The relevance of family relationships in the outcome of various disorders has been highlighted from different domains. Specifically, empirical studies on the relationship between the outcome of schizophrenia and various affective dimensions of family relationships have allowed the identification of particularly relevant aspects: criticism, hostility, and over-protection.

The present study aims to adapt and validate an abbreviated Spanish version of the Influential Relationship Questionnaire (IRQ), an instrument that measures the patient’s own perception of the affective dimensions of family relationships.

Participants were 188 patients (63.8% male) of the Public Health Service in Andalusia (Spain) with a diagnosis of schizophrenia or a related disorder. One hundred and thirty-six participants provided data related to both father and mother, and 52 only related to mother or father, so the analyses were carried out with a total of 324 questionnaires. Simultaneously, in 130 participants, the Perceived Criticism Scale was applied, and in 50 cases, relatives were asked to complete the Family Attitudes Scale.

Principal component analysis allowed for the identification of four factors that explained 61.53% of the total variance (criticism, over-protection, restriction, and care). The values of Cronbach’s alpha coefficient, as well as the omega coefficient, showed high consistency. The temporal reliability for an interval of 3 months was high. The correlations between the IRQ dimensions and the other variables included in the study were significant and in the expected direction.

The results support the reliability and validity of the abbreviated version of the IRQ.

There is heterogeneity in the long-term trajectories of depressive symptoms among patients. To date, there has been little effort to inform the long-term trajectory of symptom change and the factors associated with different trajectories. Such knowledge is key to treatment decision-making in primary care, where depression is a common reason for consultation. We aimed to identify distinct long-term trajectories of depressive symptoms and explore pre-treatment characteristics associated with them.

A total of 483 patients from the PsicAP clinical trial were included. Growth mixture modeling was used to identify long-term distinct trajectories of depressive symptoms, and multinomial logistic regression models to explore associations between pre-treatment characteristics and trajectories.

Four trajectories were identified that best explained the observed response patterns: “recovery” (64.18%), “late recovery” (10.15%), “relapse” (13.67%), and “chronicity” (12%). There was a higher likelihood of following the recovery trajectory for patients who had received psychological treatment in addition to the treatment as usual. Chronicity was associated with higher depressive severity, comorbidity (generalized anxiety, panic, and somatic symptoms), taking antidepressants, higher emotional suppression, lower levels on life quality, and being older. Relapse was associated with higher depressive severity, somatic symptoms, and having basic education, and late recovery was associated with higher depressive severity, generalized anxiety symptoms, greater disability, and rumination.

There were different trajectories of depressive course and related prognostic factors among the patients. However, further research is needed before these findings can significantly influence care decisions.

Patients with a first episode of psychosis (FEP) display clinical, cognitive, and structural brain abnormalities at illness onset. Ventricular enlargement has been identified in schizophrenia since the initial development of neuroimaging techniques. Obstetric abnormalities have been associated with an increased risk of developing psychosis but also with cognitive impairment and brain structure abnormalities. Difficulties during delivery are associated with a higher risk of birth asphyxia leading to brain structural abnormalities, such as ventriculomegaly, which has been related to cognitive disturbances.

We examined differences in ventricular size between 142 FEP patients and 123 healthy control participants using magnetic resonance imaging. Obstetric complications were evaluated using the Lewis–Murray scale. We examined the impact of obstetric difficulties during delivery on ventricle size as well as the possible relationship between ventricle size and cognitive impairment in both groups.

FEP patients displayed significantly larger third ventricle size compared with healthy controls. Third ventricle enlargement was associated with diagnosis (higher volume in patients), with difficulties during delivery (higher volume in subjects with difficulties), and was highest in patients with difficulties during delivery. Verbal memory was significantly associated with third ventricle to brain ratio.

Our results suggest that difficulties during delivery might be significant contributors to the ventricular enlargement historically described in schizophrenia. Thus, obstetric complications may contribute to the development of psychosis through changes in brain architecture.

The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.

Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.

COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).

COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.

Peru’s health infrastructures, particularly hospitals, are exposed to disaster threats of different natures. Traditionally, earthquakes have been the main disaster in terms of physical and structural vulnerability, but the coronavirus disease 2019 (COVID-19) pandemic has also shown their functional vulnerability. Public hospitals in Lima are very different in terms of year constructed, type of construction, and number of floors, making them highly vulnerable to earthquakes. In addition, they are subject to a high demand for care daily. Therefore, if a major earthquake were to occur in Lima, the hospitals would not have the capacity to respond to the high demand.

The aim of this study was to analyze the Hospital Safety Index (HSI) in hospitals in Lima (Peru).

This was a cross-sectional observational study of 18 state-run hospitals that met the inclusion criteria; open access data were collected for the indicators proposed by the Pan American Health Organization (PAHO) Version 1. Associations between variables were calculated using the chi-square test, considering a confidence level of 95%. A P value less than .05 was considered to determine statistical significance.

The average bed occupancy rate was 90%, the average age was 70 years, on average had one bed per 25,126 inhabitants, and HSI average score was 0.36 with a vulnerability of 0.63. No association was found between HSI and hospital characteristics.

Most of the hospitals were considered Category C in earthquake and disaster safety, and only one hospital was Category A. The hospital situation needs to be clarified, and the specific deficiencies of each institution need to be identified and addressed according to their own characteristics and context.

To describe IMP-type carbapenemase-producing Pseudomonas aeruginosa outbreaks at Galdakao University Hospital between March 2021 to December 2021.

Outbreak report.

Galdakao University Hospital is a tertiary-care hospital in the Basque Country (northern Spain).

All patients with a positive IMP-type carbapenemase producing Pseudomonas aeruginosa (IMP-PA) culture were included in this study, both colonization and infection cases.

An outbreak investigation was conducted, in which molecular epidemiology analysis [pulsed-field gel electrophoresis and whole-genome sequencing (WGS)] and environmental screenings were performed.

Between March and December 2021, 21 cases of IMP-PA were detected in Galdakao University Hospital: 18 infection cases and 3 colonization cases. In total, 4 different pulsotypes were detected belonging to 4 clones according to WGS: ST175 (n = 14), ST633 (n = 3), ST179 (n = 3), and ST348 (n = 1). IMP-13 was detected in most isolates belonging to the ST175 clone and in all ST179 and ST348 clones, whereas IMP-29 was detected in isolates belonging to the ST633 clone. Clinical isolates belonging to the ST175 clone were isolated mainly from patients admitted to the respiratory ward, and isolates belonging to the ST633 clone from patients admitted to the ICU. Two environmental isolates belonging to the ST175 clone were detected in the respiratory ward.

Molecular and genomic epidemiology revealed that there had been 2 independent IMP-PA outbreaks, one of long duration in the respiratory ward and the other more limited in the ICU.

The aim of this study was to establish the frequency and profile of disasters and to analyze trends in disasters and their impact on Spanish public health.

Retrospective observational study of disasters that occurred in Spain from 1950 through 2020 was conducted. The variables studied for each episode were number of people affected, number of injured/sick, and number of deaths. Absolute and relative frequencies, population rates, mean, median, standard error of the mean (SEM), and 95% confidence intervals (CI) were used, and trend analysis was performed using exponential smoothing and linear regression.

A total of 491 disasters were identified in Spain. Of these, 255 (51.9%) were natural disasters, 224 (45.7%) technological disasters, and 12 (2.4%) man-made disasters. The average number of disasters per year was 7.01 (95% CI, 5.99-9.34). These disasters affected a total of 820,489 people, with an average of 3,491 people (SEM = 2.18) per episode. There was a significant increase (P <.001) in the total frequency of disasters in Spain during the period studied.

Spain has a disaster profile of mixed type, combining natural with technological disasters. From 1950 through 2020, there was a significant increase in the number of disasters, with an overall profile similar to that of Europe, with climatological disasters being the most frequent type.

Psychotic disorders exhibit a complex aetiology that combines genetic and environmental factors. Among the latter, obstetric complications (OCs) have been widely studied as risk factors, but it is not yet well understood how OCs relate to the heterogeneous presentations of psychotic disorders. We assessed the clinical phenotypes of individuals with a first episode of psychosis (FEP) in relation to the presence of OCs.

Two-hundred seventy-seven patients with an FEP were assessed for OCs using the Lewis–Murray scale, with data stratified into three subscales depending on the timing and the characteristics of the obstetric event, namely: complications of pregnancy, abnormal foetal growth and development and difficulties in delivery. We also considered other two groups: any complications during the pregnancy period and all OCs taken altogether. Patients were clinically evaluated with the Positive and Negative Syndrome Scale for schizophrenia.

Total OCs and difficulties in delivery were related to more severe psychopathology, and this remained significant after co-varying for age, sex, traumatic experiences, antipsychotic dosage and cannabis use.

Our results highlight the relevance of OCs for the clinical presentation of psychosis. Describing the timing of the OCs is essential in understanding the heterogeneity of the clinical presentation.

To describe the epidemiological profile of multiple casualty incidents (MCI) and contribute to the better understanding of their impacts in Northern Spain.

Retrospective, population-based observational study of MCI between 2014 and 2020 in 5 autonomous communities (Aragón, Castilla y León, Galicia, the Basque Country and Principado de Asturias) that participated in the MCI Database of Northern Spain. Inclusion criteria was any incident with 4 or more patients needing ambulance mobilization. A total of 54 variables were collected. This study presents the most relevant results.

There were 253 MCI. Of these, 79.8% were road traffic accidents, 12.3% fires or explosions, 2.0% poisonings and 5.9% defined as others. Monthly average was 2.9 (SD = 0.35; EEM = 15.90), average of victims by MCI was 6.8 (CI95% 6.16 - 7.60). There were significantly (P < 0.05) more victims in 3 types of MCI (fires, poisonings, and others). We saw 37.7% of MCI involved 4 victims, 18.8% 5 victims, and 37.9% more than 5. Mean response time was 30.8 minutes (95% CI 28.6 - 33.1), longer in maritime incidents. A total of 67% (95% CI 64.5 - 69.5) of victims were mild.

Road traffic accidents are the most frequent MCI and minor injuries predominate. More than 50% of the MCI have 5 or fewer patients. Fires had significantly more mild patients and significantly more resources deployed. Maritime incidents had a significantly longer response time.