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Oquendo MA, Baca-Garcia E. Suicidal behavior: Not just an epiphenomenon of psychiatric illness. Eur Neuropsychopharmacol 2024; 81:41-42. [PMID: 38324939 DOI: 10.1016/j.euroneuro.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Affiliation(s)
- Maria A Oquendo
- Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania, US.
| | - Enrique Baca-Garcia
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain; Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of psychiatry, Centre Hospitalier Universitaire de Nîmes, France; CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
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Chancel R, Lopez-Castroman J, Baca-Garcia E, Mateos Alvarez R, Courtet P, Conejero I. Biomarkers of Bipolar Disorder in Late Life: An Evidence-Based Systematic Review. Curr Psychiatry Rep 2024; 26:78-103. [PMID: 38470559 DOI: 10.1007/s11920-024-01483-7] [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] [Accepted: 01/09/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE OF REVIEW Review the current evidence on biomarkers for bipolar disorder in the older adults. We conducted a systematic search of PubMed MEDLINE, PsycINFO, and Web of Science databases using the MeSH search terms "Biomarkers", "Bipolar Disorder", "Aged" and and "Aged, 80 and over". Studies were included if they met the following criteria: (1) the mean age of the study population was 50 years old or older, (2) the study included patients with bipolar disorder, and (3) the study examined one type of biomarkers or more including genetic, neuroimaging, and biochemical biomarkers. Reviews, case reports, studies not in English and studies for which no full text was available were excluded. A total of 26 papers were included in the final analysis. RECENT FINDINGS Genomic markers of bipolar disorder in older adults highlighted the implication of serotonin metabolism, while the expression of genes involved in angiogenesis was dysregulated. Peripheral blood markers were mainly related with low grade inflammation, axonal damage, endothelial dysfunction, and the dysregulation of the HPA axis. Neuroanatomical markers reflected a dysfunction of the frontal cortex, a loss of neurones in the anterior cingulate cortex and a reduction of the hippocampal volume (in patients older than 50 years old). While not necessarily limited to older adults, some of them may be useful for differential diagnosis (neurofilaments), disease staging (homocysteine, BDNF) and the monitoring of treatment outcomes (matrix metalloproteinases). Our review provides a comprehensive overview of the current evidence on biomarkers for bipolar disorder in the older adults. The identification of biomarkers may aid in the diagnosis, treatment selection, and monitoring of bipolar disorder in older adults, ultimately leading to improved outcomes for this population. Further research is needed to validate and further explore the potential clinical utility of biomarkers in this population.
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Affiliation(s)
- R Chancel
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - J Lopez-Castroman
- Department of Psychiatry, Nimes University Hospital, Nimes, France
- Department of Signal Theory and Communications, Carlos III University, Madrid, Spain
- Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - E Baca-Garcia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Universidad Católica del Maude, Talca, Chile
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - R Mateos Alvarez
- Department of Psychiatry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Psychogeriatric Unit, CHUS University Hospital, Santiago de Compostela, Spain
| | - Ph Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - I Conejero
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Universidad Autónoma de Madrid, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, CHU Nîmes, PSNREC, INSERM, University of Montpellier, Nîmes, France.
- Pôle de psychiatrie, CHU Nîmes, Rue du Professeur Robert Debré, 30900, Nîmes, France.
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Sükei E, Romero-Medrano L, de Leon-Martinez S, Herrera López J, Campaña-Montes JJ, Olmos PM, Baca-Garcia E, Artés A. Continuous Assessment of Function and Disability via Mobile Sensing: Real-World Data-Driven Feasibility Study. JMIR Form Res 2023; 7:e47167. [PMID: 37902823 PMCID: PMC10644188 DOI: 10.2196/47167] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/22/2023] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Functional limitations are associated with poor clinical outcomes, higher mortality, and disability rates, especially in older adults. Continuous assessment of patients' functionality is important for clinical practice; however, traditional questionnaire-based assessment methods are very time-consuming and infrequently used. Mobile sensing offers a great range of sources that can assess function and disability daily. OBJECTIVE This work aims to prove the feasibility of an interpretable machine learning pipeline for predicting function and disability based on the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 outcomes of clinical outpatients, using passively collected digital biomarkers. METHODS One-month-long behavioral time-series data consisting of physical and digital activity descriptor variables were summarized using statistical measures (minimum, maximum, mean, median, SD, and IQR), creating 64 features that were used for prediction. We then applied a sequential feature selection to each WHODAS 2.0 domain (cognition, mobility, self-care, getting along, life activities, and participation) in order to find the most descriptive features for each domain. Finally, we predicted the WHODAS 2.0 functional domain scores using linear regression using the best feature subsets. We reported the mean absolute errors and the mean absolute percentage errors over 4 folds as goodness-of-fit statistics to evaluate the model and allow for between-domain performance comparison. RESULTS Our machine learning-based models for predicting patients' WHODAS functionality scores per domain achieved an average (across the 6 domains) mean absolute percentage error of 19.5%, varying between 14.86% (self-care domain) and 27.21% (life activities domain). We found that 5-19 features were sufficient for each domain, and the most relevant being the distance traveled, time spent at home, time spent walking, exercise time, and vehicle time. CONCLUSIONS Our findings show the feasibility of using machine learning-based methods to assess functional health solely from passively sensed mobile data. The feature selection step provides a set of interpretable features for each domain, ensuring better explainability to the models' decisions-an important aspect in clinical practice.
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Affiliation(s)
- Emese Sükei
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
| | - Lorena Romero-Medrano
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Evidence-Based Behavior S.L., Leganés, Spain
| | - Santiago de Leon-Martinez
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Kempelen Institute of Intelligent Technologies, Bratislava, Slovakia
- Faculty of Information Technology, Brno University of Technology, Brno, Czech Republic
| | - Jesús Herrera López
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Evidence-Based Behavior S.L., Leganés, Spain
| | | | - Pablo M Olmos
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Grupo de Tratamiento de Señal, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Enrique Baca-Garcia
- Evidence-Based Behavior S.L., Leganés, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Madrid, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- Centro de Investigacion en Salud Mental, Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, Universidad Catolica del Maule, Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire, Nîmes, France
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
| | - Antonio Artés
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Evidence-Based Behavior S.L., Leganés, Spain
- Grupo de Tratamiento de Señal, Gregorio Marañón Health Research Institute, Madrid, Spain
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Courtet P, Amiot O, Baca-Garcia E, Bellardita L, Cerveri G, Clair AH, De Leo D, Drapier D, Fakra E, Gheysen F, Giner L, Gonzalez-Pinto A, Gussoni G, Haffen E, Lecardeur L, Mayoral-Cleries F, Mennini FS, Sáiz PA, Vieta E, Hidalgo DA, Volpe U. Understanding the potential of digital therapies in implementing the standard of care for depression in Europe. Eur Psychiatry 2023; 66:e82. [PMID: 37872705 PMCID: PMC10755564 DOI: 10.1192/j.eurpsy.2023.2453] [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: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 10/25/2023] Open
Abstract
Depressive disorders represent the largest proportion of mental illnesses, and by 2030, they are expected to be the first cause of disability-adjusted life years [1]. The COVID-19 pandemic exacerbated prevalence and burden of depression and increased the occurrence of depressive symptoms in general population [2]. The urgency of implementing mental health services to address new barriers to care persuaded clinicians to use telemedicine to follow patients and stay in touch with them, and to explore digital therapeutics (DTx) as potential tools for clinical intervention [2]. The combination of antidepressants and psychotherapy is widely recommended for depression by international guidelines [3] but is less frequently applied in real-world practice. Commonly used treatments are pharmacological, but while being effective, some aspects such as adherence to the drug regimen, residual symptoms, resistance, lack of information, and stigma may hinder successful treatment. In case of less severe depression, standalone psychological therapies should be the first-line treatment option [3], but access to trained psychotherapists remains inequitable. DTx are evidence-based therapies driven by software programs to treat or complement treatment of a specific disease. DTx are classified as Medical Devices, and given their therapeutic purpose, they need to be validated through randomized controlled clinical trials, as for drug-based therapies. In the last 10 years, studies of digital interventions have proliferated; these studies demonstrate that digital interventions increase remission rates and lower the severity of depressive symptoms compared with waitlist, treatment as usual, and attention control conditions [4]. Despite the efficacy demonstrated in clinical trials, many of these tools never reach real-life patients; thus, it might be necessary to implement DTx in the public health system to expand access to valid treatment options. In this framework, DTx represent a good opportunity to help people with depression receive optimal psychotherapeutic care [5].
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Affiliation(s)
- Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Odile Amiot
- GH Paul Guiraud, Boulogne Billancourt, France
| | - Enrique Baca-Garcia
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- Centro de Investigacion en Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | | | | | - Anne-Hélène Clair
- Institut du Cerveau – Paris Brain Institute – ICM, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Diego De Leo
- Department of Psychology, Primorska University, Koper, Slovenia
| | - Dominique Drapier
- Centre Hospitalier Guillaume régnier, Pôle Hospitalo universitaire de psychiatrie, CIC Rennes INSERM, Rennes, France
| | - Eric Fakra
- Saint Étienne University Hospital, University Jean Monnet, Saint Étienne, France
- PsyR2 Team, Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM U1028, CNRS UMR 5292, Université Jean Monnet Saint Etienne, Université Lyon 1, Saint-Étienne, France
| | | | - Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain
| | - Ana Gonzalez-Pinto
- BIOARABA, Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, CIBERSAM, Vitoria, Spain
| | - Gualberto Gussoni
- Clinical Research Department, Italian Scientific Society of Internal Medicine (FADOI), Milan, Italy
| | - Emmanuel Haffen
- UR LINC, Service de psychiatrie de l’adulte, CIC-1431 INSERM, CHU de Besançon, Université de Franche-Comté, Besançon, France
| | | | - Fermin Mayoral-Cleries
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Francesco Saverio Mennini
- EEHTA-CEIS, DEF Department, Faculty of Economic, University of Rome Tor Vergata, Roma, Italy
- Institute for Leadership and Management in Health, Kingston University, London, UK
| | - Pilar A Sáiz
- Centro de Investigacion en Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Diego Alberto Hidalgo
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, Ancona, Italy
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Giner L, Baca-Garcia E, Saiz PA. The urgent need for suicide prevention tools in Spain. Span J Psychiatry Ment Health 2023:S2950-2853(23)00004-2. [PMID: 38592433 DOI: 10.1016/j.sjpmh.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain.
| | - Enrique Baca-Garcia
- Department of Psychiatry, University Hospital Fundación Jiménez Díaz, Madrid, Spain; Health Research Institute, Fundación Jiménez Díaz, Madrid, Spain; Department of Psychiatry, General Hospital of Villalba, Villalba, Madrid, Spain; Department of Psychiatry, Hospital Infanta Elena, Valdemoro, Madrid, Spain; Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain; Department of Psychiatry, Hospital Rey Juan Carlos, Mostoles, Spain; Department of Psychology, Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Pilar A Saiz
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
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Barrigon ML, Romero-Medrano L, Moreno-Muñoz P, Porras-Segovia A, Lopez-Castroman J, Courtet P, Artés-Rodríguez A, Baca-Garcia E. One-Week Suicide Risk Prediction Using Real-Time Smartphone Monitoring: Prospective Cohort Study. J Med Internet Res 2023; 25:e43719. [PMID: 37656498 PMCID: PMC10504627 DOI: 10.2196/43719] [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] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/03/2023] [Accepted: 06/26/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Suicide is a major global public health issue that is becoming increasingly common despite preventive efforts. Though current methods for predicting suicide risk are not sufficiently accurate, technological advances provide invaluable tools with which we may evolve toward a personalized, predictive approach. OBJECTIVE We aim to predict the short-term (1-week) risk of suicide by identifying changes in behavioral patterns characterized through real-time smartphone monitoring in a cohort of patients with suicidal ideation. METHODS We recruited 225 patients between February 2018 and March 2020 with a history of suicidal thoughts and behavior as part of the multicenter SmartCrisis study. Throughout 6 months of follow-up, we collected information on the risk of suicide or mental health crises. All participants underwent voluntary passive monitoring using data generated by their own smartphones, including distance walked and steps taken, time spent at home, and app usage. The algorithm constructs daily activity profiles for each patient according to these data and detects changes in the distribution of these profiles over time. Such changes are considered critical periods, and their relationship with suicide-risk events was tested. RESULTS During follow-up, 18 (8%) participants attempted suicide, and 14 (6.2%) presented to the emergency department for psychiatric care. The behavioral changes identified by the algorithm predicted suicide risk in a time frame of 1 week with an area under the curve of 0.78, indicating good accuracy. CONCLUSIONS We describe an innovative method to identify mental health crises based on passively collected information from patients' smartphones. This technology could be applied to homogeneous groups of patients to identify different types of crises.
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Affiliation(s)
- Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation University Hospital, Madrid, Spain
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lorena Romero-Medrano
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
- Evidence-Based Behavior (eB2), Madrid, Spain
| | - Pablo Moreno-Muñoz
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
- Cognitive Systems Section, Technical University of Denmark, Lyngby, Denmark
| | | | - Jorge Lopez-Castroman
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire Nîmes, Nîmes, France
- Institut de Génomique Fonctionnelle, CNRS-INSERM, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Institut de Génomique Fonctionnelle, CNRS-INSERM, University of Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire, Montpellier, France
| | - Antonio Artés-Rodríguez
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
- Evidence-Based Behavior (eB2), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain
- Instituto de Investigacion Sanitaria Gregorio Marañón, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation University Hospital, Madrid, Spain
- Evidence-Based Behavior (eB2), Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire Nîmes, Nîmes, France
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
- Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Madrid, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Madrid, Spain
- Department of Psychology, Universidad Catolica del Maule, Talca, Chile
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Kravić N, Pajević I, Hasanović M, Karahasanović N, Voracek M, Baca-Garcia E, Dervic K. Bosnian Paternal War Orphans: Mental Health in Postwar Time. J Nerv Ment Dis 2023; 211:486-495. [PMID: 36996318 DOI: 10.1097/nmd.0000000000001651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
ABSTRACT More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans 1 who lost their father during the war in Bosnia and Herzegovina (1992-1995) and 50 age- and sex-matched adolescents from two-parent families during 2011-2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.
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Affiliation(s)
| | | | | | - Nejla Karahasanović
- Department of Neurology, Imaging Based Functional Brain Diagnostics and Therapy, Medical University of Vienna, Vienna, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Kanita Dervic
- Division of Child Psychosomatics, Department of Pediatrics and Adolescent Medicine/University Hospital, Medical University of Vienna, Vienna, Austria
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Guerrero-Jiménez M, Ruiz M, Gutiérrez-Rojas L, Jiménez-Muñoz L, Baca-Garcia E, Porras-Segovia A. Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review. World J Psychiatry 2023; 13:182-190. [PMID: 37123096 PMCID: PMC10130960 DOI: 10.5498/wjp.v13.i4.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/14/2023] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Physical exercise is an underutilized tool for the management of mental disorders. New technologies have made a breakthrough in health care, and one of its possible applications (apps) could be that of customizing exercise programs for special populations, such as patients with mental disorders. However, the app of the so-called e-health to mental health care is still limited.
AIM To know the efficacy of apps to promote physical activity in patients with mental disorders.
METHODS We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric illness. Following the selection process, 10 articles were included in the review.
RESULTS The most commonly used devices in this type of intervention are wearable devices and web platforms. Good results in terms of effectiveness and acceptability were obtained in most of the studies.
CONCLUSION Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.
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Affiliation(s)
| | - Marta Ruiz
- Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles 28933, Madrid, Spain
| | | | - Laura Jiménez-Muñoz
- Department of Psychiatry, Hospital Universitario Jiménez Díaz, Madrid 28040, Spain
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Martinez-Nicolas I, Basaraba C, Delgado-Gomez D, Lopez-Fernandez O, Baca-Garcia E, Wainberg ML. The Electronic Mental Wellness Tool as a Self-Administered Brief Screening Instrument for Mental Disorders in the General Spanish Population during the Post-COVID-19 Era. Int J Environ Res Public Health 2023; 20:3204. [PMID: 36833900 PMCID: PMC9959534 DOI: 10.3390/ijerph20043204] [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] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/29/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: In the "post-COVID-19 era", there is a need to focus on properly assessing and addressing the extent of its well-established mental health collateral damage. The "Electronic Mental Wellness Tool" (E-mwTool) is a 13-item validated stepped-care or stratified management instrument that aims at the high-sensitivity captures of individuals with mental health disorders to determine the need for mental health care. This study validated the E-mwTool in a Spanish-speaking population. (2) Methods: It is a cross-sectional validation study using the Mini International Neuropsychiatric Interview as a criterion standard in a sample of 433 participants. (3) Results: About 72% of the sample had a psychiatric disorder, and 67% had a common mental disorder. Severe mental disorders, alcohol use disorders, substance use disorders, and suicide risk had a much lower prevalence rate (6.7%, 6.2%, 3.2%, and 6.2%, respectively). The first three items performed excellently in identifying any mental health disorder with 0.97 sensitivity. Ten additional items classified participants with common mental disorders, severe mental disorders, substance use disorders, and suicide risk. (4) Conclusions: The E-mwTool had high sensitivity in identifying common mental disorders, alcohol and substance use disorders, and suicidal risk. However, the tool's sensitivity in detecting low-prevalence disorders in the sample was low. This Spanish version may be useful to detect patients at risk of mental health burden at the front line of primary and secondary care in facilitating help-seeking and referral by their physicians.
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Affiliation(s)
- Ismael Martinez-Nicolas
- Faculty of Life Sciences, Catholic University of Murcia (UCAM), 30107 Guadalupe, Spain
- Sistema Español de Notificación en Seguridad en Anestesia y Reanimación (SENSAR), IDEhA Simulation Centre, Fundación Alcorcon University Hospital, 28922 Alcorcon, Spain
| | - Cale Basaraba
- New York State Psychiatric Institute, Columbia University, New York, NY 10024, USA
| | - David Delgado-Gomez
- Department of Statistics, University Carlos III of Madrid, 28903 Getafe, Spain
- Santander Big Data Institute, Universidad Carlos III de Madrid, 28903 Getafe, Spain
| | - Olatz Lopez-Fernandez
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, 28040 Madrid, Spain
- Faculty of Psychology, Madrid Complutense University, 28049 Madrid, Spain
- Faculty of Psychology, Francisco de Vitoria University, 28049 Madrid, Spain
- Faculty of Psychology, Cardenal Cisneros Centro de Estudios Universitarios, 28223 Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, 28040 Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Móstoles, Spain
- Department of Psychiatry, General University Hospital of Villalba, 28400 Collado Villalba, Spain
- Department of Psychiatry, University Hospital Infanta Elena, 28342 Valdemoro, Spain
- Department of Psychiatry, Madrid Autonomous University, 28049 Madrid, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Faculty of Psychology, Universidad Catolica del Maule, Talca 3605, Chile
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, 30900 Nîmes, France
| | - Milton L. Wainberg
- New York State Psychiatric Institute, Columbia University, New York, NY 10024, USA
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10
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Sastre-Buades A, Caro-Cañizares I, Ochoa S, Lorente-Rovira E, Barajas A, Gutiérrez-Zotes A, Sánchez-Alonso S, López-Carrilero R, Grasa E, Pousa E, Pélaez T, Cid J, González-Higueras F, Ruiz-Delgado I, Baca-Garcia E, Barrigon ML. Relationship between cognition and suicidal behavior in recent-onset psychosis. Schizophr Res 2023; 252:172-180. [PMID: 36652834 DOI: 10.1016/j.schres.2022.12.042] [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: 03/29/2022] [Revised: 08/22/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023]
Abstract
Suicidal behavior (SB) is common in first-episode psychosis (FEP), and cognitive impairment has also been described in psychosis. Despite well-established risk factors for SB in psychosis, the role of cognition and insight remains unclear. This study aimed to explore the relationship between history of SB and cognition in recent-onset FEP, distinguishing between neurocognition, social cognition, and metacognition, and including cognitive insight (CI) as a metacognitive variable. The sample consisted of 190 participants with recent-onset FEP recruited from two multicentric studies. Two groups were formed based on presence/absence of a history of SB. Demographic, clinical, and cognitive data were compared by group, including significance level adjustments and size effect calculation. No differences were found regarding demographic, clinical, neurocognitive, social cognition, and metacognitive variables except for CI (18.18 ± 4.87; t = -3.16; p = 0.0020; d = -0.635), which showed a medium effect size. Small to medium effect size were found for attributional style (externalizing bias) (1.15 ± 3.94; t = 2.07; d = 0.482), theory of mind (ToM) (1.73 ± 0.22; t = 2.04; d = -0.403), jumping to conclusions bias (JTC) (23.3 %; X2 = 0.94; V = 0.178). In recent-onset psychosis, neurocognitive functioning was not related to the history of SB. As novelty, individuals with previous SB showed higher CI. Also, regarding social cognition and metacognition, individuals with prior SB tended to present extremely low externalizing bias, better ToM, and presence of JTC.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Irene Caro-Cañizares
- Department of Psychology, Universidad a Distancia de Madrid (UDIMA), Collado-Villalba, Spain.
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | | | - Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Cerdanyola del Vallès, Spain; Serra Húnter Programme, Goverment of Catalonia, Barcelona, Spain.
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovirai Virgili, Reus, Spain.
| | | | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Barcelona, Spain; Neuropsiquiatria i Addiccions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | | | | | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Spain; Department of Psychiatry, Hospital General de Villalba, Madrid, Spain; Carlos III Institute of Health, Madrid, Spain; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Nimes University Hospital, Nimes, France.
| | | | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, University Hospital Puerta de Hierro, Majadahonda, Spain.
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Barrigon ML, Porras-Segovia A, Courtet P, Lopez-Castroman J, Berrouiguet S, Pérez-Rodríguez MM, Artes A, Baca-Garcia E. Smartphone-based Ecological Momentary Intervention for secondary prevention of suicidal thoughts and behaviour: protocol for the SmartCrisis V.2.0 randomised clinical trial. BMJ Open 2022; 12:e051807. [PMID: 36127081 PMCID: PMC9490606 DOI: 10.1136/bmjopen-2021-051807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Suicide is one of the leading public health issues worldwide. Mobile health can help us to combat suicide through monitoring and treatment. The SmartCrisis V.2.0 randomised clinical trial aims to evaluate the effectiveness of a smartphone-based Ecological Momentary Intervention to prevent suicidal thoughts and behaviour. METHODS AND ANALYSIS The SmartCrisis V.2.0 study is a randomised clinical trial with two parallel groups, conducted among patients with a history of suicidal behaviour treated at five sites in France and Spain. The intervention group will be monitored using Ecological Momentary Assessment (EMA) and will receive an Ecological Momentary Intervention called 'SmartSafe' in addition to their treatment as usual (TAU). TAU will consist of mental health follow-up of the patient (scheduled appointments with a psychiatrist) in an outpatient Suicide Prevention programme, with predetermined clinical appointments according to the Brief Intervention Contact recommendations (1, 2, 4, 7 and 11 weeks and 4, 6, 9 and 12 months). The control group would receive TAU and be monitored using EMA. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the University Hospital Fundación Jiménez Díaz. It is expected that, in the near future, our mobile health intervention and monitoring system can be implemented in routine clinical practice. Results will be disseminated through peer-reviewed journals and psychiatric congresses. Reference number EC005-21_FJD. Participants gave informed consent to participate in the study before taking part. TRIAL REGISTRATION NUMBER NCT04775160.
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Affiliation(s)
- Maria Luisa Barrigon
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Autonoma de Madrid, Madrid, Spain
| | - Alejandro Porras-Segovia
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France
| | | | | | | | - Antonio Artes
- Departamento de Teoría de Señal, Universidad Carlos III de Madrid, Getafe, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Autonoma de Madrid, Madrid, Spain
- Department of Adult Psychiatry, Nîmes University Hospital, Nimes, France
- Universidad Catolica del Maule, Talca, Chile
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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12
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de Leon-Martinez S, Ruiz M, Parra-Vargas E, Chicchi-Giglioli I, Courtet P, Lopez-Castroman J, Artes A, Baca-Garcia E, Porras-Segovia AA, Barrigon ML. Virtual reality and speech analysis for the assessment of impulsivity and decision-making: protocol for a comparison with neuropsychological tasks and self-administered questionnaires. BMJ Open 2022; 12:e058486. [PMID: 35831051 PMCID: PMC9280903 DOI: 10.1136/bmjopen-2021-058486] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Impulsivity is present in a range of mental disorders and has been associated with suicide. Traditional measures of impulsivity have certain limitations, such as the lack of ecological validity. Virtual reality (VR) may overcome these issues. This study aims to validate the VR assessment tool 'Spheres & Shield Maze Task' and speech analysis by comparing them with traditional measures. We hypothesise that these innovative tools will be reliable and acceptable by patients, potentially improving the simultaneous assessment of impulsivity and decision-making. METHODS AND ANALYSIS This study will be carried out at the University Hospital Fundación Jiménez Díaz (Madrid, Spain). Our sample will consist of adults divided into three groups: psychiatric outpatients with a history of suicidal thoughts and/or behaviours, psychiatric outpatients without such a history and healthy volunteers. The target sample size was established at 300 participants (100 per group). Participants will complete the Barratt Impulsiveness Scale 11; the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency, Impulsive Behaviour Scale; Iowa Gambling Task; Continuous Performance Test; Stop signal Task, and Go/no-go task, three questions of emotional affect, the Spheres & Shield Maze Task and two satisfaction surveys. During these tasks, participant speech will be recorded. Construct validity of the VR environment will be calculated. We will also explore the association between VR-assessed impulsivity and history of suicidal thoughts and/or behaviour, and the association between speech and impulsivity and decision-making. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of the University Hospital Fundación Jiménez Díaz (PIC128-21_FJD). Participants will be required to provide written informed consent. The findings will be presented in a series of manuscripts that will be submitted to peer-reviewed journals for publication. TRIAL REGISTRATION NUMBER NCT05109845; Pre-results.
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Affiliation(s)
| | - Marta Ruiz
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Mostoles, Spain
| | - Elena Parra-Vargas
- Laboratory of Immersive Neurotechnologies (LabLENI), Universidad Politécnica de Valencia, Valencia, Spain
| | - Irene Chicchi-Giglioli
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Getafe, Spain
| | - Philippe Courtet
- Unité de recherche U1061, Institut national de la santé et de la recherche médicale, Paris, France
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Antonio Artes
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, University Hospital Centre Nimes, Nimes, France
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
- Universidad Catolica del Maule, Talca, Chile
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- Department of Psychiatry, General Hospital of Villalba, Villaba, Madrid, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Madrid, Spain
| | - Alejandro Albán Porras-Segovia
- Grupo de Investigación en Psiquiatría Translacional, Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz, Madrid, Spain
- Division of Psychiatry, Imperial College London, London, UK
| | - Maria Luisa Barrigon
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Hernando-Merino E, Baca-Garcia E, Barrigón ML. Comparison of disability between common mental disorders and severe mental disorders using WHODAS 2.0. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:205-210. [PMID: 36216725 DOI: 10.1016/j.rpsmen.2022.09.008] [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] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/25/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility. MATERIAL AND METHODS Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test. RESULTS Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p < 0.001) and participation in society (p = 0.041). CONCLUSIONS In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.
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Affiliation(s)
- Elena Hernando-Merino
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, Spain; Departamento de Psiquiatría, Hospital Clínico San Carlos, Madrid, Spain
| | - Enrique Baca-Garcia
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, Spain; Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma, Madrid, Spain; Departamento de Psiquiatría, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Departamento de Psiquiatría, Hospital General de Villalba, Madrid, Spain; CIBERSAM (Centro de Investigación en Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, France
| | - Maria Luisa Barrigón
- Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma, Madrid, Spain.
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14
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Méndez-Bustos P, Fuster-Villaseca J, Lopez-Castroman J, Jiménez-Solomon O, Olivari C, Baca-Garcia E. Longitudinal trajectories of suicidal ideation and attempts in adolescents with psychiatric disorders in Chile: study protocol. BMJ Open 2022; 12:e051749. [PMID: 35193905 PMCID: PMC8867341 DOI: 10.1136/bmjopen-2021-051749] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Adolescent suicide is a worldwide public health problem, being the second and the third leading cause of death in the 15-29 and the 15-19 age groups, respectively. Among adolescents, it is estimated that for every suicide, there are 100-200 suicide attempts. Although 79% of suicides in the world occur in low/middle-income countries, most of scientific evidence comes from high-income and low-risk countries. In recent years, adolescent suicide rates have steadily increased in Chile. Deaths caused by self-harm increased by 220% in the population aged 10-19 years between 2000 and 2015. The Maule Region is one of the regions of Chile with the highest levels of suicide among those aged 15 and 19 years old. The objective of this study is to evaluate the trajectories of ideation and suicidal attempts in adolescents with psychiatric disorders treated within the public health system of the Maule Region, Chile, based on different clinical, psychological and neuropsychological factors. METHOD A prospective naturalistic study of a clinical sample of adolescents under psychiatric treatment in the Maule Region, Chile. Adolescents will be evaluated using a thorough protocol that includes suicide-related clinical variables. The study seeks to establish patterns of change in the trajectories of ideation and suicide attempts among adolescents. ETHICS AND DISSEMINATION Ethical approval was granted by the Scientific Ethics Committee of the Universidad Católica del Maule in Chile. This protocol was registered in ClinicalTrials.gov. The results of this study will be disseminated to health centres through executive reports and feedback sessions. In addition, the most relevant findings will be presented in scientific articles, conferences and seminars open to the community. TRIAL REGISTRATION NUMBER NCT04635163.
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Affiliation(s)
- Pablo Méndez-Bustos
- Department of Psychology, Universidad Católica del Maule, Talca, Chile
- Faculty of Health Sciences, Universidad Católica del Maule, The Neuropsychology and Cognitive Neurosciences Research Center (CINPSI Neurcog), Talca, Chile
| | | | - Jorge Lopez-Castroman
- Department of Adult Psychiatry, Nîmes University Hospital, Nimes, France
- IGF, CNRS-INSERM, University Montpellier, Montpellier, France
- CIBERSAM, Madrid, Spain
| | - Oscar Jiménez-Solomon
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, USA
- Center on Poverty and Social Policy, School of Social Work, Columbia University, New York, New York, USA
| | - Cecilia Olivari
- Department of Psychology, Universidad Católica del Maule, Talca, Chile
- Faculty of Health Sciences, Universidad Católica del Maule, The Neuropsychology and Cognitive Neurosciences Research Center (CINPSI Neurcog), Talca, Chile
| | - Enrique Baca-Garcia
- Department of Psychology, Universidad Católica del Maule, Talca, Chile
- Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- Psychiatry, Autonomous University of Madrid, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Villalba, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
- Department of psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
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Lejeune A, Le Glaz A, Perron PA, Sebti J, Baca-Garcia E, Walter M, Lemey C, Berrouiguet S. Artificial intelligence and suicide prevention: a systematic review. Eur Psychiatry 2022; 65:1-22. [PMID: 35166203 PMCID: PMC8988272 DOI: 10.1192/j.eurpsy.2022.8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Suicide is one of the main preventable causes of death. Artificial intelligence (AI) could improve methods for assessing suicide risk. The objective of this review is to assess the potential of AI in identifying patients who are at risk of attempting suicide. Methods A systematic review of the literature was conducted on PubMed, EMBASE, and SCOPUS databases, using relevant keywords. Results Thanks to this research, 296 studies were identified. Seventeen studies, published between 2014 and 2020 and matching inclusion criteria, were selected as relevant. Included studies aimed at predicting individual suicide risk or identifying at-risk individuals in a specific population. The AI performance was overall good, although variable across different algorithms and application settings. Conclusions AI appears to have a high potential for identifying patients at risk of suicide. The precise use of these algorithms in clinical situations, as well as the ethical issues it raises, remain to be clarified.
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Affiliation(s)
- Alban Lejeune
- URCI Mental Health Department, Brest Medical University Hospital, Brest, France
| | - Aziliz Le Glaz
- URCI Mental Health Department, Brest Medical University Hospital, Brest, France
| | | | - Johan Sebti
- Mental Health Department, French Polynesia Hospital, FFC3+H9G, Pirae, French Polynesia
| | | | - Michel Walter
- URCI Mental Health Department, Brest Medical University Hospital, Brest, France
- EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Christophe Lemey
- URCI Mental Health Department, Brest Medical University Hospital, Brest, France
- EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France
- SPURBO, IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France
| | - Sofian Berrouiguet
- URCI Mental Health Department, Brest Medical University Hospital, Brest, France
- LaTIM, INSERM, UMR 1101, Brest, France
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16
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Peñuelas-Calvo I, Jiang-Lin LK, Girela-Serrano B, Delgado-Gomez D, Navarro-Jimenez R, Baca-Garcia E, Porras-Segovia A. Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:5-20. [PMID: 32424511 DOI: 10.1007/s00787-020-01557-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and serious disorder among children. Video games have shown potential for aiding in child healthcare. Video games could contribute to the assessment and management of ADHD, but there are no previous reviews on this topic. Here, we systematically review the evidence about video game-based assessment tools and interventions for children diagnosed with ADHD. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in PROSPERO database. We searched four databases-PubMed, PsycInfo, Embase and clinicaltrials.gov-to identify original studies exploring either video game-based interventions or video game-based assessment tools in children with ADHD. After initial screening, full text revision and study selection, 22 articles were finally included in the review. Most studies used PC as platform, with a minority using a video console, pad, or 3D device. Video game-based assessment tools were generally effective in discriminating ADHD cases from controls, and in discriminating between ADHD subtypes. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas and decreasing ADHD symptoms. Gamification and cognitive training could be the main mechanisms underlying the usefulness and effectiveness of video game-based assessment tools and interventions. Software optimization and greater collaboration between developers and healthcare professionals are some of the priorities for future research in this area.
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Affiliation(s)
- Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. .,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Department of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
| | - Lin Ke Jiang-Lin
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Braulio Girela-Serrano
- Mood Instability Research Group, Centre for Psychiatry, Imperial College London, London, UK
| | | | - Rocio Navarro-Jimenez
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.,CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain.,Department of Psychiatry, Universidad Católica del Maule, Talca, Chile
| | - Alejandro Porras-Segovia
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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17
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Salvador Robert M, Porras-Segovia A, Peñuelas-Calvo I, Baca-Garcia E. Physical comorbidity and use of healthcare services in people with schizophrenia: protocol for a systematic review. BMJ Open 2021; 11:e053324. [PMID: 34907063 PMCID: PMC8671972 DOI: 10.1136/bmjopen-2021-053324] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION People with schizophrenia die about 15-20 years earlier than the general population. A constellation of factors contributes to this gap in life expectancy: side effects of psychotropic drugs, unhealthy lifestyles (inactivity, unhealthy diet) and inequality in the provision of healthcare services. This is a topic of main importance, which requires constant update and synthesis of the literature. The aim of this review is to explore the evidence of physical comorbidity and use of healthcare services in people with schizophrenia. METHODS AND ANALYSIS We will conduct a systematic literature search in the databases PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and Cochrane Library, Proquest Health Research Premium Collection, in order to identify studies that answer to our research question: Are patients with schizophrenia different from the non-psychiatric population in terms of physical comorbidity and use of healthcare services? Two authors will independently review the studies and extract the data. ETHICS AND DISSEMINATION This study does not include human or animal subjects. Thus, ethics considerations are not applicable. Dissemination plans include publications in peer-reviewed journals and discussion of results in psychiatric congresses. PROSPERO REGISTRATION NUMBER CRD42020139972.
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Affiliation(s)
| | | | | | - Enrique Baca-Garcia
- Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
- Universidad Catolica del Maule, Talca, Chile
- Department of psychiatry, Centre Hospitalier Universitaire de Nîmes, France, Nîmes, France
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18
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Sastre-Buades A, Alacreu-Crespo A, Courtet P, Baca-Garcia E, Barrigon ML. Decision-making in suicidal behavior: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 131:642-662. [PMID: 34619171 DOI: 10.1016/j.neubiorev.2021.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 01/19/2023]
Abstract
Impaired decision-making (DM) is well-known in suicidal behavior (SB). We aimed to review the evidence on DM and its mediating factors in SB and perform a meta-analysis on DM assessed using the Iowa Gambling Task (IGT). We conducted a search on databases of papers published on DM and SB up to 2020: 46 studies were included in the systematic review, and 18 in the meta-analysis. For meta-analysis, we compared DM performance between suicide attempters (SAs) and patients (PCs) or healthy controls (HCs). The systematic review showed that SAs have greater difficulties in all DM domains. The meta-analysis found worse IGT performance among SAs in comparison with PCs and HCs. A meta-regression did not find differences for age, gender, psychiatric disorder, and clinical status. Our findings indicate that SAs exhibited deficits in DM under conditions of risk though not ambiguity. Worse DM was independent of age, gender, psychiatric disorder, and suggested that DM impairment could be considered a cognitive trait of suicidal vulnerability, a risk factor and an attribute of SAs.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Fundación Jimenez Diaz University Hospital, Madrid, Spain; Department of Neurology, Son Llatzer University Hospital, Palma, Spain.
| | - Adrián Alacreu-Crespo
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, University of Zaragoza, Teruel, Spain.
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.
| | - Enrique Baca-Garcia
- Department of Psychiatry, Fundación Jimenez Diaz University Hospital, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Autonomous University of Madrid, Spain; Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Madrid, Spain; Universidad Católica del Maule, Talca, Chile.
| | - Maria Luisa Barrigon
- Department of Psychiatry, Fundación Jimenez Diaz University Hospital, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Autonomous University of Madrid, Spain; Department of Psychiatry, Virgen del Rocío University Hospital, Sevilla, Spain.
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19
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Ryu J, Sükei E, Norbury A, H Liu S, Campaña-Montes JJ, Baca-Garcia E, Artés A, Perez-Rodriguez MM. Shift in Social Media App Usage During COVID-19 Lockdown and Clinical Anxiety Symptoms: Machine Learning-Based Ecological Momentary Assessment Study. JMIR Ment Health 2021; 8:e30833. [PMID: 34524091 PMCID: PMC8448085 DOI: 10.2196/30833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anxiety symptoms during public health crises are associated with adverse psychiatric outcomes and impaired health decision-making. The interaction between real-time social media use patterns and clinical anxiety during infectious disease outbreaks is underexplored. OBJECTIVE We aimed to evaluate the usage pattern of 2 types of social media apps (communication and social networking) among patients in outpatient psychiatric treatment during the COVID-19 surge and lockdown in Madrid, Spain and their short-term anxiety symptoms (7-item General Anxiety Disorder scale) at clinical follow-up. METHODS The individual-level shifts in median social media usage behavior from February 1 through May 3, 2020 were summarized using repeated measures analysis of variance that accounted for the fixed effects of the lockdown (prelockdown versus postlockdown), group (clinical anxiety group versus nonclinical anxiety group), the interaction of lockdown and group, and random effects of users. A machine learning-based approach that combined a hidden Markov model and logistic regression was applied to predict clinical anxiety (n=44) and nonclinical anxiety (n=51), based on longitudinal time-series data that comprised communication and social networking app usage (in seconds) as well as anxiety-associated clinical survey variables, including the presence of an essential worker in the household, worries about life instability, changes in social interaction frequency during the lockdown, cohabitation status, and health status. RESULTS Individual-level analysis of daily social media usage showed that the increase in communication app usage from prelockdown to lockdown period was significantly smaller in the clinical anxiety group than that in the nonclinical anxiety group (F1,72=3.84, P=.05). The machine learning model achieved a mean accuracy of 62.30% (SD 16%) and area under the receiver operating curve 0.70 (SD 0.19) in 10-fold cross-validation in identifying the clinical anxiety group. CONCLUSIONS Patients who reported severe anxiety symptoms were less active in communication apps after the mandated lockdown and more engaged in social networking apps in the overall period, which suggested that there was a different pattern of digital social behavior for adapting to the crisis. Predictive modeling using digital biomarkers-passive-sensing of shifts in category-based social media app usage during the lockdown-can identify individuals at risk for psychiatric sequelae.
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Affiliation(s)
- Jihan Ryu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Emese Sükei
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
| | - Agnes Norbury
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Shelley H Liu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Enrique Baca-Garcia
- Evidence Based Behavior, Madrid, Spain.,Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
| | - Antonio Artés
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain.,Evidence Based Behavior, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain
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20
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Hernando-Merino E, Baca-Garcia E, Barrigón ML. Comparison of disability between common mental disorders and severe mental disorders using WHODAS 2.0. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 15:S1888-9891(21)00099-9. [PMID: 34534707 DOI: 10.1016/j.rpsm.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility. MATERIAL AND METHODS Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test. RESULTS Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p<0.001) and participation in society (p=0.041). CONCLUSIONS In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.
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Affiliation(s)
- Elena Hernando-Merino
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, España; Departamento de Psiquiatría, Hospital Clínico San Carlos, Madrid, España
| | - Enrique Baca-Garcia
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, España; Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, España; Departamento de Psiquiatría, Universidad Autónoma, Madrid, España; Departamento de Psiquiatría, Hospital Universitario Rey Juan Carlos, Móstoles, España; Departamento de Psiquiatría, Hospital General de Villalba, Madrid, España; CIBERSAM (Centro de Investigación en Salud Mental), Instituto de Salud Carlos III, Madrid, España; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Francia
| | - Maria Luisa Barrigón
- Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, España; Departamento de Psiquiatría, Universidad Autónoma, Madrid, España.
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21
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Ovejero S, Barrigon ML, Guadalajara H, Pérez-Santos E, Baca-Garcia E. COVID-19 and the education of health professionals in mental health: Challenges in practical teaching. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:119-121. [PMID: 34099437 PMCID: PMC8141724 DOI: 10.1016/j.rpsmen.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Santiago Ovejero
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; School of Psychology, University Complutense of Madrid, Madrid, Spain
| | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
| | - Héctor Guadalajara
- Department of General and Digestive Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | | | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, France; Universidad Católica del Maule, Talca, Chile; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain.
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22
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Lopez-Morinigo JD, Luisa BEM, Porras-Segovia A, Martínez ASE, Escobedo-Aedo PJ, Ruiz-Ruano VG, Mata-Iturralde L, Muñoz-Lorenzo L, Sánchez-Alonso S, Artés-Rodríguez A, Baca-Garcia E. Pending challenges to e-mental health in the COVID-19 era: Acceptability of a smartphone-based ecological momentary assessment application among patients with schizophrenia spectrum disorders. Eur Psychiatry 2021. [PMCID: PMC9470873 DOI: 10.1192/j.eurpsy.2021.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Concerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic. Objectives To investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this. Methods Sample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model. Results Sample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).Multivariable binary logistic regression model on ‘user’ as outcome | | β | SE | Wald | p | OR | 95% CI | Age | -0.075 | 0.038 | 3.910 | 0.048 | 0.928 | 0.861-0.999 | Education level | -0.967 | 1.289 | 0.563 | 0.453 | 0.380 | 0.030-4.755 | Early adolescence premorbid adjustment | -0.285 | 0.110 | 6.695 | 0.010 | 0.752 | 0.606-0.933 | Trail Making Test A | -0.030 | 0.025 | 1.488 | 0.222 | 0.970 | 0.924-1.018 | Trail Making Test B | -0.005 | 0.010 | 0.278 | 0.598 | 0.995 | 0.976-1.014 | Cognitive Insight | 0.062 | 0.061 | 1.043 | 0.307 | 1.064 | 0.944-1.200 |
![]() X2=25.296,df=6,p<0.001. Nagelkerke-R2=44.7%. Correctly classified: 76.9%, users:54.5%, non-users:88.4%. Conclusions Acceptability of a smartphone-based EMA application among SSD patients was low. Age (young) and good premorbid adjustment predicted acceptability. e-Mental Health methods need to be tailored for patients with SSD. Otherwise, these highly vulnerable individuals may be neglected by e-health-based services in the post-COVID-19 years ahead.
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Ovejero S, Barrigon ML, Guadalajara H, Pérez-Santos E, Baca-Garcia E. [COVID-19 and the education of health professionals in mental health: challenges in practical teaching]. Rev Psiquiatr Salud Ment 2021; 14:119-121. [PMID: 33434681 PMCID: PMC7796669 DOI: 10.1016/j.rpsm.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/29/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Santiago Ovejero
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, España.,School of Psychology, University Complutense of Madrid, Madrid, España
| | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, España.,Department of Psychiatry, Madrid Autonomous University, Madrid, España
| | - Héctor Guadalajara
- Department of General and Digestive Surgery, Fundación Jiménez Díaz University Hospital, Madrid, España
| | | | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, España.,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, España.,Department of Psychiatry, General Hospital of Villalba, Madrid, España.,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, España.,Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Francia.,Universidad Católica del Maule, Talca, Chile.,Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, España
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24
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Carli V, Hadlaczky G, Petros NG, Iosue M, Zeppegno P, Gramaglia C, Amore M, Baca-Garcia E, Batra A, Cosman D, Courtet P, Di Sciascio G, Ekstrand J, Galfalvy H, Gusmão R, Jesus C, Heitor MJ, Constante M, Rad PM, Saiz PA, Wojnar M, Sarchiapone M. A Naturalistic, European Multi-Center Clinical Study of Electrodermal Reactivity and Suicide Risk Among Patients With Depression. Front Psychiatry 2021; 12:765128. [PMID: 35069276 PMCID: PMC8766803 DOI: 10.3389/fpsyt.2021.765128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/26/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Electrodermal hyporeactivity has been proposed as a marker of suicidal risk. The EUDOR-A study investigated the prevalence of electrodermal hyporeactivity among patients with depression and its association with attempted and completed suicide. Methods: Between August 2014 and March 2016, 1,573 in- and outpatients with a primary diagnosis of depression (active or remission phase) were recruited at 15 European psychiatric centers. Each patient was followed-up for 1 year. Electrodermal activity was assessed at baseline with the ElectroDermal Orienting Reactivity Test. Data on the sociodemographic characteristics, clinical diagnoses, and treatment of the subjects were also collected. The severity of the depressive symptoms was assessed through the Montgomery-Asberg Depression Rating Scale. Information regarding number, time, and method of suicide attempts was gathered at baseline and at the end of the 1-year follow-up. The same data were collected in case of completed suicide. Results: Hyporeactive patients were shown to be significantly more at risk of suicide attempt compared to reactive patients, both at baseline and follow-up. A sensitivity of 29.86% and a positive predictive value (PPV) of 46.77% were found for attempted suicide at baseline, while a sensitivity of 35.36% and a PPV of 8.92% were found for attempted suicide at follow-up. The sensitivity and PPV for completed suicide were 25.00 and 0.61%, respectively. However, when controlled for suicide attempt at baseline, the association between hyporeactivity and follow-up suicide attempt was no longer significant. The low number of completed suicides did not allow any analysis.
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Affiliation(s)
- Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Gergo Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Nuhamin Gebrewold Petros
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Miriam Iosue
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Patrizia Zeppegno
- Department of Translational Medicine, Azienda Ospedaliero Universitaria Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Azienda Ospedaliero Universitaria Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Mario Amore
- Clinica Psichiatrica, DINOGMI, University of Genoa, Genoa, Italy
| | - Enrique Baca-Garcia
- Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Doina Cosman
- Clinical Psychology and Mental Health Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, University Hospital of Montpellier, Montpellier, France
| | | | - Joakim Ekstrand
- Department of Psychiatry, Institute of Clinical Sciences, Lund University, Lund, Sweden
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States
| | - Ricardo Gusmão
- Department of Psychiatry, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental (CHLO), Lisbon, Portugal.,Instituto de Saúde Pública, Universidade Do Porto (ISPUP), Porto, Portugal
| | - Catarina Jesus
- Department of Psychiatry, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental (CHLO), Lisbon, Portugal
| | | | - Miguel Constante
- Psychiatry Service, Hospital Beatriz Ângelo (HBA), Loures, Portugal
| | - Pouya Movahed Rad
- Department of Psychiatry, Institute of Clinical Sciences, Lund University, Lund, Sweden
| | - Pilar A Saiz
- Department of Psychiatry, Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Mental Health Services of Principado de Asturias (SESPA), University of Oviedo, Oviedo, Spain
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Marco Sarchiapone
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
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Postolache TT, Wadhawan A, Rujescu D, Hoisington AJ, Dagdag A, Baca-Garcia E, Lowry CA, Okusaga OO, Brenner LA. Toxoplasma gondii, Suicidal Behavior, and Intermediate Phenotypes for Suicidal Behavior. Front Psychiatry 2021; 12:665682. [PMID: 34177652 PMCID: PMC8226025 DOI: 10.3389/fpsyt.2021.665682] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/08/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022] Open
Abstract
Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii (T. gondii) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our publication of associations between T. gondii IgG serology and suicidal behavior in persons with mood disorders. This "legacy" article presents, chronologically, our primary studies in individuals with mood disorders and schizophrenia in Germany, recent attempters in Sweden, and in a large cohort of mothers in Denmark. Then, it reviews findings from all three meta-analyses published to date, confirming our reported associations and overall consistent in effect size [ranging between 39 and 57% elevation of odds of suicide attempt in T. gondii immunoglobulin (IgG) positives]. Finally, the article introduces certain links between T. gondii and biomarkers previously associated with suicidal behavior (kynurenines, phenylalanine/tyrosine), intermediate phenotypes of suicidal behavior (impulsivity, aggression) and state-dependent suicide risk factors (hopelessness/dysphoria, sleep impairment). In sum, an abundance of evidence supports a positive link between suicide attempts (but not suicidal ideation) and T. gondii IgG (but not IgM) seropositivity and serointensity. Trait impulsivity and aggression, endophenotypes of suicidal behavior have also been positively associated with T. gondii seropositivity in both the psychiatrically healthy as well as in patients with Intermittent Explosive Disorder. Yet, causality has not been demonstrated. Thus, randomized interventional studies are necessary to advance causal inferences and, if causality is confirmed, to provide hope that an etiological treatment for a distinct subgroup of individuals at an increased risk for suicide could emerge.
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Affiliation(s)
- Teodor T Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD, United States
| | - Abhishek Wadhawan
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Saint Elizabeth's Hospital, Washington, DC, United States
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle, Halle, Germany
| | - Andrew J Hoisington
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Systems Engineering and Management, Air Force Institute of Technology, Dayton, OH, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aline Dagdag
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain.,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain.,Universidad Catolica del Maule, Talca, Chile.,Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Olaoluwa O Okusaga
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,Michael E DeBakey VA Medical Center, Houston, TX, United States
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Psychiatry & Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Montoro M, Arrua-Duarte E, Peñalver-Argüeso B, Migoya-Borja M, Baca-Garcia E, Barrigón ML. Comparative study of paper-and-pencil and electronic formats of the Snaith-Hamilton Pleasure Scale. J Health Psychol 2020; 27:557-567. [PMID: 33040577 DOI: 10.1177/1359105320963552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The gold standard for measuring anhedonia is the Snaith-Hamilton Pleasure Scale (SHAPS). To date, there are no validated electronic versions of this questionnaire. We aim to study the equivalence between the traditional paper-and-pencil format and a digital version of the SHAPS. A group of 67 patients completed both SHAPS formats, and differences between formats were assessed. McNemar's test showed no significant differences between the two systems. The Kappa coefficient was over 40% for most items, and reliability was above 0.8, showing good to excellent levels of internal consistency. Thus, we have demonstrated a close equivalence between paper-and-pencil and electronic SHAPS.
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Affiliation(s)
| | - Elsa Arrua-Duarte
- Autónoma University, Madrid, Spain.,Mentalia Salud-Arévalo (Ávila), Spain
| | - Belén Peñalver-Argüeso
- Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad - Instituto de Salud Carlos III, Madrid, Spain
| | | | - Enrique Baca-Garcia
- Autónoma University, Madrid, Spain.,University Hospital Jimenez Diaz Foundation, Madrid, Spain.,Rey Juan Carlos University Hospital, Móstoles, Spain.,General Hospital of Villalba, Madrid, Spain.,Infanta Elena University Hospital, Valdemoro, Spain.,Universidad Católica del Maule, Talca, Chile.,Department of Adult Psychiatry, Centre Hospitalier Universitaire de Nîmes, France
| | - Maria Luisa Barrigón
- Autónoma University, Madrid, Spain.,University Hospital Jimenez Diaz Foundation, Madrid, Spain
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27
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Martínez Nicolás I, Lê Cook B, Flores M, Del Olmo Rodriguez M, Hernández Rodríguez C, Llamas Sillero P, Baca-Garcia E. The impact of a comprehensive electronic patient portal on the health service use: an interrupted time-series analysis. Eur J Public Health 2020; 29:413-418. [PMID: 30544169 DOI: 10.1093/eurpub/cky257] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is little empirical research on the potential benefit that electronic patient portals (EPP) can have on the care quality and health outcomes of diverse multi-ethnic international populations. The purpose of this study is to determine the extent to which an EPP was associated with improvements in health service use. METHODS Using a quasi-experimental interrupted time-series approach, we assessed health service use before (April 2012-September 2015) and after (October 2015-December 2016) the implementation of a comprehensive EPP at four hospitals in Madrid, Spain. Primary outcomes were number of outpatient visits, any hospital admission, any 30-day all-cause readmission and any emergency department visit. RESULTS Implementation of the EPP was associated with a significant decline in readmissions. Among patients with chronic heart failure, EPP implementation was associated with a significant decline for all outcome measures, and among patients with COPD, a decline in all outcomes except readmissions. Among patients diagnosed with malignant hematological diseases, no significant changes were identified. CONCLUSIONS EPPs hold promise for reducing hospital readmissions. Certain patient populations with chronic conditions may differentially benefit from portal use depending on their needs for communication with their providers.
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Affiliation(s)
| | - Benjamin Lê Cook
- Health Equity Research Laboratory, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA
| | - Michael Flores
- Health Equity Research Laboratory, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA
| | | | - Corazón Hernández Rodríguez
- Obstetrics and Gynecology Service, Institute of Assisted Reproduction, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Llamas Sillero
- Hematology Department, Oncohealth Institute, IIS-Jimenez Diaz Foundation, University Hospital Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Psychiatry Department, Autonoma University, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.,CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, Madrid, Spain.,Universidad Católica del Maule, Talca, Chile
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Sanchez-Alonso S, Ovejero S, Barrigon ML, Baca-Garcia E. Psychotic relapse from COVID-19 quarantine, a case report. Psychiatry Res 2020; 290:113114. [PMID: 32516677 PMCID: PMC7242195 DOI: 10.1016/j.psychres.2020.113114] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/17/2020] [Accepted: 05/17/2020] [Indexed: 12/02/2022]
Abstract
• The coronavirus disease 2019 (COVID-19), first reported on December 31st, 2019 in China, has currently spread worldwide and became pandemic on March 11th. • Besides causing an emotional impact in people affected, COVID-19 pandemic could specially affect people with previous mental health conditions, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population. • Worldwide, in different countries, among them Spain, it has been necessary to adopt confinement measures to preserve public health. These measures might represent to an extra stressful situation, particularly in vulnerable patients, such as those suffering from psychotic disorders. • This case report highlights the importance to developing specific support programs for this vulnerable population in an unprecedented situation such us the COVID-19 crisis. The role of telemedicine it has been suggested for that purpose.
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Affiliation(s)
| | - Santiago Ovejero
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain,Universidad Católica del Maule, Talca, Chile,Department of Psychiatry. Centre Hospitalier Universitaire de Nîmes, Spain
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29
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Arenas-Castañeda PE, Aroca Bisquert F, Martinez-Nicolas I, Castillo Espíndola LA, Barahona I, Maya-Hernández C, Lavana Hernández MM, Manrique Mirón PC, Alvarado Barrera DG, Treviño Aguilar E, Barrios Núñez A, De Jesus Carlos G, Vildosola Garcés A, Flores Mercado J, Barrigon ML, Artes A, de Leon S, Molina-Pizarro CA, Rosado Franco A, Perez-Rodriguez M, Courtet P, Martínez-Alés G, Baca-Garcia E. Universal mental health screening with a focus on suicidal behaviour using smartphones in a Mexican rural community: protocol for the SMART-SCREEN population-based survey. BMJ Open 2020; 10:e035041. [PMID: 32690505 PMCID: PMC7371217 DOI: 10.1136/bmjopen-2019-035041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Mental disorders represent the second cause of years lived with disability worldwide. Suicide mortality has been targeted as a key public health concern by the WHO. Smartphone technology provides a huge potential to develop massive and fast surveys. Given the vast cultural diversity of Mexico and its abrupt orography, smartphone-based resources are invaluable in order to adequately manage resources, services and preventive measures in the population. The objective of this study is to conduct a universal suicide risk screening in a rural area of Mexico, measuring also other mental health outcomes such as depression, anxiety and alcohol and substance use disorders. METHODS AND ANALYSIS A population-based cross-sectional study with a temporary sampling space of 9 months will be performed between September 2019 and June 2020. We expect to recruit a large percentage of the target population (at least 70%) in a short-term survey of Milpa Alta Delegation, which accounts for 137 927 inhabitants in a territorial extension of 288 km2.They will be recruited via an institutional call and a massive public campaign to fill in an online questionnaire through mobile-assisted or computer-assisted web app. This questionnaire will include data on general health, validated questionnaires including Well-being Index 5, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale 2, Alcohol Use Disorders Identification Test, selected questions of the Drug Abuse Screening Test and Columbia-Suicide Severity Rating Scales and Diagnostic and statistical manual of mental disorders (DSM-5) questions about self-harm.We will take into account information regarding time to mobile app response and geo-spatial location, and aggregated data on social, demographical and environmental variables. Traditional regression modelling, multilevel mixed methods and data-driven machine learning approaches will be used to test hypotheses regarding suicide risk factors at the individual and the population level. ETHICS AND DISSEMINATION Ethical approval (002/2019) was granted by the Ethics Review Board of the Hospital Psiquiátrico Yucatán, Yucatán (Mexico). This protocol has been registered in ClinicalTrials.gov. The starting date of the study is 3 September 2019. Results will serve for the planning and healthcare of groups with greater mental health needs and will be disseminated via publications in peer-reviewed journal and presented at relevant mental health conferences. TRIAL REGISTRATION NUMBER NCT04067063.
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Affiliation(s)
- Pavel E Arenas-Castañeda
- Secretaría de Salud de la Ciudad de México, Jurisdicción Sanitaria Milpa Alta, Milpa Alta, Mexico
| | - Fuensanta Aroca Bisquert
- Instituto de Matemáticas. Unidad de Cuernavaca. Universidad Nacional Autónoma de México, Cuernavaca, Mexico
- CNRS-UMI 4584 - LaSoL Laboratorio Internacional Solomon Lefschetz, Ciudad de Mexico, Mexico
| | | | | | - Igor Barahona
- Cátedra-Conacyt, Instituto de Matemáticas, Unidad de Cuernavaca, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - Cynthya Maya-Hernández
- Center for Evaluation and Surveys Research, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | | | - Paulo César Manrique Mirón
- Cátedra-Conacyt, Instituto de Matemáticas, Unidad de Cuernavaca, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | | | - Erik Treviño Aguilar
- Instituto de Matemáticas. Unidad de Cuernavaca. Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | | | - Giovanna De Jesus Carlos
- Instituto de Matemáticas. Unidad de Cuernavaca. Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | | | | | - Maria Luisa Barrigon
- Psychiatry, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
| | - Antonio Artes
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Madrid, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain
| | - Santiago de Leon
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Madrid, Spain
| | | | | | | | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, University of Montpellier, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Enrique Baca-Garcia
- Psychiatry, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- Universidad Catolica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Department of psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
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30
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Arrojo M, Baca-Garcia E, Perez-Rodriguez MM, Dolengevich-Segal H, Navio-Acosta M, Rodriguez-Salgado B, Saiz-Ruiz J. Platelet monoamine oxidase activity in obsessive-compulsive disorder. Eur Psychiatry 2020; 22:525-9. [PMID: 17761404 DOI: 10.1016/j.eurpsy.2007.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 06/28/2007] [Accepted: 06/30/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractResponse to SSRIs suggests the implication of the serotonergic system in obsessive-compulsive disorder (OCD). However, biological studies on serotonergic function in OCD have yielded contradictory results. Platelet monoamine oxidase (MAO) activity has been proposed as an index of cerebral serotonin activity.The aim of this study was to examine platelet MAO activity in 29 OCD patients and 29 healthy controls matched by age, sex and tobacco use. We also explored the relationship between platelet MAO activity and aggressive obsessions in OCD patients.There were no differences in platelet MAO activity between OCD patients and healthy controls. We found a significant correlation between platelet MAO activity and Y-BOCS scores in the group of patients with Y-BOCS scores >15.OCD patients with aggressive obsessions had significantly lower levels of platelet MAO activity than patients without aggressive obsessions.Our results suggest that platelet MAO activity may be a marker of OCD severity, and that low platelet MAO activity may be associated with aggressive obsessions in OCD patients.
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Affiliation(s)
- Manuel Arrojo
- Department of Psychiatry, Ramon y Cajal Hospital, Carretera de Colmenar Viejo km 9.1, 28034 Madrid, Spain.
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31
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Bonilla-Escribano P, Ramirez D, Sedano-Capdevila A, Campana-Montes JJ, Baca-Garcia E, Courtet P, Artes-Rodriguez A. Assessment of e-Social Activity in Psychiatric Patients. IEEE J Biomed Health Inform 2019; 23:2247-2256. [PMID: 31135374 DOI: 10.1109/jbhi.2019.2918687] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper introduces a novel method to assess the social activity maintained by psychiatric patients using information and communication technologies. In particular, we model the daily usage patterns of phone calls and social and communication apps using point processes. We propose a novel nonhomogeneous Poisson process model with periodic (circadian) intensity function using a truncated Fourier series expansion, which is inferred using a trust-region algorithm. We also extend the model using a mixture of periodic intensity functions to cope with the different daily patterns of a person. The analysis of the usage of phone calls and social and communication apps of a cohort of 259 patients reveals common patterns shared among patients with relatively high homogeneity and differences among patient pathologies.
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32
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Peis I, Olmos PM, Vera-Varela C, Barrigon ML, Courtet P, Baca-Garcia E, Artes-Rodriguez A. Deep Sequential Models for Suicidal Ideation From Multiple Source Data. IEEE J Biomed Health Inform 2019; 23:2286-2293. [PMID: 31144649 DOI: 10.1109/jbhi.2019.2919270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents a novel method for predicting suicidal ideation from electronic health records (EHR) and ecological momentary assessment (EMA) data using deep sequential models. Both EHR longitudinal data and EMA question forms are defined by asynchronous, variable length, randomly sampled data sequences. In our method, we model each of them with a recurrent neural network, and both sequences are aligned by concatenating the hidden state of each of them using temporal marks. Furthermore, we incorporate attention schemes to improve performance in long sequences and time-independent pre-trained schemes to cope with very short sequences. Using a database of 1023 patients, our experimental results show that the addition of EMA records boosts the system recall to predict the suicidal ideation diagnosis from 48.13% obtained exclusively from EHR-based state-of-the-art methods to 67.78%. Additionally, our method provides interpretability through the t-distributed stochastic neighbor embedding (t-SNE) representation of the latent space. Furthermore, the most relevant input features are identified and interpreted medically.
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33
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Lopez-Castroman J, Moulahi B, Azé J, Bringay S, Deninotti J, Guillaume S, Baca-Garcia E. Mining social networks to improve suicide prevention: A scoping review. J Neurosci Res 2019; 98:616-625. [PMID: 30809836 DOI: 10.1002/jnr.24404] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 12/03/2018] [Accepted: 02/07/2019] [Indexed: 12/18/2022]
Abstract
Attention about the risks of online social networks (SNs) has been called upon reports describing their use to express emotional distress and suicidal ideation or plans. On the Internet, cyberbullying, suicide pacts, Internet addiction, and "extreme" communities seem to increase suicidal behavior (SB). In this study, the scientific literature about SBs and SNs was narratively reviewed. Some authors focus on detecting at-risk populations through data mining, identification of risks factors, and web activity patterns. Others describe prevention practices on the Internet, such as websites, screening, and applications. Targeted interventions through SNs are also contemplated when suicidal ideation is present. Multiple predictive models should be defined, implemented, tested, and combined in order to deal with the risk of SB through an effective decision support system. This endeavor might require a reorganization of care for SNs users presenting suicidal ideation.
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Affiliation(s)
- Jorge Lopez-Castroman
- INSERM U888, La Colombière Hospital, Montpellier, France.,Department of Adult Psychiatry, CHRU Nimes, Nimes, France.,Departments of Psychiatry, Media and Internet, and Telecommunication and Networks, University of Montpellier UM, Montpellier, France
| | - Bilel Moulahi
- Departments of Psychiatry, Media and Internet, and Telecommunication and Networks, University of Montpellier UM, Montpellier, France.,LIRMM UMR 5506, Montpellier, France
| | - Jérôme Azé
- Departments of Psychiatry, Media and Internet, and Telecommunication and Networks, University of Montpellier UM, Montpellier, France.,LIRMM UMR 5506, Montpellier, France
| | - Sandra Bringay
- Departments of Psychiatry, Media and Internet, and Telecommunication and Networks, University of Montpellier UM, Montpellier, France.,LIRMM UMR 5506, Montpellier, France.,Department of Applied Mathematics and Informatics, Paul-Valery University, Montpellier, France
| | | | - Sebastien Guillaume
- INSERM U888, La Colombière Hospital, Montpellier, France.,Departments of Psychiatry, Media and Internet, and Telecommunication and Networks, University of Montpellier UM, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, Montpellier University Hospital, Montpellier, France
| | - Enrique Baca-Garcia
- Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.,CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, Madrid, Spain.,Universidad Catolica del Maule, Talca, Chile
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Velupillai S, Hadlaczky G, Baca-Garcia E, Gorrell GM, Werbeloff N, Nguyen D, Patel R, Leightley D, Downs J, Hotopf M, Dutta R. Risk Assessment Tools and Data-Driven Approaches for Predicting and Preventing Suicidal Behavior. Front Psychiatry 2019; 10:36. [PMID: 30814958 PMCID: PMC6381841 DOI: 10.3389/fpsyt.2019.00036] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 06/29/2018] [Accepted: 01/21/2019] [Indexed: 12/14/2022] Open
Abstract
Risk assessment of suicidal behavior is a time-consuming but notoriously inaccurate activity for mental health services globally. In the last 50 years a large number of tools have been designed for suicide risk assessment, and tested in a wide variety of populations, but studies show that these tools suffer from low positive predictive values. More recently, advances in research fields such as machine learning and natural language processing applied on large datasets have shown promising results for health care, and may enable an important shift in advancing precision medicine. In this conceptual review, we discuss established risk assessment tools and examples of novel data-driven approaches that have been used for identification of suicidal behavior and risk. We provide a perspective on the strengths and weaknesses of these applications to mental health-related data, and suggest research directions to enable improvement in clinical practice.
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Affiliation(s)
- Sumithra Velupillai
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Gergö Hadlaczky
- National Center for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,National Center for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services (SLSO), Stockholm, Sweden
| | - Enrique Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, Autonoma University, Madrid, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,CIBERSAM, Carlos III Institute of Health, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.,Department of Psychiatry, Universidad Católica del Maule, Talca, Chile
| | - Genevieve M Gorrell
- Department of Computer Science, University of Sheffield, Sheffield, United Kingdom
| | - Nomi Werbeloff
- Division of Psychiatry, University College London, London, United Kingdom
| | - Dong Nguyen
- Alan Turing Institute, London, United Kingdom.,School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Rashmi Patel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Daniel Leightley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Johnny Downs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Rina Dutta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
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35
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Calati R, Fang F, Mostofsky E, Shen Q, Di Mattei VE, Garcia-Foncillas J, Baca-Garcia E, Cipriani A, Courtet P. Cancer and suicidal ideation and behaviours: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e020463. [PMID: 30099389 PMCID: PMC6089268 DOI: 10.1136/bmjopen-2017-020463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Prevalence of suicidal ideation (SI) and behaviours are higher among patients with cancer than general population. No systematic review/meta-analysis investigated this topic; therefore, our aim will be to assess the relationship between cancer and SI and behaviours. METHODS We will search PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO and Cochrane Library databases from their inception until 30 June 2018. Case-control and cohort studies focused on the association between cancer (any type) and suicidal outcomes (suicide, suicide attempt and SI) will be included. Two team members will independently: (A) perform the selection of the included studies and data extraction, with the supervision of a third member in case of discrepancies and (B) assess each study with: (1) Newcastle-Ottawa Scale (NOS); (2) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement; (3) Grading of Recommendations Assessment, Development and Evaluation (GRADE). We will conduct a random-effects meta-analysis. Individual and pooled ORs and associated 95% CIs will be calculated as well as between-study heterogeneity. We will examine the potential for publication bias. If possible, we will explore reasons for potential between-study heterogeneity. ETHICS AND DISSEMINATION This study does not require ethical approval. The study will be submitted to a peer-reviewed journal, will be publicly disseminated and will be the topic of research presentations. PROSPERO REGISTRATION NUMBER CRD42017072482.
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Affiliation(s)
- Raffaella Calati
- Department of Psychiatric Emergency & Post-Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
- Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, UK
| | - Qing Shen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Valentina Elisabetta Di Mattei
- Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Jesus Garcia-Foncillas
- OncoHealth Institute, Department of Oncology, Translational Oncology Division, Health Research Institute University Hospital "Fundacion Jimenez Diaz", Autonomous University of Madrid, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, CIBERSAM, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
| | | | - Philippe Courtet
- Department of Psychiatric Emergency & Post-Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
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Caro-Canizares I, de Neira MD, Buratti AF, Segura-Frontelo A, Baca-Garcia E, Carballo JJ. Stability and Persistence of the Dysregulation Profile in a Followup Study in a Clinical Sample of Children and Adolescents. APS 2018. [DOI: 10.2174/2210676608666180209124408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | | | | | | | - Juan J Carballo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain
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37
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Delgado-Gomez D, Baca-Garcia E, Aguado D, Courtet P, Lopez-Castroman J. Computerized adaptive tests: A decision tree approach. Reply to "Einstein, measurement, and prediction" by Gibbons et al. J Affect Disord 2017; 212:46-47. [PMID: 28142082 DOI: 10.1016/j.jad.2017.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 01/23/2017] [Indexed: 11/19/2022]
Affiliation(s)
- D Delgado-Gomez
- Department of Statistics, Carlos III University, Madrid, Spain
| | - E Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, CIBERSAM, Madrid, Spain; Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York
| | - D Aguado
- Instituto Ingeniería del Conocimiento, Autonoma University of Madrid, Madrid, Spain
| | - P Courtet
- CHRU Montpellier and University of Montpellier, France; INSERM Unit 1061, Montpellier, France
| | - J Lopez-Castroman
- INSERM Unit 1061, Montpellier, France; CHU Nimes and University of Montpellier, France
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Sarchiapone M, Iosue M, Carli V, Amore M, Baca-Garcia E, Batra A, Cosman D, Courtet P, Di Sciascio G, Gusmao R, Parnowski T, Pestality P, Saiz P, Thome J, Tingström A, Wojnar M, Zeppegno P, Thorell LH. EUDOR-A multi-centre research program: A naturalistic, European Multi-centre Clinical study of EDOR Test in adult patients with primary depression. BMC Psychiatry 2017; 17:108. [PMID: 28330446 PMCID: PMC5363034 DOI: 10.1186/s12888-017-1246-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 09/02/2016] [Accepted: 02/24/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Electrodermal reactivity has been successfully used as indicator of interest, curiosity as well as depressive states. The measured reactivity depends on the quantity of sweat secreted by those eccrine sweat glands that are located in the hypodermis of palmar and plantar regions. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high specificity for suicide. The aims of the present study are to test the effectiveness and the usefulness of the EDOR (ElectroDermal Orienting Reactivity) Test as a support in the suicide risk assessment of depressed patients and to assess the predictive value of electrodermal hyporeactivity, measured through the EDOR Test, for suicide and suicide attempt in adult patients with a primary diagnosis of depression. METHODS AND DESIGN 1573 patients with a primary diagnosis of depression, whether currently depressed or in remission, have been recruited at 15 centres in 9 different European countries. Depressive symptomatology was evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts were registered and the suicide intent of the worst attempt was rated according to the first eight items of the Beck Suicide Intent Scale. The suicide risk was also assessed according to rules and traditions at the centre. The EDOR Test was finally performed. During the EDOR Test, two fingers are put on gold electrodes and direct current of 0.5 V is passed through the epidermis of the fingers according to standards. A moderately strong tone is presented through headphones now and then during the test. The electrodermal responses to the stimuli represent an increase in the conductance due to the increased number of filled sweat ducts that act as conductors through the electrically highly resistant epidermis. Each patient is followed up for one year in order to assess the occurrence of intentional self-harm. DISCUSSION Based on previous studies, expected results would be that patients realizing a suicide attempt with a strong intent or committing suicide should be electrodermally hyporeactive in most cases and non-hyporeactive patients should show only few indications of death intent or suicides. TRIAL REGISTRATION The German Clinical Trials Register, DRKS00010082 . Registered May 31st, 2016. Retrospectively registered.
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Affiliation(s)
- Marco Sarchiapone
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. .,National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy.
| | - Miriam Iosue
- 0000000122055422grid.10373.36Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institutet, Solna, Sweden
| | - Mario Amore
- 0000 0001 2151 3065grid.5606.5Clinica Psichiatrica, DINOGMI, University of Genoa, Genoa, Italy
| | - Enrique Baca-Garcia
- 0000000119578126grid.5515.4Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Anil Batra
- 0000 0001 0196 8249grid.411544.1Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Doina Cosman
- 0000 0004 0571 5814grid.411040.0Clinical Psychology and Mental Health Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Philippe Courtet
- 0000 0000 9961 060Xgrid.157868.5Department of psychiatry and medical psychology, University Hospital of Montpellier, Montpellier, France
| | - Guido Di Sciascio
- 0000 0001 0120 3326grid.7644.1Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Ricardo Gusmao
- 0000 0001 1009 677Xgrid.414462.1Centro Hospitalar de LisboaOcidental (CHLO), Lisbon, Portugal
| | - Tadeusz Parnowski
- 0000 0001 2237 2890grid.418955.42nd Psychiatric Department, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Peter Pestality
- National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Pilar Saiz
- 0000 0001 2164 6351grid.10863.3cDepartment of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Johannes Thome
- 0000000121858338grid.10493.3fKlinikfür Psychiatrie und Psychotherapie der Universität Rostock, Rostock, Germany
| | - Anders Tingström
- 0000 0001 0930 2361grid.4514.4Psychiatric Neuromodulation Unit, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden ,0000 0004 0623 9987grid.412650.4Psychiatric Neuromodulation Unit (PNU), Department of Clinical Neuroscienses, Malmö University Hospital, Malmö, Sweden
| | - Marcin Wojnar
- 0000000113287408grid.13339.3bDepartment of Psychiatry, First Faculty of Medicine, Warsaw Medical University, Warsaw, Poland
| | - Patrizia Zeppegno
- 0000000121663741grid.16563.37Department of Translational Medicine, Azienda Ospedaliero Universitaria Maggiore della Carità, University of Piemonte Orientale “Amedeo Avogadro”, Novara, Italy
| | - Lars-Håkan Thorell
- EMOTRA AB, Sävedalen, Sweden ,0000 0001 2162 9922grid.5640.7Linköping University, Linköping, Sweden
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Coleman D, Lawrence R, Parekh A, Galfalvy H, Blasco-Fontecilla H, Brent DA, Mann JJ, Baca-Garcia E, Oquendo MA. Narcissistic Personality Disorder and suicidal behavior in mood disorders. J Psychiatr Res 2017; 85:24-28. [PMID: 27816770 PMCID: PMC5191918 DOI: 10.1016/j.jpsychires.2016.10.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
The relationship of Narcissistic Personality Disorder (NPD) to suicidal behavior is understudied. The modest body of existing research suggests that NPD is protective against low-lethality suicide attempts, but is associated with high lethality attempts. Mood-disordered patients (N = 657) received structured interviews including Axis I and II diagnosis and standardized clinical measures. Following chi-square and t-tests, a logistical regression model was constructed to identify predictors of suicide attempt. While there was no bivariate relationship of NPD on suicide attempt, in the logistic regression patients with NPD were 2.4 times less likely to make a suicide attempt (OR = 0.41; 95% CI = 0.19 - 0.88; p < 0.05), compared with non-NPD patients and controlling for possible confounding variables. NPD was not associated with attempt lethality. NPD patients were more likely to be male, to have a substance use disorder, and to have high aggression and hostility scores. Limitations include that the sample consists of only mood-disordered patients, a modest sample size of NPD, and the data are cross-sectional. The multivariate protective effect of NPD on suicide attempt is consistent with most previous research. The lower impulsivity of NPD patients and less severe personality pathology relative to other personality disorders may contribute to this effect. No relationship of NPD to attempt lethality was found, contradicting other research, but perhaps reflecting differences between study samples. Future studies should oversample NPD patients and include suicide death as an outcome. Clinical implications include discussion of individualized suicide risk assessment with NPD patients.
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Affiliation(s)
- Daniel Coleman
- Graduate School of Social Service, Fordham University, New York, NY, USA.
| | - Ryan Lawrence
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Amrita Parekh
- School of Social Work, Columbia University, New York, NY, USA
| | - Hanga Galfalvy
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Autonoma University, CIBERSAM, Madrid, Spain
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - J. John Mann
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation, Autonoma University, Madrid, Spain
| | - Maria A. Oquendo
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
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Abstract
Suicidal behavior and its prevention constitute a major public health issue. Etiology of suicidal behavior is multifactorial. Whereas current research is mostly focused on clinical and biological risk factors, the sociodemographic risk factors for suicidal behavior, first highlighted by Durkheim, have received less attention. Besides the well-known impact of age and gender, sociodemographic variables such as marital and parental status, education, occupation, income, employment status, religion, migration or minority status, and sexual orientation are repeatedly reported to play an important role in suicidal behavior. This narrative review aimed to summarize recent research on sociodemographic risk factors for suicidal behavior and to elicit possible implications for suicide prevention.
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Affiliation(s)
- Ismael Conejero
- Department of Emergency Psychiatry, CHRU Montpellier, Montpellier, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, CHU Nimes, Nimes, France. .,Inserm U1061, Hôpital La Colombiere, Pavillon 42, 39 Av Charles Flauhault, BP: 34493, 34093, Montpellier, France. .,University of Montpellier 1, Montpellier, 34000, France.
| | - Lucas Giner
- Department of Psychiatry, University of Sevilla, Sevilla, Spain
| | - Enrique Baca-Garcia
- IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain.,Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
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de Leon J, Baca-Garcia E, Blasco-Fontecilla H. Reply to the Multifaceted Aspects of Suicide Behavior by Tondo. Psychother Psychosom 2016; 85:112-3. [PMID: 26809133 DOI: 10.1159/000442422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jose de Leon
- Mental Health Research Center at Eastern State Hospital, Lexington, Ky., USA
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Diaz-Frutos D, Baca-Garcia E, García-Foncillas J, López-Castroman J. Predictors of psychological distress in advanced cancer patients under palliative treatments. Eur J Cancer Care (Engl) 2016; 25:608-15. [DOI: 10.1111/ecc.12521] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- D. Diaz-Frutos
- Department of Psychiatry and Clinical Psychology; Fundación Jiménez Díaz Hospital; Autonoma University of Madrid (UAM); Madrid Spain
- Department of Oncology; Fundación Jiménez Díaz Hospital; Autonoma University of Madrid (UAM); Madrid Spain
- Spanish Association Against Cancer (AECC); Barcelona Spain
| | - E. Baca-Garcia
- Department of Psychiatry and Clinical Psychology; Fundación Jiménez Díaz Hospital; Autonoma University of Madrid (UAM); Madrid Spain
| | - J. García-Foncillas
- Department of Oncology; Fundación Jiménez Díaz Hospital; Autonoma University of Madrid (UAM); Madrid Spain
| | - J. López-Castroman
- Department of Psychiatry and Clinical Psychology; Fundación Jiménez Díaz Hospital; Autonoma University of Madrid (UAM); Madrid Spain
- Department of Emergency Psychiatry; CHRU Montpellier; Montpellier France
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Lopez-Castroman J, Delgado-Gomez D, Courtet P, Baca-Garcia E. Optimizing the assessment of suicide attempters with a decision tree. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BackgroundOptimizing psychiatric assessments could help to standardize the use of structured instruments in clinical practice. In recent years, several research groups have applied Computerized Adaptive Tests (CATs) to simplify assessments in depression, anxiety and also suicidal behaviors. We aimed to construct a shortened test to classify suicide attempters using a decision tree methodology that allows the integration of relevant clinical information, namely the history of past suicide attempts, in the construction of the test.MethodsThe sample was composed of 902 adult participants in three subsamples: first-time suicide attempters, psychiatric inpatients that never attempted suicide and healthy controls. The performance of a decision tree built using the items of a previously developed scale for suicidal risk was examined. The history of past suicide attempts was used to separate patients in the decision tree. The data was randomly divided in a training set and a test set. The test set, that contained 25% of the data, was used to determine the accuracy of the decision tree. Twenty-five cross-validations of this set up were conducted.ResultsThe first four items of the decision tree classified correctly 81.4% of the patients.ConclusionAs a result of a methodology based on decision trees that, contrary to CATs, can incorporate relevant information in building the test we were able to create a shortened test capable of separating suicidal and non-suicidal patients. Using all the information that is available improves the precision and utility of instruments adapted for psychiatric assessments.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lopez-Castroman J, Blasco-Fontecilla H, Courtet P, Baca-Garcia E, Oquendo MA. Are we studying the right populations to understand suicide? World Psychiatry 2015; 14:368-9. [PMID: 26407798 PMCID: PMC4592665 DOI: 10.1002/wps.20261] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jorge Lopez-Castroman
- Centre Hospitalier Universitaire Régional Montpellier and University of Montpellier, Montpellier, France
| | | | - Philippe Courtet
- Centre Hospitalier Universitaire Régional Montpellier and University of Montpellier, Montpellier, France
| | - Enrique Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
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Lopez-Castroman J, Mendez-Bustos P, Perez-Fominaya M, Villoria LB, Zamorano MJI, Molina CA, Lorie AV, Pacheco-Tabuenca T, Casado-Florez I, Baca-Garcia E. Code 100: a study on suicidal behavior in public places. Actas Esp Psiquiatr 2015; 43:142-148. [PMID: 26150058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 06/04/2023]
Abstract
Every day, the emergency departments in our country receive a large number of patients that have thought about or attempted suicide. Unfortunately, these patients are very often reluctant to maintain a regular follow-up in mental health services. In this study we describe an original program to encourage assessment and treatment of suicidal patients, particularly when they receive medical treatment in public places. We summarize the application of the program and compare the results of a specific follow-up between two groups of patients: suicidal patients assessed by emergency services in public places and all other suicidal patients assessed in the emergency department of a tertiary hospital.
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Affiliation(s)
| | | | | | | | | | | | - Alex Vega Lorie
- IIS-Fundación Jiménez Díaz, Department of Psychiatry, CIBERSAM, Madrid, España
| | | | | | - Enrique Baca-Garcia
- IIS-Fundación Jiménez Díaz, Department of Psychiatry, CIBERSAM, Madrid, España Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA
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Diaz-Frutos D, Baca-Garcia E, Mahillo-Fernandez I, Garcia-Foncillas J, Lopez-Castroman J. Suicide ideation among oncologic patients in a Spanish ward. PSYCHOL HEALTH MED 2015; 21:261-71. [DOI: 10.1080/13548506.2015.1058960] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Carmona Camacho R, Cook B, Baca-Garcia E, Chavez L, Collazos F, Iza M, Alegria M. Comparison of Mental Health Treatment Expenditures in Usual Psychiatric Care Between Madrid and Boston Hospital Systems. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Berrouiguet S, Courtet P, Perez-Rodriguez M, Oquendo M, Baca-Garcia E. The Memind Project: a New Web-based Mental Health Tracker Designed for Clinical Management and Research. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31968-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lopez-Castroman J, Courtet P, Baca-Garcia E, Oquendo MA. Identification of suicide risk in bipolar disorder. Bipolar Disord 2015; 17:22-3. [PMID: 25346206 DOI: 10.1111/bdi.12264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/19/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Jorge Lopez-Castroman
- Department of Emergency Psychiatry, CHRU Montpellier, Montpellier, France; IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain
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Abstract
Current methodologies employed in collecting data for suicide research present several limitations. In this article, we describe a novel method and tool to prospectively study suicidal behavior and its related risk and protective factors in different countries. This tool is a web-based database, which will initially be developed and piloted by suicide research groups from Austria, Brazil, Chile, France, Italy, Mexico, Spain, Sweden, and the US. The database will develop and integrate research tools key to collaboration, permit exploration of ethical considerations, and provide a universal interface in English, Spanish, French, Portuguese, Italian, and German that will make it possible to incorporate new groups from different countries to the network. The common database resulting of this cross-national effort will allow researchers to share and compare data across countries in a large sample of patients. Using anonymous electronic records of patients, we will: 1) determine the impact of risk and protective factors (viz. aggression and religious affiliation) in different socio-cultural environments; 2) develop a clinical model of suicidal behavior that integrates the multiple dimensions implicated; 3) try differentiating the effects of biological, environmental, and cultural factors on suicidal behavior, and 4) offer the global psychiatric research community a tool that will standardize assessment across nations, allowing for better generalization.
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