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Although dried orange pulp (DOP) may conveniently replace cereals in ruminant diets, few studies have considered similar diet substitution for goats. We hypothesised that DOP could replace cereal-based concentrate in goat diets without detrimental effects on growth performance and carcass quality of suckling kids and milk performance and blood biochemical parameters of dams in early lactation. We also hypothesised that DOP substitution may increase the levels of antioxidants, such as phenolic compounds and vitamin E, in milk and improve its total antioxidant capacity (TAC). Therefore, 44 primiparous Payoya dairy goats were allocated to three experimental groups, each fed a different diet: control (CD, n = 14) based on a commercial concentrate with alfalfa hay as forage; and DOP40 (n = 16) in which 40% and DOP80 (n = 14) in which 80% of the cereal in the concentrate were replaced by DOP. The experiment lasted from the final month of pregnancy to 55 days postpartum. The DOP diets did not affect suckling kids’ carcass quality, but at 28 days, led to improvement in live weight (LW) and average daily gain (ADG) from birth, although no differences were found between DOP40 and DOP80 (for CD, DOP40 and DOP80, LW at 28 days was 8.00, 8.58 and 8.34 kg and ADG was 184, 199 and 195 g/day, respectively). Diet had no significant effect on milk yield (average daily milk yield and total yield at 55 days were 1.66 l/day and 90.6 l, respectively) and commercial and fatty acid composition. Nevertheless, α-tocopherol, total phenolic compound (TPC) and TAC concentration in milk increased with substitution of cereals by DOP (for CD, DOP40 and DOP80, concentration of α-tocopherol was 21.7, 32.8 and 42.3 μg/100 g, TPCs was 63.5, 84.1 and 102 mg gallic acid equivalents/l, and TAC was 6.63, 11.1 and 12.8 μmol Trolox equivalents/ml, respectively). Every plasma biochemistry parameter considered was within reference values for healthy goats; therefore, no pathological effect was detected for these variables due to dietary treatment. However, DOP diets caused a reduction in plasmatic creatine kinase and aspartate aminotransferase, implying reduced oxidative damage to muscles. In conclusion, DOP may be an interesting alternative to cereals in early lactation goat diets for increasing farmers’ income and the healthy antioxidant capacity of milk.
The Cenozoic genus Terebratula seems to be an exception to the post-Permian trend in brachiopod retreat to offshore habitats, because it was species rich and numerically abundant in warm-temperate shallow-water environments in the Mediterranean and the Paratethys realms. This was so despite the general dominance of bivalves and the pervasive bioturbation and predation pressure during the Neogene. Terebratula, however, went extinct in the Calabrian (Pleistocene). The optimal environmental conditions for Terebratula during its prime are poorly known. The Águilas Basin (SE Spain) is an ideal study area to investigate the habitat of Terebratula, because shell beds of this brachiopod occur there cyclically in early Pliocene deposits. We evaluate the paleoecological boundary conditions controlling the distribution of Terebratula by estimating its environmental tolerances using benthic and planktic foraminiferal and nannoplanktic assemblages and oxygen isotopes of the secondary layer brachiopod calcite. Our results suggest that Terebratula in the Águilas Basin favored oligotrophic to mesotrophic, well-oxygenated environments at water depths of 60–90 m. Planktic foraminiferal assemblages and oxygen isotopes point to sea-surface temperatures between ~16°C and 22°C, and bottom-water temperatures between 17°C and 24°C. The analyzed proxies indicate that Terebratula tolerated local variations in water depth, bottom temperature, oxygenation, productivity, and organic enrichment. Terebratula was probably excluded by grazing pressure from well-lit environments and preferentially occupied sediment-starved, current-swept upper offshore habitats where coralline red algae were absent. Narrow temperature ranges of Terebratula species might have been a disadvantage during the high-amplitude seawater temperature fluctuations that started about 1 Ma, when the genus went extinct.
“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.
Despite lithium has been used for the last 50 years as a maintenance treatment for bipolar disorder during pregnancy, there is limited information about perinatal clinical outcomes from fetal exposure to lithium.
1. To quantify the rate of lithium placental passage
2. To assess any association between plasma concentration of lithium at delivery and perinatal outcome.
Observational and prospective study. Subjects: Women in maintenance treatment with lithium, being attended during pregnancy at the Perinatal Psychiatry Programme of Hospital Clínic (Barcelona, Spain) between 2007 and 2009. Procedure: We assessed sociodemographical data; dose/day of lithium carbonate; other drugs doses; plasmatic concentration of lithium carbonate in maternal blood intrapartum and in the umbilical cord; obstetrical maternal complications; gestational age at delivery; weight at delivery; Apgar scores; congenital malformations; hospital stays, infant serum concetrations of thyroid-stimulating hormone.
Eight mother-child diads. Mean age of the mother (SD): 32.1 (4,7); 100% caucasian and married. Mean dose of maternal lithium (SD): 675mg (237,5mg). Premature rupture of membranes (%):25. Gestational mean age (in weeks) (SD): 39,9 (1). Birth weight (SD) : 3625gr (451,2gr); Mean Apgar1min (SD): 8,38 (1,1); Mean Apgar5min (SD): 9,75 (0,4). Loss of fetal intrapartum wellness (%): 12,5. Days of hospitalization (mean) (SD):9,5(16,6). Lithium plasmatic concentration (mEq/L), mean (SD): maternal 0,45(0,1), umbilical cord 0,33(0,1), lithium ratio uc/m 0,93 (0,3); infant TSH μU/mL mean (SD): 4,9(4,6).
Lithium placental passsage was 0,93 (0,63-1,07). ≤At umbilical cord lithium levels ≤ 0.60 mEq/L, we didn't have any preterm deliveries, low birth weight newborns, nor neonatal complications.
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.
To examine whether the postpartum depression (PPD) subgroup with positive antithyroid antibodies (Ab+) compared with the PPD subgroup without positive presence of Ab (Ab -) have a different psycho-social and psychopathological characteristics.
One hundred three (N=103) patients with PPD according with DSM-IV criteria were included. Autoimmune status of the thyroid (Thyroperoxidasa antibodies, Thyroglobulin antibodies), severity of depression and anxiety (EPDS and 21-item Hamilton and STAI-S scales), psychosocial variables (Early Trauma Inventory, Saint Paul Ramsey Questionnaire, Marital Adjustment Test) were assessed joint with other several demographics and reproductive variables.
The presence of childhood sexual abuse in PPD women increase the probability of Ab(+) (OR= 2,528 ; 95% CI =1,00-6,39). The levels of Thyroid peroxidase antibodies (TPOAb) titers have a strongly correlation (p<0,000) with the levels of the Early Trauma Inventory.
The results of our study give a link between early stress, the immune system, and postpartum depression.The implication of the immunitary system in the etiopathogenesis of the PPD through the long lasting sensitization of the inflammatory response system and the endocrine system in front to stress behind the CNS and their transmisors and receptors activation is discussed.
To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).
100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.
APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).
APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
High prolactin blood levels is an adverse effect of neuroleptic treatment. Typical antipsychotics seem to produce it more frequently than atypical ones.
To know hyperprolactinemia prevalence in our patients related with the type of antipsychotic drug used.
171 individuals, 31 male patients and 140 female ones, with a mean age of 61,67 years old and a mean hospital stay of 18,20 years.
The sample was divided in three groups:
– Typical antipsychotics group: 37 patients.
– Atypical antipsychotics group: 92 patients.
– Typical and atypical antipsychotics group: 42 patients.
Prolactin serum levels were determined (normal values: 1.5-25 ng/ml for fertile age women, 0.7-20 ng/ml for post-menopause women and 0-20 ng/ml for men).
Prevalence of hyperprolactinemia for every group, for single antipsychotic drugs, for age groups, for gender and for diagnosis were obtained.
Prevalence of hyperprolactinemia was 66.1% for the global sample. Results for the different groups were the following:
– Typical antipsychotics group: 73.0%
– Atypical antipsychotics group: 60.9%
– Typical and atypical antipsychotics group: 71.4%
Statistical analysis according to concrete antipsychotic drug showed the following hyperprolactinemia percentages:
– Risperidone: 90.0%
– Haloperidol: 69.2%
– Olanzapine: 44.4%
– Quetiapine: 33%
– Aripiprazol: 14.3%
– Clozapine: 11.1%
Our study finds lower hyperprolactinemia blood levels in patients on atypical antipsychotic treatment than on typical antipsychotic one. Haloperidol and risperidone got the worst results in this matter while clozapine and aripiprazol showed the best ones.
Fiction films offer unexplored support for rehabilitation in patients with schizophrenia and other psychoses. Schizophrenia produces deficits and distortions in perception and understanding of reality, also expressed in the perception and comprehension of films. After two years of experience “ad hoc” we have designed an experimental case-control study in order to study the effectiveness of the proposed technique compared with conventional “cinema-forum”
20 patients treated at the Psychiatric Day Hospital in Puerta de Hierro Hospital (Majadahonda) will participate in the study. Initially, the researcher will collect information on socio-demographic and clinical data of all participants, as well as a written informed consent. There will be an initial assessment using the following instruments:
- SCIP (schizophrenia cognitive screening)
- Scale GEOPTE (social cognition in schizophrenia)
- Social Functioning Scale (SOFAS, PSP)
- Scale of disease awareness
- IPDE (TP)
- Hamilton Scale (anxiety-depression)
The material used will be the 12 chapters of the first season of TV series “The Sopranos” by David Chase (2004). Specific techniques of cognitive and affective work are compared against a “cinema-forum”. For the evaluation of the effectiveness of the proposed technique, it will be used a measurement tool designed specifically for the activity, which includes:
1. 60 item-Scale, specific on each chapter, evaluating:
Interest in the premorbid personality of schizophrenic patients is well established in the psychiatric literature. The relationship between personality disorders and acute phase proteins (APP) in schizophrenia is not well known.
Investigating the relationship among acute phase proteins and personality disorders in schizophrenic patients in a sample of adult schizophrenic patients under psychiatric treatment in a general hospital health setting.
Material and Methods:
37 adult paranoid schizophrenics undergoing treatment in the University Hospital of the Canary Islands with DSM-IV diagnosis of paranoid schizophrenia are included. Years from onset 9.20 s.d. 6.29, age at onset 19.75 s.d. 4.73. The record of personality disorders as a secondary diagnosis in the medical chart was taking into account. A blood sample as routine standard analysis was carried out in each patient.
In 21 patients (56.7%) a personality disorder, mainly with paranoid and schizotypal traits, was registered. The percentage of each personality disorder is as follows, Schizotypal (16.2%), Paranoid (13.5%), Schizoid (2.7%), Paranoid and Schizotypal (24.3%). The results point to no significant correlation according to APP (C3, C4, alpha2-macroglobulin, alpha1-glicoprotein, ceruloplasmin) in the different diagnostic groups.
Discussion and conclusions:
In our study there is no evidence to support a significant correlation among APP and the different personality disorders in our sample of schizophrenics in spite of a positive correlation of APP and some psychopathology dimensions that has been communicated earlier elsewhere. In order to set some possible specificity of acute phase proteins and other clinical features in schizophrenia further research is required.
Pregnancy and postpartum both imply high risk for developing psychiatric disorders in women.
To study the relationship between life events (LE) and social support degree (SS) during pregnancy and depressive symptoms in early postpartum period.
A cross-sectional study of 309 consecutive Spanish women, evaluated the second day postpartum. They were all over 18 years old and have signed the informed consent. We excluded: illiteracy, cognitive impairment or severe medical illness, psychiatric disorders during pregnancy and decease of the newborn. We collected socio-demographic and obstetrical data, as well as family and personal psychiatric history, the Edinburgh Postnatal Depression Scale (EPDS), LE (Saint Paul Ramsey) and SS (DUKE-UNK).
Mean age (SD) was 31.6 (4.7). Most of women were married, had intermediated or high level of education. Sixty-one percent were primiparous. Twenty-six percent had family history and 22% had personal psychiatric history. Mean (SD) of LE was 0.95 (0.89) and of SS was 53.1 (7.6). The prevalence of depressive symptoms according to EPDS scores was 18%. This subgroup of depressed women had more psychiatric family history (p=0.046), less LE (p< 0.001) and more SS during pregnancy (p=0.048). Logistic regression analysis showed that SS was the only significant variable (OR=1.085; 95%CI=0.997-0.994; p=0.001). LE did not achieve statistical significance (OR=1.085; 95%CI=0.997-1.180; p=0.059).
Low social support degree during pregnancy is associated with depressive symptoms during immediate postpartum.
This study has been done in part with grants Instituto Carlos III: G03/184, FIS: PI04178; 05/2565.
Although it is well know that the substance use during pregnancy has a negative impact on mother and child health, there are few data on pregnancy - related substance use as a risk factor for postpartum depression and child outcomes.
Aims: To determine maternal and child outcomes at 8 and 32 weeks postpartum of women who reported substance use during pregnancy.
This is a cohort study of 1804 Caucasian women in postpartum. Exclusion criteria: psychiatric disorders during pregnancy. Women were evaluated at 2-3 days, 8 and 32 weeks postpartum. Socio-demographic, obstetric, personal and family psychiatric history and substance use during pregnancy; the Edimburgh Postpartum Depression Scale (EPDS) were assessed. All women with EPDS>9 at 8 and 32 weeks were evaluated by a structured interview (DIGS) for DSM-III major depression.
The mean (SD) age was 31.7 (4.6). Forty-six percent of them were primiparous. Thirty-one percent has a family and 16% a psychiatry history. Fifty percent of women reported substance use during pregnancy: 42% caffeine, 21.6% nicotine, 8% alcohol and 0.6% cannabis. Incidence of major postpartum depression was: 12.7%. Incidence of: Apgar scores < 7 at 5 min after birth:0.4%, gestational age at delivery < 37 weeks:7.3%, birth weigt < 2.5 Kg:7.3%, and congenital malformations:1.4%.
In the presentation, the maternal and child perinatal outcomes of women exposed to licit and ilicit drugs will be summarize and will include a discussion of the future clinical and research implications. This work has been done in part with Grants: GO3/184;FIS:PI04178;PI041635,PI041783,PI041779,PI041758,PI041761,PI041791,PI041766,PI041782,RD06/0001/1009; CIBER-SAM.
To determine which factors are associated with compliance with outpatient follow-up plan of discharged patients from a psychiatric ward of a general hospital.
A sample of 120 patients consecutively admitted to a psychiatric general ward, and referred to an outpatient clinic after discharge formed the sample.
To explore the factors predicting whether patients attended or did not attend to the outpatient clinic, a logistic regression analysis was conducted.
After controlling for age, gender, and overall clinical case severity (assessed by the Severity Psychiatric Illness Scale), have been previously attended in the outpatient clinic was the only factor that predicted the compliance with post-discharge outpatient plan (as dichotomous variable: attended/not attended), Odds Ratio (OR) = 12.53, P=0.042. Overall clinical case severity did not predict attendance to the outpatient clinic after discharge, OR=0.937, P=0.452.
Patients who were attended in an outpatient clinic prior to admission had 12-fold more likely to adhere with post-discharge outpatient plan than patients who were not previously attended. This result highlights the importance of strengthening community-hospital liaison strategies.
To verify whether most compliant patients with outpatient postdischarge follow-up plan remain in the community longer before readmission than those who don't adhere to outpatient follow-up plan.
From a total of 120 consecutive admissions to a psychiatric general ward, 63 patients were consecutively readmitted along a 2 year period after their reference first admission.
Out of the 63 patients, 25 patients were attended in an Outpatient Unit (OU) previously to their re-admission (group A), whereas 38 patients had not been attended in the OU between reference admission and readmission (group B). Patient's socio-demographic data (age, gender, marital status, and years of education) were obtained and a case-mix scale (Severity Psychiatric Illness Scale) was administered. Length of survival in community of both groups was compared by means of Analysis of Covariance, controlled for gender, age, diagnosis, clinical severity and number of previous admissions.
Group A had a mean length of survival in the community of 47.7 days (SD=44.3). Group B had a mean length of survival in the community of 23.2 days (SD=37.9). This difference was statistically significant (F=4.74, df=6, 63, p=0.034).
Being attended by OU after the discharge of reference admission lengthen significantly survival in the community after controlling for gender, age, diagnosis, clinical severity and number of previous admissions. Further research will be conducted to determine the cause of the observed differences in patient attendance to post-discharge appointments.
Pharmacologic treatment of mood disorders reduces morbidity of depressive disorders and improves quality of life. Not all patients benefit from treatment. Close to 30% to 40% does not improve enough to the first antidepressant they receive. Many factors are assumed to contribute to this. In the last years it has been studied genetic factors predisposing to drug response or side effects in mood disorders. The efficacy of antidepressant action has been associated to several polymorphisms located in candidate genes related to serotonin pathway.
The prevalence of major depression occurring in the postpartum (PPD) is estimated at 4%-6% and results in considerable morbidity for women, their infants and families. The period of higher risk of PPD appear to occur close to the time of birth between 8 to 24 weeks. It seems that PPD episode is severe and longer than episodes outside this period of life. Initial results showed that women with PPD experienced fewer episodes during illness course compared to non postpartum women and less comorbidity with personality disorders.
We presented preliminary socio-demographic, clinical and genetic data (5-HTTLPPR polymorphism) of a case control studied of women with PPD naturalist treated with SSRI visited at the Perinatal Psychiatric Unit. All women were diagnosed by a DSM-IV structured interview and assessed for personality traits. Therapeutical SSRI response was evaluated by the Edinburgh Postnatal Depression Scale and the Hamilton rating Scale for depression at baseline, 8 weeks and 24 weeks of treatment.
This project is funded in part by Marató-TV3, GO3/184, and FIS-05/2565.
Substance use in pregnancy is an increasingly common problem and become an important public health issue.
To determine the obstetric and perinatal outcomes of self-reported substance use (licit and illicit drugs) during pregnancy in Spanish women sample.
An observational, longitudinal cohort study of 309 Spanish Caucasian women and her newborn child. Psychiatric disorders during pregnancy and neonatal death were excluded. After written informed consent,women and newborn were evaluated at 2nd-day postpartum. Variables included: socio-demographic, obstetric, mothers'psychiatric condition, self-reported substance use, perinatal outcomes.
Sixty-six percent of women reported substance use during pregnancy: 59% caffeine, 26% tobacco, 9% alcohol, and 1% cannabis. Incidence of poor outcomes: Apgar scores <8 at 5 minutes after birth (Apgar5) 9.3% (N=29), gestational age at delivery <37 weeks 4.8% (N=15), birth weight <2.5 kg 7.2%(N=22), congenital malformations 2.9%(N=9). Women with newborn who had Apgar5 <8 have consumed more tobacco (271/124 cigarettes;p=0.004) and caffeine (47/32;p=0.051) in the last month of pregnancy than those with Apgar5 ≥8. Logistic regression analysis showed that the risk of Apgar5 <8 was 18.5 times greater (OR=6.001;95%CI=2.009-170.903) in women with lower educational level comparing with women with higher educational level.
The dose of tobacco and caffeine used during the last month of pregnancy are associated with poor outcome (Apgar5<8) in a sample of women of general population.These results need to be tested in a bigger sample.
This work has been done in part with Grants: Instituto Carlos III: GO3/184; FIS: PI041783.
The Day Hospital (DH) provides an intensive, multidisciplinary, coordinated, group and customized care for patients admitted for treatment. The therapeutic approach improve their clinical situation, their quality of life and facilitate their reintegration into everyday life. Our objective is to evaluate overall clinical improvement and perceived quality of life of patients admitted in a general hospital DH (2010–2012). Clinical diagnosis (DSM-IV-R) grouped (NSUD, SUD and DUAL), clinical variables, baseline/ high clinical situation (CGI-S), global impression of improvement (CGI-I) and related quality of life perceived (EQ5) at baseline / high were recorded. Data were analyzed using SPSS v15. 174 patients were evaluated, 58% women, mean age 47 years and schooling medium-high (76%). The average stay (DT) was 35 days. Patients came from 47%: acute hospitalization, 51%: Mental Health Center (MSC) or outpatient and 4%: other units. The reasons for admission were detoxification (34.5%), stabilization (33.3%), consolidation of detoxification (15.5%), decompensation (9.2%) and re-structuring of treatment (7.5%). The overall clinical improvement of the whole sample at the end of stay assessed by the CGI-I was: 35% = “much better” 38% = “moderately better”, 5% = “slightly better”, 21% = “no change” and only 1% “worse” (p = 0.001). An overall clinical improvement and quality of life perceived was observed in the three groups of patients. While it remains to know the persistence of these parameters in the long term, the Day Hospital proved to be an important therapeutic resource for overall clinical improvement of patients towards their incorporation into daily life.
There is a lack of accurate screening tools for suicide risk in the patients presenting to emergency departments. The Personality and Life Event (PLE) Scale, a set of the 27 most discriminative items from a collection of questionnaires usually employed in the assessment of suicidal behavior, demostrated an elevated accuracy, sensibility, and specificity in classifying suicide attempters.
To validate the self-administered PLE Scale.
Material and methods:
In order to examine its psychometric properties, the PLE scale was administered to 59 suicide attempters, 48 psychiatric controls, and 69 medical patients attending the Puerta de Hierro emergency department. To examine its reliability, we used: 1) Cronbach's coefficient α to evaluate the internal consistency; 2) test-retest reliability to assess if the scale is stable over time. Interrater reliability is not relevant as the PLE is a self-report. To assess its construct validity, we used some of Beck's Suicide Intent Scale (SIS). All analyses were carried out using SPSS v.20 (Macintosh).
The most frequent criteria for suicide attempters were item 4 (‘I often feel empty inside’; 88.1%) and 20 (‘I act on impulse’; 79,7%). Mean (± SD) of the PLE Scale in suicide attempters, psychiatric controls, and medical controls was 74.49 (± 32.44), 57.19 (± 29.63), and 17.48 (± 21.15), respectively. The PLE had an acceptable internal consistency (Cronbach's alpha =0,674).
Our preliminary findings support the reliability, construct validity, and ussefulness of the PLE to identify suicide attempters to those attending to emergency departments.
There is an increasing demand for treatment for dependence on different psychiatric medication like benzodiazepines. The goal is to determine the user's profile that is attended in a mental health center.
We obtained a sample of 30 users, divided into two groups: A) main drug benzodiazepines, B) primary drug others.
Sociodemographic, psychiatric and drug use variables are collected, making a descriptive retrospective analysis, using means for quantitative variables and proportions for categorical variables.
Group A is composed mainly of women (63.6%) of average age 46 years, and the group B of males (75%) with slightly higher average age (48 years). In group A and B the average level of education is primary/secondary education. Overall, they do not work and are single, having more pensioners and separated in group B.
In both groups, more than half have a history of affective disorders, often followed by anxiety disorders, with higher prevalence in group A (54.6% vs 36.8%), and personality disorders (77.3% and 75%).
In reference to group B, the primary drug of abuse is mostly alcohol. In general there is higher prevalence of nicotine dependence.
The profile of group A is a middle-aged woman who presents comorbidity with affective and personality disorders. The profile of group B is a middle-aged man, alcohol dependent, with earlier onset of use and with personality disorder.
The objective of the present study was to examine the predictive value of clinical and cognitive -including the cognitive reserve (CR) - variables on the severity of the patient's illness at one year of follow-up.
A study was held with 45 patients with first episode psychosis (FEP) from 3 main hospitals in the Basque Country (Spain). All patients underwent cognitive, clinical, and functional assessments at baseline and at 6 months follow-up. The cognitive measures included were: the Stroop test, Vocabulary sub-test from WAIS-III, the WCST, and Trail Making Test. The clinical and functional measures included were: Positive and Negative Syndrome Scale (PANSS), Young Mania Scale, Montgomery-Asberg Depression scale, and CGI (Clinical Global Impression).
Six-months follow-up data were available for 29 patients. Regression analysis was performed with the 6-month follow-up CGI measure as a dependent variable. Results showed that after controlling for CGI at baseline, -PANSS Negative Symptoms Scale (B = 0.47, p ≤ .05) and the CR measure -Vocabulary from WAIS-III- (B = 0.36, p ≤ .05) were the only two which significantly predicted severity of illness after 6 months (R2 = 0.44) and remained significant when CGI at base line was controlled in the regression analysis. The rest variables did not reach statistical significance.
These findings emphasize that CR have a role on outcome in first episode psychosis, and enhance that exist a relation between cognition and clinical measures in psychosis.
Basque Government, Health Department (2008111010); EITB-Maratoia (BIO 09/EM/015).