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Andreo-Jover J, Curto Ramos J, Bobes J, Bravo-Ortiz M, Cebria AI, Crespo-Facorro B, De la Torre-Luque A, Díaz-Marsa M, Fernández-Rodrigues V, Garrido-Torres N, Grande I, López Peña MP, Pemau A, Roberto N, Ruiz-Veguilla M, Saiz P, Rodríguez-Vega B, Pérez-Sola V. The mediating role of reflective functioning in the association between childhood trauma and suicide attempt. J Psychiatr Res 2024; 171:30-37. [PMID: 38241967 DOI: 10.1016/j.jpsychires.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.
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Affiliation(s)
- J Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - J Curto Ramos
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - J Bobes
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - M Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
| | | | - B Crespo-Facorro
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - A De la Torre-Luque
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | | | - V Fernández-Rodrigues
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Garrido-Torres
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - I Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | | | - A Pemau
- Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - N Roberto
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | - M Ruiz-Veguilla
- Hospital Virgen del Rocio/IBIS, Sevilla, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Spain
| | - P Saiz
- Department of Psychiatry, Universidad de Oviedo, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - B Rodríguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - V Pérez-Sola
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
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González-Ortega I, Diaz-Marsa M, López-Peña P, Fernández-Sevillano J, Andreo-Jover J, Bobes J, Bravo-Ortiz MF, Cebria AI, Crespo-Facorro B, de la Torre-Luque A, Elices M, Fernández-Rodrigues V, Garrido-Torres N, Grande I, Palao-Tarrero Á, Pemau A, Roberto N, Ruiz-Veguilla M, Seijo-Zazo E, Alberich S, González-Pinto A, Pérez V. Clinical predictors and psychosocial risk factors of suicide attempt severity. Span J Psychiatry Ment Health 2023:S2950-2853(23)00034-0. [PMID: 38591830 DOI: 10.1016/j.sjpmh.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/06/2023] [Accepted: 07/09/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Suicide attempts are an important predictor of completed suicide and may differ in terms of severity of medical consequences or medical lethality. There is little evidence on serious suicide attempt (SSA) and very few studies have compared SSA with non-SSA. OBJECTIVE The aim of this multisite, coordinated, cohort study was to analyze the role of clinical variables and the sociodemographic and psychological risk factors of SSA. METHOD In this multisite, coordinated, cohort study, 684 participants (222 for the mild suicide attempt group, 371 for the moderate suicide attempt group and 91 for the SSA group) were included in the study. Ordinal regression models were performed to analyze the predictor variables of SSA. RESULTS Early physical abuse (OR=1.231) and impulsivity (OR=1.036) were predictors of SSA, while depressive symptoms were associated with a lower risk of SSA. CONCLUSION Environmental and psychological factors as physical abuse and impulsivity are related with severe suicide severity. These findings will help to develop strategies to prevent suicide and may be considered for the treatment and management of suicide.
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Affiliation(s)
- Itxaso González-Ortega
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Personality, Assessment and Psychological Treatment, National University of Distance Education (UNED), Vitoria, Spain
| | - Marina Diaz-Marsa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain; Complutense University of Madrid, Madrid, Spain
| | - Purificación López-Peña
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Leioa, Spain
| | - Jessica Fernández-Sevillano
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
| | - Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julio Bobes
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - María Fe Bravo-Ortiz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Ana Isabel Cebria
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Barcelona, Spain; Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma of Barcelona, Cerdanyola del Vallès, Spain
| | - Benedicto Crespo-Facorro
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain; Department of Psychiatry, University of Sevilla, Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Complutense University of Madrid, Madrid, Spain
| | - Matilde Elices
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mar Institute of Medical Research (IMIM), Parc de Salut Mar, Barcelona, Spain
| | | | - Nathalia Garrido-Torres
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Iria Grande
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro) P. de la Vall d'Hebron, Barcelona, Spain; Department de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Ángela Palao-Tarrero
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | | | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro) P. de la Vall d'Hebron, Barcelona, Spain
| | - Miguel Ruiz-Veguilla
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain; Department of Psychiatry, University of Sevilla, Sevilla, Spain
| | - Elisa Seijo-Zazo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Susana Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Personality, Assessment and Psychological Treatment, National University of Distance Education (UNED), Vitoria, Spain
| | - Ana González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Leioa, Spain; Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain.
| | - Víctor Pérez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mar Institute of Medical Research (IMIM), Parc de Salut Mar, Barcelona, Spain; Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain; Universitat Pompeu Fabra, UPF, Barcelona, Spain
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Justicia A, Elices M, Cebria AI, Palao DJ, Gorosabel J, Puigdemont D, de Diego-Adeliño J, Gabilondo A, Iruin A, Hegerl U, Pérez V. Rationale and methods of the iFightDepression study: A double-blind, randomized controlled trial evaluating the efficacy of an internet-based self-management tool for moderate to mild depression. BMC Psychiatry 2017; 17:143. [PMID: 28420367 PMCID: PMC5395842 DOI: 10.1186/s12888-017-1306-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/10/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU. METHODS A total of 310 participants with major depression disorder (MDD) will be recruited at four different mental-health facilities in Spain. Participants will be randomly allocated to one of two study arms: iFightDepression (iFD) tool + TAU vs. internet-based psychoeducation + TAU. Both interventions last for 8 weeks and there is a 12 weeks follow up. The primary outcome measure is changes in depressive symptoms assessed with the Hamilton Depression Rating Scale. Additionally, pre-post interventions assessments will include socio-demographic data, a brief medical and clinical history and self-reported measures of depressive symptoms, quality of life, functional impairments and satisfaction with the iFD tool. DISCUSSION iFightDepression is an easy-prescribed tool that could increase the efficacy of conventional treatment and potentially reach untreated patients, shortening waiting lists to receive psychological treatment. Confirming the efficacy of the iFD internet-based self-management tool as an add-on treatment for individuals with mild to moderate depression will be clinically-relevant. TRIAL REGISTRATION Registration number NCT02312583 . Clinicaltrials.gov . December 4, 2014.
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Affiliation(s)
- Azucena Justicia
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. .,Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Cerdanyola del Vallès, Spain. .,Institut de Neuropsiquiatria i Addiccions (INAD), PSMar, Barcelona, Spain. .,Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - Matilde Elices
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,0000 0004 1767 9005grid.20522.37Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Ana Isabel Cebria
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,grid.7080.fDepartament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Cerdanyola del Vallès Spain ,0000 0000 9238 6887grid.428313.fParc Taulí Hospital Universitari, Sabadell, Spain
| | - Diego J. Palao
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,grid.7080.fDepartament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Cerdanyola del Vallès Spain ,0000 0000 9238 6887grid.428313.fParc Taulí Hospital Universitari, Sabadell, Spain
| | | | - Dolors Puigdemont
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,Departament de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Javier de Diego-Adeliño
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,grid.7080.fDepartament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Cerdanyola del Vallès Spain ,Departament de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza- Basque Health System, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Alvaro Iruin
- Outpatient Mental Health Care Network, Osakidetza- Basque Health System, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Ulrich Hegerl
- 0000 0001 2230 9752grid.9647.cUniversity Hospital, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany ,German Depression Foundation, Depression Research Centre, Leipzig, Germany
| | - Víctor Pérez
- grid.469673.9Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,grid.7080.fDepartament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Cerdanyola del Vallès Spain ,Institut de Neuropsiquiatria i Addiccions (INAD), PSMar, Barcelona, Spain ,0000 0004 1767 9005grid.20522.37Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
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4
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Cebria AI, Pérez-Bonaventura I, Cuijpers P, Kerkhof A, Parra I, Escayola A, García-Parés G, Oliva JC, Puntí J, López D, Valles V, Pamias M, Hegerl U, Pérez-Sola V, Palao DJ. Telephone Management Program for Patients Discharged From an Emergency Department After a Suicide Attempt: A 5-Year Follow-Up Study in a Spanish Population. Crisis 2016; 36:345-52. [PMID: 26502785 DOI: 10.1027/0227-5910/a000331] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM In a previous controlled study, the authors reported on the significant beneficial effects of a telephone intervention program for prevention of suicide attempts by patients for up to 1 year. This study reports the 5-year follow-up data. Outcomes were number of recurrences and time to recurrence. METHOD The intervention was carried out on patients discharged from the emergency room (ER) following attempted suicide (Sabadell). It consisted of a systematic, 1-year telephone follow-up program: after 1 week, and thereafter at 1-, 3-, 6-, 9-, and 12-month intervals to assess the risk of suicide and encourage adherence to treatment. The population in the control group (Terrassa) received treatment as usual after discharge, without additional telephone contact. RESULTS The effect of reattempt prevention observed in the first year was not maintained over the long term. CONCLUSION A telephone management program for patients discharged from an ER after attempted suicide could be considered a useful strategy in delaying further suicide attempts and reducing the rate of reattempts in the first year. However, results showed that the beneficial effects were not maintained at the 5-year follow-up.
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Affiliation(s)
- Ana Isabel Cebria
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain.,3 Centro de Investigación Biomédica En Red de Salud Mental, CIBERSAM, Sabadell, Spain
| | - Iris Pérez-Bonaventura
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,4 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain
| | - Pim Cuijpers
- 5 Department of Clinical Psychology, VU University Amsterdam, The Netherlands
| | - Ad Kerkhof
- 5 Department of Clinical Psychology, VU University Amsterdam, The Netherlands
| | - Isabel Parra
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Anna Escayola
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain
| | - Gemma García-Parés
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Joan Carles Oliva
- 6 Research Office, Corporació Sanitaria Parc Taulí de Sabadell, Barcelona, Spain
| | - Joaquim Puntí
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,4 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain
| | - David López
- 7 Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Vicenç Valles
- 7 Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Montserrat Pamias
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Ulrich Hegerl
- 8 Department of Psychiatry, University of Leipzig, Germany
| | - Victor Pérez-Sola
- 2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain.,3 Centro de Investigación Biomédica En Red de Salud Mental, CIBERSAM, Sabadell, Spain.,9 Department of Psychiatry, Parc de Salut Mar de Barcelona, Spain
| | - Diego J Palao
- 1 Department of Mental Health, Corporació Sanitaria Parc Taulí de Sabadell (Barcelona), Institut Universitari Parc Taulí-Universitat Autònoma de Barcelona, Campus d'Excellència Internacional, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
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