Actas espanolas de psiquiatria最新文献

{"title":"From Reified Identity to Relational Ipseity: Hermeneutic Phenomenology, Language Pragmatics, and Contemplative Practices of Self-Deconstruction.","authors":"Roberto Aristegui Lagos, Javier García-Campayo, Paulina Lamas-Morales","doi":"10.62641/aep.v54i4.2217","DOIUrl":"10.62641/aep.v54i4.2217","url":null,"abstract":"<p><p>This article presents a theoretical and conceptual analysis of self-deconstruction in contemporary contemplative and clinical practices. It argues that psychological suffering is not primarily related to the existence of the self as such, but to its ontological and linguistic reification as a fixed identity, corresponding to idem-identity and to what Heidegger described as an ontology of presence (Vorhandenheit). Drawing on hermeneutic phenomenology, the self is reconceptualized as ipseity (selfhood): a relational, temporal, and performative mode of being-in-the-world. From this perspective, self-deconstruction does not imply the elimination of identity but a transformation in the mode of being of the self. This framework integrates three axes: (a) Heidegger's analytics of being-in-the-world and the distinction between sameness and ipseity; (b) a pragmatic distinction between indirect and direct reference in language, allowing experiential and clinical transformation without representational reductionism; and (c) a dialogue with nondual contemplative traditions and contemporary clinical approaches, particularly mindfulness-based and third-wave therapies. The article proposes a translational architecture linking ontological analysis, phenomenology of language, and clinical practice, and shows how non-duality can be understood in a non-nihilistic way when grounded in an ontology of ipseity. Clinical implications for psychotherapy, mindfulness-based interventions, and models of self-related suffering are discussed, including connections to Acceptance and Commitment Therapy, cognitive defusion, and decentering, as well as boundary conditions and safeguards for contemplative practices.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1304-1312"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression as a Longitudinal Modulator of Physical-Verbal Aggression in Early Adolescence: Trajectories and Sex Comparisons.","authors":"Rodolfo Gordillo, Victoria Del Barrio, Miguel Ángel Carrasco","doi":"10.62641/aep.v54i4.2265","DOIUrl":"10.62641/aep.v54i4.2265","url":null,"abstract":"<p><strong>Background: </strong>Depression during early adolescence has been associated with increased aggressive behaviour; however, longitudinal evidence focused on this developmental stage remains limited, and findings regarding sex differences are inconsistent. In addition, few studies have examined physical and verbal aggression jointly across early adolescence. This study aims to examine the longitudinal association between depression and physical-verbal aggression during early adolescence and to analyse whether sex moderates the developmental trajectories and severity of aggression.</p><p><strong>Methods: </strong>A three wave longitudinal study was conducted with 251 adolescents (66.5% girls), aged 10-14 years, recruited from secondary schools in Madrid, Spain. Depressive symptoms were assessed using the Children's Depression Inventory-Short version (CDI-S), and physical- verbal aggression was measured with the Physical and Verbal Aggression Questionnaire (PVAQ). Repeated-measures analysis of variance (RM-ANOVA) was used to analyse changes in aggression across three approximately annual assessments (mean ages: 10.8, 11.8, and 12.8 years), with sex and depression status included as between subject factors.</p><p><strong>Results: </strong>Adolescents with depression consistently showed higher levels of physical-verbal aggression across all three assessment waves compared with those without depression. Aggressive behaviour followed a quadratic trajectory, increasing between ages 10.8 and 11.8 and decreasing at age 12.8, although elevated levels persisted in the presence of depression. Boys and girls exhibited similar developmental patterns; however, boys showed greater severity and persistence of aggression. The association between depression and physical-verbal aggression was independent of normative sex differences and emerged as early as 10.8 years of age, highlighting early adolescence as a key period for preventive screening and intervention.</p><p><strong>Conclusions: </strong>Adolescents with depression show a high and persistent physical-verbal aggression during early adolescence, with sex differences emerging primarily in severity rather than in the form of developmental trajectories. These findings underscore early adolescence as a key period for identifying adolescents at increased risk and highlight the value of longitudinal assessment for informing preventive and clinically relevant interventions targeting the co occurrence of depressive mood states and aggressive behaviour.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1005-1017"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Phased Rehabilitation Nursing Combined With Mindfulness-Based Stress Reduction in Patients With Acute Cerebral Infarction.","authors":"Meng Li, Qian Ning, Yao Wang, Qianqian Xu","doi":"10.62641/aep.v54i4.2225","DOIUrl":"10.62641/aep.v54i4.2225","url":null,"abstract":"<p><strong>Background: </strong>This study retrospectively analysed the clinical outcomes of phased rehabilitation nursing combined with mindfulness-based stress reduction on depression and neurological deficit severity in patients with acute cerebral infarction (ACI).</p><p><strong>Methods: </strong>This study employed a retrospective analysis. A total of 399 patients with cerebral infarction admitted between January 2023 and December 2025 were enrolled. Based on previous nursing practices, the subjects were divided into a traditional nursing group (n = 199) and a phased nursing group (n = 200). The traditional nursing group received conventional care, whereas the phased nursing group received phased rehabilitation care combined with mindfulness-based stress reduction psychological care. Intergroup differences in nursing satisfaction were analysed, and comparisons of Beck Depression Inventory-II (BDI-II) scores, motor function, neurological function, activities of daily living and quality of life were conducted between the two groups at baseline and 3 months after nursing measures.</p><p><strong>Results: </strong>The phased nursing group demonstrated higher nursing satisfaction than the traditional nursing group (<i>p</i> < 0.05). After 3 months of nursing care, the phased nursing group exhibited lower scores on the somatisation and affective dimensions of the BDI-II scale than the traditional nursing group (<i>p</i> < 0.05). Moreover, the phased nursing group demonstrated higher scores on the functional motor scale, Barthel index, and stroke-specific quality of life than the traditional care group while exhibiting lower scores on the National Institutes of Health Stroke Scale (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The application of phased rehabilitation nursing combined with mindfulness-based stress reduction in patients with ACI significantly improves depressive symptoms, enhances motor function, reduces neurological deficits and ultimately boosts adaptive daily living activities and overall quality of life. This approach plays a crucial role in promoting comprehensive recovery.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1212-1219"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Postoperative Sleep Disturbance in Elderly Patients Undergoing Hip Arthroplasty Surgery: The Role of Preoperative Depression and Anxiety.","authors":"Qian Fang, Rong Li, Jinyan Xiao, Chenyu Liu","doi":"10.62641/aep.v54i4.2244","DOIUrl":"10.62641/aep.v54i4.2244","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sleep disturbance (PSD) is a common complication following hip arthroplasty surgery (HAS), yet the role of preoperative psychological factors remains incompletely understood. This study aimed to identify risk factors for PSD in elderly patients undergoing HAS, with a specific focus on the impact of preoperative depression and anxiety.</p><p><strong>Methods: </strong>A case-control study was conducted on 204 elderly patients (age ≥ 60 years) who underwent HAS. Patients were categorized into PSD (n = 81) and non-PSD (n = 123) groups based on a Pittsburgh Sleep Quality Index (PSQI) global score > 7 at one-month follow-up. Data on demographics, preoperative psychological status (measured using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) as documented in medical records), perioperative clinical indicators, and postoperative sleep quality were extracted from electronic medical records. Univariate analyses, multivariable logistic regression, correlation analysis, and interaction assessments were performed.</p><p><strong>Results: </strong>Multivariable logistic regression identified four independent risk factors for PSD: higher preoperative SAS score (odds ratio (OR) = 1.14, 95% confidence interval (CI): 1.08-1.20, p < 0.001), higher preoperative SDS score (OR = 1.14, 95% CI: 1.08-1.21, p < 0.001), higher postoperative day 1 pain score (OR = 1.69, 95% CI: 1.13- 2.53, p = 0.011), and longer time to first ambulation (OR = 1.13, 95% CI: 1.08-1.18, p < 0.001). Preoperative SAS and SDS scores were positively correlated with postoperative PSQI scores (r = 0.36 and r = 0.28, respectively, both p < 0.001). Stratified analysis confirmed preoperative anxiety/depression's significant association with PSD regardless of preoperative sleep status. Preoperative anxiety and postoperative high pain showed a significant positive additive interaction (Relative Excess Risk due to Interaction (RERI) = 9.41, 95% CI: 2.77-34.12). The model had an area under curve (AUC) of 0.90 (95% CI: 0.85-0.94) and good calibration (Hosmer-Lemeshow p = 0.316).</p><p><strong>Conclusions: </strong>Preoperative depression and anxiety are significant independent risk factors for PSD in elderly HAS patients, exhibiting a synergistic effect with postoperative pain. These findings underscore the critical need to integrate routine preoperative psychological screening and targeted multidisciplinary interventions into perioperative care protocols to mitigate PSD and improve recovery outcomes.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1120-1131"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Well-Being and Burnout in University Faculty: The Mediating Role of Emotional Exhaustion.","authors":"María J García-Rubio, Laura Viqueira Gutiérrez, Sandra Hoyos, Paloma López-Hernández, Irene Cano-López, Alejandro Cano-Villagrasa","doi":"10.62641/aep.v54i4.2346","DOIUrl":"10.62641/aep.v54i4.2346","url":null,"abstract":"<p><strong>Background: </strong>To examine the relationship between psychological well-being and burnout dimensions among university faculty members, as well as the mediating role of emotional exhaustion in the association between psychological well-being and professional accomplishment.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 597 university faculty members from several Spanish universities. Participants completed the Spanish adaptation of Ryff's Psychological Well-Being Scales and the emotional exhaustion and personal accomplishment subscales of the Maslach Burnout Inventory. Correlation, regression, and mediation analyses were performed.</p><p><strong>Results: </strong>All dimensions of psychological well-being were negatively associated with emotional exhaustion and positively associated with professional accomplishment. Environmental mastery emerged as the strongest predictor of lower emotional exhaustion (β = -0.405, p < 0.001) and higher professional accomplishment (β = 0.263, p < 0.001). Mediation analyses indicated that emotional exhaustion partially mediated the relationship between psychological well-being and professional accomplishment.</p><p><strong>Conclusions: </strong>Psychological well-being may function as a protective personal resource associated with lower levels of burnout among university faculty members. In particular, environmental mastery may represent a key psychological resource associated with lower emotional exhaustion and greater professional accomplishment in higher education settings. Interventions aimed at strengthening psychological well-being and reducing emotional exhaustion may contribute to improving occupational mental health in academic professionals.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1201-1211"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Comprehensive Bundled Nursing Care on Psychological Disorders in Mechanically Ventilated Intensive Care Unit Patients.","authors":"Yanyan Zhang, Yun Chen","doi":"10.62641/aep.v54i4.2242","DOIUrl":"10.62641/aep.v54i4.2242","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the effects of comprehensive bundled nursing care on psychological disorders (anxiety, depression, post-traumatic stress disorder [PTSD], and cognitive impairment) in mechanically ventilated patients in the intensive care unit (ICU). In addition, the study analysed the effect of these nursing strategies on patient treatment adherence, providing evidence for optimizing psychological nursing strategies in the ICU.</p><p><strong>Methods: </strong>This retrospective study included 116 ICU patients who received mechanical ventilation. They were divided into two groups based on the type of nursing care: the bundled comprehensive nursing group (n = 58) and the control group (n = 58). The control group received routine nursing care, whereas the bundled comprehensive nursing group received comprehensive nursing care, which included psychological care as the core component, supplemented by position optimization, oral care, and nutritional support. Psychological and cognitive outcomes were assessed using the Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Post-traumatic Stress Disorder Checklist (PCL-C), and Montreal Cognitive Assessment (MoCA) before and after nursing care. Additionally, treatment adherence was compared between the two groups.</p><p><strong>Results: </strong>Before the nursing care, no significant differences were found between the two groups in any of the above scales (all p > 0.05). After the nursing care, the bundled comprehensive nursing group showed significantly lower HAMA, HAMD, and PCL-C scores and higher MoCA scores compared with the control group (all p < 0.001). In addition, treatment adherence was significantly improved in the intervention group (p < 0.01).</p><p><strong>Conclusions: </strong>The bundled comprehensive nursing was associated with reduced anxiety, depression, and PTSD symptoms, improved cognitive function, and enhanced treatment adherence in mechanically ventilated ICU patients. This study provides an important clinical reference for optimizing psychological nursing strategies in the ICU.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1159-1167"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy Study of Escitalopram Combined With Low-Frequency Repetitive Transcranial Magnetic Stimulation in Patients With Post-Ischemic Stroke Depression and Anxiety.","authors":"Yan Long, Qingxian Wei, Xiujin Deng, Jiezhi Wei, Ailing Jiang, Qing Guo, Yuanqiu Zhong","doi":"10.62641/aep.v54i4.2250","DOIUrl":"10.62641/aep.v54i4.2250","url":null,"abstract":"<p><strong>Background: </strong>To retrospectively analyze the clinical efficacy of escitalopram combined with low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in treating anxiety and depression in ischemic stroke patients.</p><p><strong>Methods: </strong>Eighty ischemic stroke patients with concurrent depression and anxiety who received treatment at Jiangbin Hospital of Guangxi Zhuang Autonomous Region from January 2025-December 2025 were retrospectively collected. Patients were divided into a conventional treatment group and a combined treatment group, with 40 patients in each group. The conventional treatment group received routine treatment combined with oral escitalopram, while the combined treatment group received the same treatment as the conventional treatment group, combined with LF-rTMS. To evaluate clinical efficacy, Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores were collected before and at the end of treatment in both groups. Transcranial ultrasound imaging of the brainstem raphe (BR) region was also performed, and adverse reactions during treatment were recorded.</p><p><strong>Results: </strong>The total effective rate in the combined treatment group was significantly higher than that in the conventional treatment group. After adjusting for baseline scores, post-treatment HAMD and HAMA scores in the combined treatment group were significantly lower than those in the conventional treatment group. The proportion of patients with abnormal echogenicity decreased in both groups, and the number of patients with abnormal echogenicity in the combined treatment group was less than that in the conventional treatment group. There was no statistically significant difference in the incidence of adverse reactions between the two groups.</p><p><strong>Conclusions: </strong>Escitalopram combined with LF-rTMS can effectively alleviate anxiety and depression in ischemic stroke patients and show beneficial changes in BR echogenicity as an exploratory imaging finding. It may serve as a potential and promising treatment option for post-ischemic stroke depression and anxiety, although further validation is needed.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1088-1097"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing Factors and Prediction Model Construction of Anxiety and Depression in Patients With Coronary Heart Disease Undergoing In-Stent Restenosis.","authors":"Sihui Sun, Xiaoxian Wu, Lichen Tang, Haiyan Jiang","doi":"10.62641/aep.v54i4.2249","DOIUrl":"10.62641/aep.v54i4.2249","url":null,"abstract":"<p><strong>Background: </strong>In-stent Restenosis (ISR) represents a major challenge in interventional cardiology, and psychological distress is known to worsen coronary heart disease outcomes. However, the prevalence and determinants of anxiety and depression specifically in ISR patients remain largely uncharacterized. This study aimed to investigate the incidence and independent risk factors of these symptoms and to develop predictive models for their early identification.</p><p><strong>Methods: </strong>A single-center retrospective study involving 256 patients with confirmed ISR was conducted. Psychological status was assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Univariate and multivariate logistic regression analyses were employed to identify independent risk factors. Nomograms were constructed and validated based on these factors, with model performance evaluated by the area under the curve (AUC), calibration plots, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>The prevalence of anxiety and depression symptoms was 37.89% and 42.58%, respectively. Multivariate analysis identified poorer sleep quality (higher Pittsburgh Sleep Quality Index (PSQI) score), lower social support (lower Social Support Rating Scale (SSRS) score), higher New York Heart Association (NYHA) classification (≥Ⅲ), multiple stents (≥2), and suburban/rural residence as independent risk factors for anxiety. For depression, older age, higher PSQI score, lower SSRS score, multiple stents, and advanced Mehran classification (III/IV) were significant predictors. The nomograms demonstrated good predictive accuracy, with AUCs of 0.79 (95% confidence interval (CI): 0.74-0.85) for anxiety and 0.82 (95% CI: 0.76-0.87) for depression, along with good calibration and clinical utility.</p><p><strong>Conclusions: </strong>Anxiety symptoms and depressive symptoms are highly prevalent in ISR patients. The developed nomograms, incorporating clinical and psychosocial factors, provide effective tools for individualized risk stratification, facilitating early identification and targeted psychological interventions to improve patient outcomes.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1189-1200"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Anxiety or Depression in Patients With Stroke During the Acute and Recovery Phases: An Independent Cohort Study.","authors":"Mei Li, Chuchu Ge, Yu Han, Yan Tang, Li Zhao","doi":"10.62641/aep.v54i4.2286","DOIUrl":"10.62641/aep.v54i4.2286","url":null,"abstract":"<p><strong>Background: </strong>To identify the overall risk factors for any clinically significant anxiety or depressive anxiety or depression in patients with stroke in the acute and recovery phase cohorts, compare the differences in overall risk factors between two independent patient cohorts at different disease stages, so as to provide a reliable basis for early screening and staged intervention of post-stroke emotional anxiety or depression.</p><p><strong>Methods: </strong>This is a retrospective study that included 252 stroke patients admitted to Nantong Rici Hospital Affiliated to Yangzhou University from August 2023 to October 2025, which were divided into two independent cohorts: the acute phase cohort (7-14 days after onset, n = 143) and the recovery phase cohort (3 months after onset, n = 109), all eligible patients were assigned to either the anxiety or depression group or the non-anxiety or depression group according to the 14-item Hamilton Anxiety Rating Scale (HAMA-14) and 24-item Hamilton Depression Rating Scale (HAMD-24). Following univariate analysis-based screening of potential risk factors, the significantly different indicators were further included in the multivariate Logistic regression model to identify independent determinants and clarify differences across stages.</p><p><strong>Results: </strong>In the acute phase cohort, the incidence of anxiety or depression was 30.07% (43/143), and the independent risk factors identified were age [odds ratio (OR) = 1.23, 95% confidence interval (CI): 1.10-1.38], illiterate educational level (OR = 8.15, 95% CI: 2.28-29.12), no dedicated care (OR = 5.52, 95% CI: 1.58-19.34), hemorrhagic stroke (OR = 6.39, 95% CI: 1.61-25.30), multiple lesions (OR = 5.07, 95% CI: 1.31-19.66), National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.25, 95% CI: 1.03-1.52), and combined atrial fibrillation (AF) (OR = 5.38, 95% CI: 1.20-24.09) (<i>p</i> all < 0.05). In the recovery phase cohort, the incidence of anxiety or depression was 25.69% (28/109), and the independent risk factorsidentified were age (OR = 1.21, 95% CI: 1.05-1.39), combined diabetes mellitus (DM) (OR = 4.63, 95% CI: 1.18-18.20), AF (OR = 3.94, 95% CI: 1.07-14.45), and coronary heart disease (CHD) (OR = 5.86, 95% CI: 1.45-23.73) (<i>p</i> all < 0.05). Age and combined AF were the common independent risk factors in both cohorts.</p><p><strong>Conclusions: </strong>There are differences in the risk factors for anxiety/depression between independent stroke patients cohorts at different disease stages. Clinically, individualized intervention should be carried out according to the key risk factors of each disease stage to reduce the risk of anxiety or depression.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1077-1087"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mediating Role of Negative Affect in the Relationship Between Anger Rumination and Somatic Symptoms.","authors":"Concepción Muñoz-Sosa, Bárbara Luque, Esperanza García-Sancho, Carmen Tabernero","doi":"10.62641/aep.v54i4.2193","DOIUrl":"10.62641/aep.v54i4.2193","url":null,"abstract":"<p><strong>Background: </strong>A high prevalence of somatisation is associated with a strong impairment of quality of life. Recent research suggests common underlying mechanism of central sensitisation in functional syndromes and chronic pain, with emotion regulation (ER) processes closely linked to somatic symptoms. This study examines the relationship between negative affect (NA) and anger rumination (AR) and its influence on somatisation.</p><p><strong>Methods: </strong>Five hundred seven individuals participated (mean age = 34.60 ± 13.22 years; 380 women). They completed the Patient Health Questionnaire, Negative Affect Scale, and Displaced Aggression Questionnaire. A cross-sectional multivariate factorial relational design was used. Descriptive, multiple linear regression, and mediation analyses were conducted on the total and sex-separated samples.</p><p><strong>Results: </strong>Data analysis revealed a significant positive relationship between NA and AR (r = 0.55, <i>p</i> < 0.01), and both were significantly associated with somatisation (rumination: r = 0.37, <i>p</i> < 0.01; NA: r = 0.54, <i>p</i> < 0.01). Simple linear regressions confirmed that higher levels of NA and AR individually predicted increased somatic symptoms in both sexes. However, multiple regression analyses revealed that the effect of AR on somatisation was reduced in women and became non-significant in men when accounting for NA. Mediation analysis showed a significant indirect effect of AR on somatisation through negative affect (B = 0.005, 95% bootstrap confidence interval [0.004, 0.006]), accounting for 62.5% of the total effect. The mediation pattern was replicated in both women (indirect effect B = 0.005, 95% confidence interval [0.004, 0.007]) and men (indirect effect B = 0.004, 95% confidence interval [0.002, 0.006]). These findings indicated that part of the effect of AR on somatisation occurred under the influence of NA.</p><p><strong>Conclusions: </strong>NA and AR were associated with increased somatic symptoms. These findings suggest the benefit of developing interventions that encourage the use of functional ER strategies. These can help to reduce NA, which in a prolonged form can constitute a vulnerability for organisms, especially in those people with a tendency to somatise.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 4","pages":"1098-1109"},"PeriodicalIF":2.1,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}