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Behaviour disorders in adolescents are a risk factor associated with suicidal behavior.
To examine the distribution of the Strengths and Difficulties Questionnaire (SDQ) scores in the Spanish sample of adolescents from the “Saving and Empowering Young Lives in Europe” (SEYLE) project and study the differences according to the gender and the relationship with both suicide attempts (SA) and suicidal ideation (SI).
875 pupils from 12 secondary schools sited in Asturias (Spain) [50.7% males; mean age (SD) =14.5 (0.72)] were assessed through the SDQ and Paykel Suicide Scale (PSS).
No significant differences were found in the SDQ total score by gender, but were found (p< 0.001) in some subscales as emotional symptoms (t=-6.769) (women scoring higher), hyperactivity (t=3.283) and prosocial (t=5.260) (men scoring higher). Regarding PSS, 3.1% tried to take their life during past six months. No significant differences were found in SA by gender but were found (p< 0.050) for the thought that life not worth (t=-3.597), women scoring higher, and about wish to be dead (t=-2.630), men scoring higher. Previous SA were significant related (p< 0.001) with SDQ total score (X2=38,437), emotional symptoms (X2=25,528), hyperactivity (X2=13,572) and behaviour disorders (X2=7,505). SI was significant related (p< 0.001) with SDQ total score (X2=38,437), emotional symptoms (X2=31,077), behaviour disorders (X2=33,011), peer problems (X2=35,161) and prosocial behavior (X2=17,978).
SA and SI were related with difficulties (SDQ criteria), mainly on emotional symptoms and behaviour disorders. Prevention strategies in high risk groups are likely to become increasingly important.
To identify differences in personality traits (temperament and character) using Cloninger's typology according to the presence of physical illness (WONCA criteria).
404 subjects, without psychiatric pathology, from Asturias (Northern Spain) were included in the study [50% men; mean age (SD)= 40.5 (11.3)]. Assessments were made using an ad hoc interview (socio-demographic and clinical data), and the Spanish versions of the MINI International Neuropsychiatric Interview (DSM-IV criteria) (Sheehan et al., 1997), and the Temperament and Character Inventory (TCI) (Cloninger et al., 1994).
154 (38.1%) subjects have at least one diagnosis of physical illness. Subjects with physical illness scored significantly higher in: i) temperament scales: harm avoindance (HA) (17.02 vs 15.76, t= -1.968; p= 0.050); fatigability and asthenia (HA4) (3.56 vs 2.82, t= -3.652; p< 0.000), ii) character scales: transpersonal (ST2) (3.91 vs 3.26, t= -2.900; p= 0.004). However, they scored significantly lower in: i) temperament scales: attachment (RD3) (5.18 vs 5.70, t= 2.346; p= 0.019), ii) character scales: responsibility (SD1) (5.57 vs 5.96, t= 1.984; p=0.048); purposeful (SD2) (5.43 vs 5.84, t= 2.092; p= 0.037); cooperativeness (C) (31.52 vs 33.26, t= 3.166; p< 0.000); social acceptance (C1) (6.50 vs 6.89, t= 2.536; p= 0.012); empathy (C2) (4.81 vs 5.18, t= 2.484; p= 0.013); compassion (C4) (7.44 vs 7.94, t= 2.190; p= 0.019); pure-hearted (C5) (6.55 vs 7.06, t= 3.225; p= 0.001). No other significant differences were found between the groups.
Our data suggest that physical illness might influence personality traits in non-psychiatric population.
To describe the physical health profile of patients with drug use disorders who were included in the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.
Multicentre, observational, longitudinal, prospective study. A total of 194 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.
Men were 79.9%, mean ages were 41.08 (SD 11.64), 42.3% were single and 87.6% were acute patients. The severity score in the Physical Health area was 44.32 (SD 9.51). The most prevalent diseases were: 25.3% hepatitis, 11.9% had high blood pressure, 8.2% cirrhosis or hepatic disease, 6.7% epilepsy or convulsions and 5.7% tuberculoses. No statistically significant differences were found according to gender. Acute patients had statistically significant higher proportion of pregnant woman (2.3% vs. 0% p< 0.05) and lower proportion of diabetes (3.5% vs. 12.5% p= 0.05).
Patients with drug use disorders have a mild-moderate severity of physical health. Physical health is not influenced by gender, but it is by the clinical state.
To identify the differences in the ASI-6 scores according to main substance of consumption among patients with drug use disorder who were included at the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.
Multicentre, observational, longitudinal, prospective study. 186 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.
Main substance of consumption: 57% alcohol, 19.9% cocaine and 19.4% opiates. Men were 77.4% vs. 81.1% vs. 83.3% (p n.s.), mean ages were 47.12 (SD 10.18) vs. 32.62 (SD 8.20) vs. 36.47 (SD 8.04) years (p< 0.001), and 25.5% vs. 64.9% vs. 55.6% were single (p< 0.001). The greatest severity was found in the Alcohol area in the case of alcohol users (56.86) and in the Family/Social Partner Problems area in the case of cocaine and the opiate users (50.43 and 51.22). Alcohol users had statistically significant greater severity than the other two groups in the Alcohol area (56.86 vs. 49.38 vs. 45.17, p< 0.001) and tended to have lower severity in the Legal area than cocaine users (46.78 vs. 48.43, p 0.079).
Cocaine users were the youngest and used to be single. The ASI-6 only differentiated in the severity of the Alcohol area. Further studies including a higher proportion of cocaine and opiate users are needed.
Healthy sexual functioning is an important part of the human experience, but there is a lack of studies regarding sexuality and sexual behavior in schizophrenia and bipolar disorder (García-Portilla, 2010).
To determine the differences on the sexual dysfunction profile between patients with schizophrenia and bipolar disorder.
Naturalistic, cross-sectional, multicentre, validation study. A total of 89 patients with schizophrenia (SQF) and 82 with bipolar disorder (BPD) were evaluated using the Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14).
Sample description (SQF vs BPD): Mean age (SD) were 39.2 (11.0) vs 46.7 (10.9) (p < 0.001), men were 58.8% vs 41.2% (χ2 = 4.0, df. = 1, p < 0.05), 61.8% vs 38.2% were single (χ2 = 12.8, df. = 1, p < 0.001). Mean (SD) scores on CSFQ-14 scales were (SQF vs BPD): Pleasure 2.2 (1.0) vs 2.6 (1.0) (t = -2.2, p < 0.05), Sexual desire/frequency 5.3 (2.0) vs 5.9 (2.0) (t = -2.0, p < 0.05), Sexual desire/interest 5.7 (2.6) vs 6.9 (3.0) (t = -2.5, p < 0.05), Arousal/excitement 8.6 (3.1) vs 8.9 (3.4), Orgasm/completion 7.9 (3.2) vs 8.8 (3.2), Desire 11.1 (3.9) vs 12.9 (4.4) (t = -2.7, p < 0.05), Arousal 8.6 (3.1) vs 8.9 (3.4), Orgasm 7.9 (3.2) vs 8.8 (3.2) and Total 39.5 (9.7) vs 42.2 (11.0).
Patients with schizophrenia have more difficulty to get pleasure and more problems in the phase of desire (frequency and interest) than the patients with bipolar disorder.
i. To establish the sociodemographic profile of the subjects who attempted suicide in the Health Area IV of Asturias (Northern Spain);
ii. To determinate the mental disorders more frequently associated with suicide attempts (SA);
iii. To study the relationship between repetition of suicidal behaviour and severity of the SA;
iv. To determinate the more commonly used methods for SA.
1,633 suicide attempters who attended the Emergency Room of the University Central Hospital of Asturias during the period 2003-2005 were included in the study. Evaluation of these patients was made using the WHO/Euro Multicentre Study Protocol. Psychiatric diagnoses were made following ICD-10 criteria.
Sociodemographic data: mean age (SD) = 38.66 (15.13); females: 62%; single: 39.8%; living with their family: 83.8%; lowest educational level: 67%; economically inactive: 33.8%. More prevalent psychiatric diagnoses were affective disorders (24.1%) and anxiety disorders (21.6%). Previous SA were present in 49.2% and 40% repeat the attempt during the monitoring period. Severity of the attempt (lethality of method and intentionality) was related with repetition of the behaviour during the monitoring period (p = 0.001). More frequent methods were overdose (74.8%) followed by cutting (18.5%).
SA was more prevalent in a single woman with age between 30 and 50 years who suffering for affective or anxiety disorders. Many of the patients repeat the suicidal behaviour and this was related to the severity of the attempt. Individuals appear to use the methods that are available to them to attempt suicide.
To date, little is known about the impact of substance use on physical health of patients with bipolar disorder. This study provides data on the impact of tobacco, alcohol and cannabis upon weight, metabolic profile and cardiovascular risk in these patients.
Naturalistic, cross-sectional, multicenter study conducted in Spain. Current use of tobacco, alcohol and cannabis was registered based on patient’ self-reports. Patients were evaluated for presence of metabolic syndrome (MetS) according to modified NCEP ATP III criteria, for cardiovascular risk using the Framinghan function (CHD) and the Systematic COronary Risk Evaluation (SCORE) function (CMR).
The mean age was 46.6 years and 49% were male. Fitty-one percent used tobacco, 13% alcohol and 12.5% cannabis. Mean body mass index (BMI) was 27.9 kg/m2, 22.4% had MetS and ten-year CHD and CMR risks were 7.6% and 1.8% respectively. Patients who used tobacco had significantly higher CHD risk (8.82 versus 5.74, p < 0.01), and used more antipsychotic (1.23 versus 1.04, p 0.002) and overall (3.18 versus 2.71, p 0.01) drugs for the treatment of their bipolar disorder. Patients who used cannabis had significantly lower BMI (26.0 versus 28.2, p < 0.05) and lower CMR (0.37 versus 1.99, p < 0.001), however, when controlling by age, severity of mania and presence of metabolic syndrome these associations disappear.
Substance use, mainly tobacco, is high in patients with bipolar disorder. Use of tobacco is associated with higher cardiovascular risk and greater number of antipsychotic and overall drugs for the bipolar disorder.
Schizophrenia is not only a mental disorder but also has other components affecting the physical part of the body. Several studies have suggested that neuroinflammatory processes may play a role in schizophrenia pathogenesis, at least in a subgroup of patients.
This poster reported the preliminary results of a project aiming to find schizophrenia biomarkers. We present biological parameters and clinical variables of patients with schizophrenia according to the lab results and the clinical assessments.
Cross-sectional, naturalistic study. Inclusion criteria: DSM-IV diagnosis of schizophrenia; age >17 years; and written informed consent given.
123 patients with schizophrenia. Mean age 40.75 (10.37), 67.5% males. There is relationship between homocysteine(oxidative stress) and psychopathology: PANSS [negative subscale 0.27 (p=0.003), general subscale 0.21 (p=0.028) and Marder factor 0.28 (p=0.003)], NSA [global score 0.24 (p=0.010), and some factors: communication 0.26 (p=0.005), affect 0.28 (p=0.002), motivation 0.30 (p=0.001) and motor retardation 0.27 (p=0.004)]; Functioning [(PSP total score -0.24 (p=0.011) and some PSP factors: work 0.30 (p=0.001), self-care 0.21 (p=0.022)]. However, there is no relationship between C-reactive protein(inflammation) and any clinical variable. On the other hand, there is relationship between: glucose and cognitive impairment; cholesterol and NSA motivation score, cognitive impairment and PSP (total score, self-care and work); triglycerides and HDRS (total score, melancholia factor and vitality factor), NSA motivation score and cognitive impairment.
The negative dimension of schizophrenia is associated with high homocysteine levels, which means an oxidative stress state. As well, a worse functioning level is associated with high homocysteine level.
Some coping strategies might serve as protective functions by regulating the negative emotions associated with stress, whereas others may exacerbate the effects of stress and contribute to maladaptation.
To examine the distribution of the Beck Depression Inventory II (BDI-II) scores in the Spanish sample of adolescents from the “Working in Europe to Stop Truancy among Youth” Project (WE-STAY) and study the differences according to the coping style.
Sample: 1409 pupils from 23 schools sited in Asturias (Spain) [48.55% males; mean age(SD) = 15.16(1.22)]. Instruments:
(1) Coping Across Situations Questionnaire (CASQ);
7.3% of the sample scored in mild depression, while 4.9% did so in moderate (BDI-II criteria). Significant differences were found by gender in BDI-II scores, females scoring higher in severe, moderate and mild depression (p< .005). Regarding to the coping style, 65.4% of the sample showed internal style. The least representative was the withdrawal style (13.9%). Significant differences were found in the coping style by gender, females scoring higher in both active and withdrawal styles (p< .050). Regarding to the relation between BDI-II scores and coping style, pupils with withdrawal style score higher in severe, moderate and mild depression (p< .000).
Although ideally would be an active style, pupils showed mainly an internal coping style (which includes assessing a situation and looking for a compromise). Coping style was related with the severity of depression. Withdrawal style (which includes denial) is related to a worsening of depression. Thereby, training coping skills may be important.
The self-medication hypothesis suggests that patients diagnosed with schizophrenia might smoke as an attempt to self-medicate theirsymptoms. As a consequence, smoking cessation could worsen their clinical status.
To assess the clinical changes associated with tobacco cessation in a sample of smoking outpatients with schizophrenia.
Sample: 63 smoking outpatients with DSM-IV Schizophrenia from three Mental Health Centers located in Northern Spain [77.0% males; mean age (SD) = 43.90 (8.72); average daily cigarette use (SD) = 27.99 (12.55)]. Instruments: (1) Clinical symptoms: Positive and Negative Symptoms Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression (CGI). (2) Pattern of tobacco use: n° cigarettes/day; Expired carbon monoxide (CO ppm). Design: A quasi-experimental design with two groups was implemented: control group (GC − 18 patients not willing to stop smoking), and treatment group [TG − 45 patients in smoking cessation supported by nicotine patches or vareniclina (12 weeks)]. Patients were evaluated at baseline and at week 11 (end of program). Paired sample t-test was used to detect changes in clinical symptoms from baseline to follow-up.
23.1% stopped smoking (from TG). No significant differences were found between baseline and follow-up scores (p>.05) among smokers and abstinent in PANSS subscales, HDRS and CGI.
Tobacco cessation did not have a significant effect on the clinical symptoms of this group of patients. Further studies should analyze the stability of these outcomes at longer follow-ups to confirm our results.
Information about the perception of suicide attempters regarding prevention of their suicide attempt may be helpful in implementing preventive strategies.
(i) sociodemographic profile,
(ii) distribution of the Suicide Intent Scale, and
(iii) differences according to the gender in the sample of participants in a controlled study to determine the effectiveness of case management programme in the prevention of recurrent suicidal behaviour.
106 suicide attempters who attended the Emergency Room of the Hospital of Asturias from July- 2011 to October- 2012 were included in the study [33% males; mean age (SD)= 41.82 (13.16)]. Instruments: Ad hoc Sociodemographic- Questionnaire; Suicide Intent Scale (SIS); SAD-PERSON Scale; Medical Damage Scale; List of Threatening Experiences; Hamilton Depression Rating Scale.
Profile: 45-54 years old (30.4%), married (34%), with bachelor's degree (42.5%), unemployed (29.2%), with children (61.3%) and living with partner (34.9%). 36.2% of the sample had the intention to repeat at the time of the suicide attempt (SA), while 22.6% actually repeated it. The intention to repeat the SA was associated with the commission of SA at 12-months follow-up (p=.002). SIS data: mean total score (SD)=15.99(4.71); mean objective score (SD)=5.69(2.48); mean subjective score (SD)=10.28(3.29). Significant differences in SIS scores were found by gender (p=.007), men scoring higher. Repetition of the SA was related with higher scores (p=.002).
SA severity and its repetition at 12-months follow-up was related with the intention of repetition; nevertheless we didn’t find relation between the SA severity and the repetition of SA one year later.
The self-medication hypothesis proposes that schizophrenia patients may smoke as an attempt to reduce their cognitive deficits, their symptoms or the antipsychotic side-effects.
to identify the relationship between the smoking topography and psychopathology among outpatients with DSM-IV schizophrenia.
The sample included 26 smoking outpatients with DSM-IV schizophrenia from a Mental Health Center sited in the North of Spain [65.5% males; mean age (SD) = 44.66 (7.83)]. Instruments: (1) Psychopathology: Positive and Negative Syndrome Scales (PANSS); Clinical Global Impression of Severity (CGI-S); n° antipsychotic. (2) Pattern of tobacco use: n° cigarettes/day; Fargerstrom test for nicotine physical dependence; Glover-Nilsson test for nicotine psychological dependence; Expired carbon monoxide (CO ppm).
prevalence was 59.3% for non-heavy smokers [<30 cigarettes/day; Mean CO (SD)= 24 ppm (9.70)] and 40.7% for heavy smokers [≥30 cigarettes/day; Mean CO (SD) = 36 ppm (16.06)]. PANSS mean score (SD) = 54.07 (12.45); CGI-G mean score (SD) = 3.50 (1.17); Mean number of antipsychotic (SD) = 1.79 (0.88). No significant differences were found between the severity of the psychopatology (PANSS, CGI-S, n° antipsychotic) and all the variables of the pattern of tobacco use (n° cigarettes/day; expired carbon monoxide; Fargerstrom; Glover-Nilsson).
In this sample of schizophrenia patients, there is no relation between the severity of psychopathology and the dependence of nicotine. However, the sample of this study is small.
Several adolescents engaging in suicidal behavior represent a hidden population who do not receive professional help. Aim: to increase understanding of adolescents who were screened as being at high risk of suicide.
Sample: 1,409 pupils from 23 schools sited in Asturias (Spain) participants in the ‘Working in Europe to Stop Truancy among Youth’ Project (WESTAY) (48.55% males; mean age=15.16 years). Emergency cases: those with severe suicide ideation and/or suicide attempt (SA) in the past 2 weeks. 45 pupils identified as emergency cases (46.7% males; mean age=15.02 years).
Evaluation: Beck Depression Inventory II (BDI-II), Deliberate Self-Harm Inventory (DSHI), Strengths and Difficulties Questionnaire (SDQ), Well Being Index (WHO-5), Paykel Suicide Scale (PSS).
3.2% (n=45) of the sample self-reported acute suicidality (22 attended the clinical interview, 5 were referred to mental health services). More girls than boys were identified as cases, attended the interview and were referred to services. Emergency cases scored significantly higher (p=0.000) in SDQ total scores, emotional symptoms, conduct problems, hyperactivity and peer relationship problems, however, no significant differences were found in the prosocial scale. Emergency cases also manifested significant (p=0.000) higher level of depressive symptoms (BDI-II) and lower well-being. Emergency cases were more likely to have a history of DSH (p=0.000). No significant differences were found between those who attended the interview or not.
There is a high rate of self-reported acute suicidality among adolescents; however, their suicide risk after a clinical assessment was considered as low.
Tobacco use has been associated with more excitement and agitation symptoms, greater severity of global psychopathology as measured by the Clinical General Impression (CGI) Scale, and psychotic symptoms in patients with schizophrenia.
To assess the effects of nicotine abstinence versus nicotine maintenance on the clinical symptoms of a sample of outpatients smokers diagnosed with schizophrenia.
Sample: 81 outpatients with schizophrenia [72.8% males; mean age (SD) = 43.35 (8.82)] currently smoking tobacco [no. of cigarettes (SD) = 27.96 (12.29)]. Desing: non-randomized, open-label, 6-month follow-up and multi-center study conducted at 3 sites in Spain (Oviedo, Santiago de Compostela and Orense). Instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression for Schizophrenia (CGI-SCH), Hamilton Depression Rating Scale (HDRS). Antropometric measures: Body mass index (BMI) and waist circumference. Vital sings: heart rate. Procedure: Patients were assigned to 2 conditions:
– control group = patients continuing their tobacco use;
– experimental group = patients participated in vareniclina or nicotine patches treatment for smoking cessation.
Patients were evaluated at baseline (all patients smoking) and after 3 and 6 months.
No significant differences (P>.05) were found between groups at baseline evaluation. Likewise, there were no significant differences between smokers and non-smokers after treatment (3 and 6 months follow-up) in their clinical symptomatology (according to PANSS, HDRS and CGI-SCH), anthropometric measures and heart rate.
No significant differences were found in the clinical symptoms after a period of nicotine abstinence. Therefore, clinicians should motivate and help their patients to quit smoking (CIBERSAM - FIS PI11/01891).
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
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