Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients.

Objective: Psychological factors, such as stress, anxiety, and depression, are frequently related to inflammatory bowel disease (IBD). However, few studies have examined these factors in patients newly diagnosed with IBD. The aim of the present study was to test the psychological burden in patients with a recent diagnosis of IBD and the factors related to this psychological burden. Methods: We performed a prospective, multi-center, observational study in patients with a new diagnosis of IBD (≤6 months). The patients were recruited from four different Spanish hospitals. Clinical and demographic characteristics were collected. Patients were evaluated using the Hospital Anxiety and Depression Scale and quality of life questionnaire for patients with inflammatory bowel disease (IBDQ-32). The Scale of Stress Perceived by the Disease was used to assess stressful life events. Results: We included 156 patients newly diagnosed with IBD [69 women; 80 Crohn's disease (CD) and 76 ulcerative colitis (UC)], with a mean age of 42.3 (SD 16.21) years. A total of 37.2% of patients had symptoms of anxiety and 17.3% had symptoms of depression. Quality of life was affected in 30.1% of patients. Factors related to anxiety in early IBD were being a woman and having CD. The only factor related to depression was the presence of comorbidity. Being a woman and having suffered previous stressful life events were factors related to impaired quality of life. Conclusion: Anxiety, depression, and impaired quality of life are frequent in patients with a recent diagnosis of IBD. This psychological burden is greater in women.

Differences in the Quality of Life of Patients Recently Diagnosed with Crohn's Disease and Ulcerative Colitis.

Inflammatory bowel diseases (IBD) are chronic diseases, encompassing Crohn's disease (CD) and ulcerative colitis (UC). An IBD diagnosis has an impact on the quality of life of patients; this impact can be different according to the type of disease. OBJECTIVE: This study aimed to analyze the differences in the impact on quality of life in the early stages after diagnosis in patients with CD and UC. PATIENTS AND METHODS: This was an observational, multi-center, and cross-sectional study, with the participation of 156 patients recently diagnosed with IBD (<6 months) from 4 hospitals from the Health Council of the Valencian Community. The patients were assessed through the use of the Inflammatory Bowel Disease Questionnaire (IBDQ-32), which measures the quality of life when living with IBD. RESULTS: The sample was composed of 80 patients with CD (51.0%) and 76 patients with a UC diagnosis. The mean age was 42.3 ± 16.2. The CD patients were more affected (42.5%) in their general quality of life than the UC patients (17.1%) (p = 0.001). In the dimensions of the IBDQ-32, the patients with CD showed significant differences in the systemic, emotional, and social spheres. The bowel dimension scores were similar in both groups. CONCLUSIONS: The patients who were recently diagnosed with CD were more affected regarding their quality of life as compared to those who were diagnosed with UC. Psychological care must be considered to mitigate the impact of an IBD diagnosis.

Validation of the Center of Applied Psychology Female Sexuality Questionnaire (CAPFS-Q).

Instruments for the measurement of human sexuality include self-report measures used to assess sexual functioning, but many of them have not yet been validated. The Center of Applied Psychology Female Sexual Questionnaire (CAPFS-Q) is an original self-report instrument. It has been developed for the study of sexuality in specific non-clinical populations, such as female university students of Medicine and other Health Sciences. The CAPFS-Q includes 26 items, organized as follows: sociodemographic and relevant data (four items); aspects of sexual relations with partner (five items); sexual practices (12 from 13 items); and dysfunctional aspects of sexual relations (four items). CAPFS-Q validity and reliability were examined in a sample of Spanish female university students of Health Sciences. Exploratory and confirmatory factor analysis (FA) showed a four-factor structure which explained 71.6% of the variance. This initial version of the CAPFS-Q is a reliable measure of women's sexual behavior, with a dimensionality that replicates the initial theoretical content and with adequate indicators of internal consistency, validity, and test-retest reliability. It is easy to administer and to complete.

Effectiveness of a Multicomponent Group Psychological Intervention Program in Patients with Inflammatory Bowel Disease: A Randomized Trial.

(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and improving quality of life and the clinical course of the disease. (2) Methods: A total of 120 patients were evaluated using the General Perceived Stress Scale, Scale of Stress Perceived by the Disease, the anxiety and depression scale, and quality of life questionnaire for patients with IBD. Disease activity was measured using the Mayo Index for ulcerative colitis and CDAI for Crohn's disease, as well as the number of relapses self-reported by patients. Patients were randomized to receive group multicomponent cognitive-behavioral therapy or treatment as usual. (3) Results: The psychological intervention reduced stress (EAE: 45.7 ± 8.8 vs. 40.6 ± 8.4, p = 0.0001; PSS: 28.0 ± 7.3 vs. 25.1 ± 5.9, p = 0.001) and improved quality of life (164.2 ± 34.3 vs. 176.2 ± 28.0, p = 0.001). An improvement was found in the number of relapses self-reported by patients (0.2 relapses/patient vs. control 0.7 relapses/patient; p = 0.027). No differences were found in disease activity indexes. (4) Conclusions: Psychological therapy was associated with improved stress, quality of life and with a decrease in the number of relapses self-reported by patients. Clinical trial registration number: NCT02614014.

Theory of Mind in Borderline Personality Disorder: A Possible Endophenotypic Factor?

The purpose of this study is to examine whether theory of mind (ToM) is an endophenotypic marker of borderline personality disorder (BPD), thus constituting an etiopathogenic factor of the disease. This would suggest familial vulnerability to BPD. This was a case-control study involving 146 individuals with 57 BPD patients, 32 first-degree relatives, and 57 controls (median age of BPD and control = 33.4 years; relatives = 52.9 years; BPD females and controls = 91.2%; female relatives = 62.5%). All the participants completed the Spanish version of the Movie for the Assessment of Social Cognition test to evaluate the ToM subclassification: interpretation of emotions, thoughts and intentions. BPD patients and their healthy first-degree relatives exhibited significant deficits in the correct interpretation of emotions and intentions compared to healthy controls. Both patients with BPD and their healthy first-degree relatives exhibited significant deficits in ToM, which suggests that it may be an etiopathogenic factor of BPD, and ToM (interpretation of emotions, thoughts and intentions) is a possible endophenotypic marker of BPD, suggesting a genetic predisposition to the disorder. Therefore, ToM could be considered as an indicator for the early detection of the disorder of and intervention for BPD.

Impact of COVID-19 on the Anxiety Perceived by Healthcare Professionals: Differences between Primary Care and Hospital Care.

The COVID-19 pandemic has had an emotional impact on healthcare professionals at different levels of care, and it is important to understand the levels of anxiety of hospital personnel (HP) compared to those of primary care personnel (PCP). The objectives herein were to assess the differences in anxiety levels between these populations and to detect factors that may influence them. The anxiety levels (measured using the Hospital Anxiety and Depression (HAD) scale) of the HP and PCP groups were compared using data collected from a cross-sectional study. The secondary variables included demographic and health data, confinement factors, contact with COVID-19 patients, having suffered from COVID-19, perceptions of protection, caregiver overload, threat, and satisfaction with management. We found anxiety "case" (35.6%) and "at-risk" (21%), with statistically significant differences in the group "at risk", and higher scores in the PCP group. The factors associated with the perception of threat and protection were significant determinants of an increase in anxiety, with all of them showing statistically significant differences. There were greater symptoms of anxiety in the PCP group than the HP group (32% vs. 18%). The factors associated with the prevalence of anxiety symptoms were the perceptions of threat, protection, management, caregiver overload, and perceived degree of threat associated with COVID-19.

Social cognition and social functioning in people with borderline personality disorder and their first-degree relatives.

BACKGROUND: A few papers studying healthy, first-degree relatives of people with borderline personality disorder (BPD) have found that this group presents attention and memory problems. However, current research has not analyzed their social cognition. MATERIALS AND METHODS: We designed an age-, gender- and education-level matched case-control study involving 57 people with BPD, 32 of their first-degree relatives, and 57 healthy controls in Spain in 2018-2019. All were assessed for social cognition and functioning using the Movie for Assessment of Social Cognition and the Social Functioning Scale; other potential confounders were also collected (marital status, occupation and household variables). RESULTS: There were differences in the social cognition domain of overmentalizing errors, with the BPD group scoring significantly higher than controls; however, there was no significant difference with relatives; in the social functioning domain of family relationships, with the controls showing the highest scores. Social engagement/withdrawal, interpersonal behavior, independence-competence, prosocial activities, full scale and categorization domains showed the same pattern: the BPD group had lower scores than their relatives and the controls. Relatives were significantly different from BPD patients in family relationships, social engagement/withdrawal and interpersonal behavior, as well as on the full Social Functioning Scale (both as a linear and categorical variable). However, only controls showed differences with relatives in family relationships. CONCLUSIONS: All in all, relatives show similar levels of social cognition and functioning compared with controls, and people with BPD show some alterations in different domains of both social cognition and functioning.

Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross-sectional study of Spanish university students.

AIM: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender-interaction with those factors and STB; among Spanish university students. METHODS: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed. RESULTS: We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95%CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females. CONCLUSIONS: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed.

Personality and psychopathology in potential live kidney donors: A cluster analysis of personality features.

BACKGROUND: The previous psychosocial evaluation of the potential living kidney donors (PLKD) requires a detailed understanding of the psychosocial benefits and the possible damages of the act of donation. OBJECTIVE: The aim was to create clusters by using the clinical patterns of personality and to evaluate their influence on psychopathological variables. METHODS: Observational, analytical and cross-sectional study that included the PLKD from February 2009 to March 2017. The patients were referred to the Hospital Psychology Unit by the Transplant Coordination Unit. The total sample was composed of 100 participants. The socio-demographic characteristics, the relationship with the recipient and the Millon Clinical Multiaxial Inventory were included. RESULTS: The final sample was composed by 100 PLKD. The mean age of the participants was 45.70, and most were women (70%). The analysis showed a final result of 3 personality clusters that best represented the data, in agreement with the DSM-5 classification. The PLKD from cluster 3 obtained greater scores in all the clinical syndromes. CONCLUSIONS: The personality evaluation of the PLKD could help with the planning of monitoring protocols of the participants who were classified to cluster 3, in order to improve their post-transplant psychosocial adjustment. This result makes us consider the usefulness of the psychosocial evaluation to preserve the psychological health of the PLKD.

What is the Role of Internalizing and Externalizing Symptoms in Adolescent Suicide Behaviors?

Suicide is the second leading cause of death in adolescents and young adults aged 15 to 29 years. Specifically, the presence of internalizing and externalizing symptomatology is related to increased risk for suicide at these ages. Few studies have analyzed the relations between these symptoms and their role as mediators in predicting suicide behavior. This study aimed to examine the relation between internalizing and externalizing symptomatology and suicide behaviors through a longitudinal study. The sample consisted of 238 adolescents aged 12 to 18 years. The data were analyzed via the PROCESS Statistical Package. The main results showed that previous depression symptoms had a significant indirect effect, through previous suicide behaviors and current depression symptoms, on current suicide behaviors, accounting for 61% of the total variance explained. Additionally, being a girl increased this risk. Therefore, the implementation of early identification and intervention programs to address youth symptoms of depression and suicidal behaviors could significantly reduce the risk for future suicidal behaviors in adolescence.

Self-esteem and suicidal behaviour in youth: A meta-analysis of longitudinal studies.

BACKGROUND: Previous literature suggests that low self-esteem is a risk factor for suicide attempts, but no meta-analyses have been conducted to assess this association in adolescents/young adults. The present study examined the relationship between low self-esteem and suicide attempts in young people (12-26 years old). METHOD: Meta-analyses were performed using random-effects models (ES) and odds ratio (OR). Heterogeneity and sensitivity analyses were performed. RESULTS: From 26,883 initial titles, 22 studies met the inclusion criteria, of which 9 studies had data that could be included in the meta-analysis. The meta-analysis showed that youths with lower self-esteem were more likely to have future suicide attempts, with an effect size (self-esteem as continuous variable) of d = .58 (95% CI = .44 - .73) and, for low self-esteem (categorical variable) an OR = 1.99 (95% CI = 1.39-2.86; p < .001). CONCLUSION: A low level of self-esteem is a risk factor for suicide attempts in adolescents/young adults.

Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies.

OBJECTIVES: To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults. METHODS: Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12-26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed. RESULTS: Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54-2.50), and males for suicide death (HR 2.50, 95% CI 1.8-3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend's suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied. CONCLUSIONS: More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.

Withdrawal symptoms predict prescription opioid dependence in chronic pain patients.

BACKGROUND: The last version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes substantial changes for prescription opioid-use disorder (POUD). After its removal as a criterion, the goal of this study was to estimate the prevalence of withdrawal symptoms in long-term users of prescription opioids and its association with the new DSM-5 POUD classification. METHODS: Data were collected from 215 long-term consumers of opioid medication who were chronic non-cancer pain patients. Participants completed sociodemographic, Adjective Rating Scale for Withdrawal (ARSW), opioid treatment characteristics, POUD criteria (DSM-5), and pain intensity measurements. RESULTS: 26.6% of the participants were classified with moderate to severe POUD. Higher intensity of withdrawal symptoms was found in patients with moderate/severe POUD, younger age, and higher pain intensity (p < .01). Anxiolytics (p < .01) and antidepressants use (p < .05) and percentage of smokers (p < .05) were significantly higher in patients with severe withdrawal. Logistic regression analyses suggested moderate [odds ratio (OR) = 3.25] and severe (OR = 10.52) withdrawal as the strongest predictor of POUD. Age, anxiolytics use, and smoking were also associated with POUD, but multilevel analysis showed that these variables do not moderate the association between withdrawal intensity and POUD. CONCLUSION: Escalation of withdrawal intensity during opioid treatment can be used to identify patients with POUD. Further studies are needed to assess the clinical implications of these findings during long-term opioid therapy for chronic pain.

Mental disorders as risk factors for suicidal behavior in young people: A meta-analysis and systematic review of longitudinal studies.

BACKGROUND: Suicide is the second leading cause of death for young people. OBJECTIVE: To assess mental disorders as risk factors for suicidal behaviour among adolescents and young adults including population-based longitudinal studies. METHOD: We conducted a systematic literature review. Bibliographic searches undertaken in five international databases and grey literature sources until January 2017 yielded a total of 26,883 potential papers. 1701 full-text articles were assessed for eligibility of which 1677 were excluded because they did not meet our eligibility criteria. Separate meta-analyses were conducted for each outcome (suicide death and suicide attempts). Odds ratio (OR) and 95% confidence intervals (95%CI) and beta coefficients and standard errors were calculated. RESULTS: 24 studies were finally included involving 25,354 participants (12-26 years). The presence of any mental disorder was associated with higher risk of suicide death (OR = 10.83, 95%CI = 4.69-25.00) and suicide attempt (OR = 3.56; 95%CI 2.24-5.67). When considering suicidal attempt as the outcome, only affective disorders (OR = 1.54; 95%CI = 1.21-1.96) were significant. Finally, the results revealed that psychiatric comorbidity was a primary risk factor for suicide attempts. LIMITATIONS: Data were obtained from studies with heterogeneous diagnostic assessments of mental disorders. Nine case-control studies were included and some data were collected in students, not in general population. CONCLUSIONS: Mental disorders and comorbidity are strong predictors of suicide behaviour in young people. Detection and management of the affective disorders as well as their psychiatric comorbidity could be a crucial strategy to prevent suicidality in this age group.

Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review. / Medidas de frecuencia utilizadas en estudios de cohortes para evaluar el comportamiento suicida en jóvenes (12-26 años): una revisión sistemática.

INTRODUCTION: A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. OBJECTIVE: To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. METHOD: A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. RESULTS: Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. CONCLUSIONS: Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem.

The Adjective Rating Scale for Withdrawal: Validation of its ability to assess severity of prescription opioid misuse.

BACKGROUND: Withdrawal symptoms have been widely shown to be a useful indicator of the severity of opioid dependence. One of the most used instruments to assess them is the Adjective Rating Scale for Withdrawal (ARSW). However, there is a lack of adaptations and validations for its use with prescription opioids, even less for chronic pain patients under treatment with these analgesics. Thus, the aims of this study were to analyse the psychometric properties and invariance across gender of the ARSW in a sample of chronic noncancer pain patients. METHODS: Data were collected from 208 consumers of opioid medication, chronic noncancer pain patients. Participants completed sociodemographic, ARSW, prescription opioid dependence (DSM-IV-TR) and prescription opioid-use disorder (DSM-5) measurements. Gender invariance was assessed through multigroup confirmatory factor analysis (CFA). RESULTS: The ARSW showed a unidimensional factor structure and high internal consistency (Cronbach's alpha = 0.85). Multigroup CFA showed configural, metric, scalar and strict invariances of ARSW across gender. Predictive validity analyses indicated that ARSW has good capacity for identifying the severity of prescription opioid-use disorder, using both DSM-IV-TR and DSM-5 criteria. CONCLUSIONS: These findings show that the ARSW is a valid and reliable tool for use in the assessment of the withdrawal of prescription opioids in chronic pain patients under treatment with these analgesics, regardless of their gender. SIGNIFICANCE: Findings supported the reliability and validity of the ARSW to assess withdrawal of prescription opioids in individuals with chronic noncancer pain. The instrument can be applied indistinctly in men and women. An increase in the ARSW scores could be used as an indicator of potential risk of prescription opioid-use disorder during long-term treatments.

Calidad de vida, emociones negativas, autoeficacia y calidad del sueño en pacientes con dolor crónico: efectos de un programa de intervención psicológica / Quality of Life, Negative Emotions, Self-Efficacy and Quality of Sleep in Patients with Chronic Pain: Effects of a Program of Psychological Intervention

Resumen El dolor crónico es un problema de salud que afecta a entre el 10 y el 30 % de la población. El objetivo del presente estudio es evaluar la eficacia de un programa de intervención grupal en dolor crónico. Se realizó un estudio cuasi experimental. La muestra estuvo compuesta por 105 participantes de la Unidad de Dolor del Hospital General Universitario de Alicante. Se administró una batería de cuestionarios pre y post a la aplicación del programa. En el estudio se midió el nivel de dolor, calidad de vida, ansiedad, depresión, atributos del sueño y autoeficacia. Se obtuvieron mejoras significativas en los niveles de ansiedad, depresión calidad de vida física, autoeficacia, en todas sus dimensiones (control de síntomas, funcionamiento físico y control del dolor) y aspectos de los atributos del sueño, como cantidad y alteraciones del sueño. El programa protocolizado y realizado por profesionales entrenados es efectivo para disminuir la percepción del dolor, aumentar la calidad de vida en su componente físico, mejorar la autoeficacia y los atributos del sueño en pacientes con dolor crónico.

Abstract Chronic pain is a health problem that affects between 10 and 30 % of the population. The goal of this study is to evaluate the effectiveness of a group intervention program for chronic pain. A quasi-experimental study was carried out. The sample consists of 105 participants of the Pain Unit of the Hospital General Universitario de Alicante. A battery of questionnaires pre and post was administered to the application of the program. The study measured the level of pain, quality of life, anxiety, depression, sleep attributes and self-efficacy. Significant improvements in levels of anxiety, depression, physical quality of life, self-efficacy in all dimensions (symptom control, physical functioning and pain control) and aspects of sleep attributes such as sleep disturbances were obtained. The program protocolized and carried out by trained professionals is effective to decrease the perception of pain, to increase the quality of life in its physical component, to improve the self-efficacy and the attributes of the dream with chronic pain patients.

Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project.

BACKGROUND: Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. METHODS: An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. DISCUSSION: The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.

Psychometric properties of the Health Professionals Communication Skills Scale (HP-CSS).

One of the main features of the relationship between health professionals and their patients is that their effects can be measured. To do this, we need instruments that are well built and that have proven their validity and reliability empirically and experimentally. The objective of this study is to analyse the psychometric properties of the Health Professionals Communication Skills Scale (HP-CSS), which evaluates the communication skills that health professionals use to relate to their patients. The sample consisted of 410 health professionals in the region of Murcia, Spain, and 517 in the province of Alicante, Spain. We obtained descriptive statistics and discrimination indices of the items, the internal structure of the scale using both exploratory and confirmatory factor analysis, the internal consistency, the temporal stability, and the external evidence of validity. The results indicate that the HP-CSS is a valid and reliable instrument and is also useful for the purpose and context in which it will be used.

Una de las principales características de la relación que se produce entre los diferentes profesionales de la salud y los pacientes es que sus efectos pueden ser medidos. Para ello precisamos de instrumentos que estén bien construidos y que demuestren, de forma empírica y experimental, su validez y fiabilidad. El objetivo de este trabajo es analizar las propiedades psicométricas de la Escala de Habilidades de Comunicación de Profesionales de la Salud (EHC-PS) que evalúa las habilidades de comunicación que los profesionales de la salud tienen al relacionarse con sus pacientes. La muestra estuvo compuesta por 410 profesionales de la salud de la Región de Murcia (España) y 517 de la Provincia de Alicante (España). Se obtuvieron los estadísticos descriptivos y los índices de discriminación de los ítems, la estructura interna de la escala mediante Análisis Factorial Exploratorio y Confirmatorio, la consistencia interna, la estabilidad temporal y evidencias externas de validez. Los resultados obtenidos indican que la EHC-PS resulta ser un instrumento válido y fiable y, además, útil para el propósito y el contexto en que va a ser utilizado.