An adaptation of meaning-centered psychotherapy integrating "essential care": A pilot study.

INTRODUCTION: There is a growing interest in the emotional state of cancer patients. The main objective of this pilot study is to assess the feasibility, acceptability, and preliminary efficacy of Meaning-Centered Psychotherapy and Essential Care (MCP-EC) in patients with advanced cancer compared with usual psychological support. We define "Essential Care" as the promotion of patient care and self-care through the recall of good care experiences and discussion of the concepts: responsibility, self-compassion, kindness, and attitude. METHOD: Pilot, single-center, and prospective study of 30 patients with advanced cancer and emotional distress. Our adaptation consisted in three session Meaning-Centered Psychotherapy-Palliative Care, plus a fourth session named "Essential Care". The study was carried out in two phases. First, 20 patients were randomized to one of the two arms: individual MCP-EC (experimental, n = 10) or usual psychological supportive (control, n = 10). In a second phase, 10 patients were assigned consecutively to Group MCP-EC (n = 10). All patients were evaluated at baseline (pre-) and post-intervention with questionnaires for sociodemographic data and clinical scales. RESULTS: Nineteen patients completed the 4 sessions of MCP-EC, 9 individual format and 10 group format. Usual supportive intervention was delivered to 10 control patients. Total 28 patients completed pre- and post-treatment evaluations. There were no pre- vs. post-differences in the evaluations of the control group. In the experimental group, significant pre- vs. post-differences were found in EQ-5D-3L, HADS, FACIT, DM, HAI, SCS-SF, and TD questionnaires. These results indicated that MCP-EC reduced anxiety and depression symptoms, hopelessness, demoralization, as well as increased spiritual well-being and sense of meaning. Participants were satisfied and found the MCP-EC intervention positively. CONCLUSIONS: This pilot study suggests that the MCP-EC has feasibility, acceptability, and preliminary efficacy reducing the emotional distress in advanced cancer patients. Larger studies are warranted to clarify the strengths and limitations of this psychotherapy.

[Prevalence of psychiatric disorders on patients admissed by the Psychiatric Service in the Security Area of H.U.M.S. (University Hospital "Miguel Servet")]. / Prevalencia de trastornos psiquiátricos en pacientes ingresados por el Servicio de Psiquiatría en el Módulo Penitenciario del H.U.M.S.

INTRODUCTION: recent epidemiological studies highlight an increase in the prevalence of psychiatric disorders amongst prison inmates. The objective of this study to determine the most prevalent primary and secondary psychiatric disorders, socio-demographic data and average stay period amongst patients admitted to the Prison Unit of a general hospital as charges of the Psychiatric Service. MATERIALS AND METHODS: retrospective cross-sectional descriptive study. The sample group consisted of a number of patients admitted into the Prison Unit as charges of the Psychiatric Service during a five year period (n=136). RESULTS: 90,4% were men and 9,6% were women. The average age was 34,18 years. The most prevalent primary psychiatric diagnoses were: Personality Disorder 22%, and Schizophrenic Disorder 16,3%. The most prevalent secondary psychiatric diagnoses were: Personality Disorder 11,9%, Substance Abuse 10,7%. CONCLUSIONS: the most prevalent primary and secondary psychiatric diagnosis was personality disorder. The existence of a high level of comorbidity of substance abuse-dependence was recorded. Prisons currently lack Mental Health multidisciplinary teams. This often means that the inmate must be transferred to a hospital with the increased work load and financial cost that this implies.

[Reliability of the evaluation of regional cerebral blood flow using SPECT in chronic schizophrenia and bipolar disorder]. / Fiabilidad de la evaluación del flujo sanguíneo cerebral regional FSCR mediante SPECT en esquizofrenia crónica y trastorno bipolar.

OBJECTS: Demonstrate the reliability of cerebral SPECT using 99 mTc-HMPAO. METHODS & MATERIALS: Evaluation of cerebral blood flow using SPECT in 24 patients with schizophrenia, 24 patients with bipolar disorder and 20 controls. In the study we have reliability between observers and intraobserver. In both cases kappa statistic has been applied for measuring reliability. RESULTS: reliability between observers represents a kappa coefficient of 0.71. Intraobserver reliability, with a medium grade concordance slightly superior, shows a medium kappa coefficient of 0.74. CONCLUSIONS: Visual evaluation of SPECT images using 99mTc--HMPAO is a trustworthy technique to document the different patterns of regional cerebral blood flow. Reliability is determinate by the improvement, during visual analysis of reliability between observers (kappa: 0.71) and intraobservers (kappa: 0.74).

Asociación de atrofia medial del lóbulo temporal en TC e hipocaptación temporoparietal mediante SPECT / Association between medial temporal lobe atrophy on ct and parietotemporal uptake decrease on SPECT to the study of cognitive impairment and depressive symptoms

La tomografía computarizada (TC) y la resonancia magnética (RM) cerebrales aportan a la evaluación diagnóstica del paciente con depresión y deterioro cognoscitiva significativo una excelente información anatómica, mientras la tomografía computarizada de emisión de fotón único (SPECT cerebral), permite obtener una información funcional a través de la medición del flujo sanguíneo cerebral regional (FSCr). Objetivo: Evaluar la validez de la combinación de atrofia del lóbulo medial temporal e hipocaptación temporoparietal al diagnóstico de demencia degenerativa primaria, así como su capacidad para discriminar entre demencia degenerativa primaria y depresión. Material: 23 pacientes, 9 hombres (39,1 por ciento) y 14 mujeres (60,9 por ciento), edad media de 61 años, con el diagnóstico de depresión y deterioro cognoscitivo significativo sin cumplir criterios de demencia, según códigos diagnósticos GMS-HAS y DSM-IV. 10 individuos sanos, de similares características sociodemograficas y sin historia anterior de trastorno psiquiátrico, neurológico ni abuso de drogas. Métodos: se ha realizado sistemáticamente tomografía axial computarizada (TC) y por emisión de fotón único (SPECT) cerebrales en sujetos mayores de 65 años con un MEC <24 y menores de 65 años con un MEC > 27. Resultados: se han establecido 6 patrones de perfusión cerebral para el grupo de pacientes El más frecuentemente observado fue el patrón C (39,13 por ciento), hipoperfusión temporal y/o parietal bilateral. Conclusiones: