RESUMEN
The purpose of this study was to test whether a syndrome model of elder psychopathology derived from collateral ratings, such as from spouses and adult children, in the United States would be generalizable in 11 other societies. Societies represented South America, Asia, and Europe. The Older Adult Behavior Checklist (OABCL) was completed by collateral informants for 6141 60- to 102-year-olds. The tested model comprised syndromes designated as Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited. The model was tested using confirmatory factor analyses in each society separately. The primary model fit index showed a good fit for all societies, while the secondary model fit indices showed acceptable to a good fit for all societies. The items loaded strongly on their respective factors, with a median item loading of 0.69 across the 11 societies. By syndrome, the overall median item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment. The OABCL syndrome structure was thus generalizable across the tested societies. The OABCL can be used for broad assessment of psychopathology for elders of diverse backgrounds in nursing services and research.
Asunto(s)
Lista de Verificación , Internacionalidad , Psicopatología/estadística & datos numéricos , Síndrome , Anciano , Anciano de 80 o más Años , Ansiedad/psicología , Cognición/fisiología , Femenino , Humanos , Masculino , Reproducibilidad de los ResultadosRESUMEN
INTRODUCTION: Individuals with psychiatric conditions smoke at higher rates than the general population and may need more intensive treatment to quit. We examined whether or not extended treatment with nicotine patch, combined with behavior counseling, would disproportionally benefit smokers with versus without a lifetime psychiatric condition. METHODS: We conducted a secondary analysis of data from an effectiveness trial of treatment with 12 counseling sessions (48 weeks) and 21-mg nicotine patch (8, 24, or 52 weeks) among 525 adult daily smokers. A structured clinical interview assessed past and current psychiatric disorders (major depression, generalized anxiety disorder, alcohol abuse and/or dependence, and substance abuse and/or dependence), as described in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Abstinence was bioverified at week 52. Logistic regression evaluated the effect of the psychiatric status × treatment duration interaction on abstinence at week 52, covarying for sociodemographics, baseline psychological symptoms, and treatment adherence. RESULTS: At baseline, 115 (21.9%) participants were diagnosed with one or more psychiatric conditions. The psychiatric status × treatment duration interaction was significant for week 52 abstinence (p = .027). Abstinence rates between smokers with versus without a psychiatric condition in the 24-week treatment arm (9.3% vs. 31.5% abstinent) significantly differed from the 8-week treatment arm (18.8% vs. 22.3%), p = .017. Abstinence rates for smokers with (22.5%) versus without a psychiatric condition (19.7%) in the 52-week treatment arm did not differ from those in the 8-week arm. CONCLUSIONS: Targeted smoking cessation treatment, rather than extending treatment duration, may be especially warranted to optimize treatment for smokers with comorbid mood, anxiety, and substance use disorders. IMPLICATIONS: Individuals with psychiatric conditions smoke at higher rates and have greater difficulty quitting compared to those in the general population, but little is known about how to best optimize treatment for this high tobacco burden population. The present study found that cessation response to extended duration treatment with the transdermal nicotine patch did not differ for smokers with versus without comorbid anxiety, mood, and substance use disorders in a large-scale clinical effectiveness trial. Development of targeted behavioral treatments may be required to optimize abstinence outcomes for this high-risk population, rather than simply extending the duration of pharmacotherapy treatments.
Asunto(s)
Trastornos Mentales/complicaciones , Psicopatología/estadística & datos numéricos , Fumadores/psicología , Trastornos Relacionados con Sustancias/patología , Trastornos Relacionados con Sustancias/terapia , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos , Adulto , Comorbilidad , Consejo , Femenino , Humanos , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Cese del Hábito de Fumar/psicología , Trastornos Relacionados con Sustancias/psicología , Resultado del TratamientoRESUMEN
OBJECTIVES: As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies. METHODS/DESIGN: The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes. RESULTS: In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies. CONCLUSIONS: The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.
Asunto(s)
Comparación Transcultural , Evaluación Geriátrica/métodos , Trastornos Mentales/diagnóstico , Psicopatología , Anciano , Anciano de 80 o más Años , Ansiedad/etnología , Asia , Cognición , Depresión/etnología , Etnicidad , Europa (Continente) , Femenino , Humanos , Masculino , Memoria , Persona de Mediana Edad , Problema de Conducta/psicología , Psicopatología/estadística & datos numéricos , Reproducibilidad de los Resultados , Síndrome , Estados UnidosRESUMEN
Psoriasis is an inflammatory disease frequently associated with psychiatric disturbances and sleep disorders. The aim of the study was to assess the prevalence of depression, interaction anxiety, audience anxiety, and sleep quality in psoriatic patients. One hundred and two psoriatic patients were enrolled and underwent the following questionnaires: Zung Self-Rating Depression Scale (SDS), Interaction Anxiousness Scale (IAS), Audience Anxiousness Scale (AAS), Pittsburgh Sleep Quality Index (PSQI). The severity of skin lesions was assessed by Psoriasis Area Severity Index (PASI). The presence of a link between clinical variables and with demographic data has been investigated. Psoriasis was linked to depression, interaction and audience anxiety, as well as to poor sleep quality; 37.5% of patients were depressed, 46.1% scored above 37 at the IAS, 47.1% scored above 33 at the AAS. Thirty-nine subjects (38.2%) presented a PSQI ≥ 5. An association between interaction anxiety and lower limbs psoriasis-related erythema as well as between PSQI and head psoriasis-related erythema was found, particularly among male patients. Hence, psoriatic patients should be assessed from a holistic point of view, in order to identify associated disorders that could benefit from targeted treatments.
Asunto(s)
Psoriasis/complicaciones , Psicopatología/estadística & datos numéricos , Calidad de Vida , Trastornos del Sueño-Vigilia/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Psoriasis/patología , Psoriasis/psicología , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/etiologíaRESUMEN
BACKGROUND: Involuntary psychiatric admission is a controversial issue with legislation varying from country to country. Research on elderly individuals being involuntary admitted has been limited. This study aims first at assessing whether elderly involuntary admitted patients (IAPs) differ with regard to demographic, psychopathological, and behavioral characteristics from voluntary admitted psychiatric patients (VAPs) and second to assess whether the former group should be treated in a different (special) way. METHODS: Forty IAPs were compared to 39 VAPs with regard to sociodemographic data, DSM-IV diagnosis, as well as behavioral issues recorded by the Patient-Staff Conflict Checklist - Shift Report (PSCC-SR). All patients were aged 60 years and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period lasted 12 months. RESULTS: VAPs were more likely to be suffering from mood disorders, while IAPs presented higher rates of delirium. From the 20 items of the PSCC-SR, differences were found only in two: IAPs presented more aggressive behavior during the first few days of admission whereas VAPs had committed recent suicide attempt just before admission. CONCLUSION: From the clinical point of view, IAPs presented with delirium and more aggressive behavior, whereas, the VAPs presented with higher rates of mood disorder and suicidality. However, from the medicolegal point of view, our findings lend support to the argument of either setting a limited time frame for involuntary admission in elderly patients, and/or allowing for elderly individuals with acute organic conditions to be treated against their will.
Asunto(s)
Internamiento Obligatorio del Enfermo Mental , Trastornos Mentales/psicología , Anciano , Anciano de 80 o más Años , Internamiento Obligatorio del Enfermo Mental/estadística & datos numéricos , Delirio/psicología , Delirio/terapia , Femenino , Grecia/epidemiología , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Trastornos Mentales/terapia , Persona de Mediana Edad , Trastornos del Humor/psicología , Trastornos del Humor/terapia , Admisión del Paciente/estadística & datos numéricos , Psicopatología/estadística & datos numéricos , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricosRESUMEN
Previous research suggests that parental psychopathology predicts suicidal behavior among offspring; however, the more fine-grained associations between specific parental disorders and distinct stages of the pathway to suicide are not well understood. We set out to test the hypothesis that parental disorders associated with negative mood would predict offspring suicide ideation, whereas disorders characterized by impulsive aggression (for example, antisocial personality) and anxiety/agitation (for example, panic disorder) would predict which offspring act on their suicide ideation and make a suicide attempt. Data were collected during face-to-face interviews conducted on nationally representative samples (N=55 299; age 18+) from 21 countries around the world. We tested the associations between a range of parental disorders and the onset and persistence over time (that is, time since most recent episode controlling for age of onset and time since onset) of subsequent suicidal behavior (suicide ideation, plans and attempts) among offspring. Analyses tested bivariate and multivariate associations between each parental disorder and distinct forms of suicidal behavior. Results revealed that each parental disorder examined increased the risk of suicide ideation among offspring, parental generalized anxiety and depression emerged as the only predictors of the onset and persistence (respectively) of suicide plans among offspring with ideation, whereas parental antisocial personality and anxiety disorders emerged as the only predictors of the onset and persistence of suicide attempts among ideators. A dose-response relation between parental disorders and respondent risk of suicide ideation and attempt was also found. Parental death by suicide was a particularly strong predictor of persistence of suicide attempts among offspring. These associations remained significant after controlling for comorbidity of parental disorders and for the presence of mental disorders among offspring. These findings should inform future explorations of the mechanisms of intergenerational transmission of suicidal behavior.
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Salud Global/estadística & datos numéricos , Encuestas Epidemiológicas/estadística & datos numéricos , Padres/psicología , Psicopatología/estadística & datos numéricos , Ideación Suicida , Intento de Suicidio/psicología , Adolescente , Adulto , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/psicología , Salud de la Familia , Humanos , Trastornos del Humor/epidemiología , Trastornos del Humor/psicología , Prevalencia , Factores de RiesgoRESUMEN
We examine the prevalence and factors associated with lifetime gun-carrying among 858 urban out-of-treatment substance using women using data collected between 2000 and 2004 in a large Midwestern city. Instruments assessed gun ownership, carrying and access, psychopathology and personal lifestyle risk factors. Analyses were conducted using logistic regression. Illegal activities for income and lifetime violent victimization were the most significant predictors of gun carrying. The implications for practice and future research are discussed along with the study's limitations. The work was supported by grants from the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.
Asunto(s)
Consumidores de Drogas/psicología , Armas de Fuego/estadística & datos numéricos , Trastornos Relacionados con Sustancias/psicología , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Víctimas de Crimen/psicología , Víctimas de Crimen/estadística & datos numéricos , Consumidores de Drogas/estadística & datos numéricos , Femenino , Humanos , Estilo de Vida , Persona de Mediana Edad , Prevalencia , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psicopatología/estadística & datos numéricos , Factores de Riesgo , Estados Unidos , Violencia/psicología , Violencia/estadística & datos numéricosRESUMEN
BACKGROUND: Atypical auditory processing (AAP) in psychotic psychopathology is evident in early (N1), mid-latency (P2/N2/mismatch negativity), and late (P3) neural responses. The influence of attention on AAP, and how temporal stages of AAP are associated with phenomenology of psychotic psychopathology are not well understood. METHODS: We used a directed attention oddball task to characterize stages of AAP in psychosis and to examine the influence of selective attention. Ninety patients with schizophrenia (SCZ), 53 patients with bipolar disorder (BP), 90 healthy controls and 72 first-degree relatives of SCZ (SREL) were studied. We used principal components analysis to decompose average-reference 64-channel subject-level ERPs. RESULTS: Altered attentional modulation was evident in SCZ at early (N1 factor) and late (P3 factor) stages of AAP, but not at mid-latency P2 factor. Irrespective of condition, N1 and P3 were reduced in SCZ, which predicted greater psychopathology and schizotypal personality traits. Diminished mid-latency mismatch detection (P2 factor) was evident in SCZ, BP, and SREL and was associated with greater positive symptoms of psychosis as well as self-reported atypical cognitive-perceptual experiences. CONCLUSIONS: Attentional modulation of early N1, and later P3 neural responses was atypical in patients, but the degree of attentional modulation did not relate to symptom severity or schizotypal traits. Our findings suggest the link between mid-latency mismatch detection and atypical cognitive/perceptual experiences is not driven by attentional deficits alone and point to the promise of mid-latency mismatch detection as a candidate endophenotype and intervention target.
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Percepción Auditiva/fisiología , Trastornos Psicóticos/fisiopatología , Esquizofrenia/diagnóstico , Adulto , Electroencefalografía/métodos , Potenciales Evocados/fisiología , Femenino , Humanos , Masculino , Psicopatología/métodos , Psicopatología/estadística & datos numéricos , Esquizofrenia/fisiopatologíaAsunto(s)
Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psicopatología/estadística & datos numéricos , Esquizofrenia/diagnóstico , Antipsicóticos/uso terapéutico , Humanos , Psicometría , Calidad de Vida/psicología , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
BACKGROUND: Aripiprazole has been linked to cases of problem gambling (PBG), but evidence supporting this association remains preliminary. Additionally, data specific to PBG in individuals with first-episode psychosis (FEP) receiving aripiprazole are limited to a few case reports, even though aripiprazole is widely used among this population that might be especially vulnerable to PBG. METHODS: To examine this association, a nested case-control study was conducted in a cohort of 219 patients followed at a FEP program located in the Quebec City, Quebec, Canada, metropolitan area. Fourteen cases meeting the PBG criteria according to the Problem Gambling Severity Index were identified and matched for gender and index date to 56 control subjects. RESULTS: In the univariable conditional logistic regression analysis, the use of aripiprazole was associated with an increased risk of PBG (odds ratio [OR] 15.2; 95% confidence interval [CI] 2.1-670.5). Cases were more likely to have a prior gambling history (either recreational or problematic) than controls at admittance in the program; they were also more frequently in a relationship and employed. After adjustment for age, relationship status, employment and Cluster B personality disorders, the use of aripiprazole remained associated with an increased risk of PBG (OR 8.6 [95% CI 1.5-227.2]). CONCLUSIONS: Findings from this study suggest that FEP patients with a gambling history, problematic or not, may be at increased risk of developing PBG when receiving aripiprazole. They also highlight the importance of systematically screening for PBG all individuals with psychotic disorders, as this comorbidity hinders recovery. While the results also add credence to a causal association between aripiprazole and PBG, further prospective studies are needed to address some of the limitations of this present study.
Asunto(s)
Aripiprazol , Juego de Azar , Trastornos Psicóticos/tratamiento farmacológico , Medición de Riesgo , Adulto , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Aripiprazol/administración & dosificación , Aripiprazol/efectos adversos , Escala de Evaluación de la Conducta , Canadá/epidemiología , Estudios de Casos y Controles , Causalidad , Femenino , Juego de Azar/diagnóstico , Juego de Azar/epidemiología , Juego de Azar/etiología , Juego de Azar/psicología , Humanos , Masculino , Determinación de la Personalidad , Psicopatología/métodos , Psicopatología/estadística & datos numéricos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Ajuste de Riesgo/métodos , Medición de Riesgo/métodos , Medición de Riesgo/estadística & datos numéricos , Factores de RiesgoRESUMEN
Understudied is psychopathy in females, particularly socially dangerous NGRI females, where the construct could be of forensic, clinical and criminologic significance. Italy's recent transformation of its mental health system created the context for studying such a population on a national level. Throughout the twentieth century until their closure in 2015, offenders found to be not guilty by reason of insanity (NGRI) and socially dangerous were placed in one of the the six high security hospitals in Italy (OPGs). Only one hospital, the Castiglione delle Stiviere maximum security hospital (OPG) in North Italy, treated female offenders, who came from all parts of Italy. The authors studied 66 of all 86 women in Castiglione delle Stiviere OPG. The aims of this study were to identify the prevalence of psychopathy in NGRI female offenders and eventually to identify any phenotypic gender-specific features of psychopathy. The SCID I and II interviews and other tests (MMPI-2, MCMI-III, R-Bans) were administered to all the women. Clinical historical information was obtained. Finally for all women who consented to participate in the study, the researchers administered the PCL-R version validated for the Italian population. The final sample consisted of 66 women, who were deemed NGRI and socially dangerous. Here the authors present the final results as well as limitations of the research.
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Defensa por Insania , Fenotipo , Prisioneros/psicología , Mujeres/psicología , Adulto , Anciano , Trastorno de Personalidad Limítrofe/diagnóstico , Conducta Peligrosa , Femenino , Hospitales Psiquiátricos , Humanos , Italia , Persona de Mediana Edad , Determinación de la Personalidad , Pruebas de Personalidad , Prevalencia , Psicopatología/estadística & datos numéricosRESUMEN
BACKGROUND: The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service. METHODS: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory (MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS (19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at < 15 months (n = 30) versus ≥15 months (n = 33). Binary MPI results (normal-abnormal) were also compared between the two groups. RESULTS: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio (OR) at 1.05 for every 1-month increase (95% confidence interval (CI) 1.02-1.08; P = 0.002). Subjects with pain duration at ≥15 months have lower faking good response score (P < 0.001 vs. those with pain duration at < 15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores (P < 0.05). Pain duration was significantly associated with the MPI variables. CONCLUSIONS: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.
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Síndromes de Dolor Regional Complejo/psicología , Personal Militar/psicología , Estudios de Cohortes , Humanos , Masculino , Personal Militar/estadística & datos numéricos , Oportunidad Relativa , Inventario de Personalidad/estadística & datos numéricos , Psicopatología/instrumentación , Psicopatología/estadística & datos numéricos , República de Corea , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: In the current debate about the categorical or dimensional classification of mental disorders many fruitful methods to illustrate one or the other aspect are employed, and suggestions are made to combine the two perspectives. METHODS: We present such an approach to combine both perspectives at the same time. Based on psychopathological AMDP-symptom profiles, a map of psychiatric patients was calculated by robust nonmetric multidimensional scaling (NMDS). RESULTS: The sample from the Ludwig-Maximilians University in Munich included the records of patients, who were admitted and discharged in 2002 and 2003 with a diagnosis of either paranoid schizophrenia, (F20.00, N = 24), bipolar affective disorder, current episode manic without psychotic symptoms (F31.1, N = 32) or severe depressive episode without psychotic symptoms (F32.2, N = 78). In the resulting map of patients we found a clear categorical distinction according to the diagnostic groups, but also high regression values of AMDP-syndromes (manic syndrome: r = 0.83, depressive syndrome: r = 0.68, and paranoid-hallucinatory syndrome, r = 0.62). DISCUSSION: The map of psychiatric patients presents an approach to consider the categorical and dimensional aspects at the same time. We were able to identify meaningful delineations between diagnostic clusters as well as continuous transitions. This method allows the whole psychopathological profile of each individual patient to be considered and also to identify misdiagnosed cases at a glance.
Asunto(s)
Trastorno Bipolar/psicología , Trastorno Depresivo/psicología , Psicopatología , Esquizofrenia Paranoide/psicología , Trastorno Bipolar/diagnóstico , Trastorno Depresivo/diagnóstico , Diagnóstico Diferencial , Errores Diagnósticos , Hospitales , Humanos , Pacientes , Escalas de Valoración Psiquiátrica , Psicopatología/métodos , Psicopatología/estadística & datos numéricos , Análisis de Regresión , Esquizofrenia Paranoide/diagnóstico , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To determine whether psychological variables (perceived stress, pregnancy-specific stress and psychopathology symptoms) and physiological variables (hair cortisol levels) are related to type of delivery (eutocic or instrumental delivery; spontaneous or induced labor). DESIGN: This was a longitudinal study. SETTING: Spain. PARTICIPANTS: A total sample of 88 pregnant women. MEASUREMENT AND FINDINGS: Perceived stress, pregnancy-specific stress, psychopathology symptoms and hair cortisol level were assessed in pregnant women throughout the third trimester of pregnancy until they gave birth. Participants were grouped by type of delivery (eutocic or instrumental delivery; spontaneous or induced labor). ANOVA tests were performed in order to determine differences between groups. We found differences between the eutocic and instrumental delivery groups in the SCL-90-R subscales somatisation (tâ¯=â¯6.98; pâ¯=â¯0.01), anxiety (tâ¯=â¯3.42; p < 0.05), depression (tâ¯=â¯5.20; p < 0.02) and psychoticism (tâ¯=â¯5.28; p < 0.01), and in the general indices global severity index (tâ¯=â¯5.57; p < 0.05) and positive symptoms (tâ¯=â¯5.21; p < 0.01). No differences were found between groups for the other variables. KEY CONCLUSIONS: Maternal psychological status could have an impact on delivery, since women who had an instrumental delivery presented more psychopathology symptoms in the third trimester. IMPLICATIONS FOR RESEARCH: The psychological assessment and treatment of pregnant women could play a key role in enhancing maternal mental health and preventing the processes and outcomes associated with poor psychological status.
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Hidrocortisona/análisis , Mujeres Embarazadas/psicología , Psicopatología/estadística & datos numéricos , Estrés Psicológico/complicaciones , Adulto , Análisis de Varianza , Biomarcadores/análisis , Biomarcadores/metabolismo , Femenino , Cabello/química , Cabello/metabolismo , Análisis de Cabello/métodos , Humanos , Hidrocortisona/metabolismo , Estudios Longitudinales , Percepción , Embarazo , Psicometría/instrumentación , Psicometría/métodos , España , Estrés Psicológico/metabolismo , Estrés Psicológico/psicologíaRESUMEN
BACKGROUND: Psychiatric history has been suggested to have an impact on long-term adjustment in burn survivors. A rigorous, prospective, longitudinal approach was used to study psychiatric history in a population-based burn sample and its impact on symptomatology of depression and posttraumatic stress disorder (PTSD) at a 12-month follow-up. METHODS: Seventy-three consecutive patients admitted to the Uppsala Burn Unit were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for psychiatric disorders, of whom 64 were also assessed after 12 months. RESULTS: Forty-eight patients (66%) presented with at least one lifetime psychiatric diagnosis; major depression (41%), alcohol abuse or dependence (32%), simple phobia (16%), and panic disorder (16%) were most prevalent. At 12-months postburn, 10 patients (16%) met criteria for major depression, 6 (9%) for PTSD, and 11 (17%) for subsyndromal PTSD. Patients with lifetime anxiety disorder and with lifetime psychiatric comorbidity were more likely to be depressed at 12 months, whereas those with lifetime affective disorder, substance use disorder and psychiatric comorbidity were more likely to have symptoms of PTSD. CONCLUSIONS: Two-thirds of burn survivors exhibit a history of lifetime psychiatric disorders. Those with a psychiatric history have a higher risk of postburn psychiatric problems.
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Unidades de Quemados/estadística & datos numéricos , Quemaduras/complicaciones , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/epidemiología , Psicopatología/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Quemaduras/etiología , Trastorno Depresivo Mayor/diagnóstico , Femenino , Humanos , Entrevista Psicológica , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , Trastornos por Estrés Postraumático/diagnóstico , Suecia/epidemiologíaRESUMEN
Psychopathology is usually recognized as an important clinical and research tool in psychiatric textbooks. However, in the era of operationalized psychiatric diagnosis, therapeutic guidelines and strong neuroscientific impact on the self-understanding of psychiatry, its role became somewhat insecure in recent decades. And it has even been argued that psychopathology will sooner or later be fully replaced by neuroscientific concepts. This paper elucidates the theoretical (and, partly, historical) framework of this debate and argues for a modern understanding of psychopathology. This understanding will, on the one hand, be compatible with neurobiological and social sciences appoaches to mental illness, and, on the other hand, will not abandon psychopathology's demand to be an indispensable foundation of psychiatry.
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Psiquiatría Comunitaria/tendencias , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Neurociencias/tendencias , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Actitud , Humanos , Modelos Psicológicos , Psicopatología/estadística & datos numéricos , Psicopatología/tendenciasRESUMEN
OBJECTIVES: Despite the frequency of disasters in Africa, almost nothing is known about ethnic affiliations in relation to psychopathology after such incidents. This study examined the mental health outcomes of members of 7 major ethnic groups exposed to the 1998 terrorist bombing of the US Embassy in Nairobi, Kenya. METHODS: Approximately 8 to 10 months after the disaster, 229 civilian employees, 99 locally engaged staff workers of the US State Department and the US Agency for International Development, and 64 workers of the Kenyan Red Cross Society (total N=392) were assessed with the Diagnostic Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Additional data were gathered on demographic characteristics, disaster exposures and injuries, and ethnic affiliations. RESULTS: Disaster-related post-traumatic stress disorder (PTSD) was significantly less prevalent among members of the Kikuyu group (28%) and post-disaster major depression was significantly more prevalent among members of the Meru group (64%), compared with all others in the sample. Preexisting psychopathology and disaster injury were independently associated with bombing-related psychopathology. CONCLUSIONS: Further study of disaster-related psychopathology in relation to African ethnic affiliations is needed to better understand these associations and to assist in planning resources and interventions for African disaster survivors. (Disaster Med Public Health Preparedness. 2018; 12: 360-365).
Asunto(s)
Etnicidad/psicología , Trastornos por Estrés Postraumático/etiología , Terrorismo/psicología , Adaptación Psicológica , Adulto , Etnicidad/estadística & datos numéricos , Sustancias Explosivas/efectos adversos , Femenino , Humanos , Kenia/etnología , Masculino , Persona de Mediana Edad , Prevalencia , Psicopatología/estadística & datos numéricos , Trastornos por Estrés Postraumático/etnología , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/psicología , Terrorismo/etnologíaRESUMEN
RESUMO. O presente artigo analisou o estado da arte da psicopatologia do trabalho no Brasil, como objeto de pesquisa e como disciplina, a partir de revisão bibliográfica sistemática integrativa. Foi realizado levantamento em bases de dados virtuais utilizando os descritores 'psicopatologia do trabalho' e 'psicopatologia' (AND) 'trabalho'. Foram incluídos artigos disponibilizados integralmente em português publicados em revistas com revisão cega de pares contendo os descritores no título, resumo, palavras-chave e/ou corpo do texto. O conjunto final dos textos analisados se constituiu de 28 artigos publicados entre 1992 e 2019 majoritariamente em periódicos da psicologia com psicodinâmica do trabalho como referencial teórico e/ou metodológico. Foram ainda identificadas três tendências no uso do termo 'psicopatologia do trabalho' nos artigos: 1) psicopatologia do trabalho como objeto de estudo; 2) como disciplina; e 3) para debater as compreensões das relações entre trabalho e patologias e suas implicações na prática. Enquanto objeto de estudo, as relações entre trabalho e doença mental são negligenciadas. Como disciplina, identificaram-se imprecisões que flexibilizam ou ignoram os limites entre psicopatologia e psicodinâmica do trabalho. Ambas as tendências da literatura podem estar relacionadas com a desconsideração de fatores históricos na determinação da construção dos campos de estudo.
RESUMEN. El presente artículo analizó el estado del arte de la Psicopatología del Trabajo en Brasil, como objeto de investigación y como disciplina, a partir de revisión bibliográfica sistemática integrativa. Se realizó un levantamiento en bases de datos virtuales utilizando los descriptores 'psicopatología del trabajo' y 'psicopatología' (AND) 'trabajo'. Se incluyeron artículos disponibles integralmente en portugués publicados en revistas con revisión ciega de pares conteniendo los descriptores en el título, resumen, palabras clave y/o cuerpo del texto. El conjunto final de textos analizados se constituyó de 28 artículos publicados entre 1992 y 2019 mayoritariamente en periódicos de Psicología con Psicodinámica del Trabajo como referencial teórico y/o metodológico. Se identificaron tres tendencias en el uso del término 'psicopatología del trabajo' en los artículos: 1) psicopatología del trabajo como objeto de estudio; 2) como disciplina; y 3) para debatir las comprensiones de las relaciones entre trabajo y patologías y sus implicaciones en la práctica. En cuanto objeto de estudio, las relaciones entre el trabajo y la enfermedad mental son poco estudiadas. Como disciplina, se identificaron imprecisiones que flexibilizan o ignoran los límites entre Psicopatología y Psicodinámica del Trabajo. Ambas tendencias de la literatura pueden estar relacionadas con la desconsideración de factores históricos en la determinación de la construcción de los campos de estudio.
ABSTRACT. This article analyzed the state of the art of psychopathology of work in Brazil, as an object of study and as a subject, by performing an integrative systematic literature review. A search was conducted in virtual databases using the descriptors 'psychopathology of work' and 'psychopathology' (AND) 'work'. We included articles available in full in Portuguese, published in blind peer-reviewed journals containing the descriptors in the title, abstract, keywords and/or body of the text. The final set of texts consisted of 28 articles published between 1992 and 2019, mostly in psychology journals using psychodynamics of work as theoretical and/or methodological reference. Three trends were also identified in the use of the term 'psychopathology of work' in the articles: 1) psychopathology of work as an object of study; 2) as a subject; and 3) to discuss the understandings of the relationships between work and pathologies and their practical implications. As an object of study, the relationship between work and mental illness is neglected. As a subject, inaccuracies that flexibilize or ignore the limits between psychopathology of work and psychodynamics of work were identified. Both trends in the literature may be related to the lack of reflections that consider the Brazilian context to understand the relations between work and pathology.
Asunto(s)
Psicopatología/estadística & datos numéricos , Trabajo/estadística & datos numéricos , Salud Mental , Distrés Psicológico , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicologíaRESUMEN
OBJECTIVE: To examine the relationship of fear of fear and broad dimensions of psychopathology in panic disorder with agoraphobia over the course of cognitive behavioural therapy in Japan. METHODS: A total of 177 Japanese patients with panic disorder with agoraphobia were treated with group cognitive behavioural therapy between 2001 and 2015. We examined associations between the change scores in Agoraphobic Cognitions Questionnaire or Body Sensations Questionnaire and the changes in subscales of Symptom Checklist-90 Revised during cognitive behavioural therapy controlling the change in panic disorder severity using multiple regression analysis. RESULTS: Reduction in Agoraphobic Cognitions Questionnaire score was related to a decrease in all Symptom Checklist-90 Revised (SCL-90-R) subscale scores. Reduction in Body Sensations Questionnaire score was associated with a decrease in anxiety. Reduction in Panic Disorder Severity Scale score was not related to any SCL-90-R subscale changes. CONCLUSIONS: Changes in fear of fear, especially maladaptive cognitions, may predict broad dimensions of psychopathology reductions in patients of panic disorder with agoraphobia over the course of cognitive behavioural therapy. For the sake of improving a broader range of psychiatric symptoms in patients of panic disorder with agoraphobia, more attention to maladaptive cognition changes during cognitive behavioural therapy is warranted.
Asunto(s)
Agorafobia/complicaciones , Agorafobia/terapia , Terapia Cognitivo-Conductual , Miedo/psicología , Trastorno de Pánico/complicaciones , Trastorno de Pánico/terapia , Psicopatología/estadística & datos numéricos , Adulto , Agorafobia/psicología , Ansiedad/psicología , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Trastorno de Pánico/psicología , Psicoterapia de Grupo , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
AbstractBackground/Objective: Emotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. Method: We examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. Results: In each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. Conclusions: Although the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.
ReportResumenAntecedentes/Objetivo: La desregulación emocional (DE) es un ámbito dimensional en Psicología, previamente operacionalizado por los instrumentos del Achenbach System of Empirically Based Assessment (ASEBA) para niños y adolescentes; sin embargo, aún se desconocen sus características interculturales y su enfoque ascendente en su aplicación a la población adulta. Método: Examinamos las puntuaciones obtenidas en el Adult Self-Report (ASR) por 9.238 personas de 18 a 59 años pertenecientes a diez sociedades que diferían en cuanto a sus características sociales, económicas, geográficas y de otro tipo. Se realizó un análisis de clases latentes con los datos de cada sociedad. Resultados: En cada sociedad se identificó una clase desregulada (DES), que se caracterizaba por pun-tuaciones elevadas en la mayoría de los síndromes ASR. La prevalencia media de DES fue del 9,2% (6,1-12,7%). Los mejores modelos oscilaron entre tres y cinco clases latentes en las diferentes sociedades. Conclusiones: Aunque el número de clases identificadas y la prevalencia de DE variaron entre las diversas sociedades, se encontró una clase DES en cada sociedad, lo que sugiere la necesidad de adoptar una visión dimensional de la psi-copatología y una perspectiva intercultural también en las poblaciones adultas.