conclusions</h3><div>It has also been observed that patients with a history of drug use have a higher risk of hospital readmission to a psychiatric unit. In the sample analysed, cannabis was the only substance that presented statistically significant differences with respect to the risk of hospital readmission.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"31 4","pages":"Article 100509"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420158","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}
Constanza Vera-Varela , María Luisa Barrigón , Enrique Baca-García
{"title":"Concordancia del autorreporte y la valoración clínica de la ideación suicida","authors":"Constanza Vera-Varela , María Luisa Barrigón , Enrique Baca-García","doi":"10.1016/j.psiq.2024.100510","DOIUrl":"10.1016/j.psiq.2024.100510","url":null,"abstract":"<div><h3>Background</h3><div>Thoughts of suicide and/or death usually precede suicide attempts and suicide deaths. We study the agreement in passive suicidal ideation between reports made by clinicians during an outpatient mental health service and patients’ online self-reports.</div></div><div><h3>Methodology</h3><div>Between 2014 and 2016, during routine psychiatric and psychological appointments in the outpatient mental-health facilities affiliated with the Fundación Jiménez Díaz Hospital in Madrid, wish of death was assessed in 25.358 patients.</div><div>Within 24 hours of this assessment, 648 patients completed a self-report in which they were asked about the presence of passive suicidal ideation. We used cluster analysis to determine the clinical profile of a population of patients according to the agreement between reports made by clinicians and self-reported information.</div></div><div><h3>Results</h3><div>A low level of agreement (kappa<!--> <!-->=<!--> <!-->0.072) was found between clinicians and patients, as 56.4% (n<!--> <!-->=<!--> <!-->366) of clinicians’ reports classified as containing no death-related ideas, although on self-report the patient did state that they had passive suicidal ideation. In this group, two clusters (cluster 2 y 4) were found to have shared characteristics: female sex, middle age, cohabitation, active employment, no history of suicidal behavior, and diagnosis of neurotic, stress-related, and somatoform disorders. Additionally, cluster 4 patients self-reported sleep disturbances, less appetite, poor treatment adherence, and aggressiveness.</div></div><div><h3>Conclusions</h3><div>We found low agreement between patients’ self-reports and clinician assessments regarding the passive suicidal ideation. Self-report may be useful in suicide risk assessment as a complementary method, that allows to generate a confidential space that could reduce the problem of underreporting of passive suicidal ideation.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"31 4","pages":"Article 100510"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420159","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}
Belén Resa-Pérez , Andrea Jiménez-Mayoral , Vanessa Gladys Velasquez-Acebey , Filip Damian Budny , Georgina Badia i Realp , Salvador Miret-Fallada , María Irigoyen-Otiñano
{"title":"Case report. Pregnancy in women with an eating disorder","authors":"Belén Resa-Pérez , Andrea Jiménez-Mayoral , Vanessa Gladys Velasquez-Acebey , Filip Damian Budny , Georgina Badia i Realp , Salvador Miret-Fallada , María Irigoyen-Otiñano","doi":"10.1016/j.psiq.2024.100511","DOIUrl":"10.1016/j.psiq.2024.100511","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy has been described as a period of symptomatic stability for women diagnosed with eating disorder (ED). However, a poor control of alimentary symptoms before and during pregnancy is associated with higher risk of adverse effects during childbirth and the postpartum period. A case report is presented and a bibliographic review is carried out.</div></div><div><h3>Methods</h3><div>The authors take the case of a 33-year-old woman diagnosed with anorexia nervosa during adolescence, who becomes pregnant at the age of 30. A non-systematic review was carried out using the Pubmed database using keywords [eating disorder] AND [pregnancy]. Studies of more than 5 years were excluded. The patient's informed consent was obtained. This work complies with the agreements of the Declaration of Helsinki.</div></div><div><h3>Results</h3><div>Eutocic delivery was carried out without incidents. Currently, the baby is 5 months old, his weight is adjusted to his age and his neurodevelopment is normal. Although the patient denies restrictions or purgative behaviors, she has lost weight in postpartum and has recovered her pre-pregnancy body mass index. No major affective symptoms have been observed in this period.</div></div><div><h3>Discussion/Conclusions</h3><div>Pregnancy and postpartum period constitute periods of greater vulnerability in terms of eating symptoms in patients with EDs. Emphasis should be placed on a multidisciplinary approach with the aim of avoiding the appearance of associated risk factors both for the mother and the baby.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"31 4","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420157","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}