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Previous studies attest that early bilinguals can modify their perceptual identification according to the fine-grained phonetic detail of the language they believe they are hearing. Following Gonzales et al. (2019), we replicate the double phonemic boundary effect in late learners (LBs) using conceptual-based cueing. We administered a forced choice identification task to 169 native English adult learners of Spanish in two sessions. In both sessions, participants identified the same /b/-/p/ voicing continuum, but language context was cued conceptually using the instructions. The data were analyzed using Bayesian multilevel regression. Learners categorized the continuum in a similar manner when they believed they were hearing English. However, when they believed they were hearing Spanish, “voiceless” responses increased as a function of L2 proficiency. This research demonstrates the double phonemic boundary effect can be conceptually cued in LBs and supports accounts positing selective activation of independent perception grammars in L2 learning.
The main objective of this study was to develop a dynamic energy balance model for dairy goats to describe and quantify energy partitioning between energy used for work (milk) and that lost to the environment. Increasing worldwide concerns regarding livestock contribution to global warming underscore the importance of improving energy efficiency utilization in dairy goats by reducing energy losses in feces, urine and methane (CH4). A dynamic model of CH4 emissions from experimental energy balance data in goats is proposed and parameterized (n = 48 individual animal observations). The model includes DM intake, NDF and lipid content of the diet as explanatory variables for CH4 emissions. An additional data set (n = 122 individual animals) from eight energy balance experiments was used to evaluate the model. The model adequately (root MS prediction error, RMSPE) represented energy in milk (E-milk; RMSPE = 5.6%), heat production (HP; RMSPE = 4.3%) and CH4 emissions (E-CH4; RMSPE = 11.9%). Residual analysis indicated that most of the prediction errors were due to unexplained variations with small mean and slope bias. Some mean bias was detected for HP (1.12%) and E-CH4 (1.27%) but was around zero for E-milk (0.14%). The slope bias was zero for HP (0.01%) and close to zero for E-milk (0.10%) and E-CH4 (0.22%). Random bias was >98% for E-CH4, HP and E-milk, indicating non-systematic errors and that mechanisms in the model are properly represented. As predicted energy increased, the model tended to underpredict E-CH4 and E-milk. The model is a first step toward a mechanistic description of nutrient use by goats and is useful as a research tool for investigating energy partitioning during lactation. The model described in this study could be used as a tool for making enteric CH4 emission inventories for goats.
There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries.
Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan–Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function.
Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care.
Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.
In spite that the patients with long-acting neuropletics(LAN)can drop out and have relapses,its use allows a more long-lasting time and more stable plasmatic concentrations that supply clinical and neurocognitive advantages.
To analyze the symptomatology and neurocognitive differences(P300)among the patients that relapse after withdrawing from the previous treatment with oral antipsychotic as regards those treated with LAN.
Material and methods
34 schizophrenic patients with a history of at least one admission in a acute adult psychiatric ward.All the patients have been assessed with the Positive and Negative Syndrome Scale (PANSS) and with potential auditory evocations(wave P300).
Clinical profile: 73.5% suffers from paranoid schizophrenia.Only 32.4% shows antipsychotic monotherapy;the 61.8% have been prescribed with long-acting Risperidone.
PANSS: The patients who had at least two admissions and who in the previous admission received long-acting Risperidone,showed a PANSS-N punctuation lower than the rest of the patients(21.64±4.6 vs. 25.4±3.2)at the end of the last admission(p=0.037).The same takes place with PANSS-PG at the end of the last admission(30.71 ± 3.8 vs. 3.61 ± 5.89(p=0.012).
P300: The latency measures of P300 are lower in those patients who in the previous admission received a long-acting Risperidone treatment(average of 314±34.65msec vs. 344.67±24.67msec),being the differences statistically relevant(p=0.012).The ranges are higher in the patients treated with long-acting Risperidone in the previous admission(average 5.3 ± 2.44vs.5±2.64 μV),though the differences are not statistically relevant.
At the end of the last admission,the patients who in the previous admission received long-acting Risperidone,showed a PANSS-N,a PANSS-PG and a latency of P300 lower than the rest of the patients but the range of P300 was higher.
“Rite of passage” is an etnographic concept developed by VanGennep that defines the vital transition of an individual between two different status. It is divided in three stages: separation, liminal/threshold and aggregation. Turner described the liminal phase, and the terms of “communitas” and “liminoid” (structure of a rite without religious/spiritual elements). One widely-known Rite of Passage is the initiation of the shamans.
Study the elements of a rite of passage present in Psychiatric Trainning.
• Field study (observational, descriptive, non-experimental).
• Preliminary Sample=10trainees (5man+5women); last year of Psychiatric Trainning.
• “ad hoc” semi-structured interview (21items subdivided in open questions). 10interviews (average duration=75mins). Permanent register:digital recorder.
• Summary and analysis of the answers. Review of the literature.
- Psychiatric Trainning shared the elements and tri-phasic structure of VanGennep's “rite of passage” concept
- Trainees saw themselves as more empathic(7/10) and humanistic(8/10) than other specialties colleagues. Stigma towards mental illness(8/10) and fear of suicide(9/10) were also considered as their distinctives.
- The collective behaved as a communitas(10/10)
- No spiritual elements(0/10): liminoid process
- Resemblances of the ancestral shamans' Initiation: Despite bloody practices were over, suffering was also present(7/10), but was seen as necessary(6/10) and well tolerated(7/10).
- Trainees felt that they grew spiritual and mentally(7/10) during the trainning years
Results suggest that Psychiatric Trainning has stable phenomena that:
• are compatible with the Rite of Passage schema
• Are considered exclusive of Psychiatry by trainees
• Have not been systematically studied as a whole, which could help to improve the training.
To determine the clinical profile of patients diagnosed of delusional disorder (DD) admitted to a psychiatric ward.
Retrospective chart review of inpatients with diagnoses of delusional disorder (DD) according ICD-10 criteria admitted to a psychiatric ward (Hospital de Conxo, Santiago de Compostela) between January 1998 and December 2008. Sociodemographic and clinical variables were collected, with special attention to comorbidity and presumed risk factors.
The sample consisted in 56 inpatients (30 women, mean age 54 ± 11). 64.3% were single including never married (33.9%), divorced, separated and widowed and 33.9% lived alone. The most frequent type of DD was persecutory (67%) followed by mixed type (16%). 16.1% presented hallucinations (most frequent auditory). In comparison with the other types, patients with persecutory delusions usually lived alone (p < 0.05). Most frequent comorbidities were substance abuse and affective disorders. Familiar background of psychoses was recorded in 21.4% and history of emigration in 12.5%. 5.4% suffered deafness. During the period studied 53.6% were admitted two or more times. After the most recent admission 32.1% were on depot antipsychotic.
In concordance with other previous reports, DD seemed to be more prevalent in women in middle or late adulthood and persecutory were the most frequent delusions. In our sample, most patients were not married and high prevalence of family antecedents of psychoses was found. It could be related with its hospital origin; then it could be hypothesized living alone and having familiar background of psychoses to be risk factors of hospitalization.
In our work we propose to use the adult developmental eye movement test (A-DEM) of Gene Sampedro et al, for the study of saccadic movements in schizophrenia.
To study the importance of saccades and attention in a sample of institutionalized patients with schizophrenia in a Unit of Psychosocial Rehabilitation.
Sample formed by 30 people.15 patients and 15 controls. 15 patients were corresponding to all the schizophrenic patients admitted in January, 2009 in a Unit of Psycosocial Rehabilitation of Conxo's Psychiatric Hospital. The 15 of the group control were selected of random form between sanitary personnel without psychiatric pathology, homogenizing the variables chronological age and sex with regard to the group of investigation.
The A-DEM vertical half to 44.37 seconds in the control group versus 59.54 seconds in the sample of patients. Regarding the results of the horizontal A-DEM obtained an average score of 47.07 seconds compared to control group obtained 60.68 seconds in the group of patients. The schizophrenic patients are characterized for having an attention diminished in 87 %, opposite to 47 % of the group control that they have a normal attention and 40 % increased. These differences of saccadic movements and of the attention are statistically significant.
Schizophrenic patients have few saccades both horizontally and vertically slower than normal people.
Schizophrenic patients show a marked deficit of attention to the normal population.
The predictD study is a pioneering international study whose main objective was to develop a risk index for the onset of major depression in general practice attendees.
The aim of this exploratory study was to determine the opinion of primary care attendees and their general practitioners about how to implement primary prevention of major depression. The intervention consisted of informing primary care attendees about their risk level and risk profile for the onset of major depression.
The study participants were primary care attendees and general practitioners in urban health centres of 7 Spanish provinces. The methodology used was qualitative: there were 14 in-depth interviews (two from each province), 7 DAFO groups and 7 focus groups.
The results showed that attendees generally welcomed this precautionary measure. Some even proposed potential changes in their lifestyles to prevent depression, such as improving social relationships, taking things more calmly or doing more leisure activities, while others asked their GP for advice. The GPs were more resistant about informing primary care attendees, raising doubts about the validity-reliability of the instrument, their lack of education about what they should or should not advise their attendees, the danger of creating excessive fear in their attendees, or the barrier of lack of time in the office to do these activities.
Primary care attendees welcome this preventive measure more than their general practitioners.
Most of the studies about Eating Disorders in adolescents have been typically focused on females, only to conclude that the approach should be similar in males. It has been stimated that 5-10% of patients with Anorexia Nervosa are males. Later age of onset and higher prevalence of premorbid overweight are considered among the main differences with female patients.
Analysis of the anthropometric variables of a sample of males with diagnosis of Restrictive Eating Disorder.
Naturalistic, Descriptive and Retrospective study
- Sample: 22 male adolescents
- Inclusion criteria: males with Restrictive Eating Disorder diagnosis (according to DSM-IV criteria) admitted to an Eating Disorder ward during 2007 and 2008
- “ad hoc” questionnaire (15 items)
- Analysis: PASW statistics 18
Age range: 7-14years (medium age=14,79±2,50years).11 patients (50%) were older than 16 years-old
- Medium BMI (Body Mass Index) at the beginning of the admission was 17,79kg/m2.
medium weight loss: 13,5±7,02kg/m2 (corresponding to a reduction of 22,24±7,52% of the previous weight)
- Medium speed of weight loss: 0,92±1,1kg/54
- BMI at discharge: 18,69 ±3,43 kg/m2
- 19/22 patients (86%) had a premorbid history of overweight
- Binge eating: 8 patients (36,4%)
- Purgative behaviour: 10 patients (45%)
- Laxatives use: 4 patients (18%)
- Intense physical exercise: 21 patients (95,5%)
- Average duration of current restrictive episode: 13,7 months
In the studied sample we observed:
- High prevalence of premobid overweight
- Very high frequency of compulsive exercise
- Drastic weight loss and loss of a very high percentage of the previous weight, in short periods of time, reaching very low BMI.
Stress and trauma have been reported as leading contributing factors in schizophrenia. And certainly child abuse (neglect, emotional, physical and sexual abuse among others) has a lasting negative impact, which is well established in literature.
To consider the presence of infant trauma and its relationship with psychopathology in paranoid schizophrenics.Methods. 37 patients (mean age 29±6.3; years from onset 9.20±4.7), meeting DSM IV paranoid schizophrenia criteria, undergoing treatment in a university hospital are studied. The PANSS is administered in order to rate psychopathology.
27 patients had infant trauma (55.8%). Main traumas are: sexual abuse (12.8%), child abuse (7.7%), both sexual and child abuse (5.18%), parental separation (7.7%), extra-rigid parents (2.6%), alcoholic parents (18.2%), child abuse and mother's death in childhood (2.6%). Infant trauma and psychopathology showed a significant relationship concerning Hostility (No 1.75±1.209, Yes 2.26±1.759), Unnatural Movements and Posture (No 1.55±0.945, Yes 1.16±0.545), Depression (No 1.25±0.550, Yes 1.74±1.284) and Preoccupation (No 2.75±1.410, Yes 3.26±1.996).
Infant trauma is common in paranoid schizophrenia and our findings give some evidence to a relationship with psychopathology, especially with dimensions as Hostility, Unnatural Movements and Posture, Depression and Preoccupation. Despite sample size, a high proportion (55.8%) of the patients presented infant trauma and future research is needed in order to open new avenues in this field, particularly studies concerning infant trauma and symptomatology specificity will be greatly appreciated as well as the plausible link to personality traits and personality disorders.
Schizophrenia is a chronic disease. Several etiopathogenic aetiologies have been posed, among them the existence of cerebral inflammation. S100B is a calcium-binding protein, mainly produced and secreted by astrocytes, that mediates the interaction among glial cells and between glial cells and neurons. Serum S100B levels have been proposed as a peripheral marker of brain inflammation.
The aim of this research is to study if the serum level of the protein S100B has relationship with positive psychopathology.
31 paranoid schizophrenic inpatients (22 male and 9 female, 36.7±10.3 years) meeting DSM-IV criteria participated in the study. Blood was sampled by venipuncture at 12:00 and 24:00 hours. Blood extractions were carried out during the first 48 hours after hospital admission. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum S100B levels were measured by sandwich ELISA techniques.
Correlations between serum levels of S100B protein and PANSS positive scores are shown in the following table. The first figure corresponds to the Pearson's correlation coefficient, while the figure in brackets corresponds to its statistical significance.
Total Positive Score
Serum levels of S100B protein may be used as a biological marker of positive psychopathology in paranoid schizophrenia.Acknowledgement
To examine whether drug use (DU) is higher in people with eating disorders (EDs) than in matched comparison groups and to collate, summarize and perform a meta analysis where possible on the literature related to DU in people with EDs.
We searched electronic databases including Medline, PsycINFO, Web of Science and CINAHL and reviewed studies published from 1994 to August, 2007, in English, German or Spanish against a priori inclusion/exclusion criteria. A total of 248 papers were eligible for inclusion. Only a total of 16 papers fulfilled all the inclusion criteria and were finally included in the systematic review.
The meta-analysis including all the different drugs for every sort of ED revealed a negligible albeit significant (z=2.34, p<.05), pooled standardized effect size of 0.119. The data showed a high degree of heterogeneity across the studies (X2(74)= 1267.61, p<.001). When ED subdiagnoses were assessed individually, DU was found to be higher in people with bulimia nervosa (BN) as a moderate sized increase in DU was found in this ED subtype (δ =0.462, z=6.69, p=<.001). People with binge eating disorder (BED) had a small increased risk of DU (δ =0.14, z=2.28, p<.05). In contrast, people with anorexia nervosa (AN) had a lower risk of DU (δ=-.167, z=1.81, p=.070, p=NS).
The differential risk observed in BN patients might be related to differences in temperament or might be the result of reward sensitisation as a result of the ED behaviours specifically associated with BN.
To examine the effectiveness of an Internet Based Therapy (IBT) for Bulimia Nervosa (BN), when compared to a brief psychoeducational group therapy (PET) or a waiting list (WL).
93 female BN patients, diagnosed according to DSM-IV criteria. An experimental group (31 IBT patients) was compared to two groups (31 PET and 31 WL). PET and WL were matched to the IBT group in terms of age, disorder duration, previous treatments and severity. All patients completed assesment, prior and after treatment.
Considering IBT, mean scores were lower at the end of treatment for some EDI scales and BITE symptoms scale, while the mean BMI was higher at post-therapy. Main predictors of good IBT outcome were higher scores in EDI perfectionism and higher scores on reward dependence. Drop-out was related to higher SCL-obsessive/compulsive (p=0.045) and novelty seeking (p=0.044) scores and lower reward dependence (p=0.018). At the end of the treatment bingeing and vomiting abstinence rates (22.6% for IBT, 33.3% for PET, and 0.0% for WL; p=0.003) and drop-out rates (35.5% IBT, 12.9% PET and 0% WL; p= 0.001) differed significantly between groups. While the concrete comparison between the two treatments (IBT and PET) did not evidence significant differences for success proportions (p=0.375), statistical differences for drop-out rates (p=0.038) were obtained.
The results of this study suggest that an online self-help approach appears to be a valid treatment option for BN, especially for people who present lower severity of their eating disorder (ED) symptomatology and some specific personality traits.
The research on the aetiology of eating disorders (EDs) has implicated many apparently disparate risk factors, which include: biochemical, genetic, familial and psychological factors. In the environmental domain, the presence of particular traits such as perfectionism, comorbidity in the family, eating patterns during childhood and exposures to adverse events have been revealed to be implicated in the aetiology of EDs. Whereas, from a biological point of view some recent new findings have suggested the important role of genetic factors, in combination with share and non-share environmental factors, developmental factors seems to have also a crucial role in the development of EDs later in life.
In order to replicate these findings in a larger sample, we performed several combined population (case-control) and family-based studies of eight independently recruited samples from several European countries participating in the European Community Framework V “Factors in Healthy Eating” project. We analyzed as well genetic as environmental factors, but also developmental factors that might be implicated.
Results and Conclusions:
The findings of our studies agree with the growing body of research indicating that a variety of environmental and social factors are associated with unhealthy individual and family eating patterns during childhood and early adolescence, and which if not detected early could result in the development of a subsequent eating disorder.
Two studies to date have been published regarding the prevalence of the metabolic syndrome in bipolar patients. The unadjusted prevalence rates reported were 30% and 32%. The aim of this study was to evaluate the prevalence of the metabolic syndrome in a group of 142 bipolar patients from Spain.
Bipolar patients (ICD-10 criteria) from 11 centres in Spain were assessed cross-sectionally for metabolic syndrome according to the NCEP ATP III criteria.
The mean age was 47.3 (SD 14.5), 51.1% were male. On average, patients were receiving 2.8 (SD 1.3) drugs for the treatment of their bipolar disorder. Ninety-one percent were receiving mood stabilizers, 63.4% antipsychotics and 29.6 antidepressants. Eighty-seven percent of the antipsychotics prescribed were atypicals. The overall prevalence of metabolic syndrome in our sample was 24.6% Fifty-seven percent of the sample met the criterion for abdominal obesity, 37.4% for met the criterion for hypertriglyceridemia, 36.4% for low HDL-cholesterol, 25.2% for high blood pressure and 12.5% for high fasting glucose. No statistically significant difference was found between with and without the metabolic syndrome for gender, illness status (acute versus in remission), CGI-S-BP scores and number of medications used. Patients taking tow mood stabilizers had significantly higher metabolic syndrome rates than patients taking one mood stabilizer and than patients without mood stabilizer treatment (40% versus 17.8% and 11.1% respectively, p .02).
The prevalence of the metabolic syndrome in bipolar patients is high. It appears to be higher than that estimated for the Spanish general population.
Anti-NMDA-receptor encephalitis is subacute disorder that has been recently described in young women and girls who often present neuropsychiatric symptoms as first clinical features; thus, it is common that they receive an initial assessment, diagnose or even treatment by a specialist in Psychiatry.
Presenting a case of Anti-NMDA-receptor encephalitis that was observed at our hospital and the steps taken from its initial assessment by Psychiatry to the final diagnose and treatment by Neurology, our objective is to describe this disorder in order to make it known to the specialists in Psychiatry.
The case is that of a 14 year old girl who presents altered behavior, bizarre delusions and auditory hallucinations with subacute onset. In psychiatric assessment it is noted that the patient presents fever, slight and language impairment: Medical and Neurological assessment are requested. The steps followed to rule out other disorders are presented. SPECT and the detection of specific anti-NMDA-receptor antibodies in serum were necessary for an accurate diagnose.
The detection of specific antibodies is necessary for the diagnose of Anti-NMDA-receptor encephalitis. NMDA receptors are ligand-gated cation channels with crucial roles in synaptic transmission and plasticity. Their alteration could be a pathogenic mechanism in disorders such as epilepsy, dementia and schizophrenia.
Anti-NMDA-receptor encephalitis is a recently described clinical entity that should be taken in consideration to rule out other causes of subacute onset psychiatric symptoms in young women and girls. Its well-defined set of clinical characteristics should become familiar to the specialists in Psychiatry.
At present,the need of antipsychotic treatments for the improvement of the condition of people with psychotic disorders is unquestionable.Despite the current availability of highly effective drugs with few secondary effects,the main cause behind hospitalization is still the lack of compliance.
Analysis of the determining variables behind the need for hospitalization and the influence of the types of antipsychotic treatments.
Retrospective and follow-up analysis of psychotic patients hospitalized in the Psychiatric Ward of the Hospital de Conxo (1998-2005).Three groups of patients:with Oral neuroleptics(170), with Depot typical neuroleptics (238),with Long-Acting Risperidone(60);and comparison based on treatment maintenance.
Males,day-to-day living with the family of origin and single status are predominant in all three groups,although in a higher proportion in the Long-Acting Risperidone one(75,71 and 85%respectively).Only 7% of the patients with Long-Acting Risperidone completed their university studies,62% were pensioners.The average duration of hospitalization periods is 21 days for the patients with Long-Acting Risperidone,23.3 days in the Oral group,29.5 days in the Depot group.The main cause behind re-hospitalization is the lack of compliance(68% in Depot group),whilst after the introduction of Long-Acting Risperidone,no compliance rate is 59%.If we compare the number of hospitalizations/year of the patients with Long-Acting Risperidone,before and after its introduction,the rate is reduced significantly from 0.89 to 0.73.
Despite the fact that patients treated with Long-Acting Risperidone show a more seriously ill condition and less social capacity,they have less need for hospitalization than patients treated with Depot neuroleptics.Median lengths of stay were shorter than patients in the other two groups,and are less re-hospitalized after the introduction of this treatment.
Explore the prevalence of lifetime suicide attempts in women with bulimia nervosa (BN), and compare eating disorder symptoms, general psychopathology, impulsivity, personality, and genetic variants in four candidate genes of the serotonin pathway: the serotonin transporter (SLC6A4), serotonin receptors 1A (HTR1A) and 2A (HTR2A) and tryptophan hydroxylase 1 (TPH1) between individuals who had and had not attempted suicide. Determine the best predictors of suicide attempts.
Lifetime prevalence of suicide attempts was 26.9% CI 95%: 23.2 to 30.5). BN subtype was not associated with lifetime suicide attempts (p=0.36). Compared to non-attempters, attempters exhibited higher unemployment, eating disorder symptomatology, general psychopathology, previous eating disorder treatment, impulsive behaviors, and lower educational level (p<0.004). In relation to personality traits, suicide attempters exhibited significantly (p<0.002) higher Harm Avoidance and lower Self-directedness, Reward Dependence and Cooperativeness. No significant differences in any of the genetic variants between attempters and non-attempters. The best predictors of suicide attempts were (p<0.006): lower education, minimum BMI, previous eating disorder treatment, family history of alcoholism and self-directedness.
Suicidality in BN patients appears to be within the range previously found. Our results support that internalizing personality traits combined with impulsivity may increase the probability of engaging in suicidal behaviors in these patients. Our data do not support the hypothesis that variants of SLC6A4, HTR1A, HTR2A or TPH1 are associated with suicide attempts in BN individuals.
Self-perceived health is a well-recognised predictor of later health outcomes and mortality, but its relationship to incident dementia has been scarcely explored.
To analyze self- perceived health as a risk factor for dementia and Alzheimer disease (AD) in a population- based survey of the elderly (NEDICES) Study.
Participants were evaluated at baseline (1994-1995) with a standardized questionnaire that included subjective and objective (chronic disorders) health status and screening questions for depression and neurologic disorders. At follow-up (a median of 3.2 years later in 1997-1998) an analogous protocol and neurological assessment were performed.
Of 5,278 participants evaluated at baseline there were 306 prevalent dementia cases, and 161 incident dementia cases were identified among 3,891 individuals assessed at follow-up (D: 115).
Cox hazard ratio analyses showed that age, stroke and illiteracy were independent risk factors for dementia and AD. Aggregation of vascular risk factors was related to a higher risk of both dementia and AD. Good (and very good) versus less than good (fair, bad and very bad) self-perceived health was an independent risk factor for dementia (CI 95% 1.13- 2.16; p= .006) and AD (CI 95% 1.02- 2.18; p= .038) after adjusting by age, sex education and vascular risk factors.
Self-perceived health increased the risk for incident dementia and AD in the NEDICES cohort as it was previously described in the United Kindom MRC- CFA Study of dementia incidence. Global health measurements (self-perceived health, quality of life) needs farther studies as risk for dementia and AD.
Acute episodes are treated in AMSA psychiatric services in a emergency service including a call center, domicilliary visits, a crisis unit, three short-term day hospitals and a short-term stay unit in a general hospital. an Intensive Brief Dynamic Group Therapy is offered in the units allowing for a decreased appearance of self and hetero aggression in patients both during the crisis and after one year as shown in a follow-up study.