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1.
BMC Public Health ; 23(1): 1076, 2023 06 05.
Artículo en Inglés | MEDLINE | ID: mdl-37277740

RESUMEN

BACKGROUND: An analysis of predictors of smoking behaviour among users of smoking cessation apps can provide useful information beyond what is already known about predictors in other contexts. Therefore, the aim of the present study was to identify the best predictors of smoking cessation, smoking reduction and relapse six months after starting to use the smartphone app Stop-Tabac. METHOD: Secondary analysis of 5293 daily smokers from Switzerland and France who participated in a randomised trial testing the effectiveness of this app in 2020, with follow-up at one and six months. Machine learning algorithms were used to analyse the data. The analyses for smoking cessation included only the 1407 participants who responded after six months; the analysis for smoking reduction included only the 673 smokers at 6-month follow-up; and the analysis for relapse at 6 months included only the 502 individuals who had quit smoking after one month. RESULTS: Smoking cessation after 6 months was predicted by the following factors (in this order): tobacco dependence, motivation to quit smoking, frequency of app use and its perceived usefulness, and nicotine medication use. Among those who were still smoking at follow-up, reduction in cigarettes/day was predicted by tobacco dependence, nicotine medication use, frequency of app use and its perceived usefulness, and e-cigarette use. Among those who had quit smoking after one month, relapse after six months was predicted by intention to quit, frequency of app use, perceived usefulness of the app, level of dependence and nicotine medication use. CONCLUSION: Using machine learning algorithms, we identified independent predictors of smoking cessation, smoking reduction and relapse. Studies on the predictors of smoking behavior among users of smoking cessation apps may provide useful insights for the future development of these apps and future experimental studies. CLINICAL TRIAL REGISTRATION: ISRCTN Registry: ISRCTN11318024, 17 May 2018. http://www.isrctn.com/ISRCTN11318024 .


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Aplicaciones Móviles , Cese del Hábito de Fumar , Humanos , Nicotina , Recurrencia , Teléfono Inteligente
2.
Eur Addict Res ; 29(3): 171-181, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37166304

RESUMEN

INTRODUCTION: Studies of the users' engagement with smoking cessation application (apps) can help understand how these apps are used by smokers, in order to improve their reach and efficacy. OBJECTIVE: The present study aimed at identifying the best predictors of the users' level of engagement with a smartphone app for smoking cessation and at examining the relationships between predictors and outcomes related to the users' level of engagement with the app. METHODS: A secondary analysis of data from a randomized trial testing the efficacy of the Stop-Tabac smartphone app was used. The experimental group used the "full" app and the control group used a "dressed down" app. The study included a baseline and 1-month and 6-month follow-up questionnaires. A total of 5,293 participants answered at least the baseline questionnaires; however, in the current study, only the 1,861 participants who answered at least the baseline and the 1-month follow-up questionnaire were included. Predictors were measured at baseline and after 1 month and outcomes after 6 months. Data were analyzed using machine learning algorithms. RESULTS: The best predictors of the outcomes were, in decreasing order of importance, intention to stop smoking, dependence level, perceived helpfulness of the app, having quit smoking after 1 month, self-reported usage of the app after 1 month, belonging to the experimental group (vs. control group), age, and years of smoking. Most of these predictors were also significantly associated with the participants' level of engagement with the app. CONCLUSIONS: This information can be used to further target the app to specific groups of users, to develop strategies to enroll more smokers, and to better adapt the app's content to the users' needs.


Asunto(s)
Aplicaciones Móviles , Cese del Hábito de Fumar , Humanos , Teléfono Inteligente , Fumar , Fumadores
3.
Psychopathology ; 56(4): 315-323, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36318899

RESUMEN

BACKGROUND: There is a growing interest in understanding the impact of video games in the clinical field, given that their excessive use could be associated with health issues. Particularly, gaming disorder (GD) is considered as an addictive behavioral disorder. Clinicians widely recognize the comorbidity of gaming and psychotic disorders (PDs). Furthermore, association between addictive (i.e., substance use disorders) and PDs are well recognized by clinicians. It seems of high interest to explore GD among people with PDs. To this day, little is known about the consequences of GD in vulnerable populations. OBJECTIVES: The aim of this scoping review was to summarize the available research on the comorbidity between GD and PD and to identify the knowledge gaps in this field. METHODS: We used Levac's six-stage methodology for scoping review. Two-hundred and forty-two articles from seven databases were identified. Eight articles respected our inclusion and exclusion criteria. RESULTS: No available study has assessed the prevalence or incidence of GD among patients with PDs. The cases reported highlight the possibility that excessive video gameplay or abrupt gaming disruption could trigger psychosis in some patients. CONCLUSION: The results highlight a significant lack of knowledge concerning PDs associated with GD as only a few reported cases and one empirical study exposed the potential association between those conditions.


Asunto(s)
Conducta Adictiva , Trastornos Psicóticos , Juegos de Video , Humanos , Conducta Adictiva/diagnóstico , Conducta Adictiva/epidemiología , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Comorbilidad , Prevalencia , Internet
4.
Rev Med Suisse ; 19(N° 809-10): 12-15, 2023 Jan 18.
Artículo en Francés | MEDLINE | ID: mdl-36660830

RESUMEN

Addictions appear everywhere, mutate, transform with new products and behaviors, playing on our painstaking efforts to try to control them. Drawn into this current, the impression that dominates invites more to understand and to coax rather than to fight. Addictions are our condition, let's deal with it, rather than fight against them. It is therefore a question of knowing the products, that everyone can identify their level of risk, and of giving as many tools as possible, at any age, whatever the behavior or the product. This article shows us that there is a lot to do, from school benches to liver transplantation. There is also a lot to discover, in the recognition of the therapeutic virtues, of cannabinoids for example or even in their prescription, of pharmaceutical heroin for example, sometimes by far the best option.


Les addictions émergent de partout, mutent, se transforment avec des nouveaux produits et comportements, se jouant de nos efforts laborieux pour tenter de les contrôler. Entraînés dans ce courant, l'impression qui domine invite davantage à comprendre et à amadouer plutôt qu'à lutter. Les addictions sont notre condition, faisons avec, plutôt que contre. Il s'agit donc de connaître les produits, que chacun puisse identifier son niveau de risque, et de donner autant d'outils que possible, à tout âge, quel que soit le comportement ou le produit. Cet article nous montre qu'il y a beaucoup à faire, des bancs de l'école à la transplantation hépatique. Il y a aussi beaucoup à découvrir, dans la reconnaissance des vertus thérapeutiques, des cannabinoïdes par exemple, ou encore dans leur prescription, de l'héroïne pharmaceutique, parfois de loin la meilleure option.


Asunto(s)
Conducta Adictiva , Humanos , Conducta Adictiva/terapia
5.
Cogn Affect Behav Neurosci ; 22(6): 1421-1431, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35698004

RESUMEN

Current research indicates deficits in cognitive function together with widespread changes in brain activity following long-term cannabis use. In particular, cannabis use has been associated with excessive spectral power of the alpha rhythm (8-12 Hz), which is also known to be modulated during attentional states. Recent neuroimaging studies have linked heavy cannabis use with structural and metabolic changes in the brain; however, the functional consequences of these changes are still not fully characterized. This study investigated the electrophysiological and behavioral correlates of cannabis dependence by comparing patients with a cannabis use disorder (CUD; N = 24) with cannabis nonuser controls (N = 24), using resting state electroencephalogram (EEG) source-imaging. In addition to evaluating mean differences between groups, we also explored whether particular EEG patterns were associated with individual cognitive-behavioral measures. First, we replicated historical findings of elevated levels of (relative) alpha rhythm in CUD patients compared with controls and located these abnormalities to mainly prefrontal cortical regions. Importantly, we observed a significant negative correlation between alpha spectral power in several cortical regions and individual attentional performance in the Go/NoGo task. Because such relationship was absent in the nonuser control group, our results suggest that reduced prefrontal cortical activation (indexed by increased relative alpha power) could be partly responsible for the reported cognitive impairments in CUD. Our findings support the use of electroencephalography as a noninvasive and cost-effective tool for biomarker discovery in substance abuse and have the potential of directly informing future intervention strategies.


Asunto(s)
Abuso de Marihuana , Trastornos Relacionados con Sustancias , Humanos , Abuso de Marihuana/diagnóstico por imagen , Abuso de Marihuana/psicología , Electroencefalografía , Atención/fisiología , Encéfalo/fisiología
6.
J Med Internet Res ; 24(10): e38963, 2022 10 20.
Artículo en Inglés | MEDLINE | ID: mdl-36264627

RESUMEN

BACKGROUND: Problematic smartphone use, like problematic internet use, is a condition for which treatment is being sought on the web. In the absence of established treatments, smartphone-provided tools that monitor or control smartphone use have become increasingly popular, and their dissemination has largely occurred without oversight from the mental health field. OBJECTIVE: We aimed to assess the popularity and perceived effectiveness of smartphone tools that track and limit smartphone use. We also aimed to explore how a set of variables related to mental health, smartphone use, and smartphone addiction may influence the use of these tools. METHODS: First, we conducted a web-based survey in a representative sample of 1989 US-based adults using the crowdsourcing platform Prolific. Second, we used machine learning and other statistical tools to identify latent user classes; the association between latent class membership and demographic variables; and any predictors of latent class membership from covariates such as daily average smartphone use, social problems from smartphone use, smartphone addiction, and other psychiatric conditions. RESULTS: Smartphone tools that monitor and control smartphone use were popular among participants, including parents targeting their children; for example, over two-thirds of the participants used sleep-related tools. Among those who tried a tool, the highest rate of perceived effectiveness was 33.1% (58/175). Participants who experienced problematic smartphone use were more likely to be younger and more likely to be female. Finally, 3 latent user classes were uncovered: nonusers, effective users, and ineffective users. Android operating system users were more likely to be nonusers, whereas younger adults and females were more likely to be effective users. The presence of psychiatric symptoms did not discourage smartphone tool use. CONCLUSIONS: If proven effective, tools that monitor and control smartphone use are likely to be broadly embraced. Our results portend well for the acceptability of mobile interventions in the treatment of smartphone-related psychopathologies and, potentially, non-smartphone-related psychopathologies. Better tools, targeted marketing, and inclusive design, as well as formal efficacy trials, are required to realize their potential.


Asunto(s)
Colaboración de las Masas , Teléfono Inteligente , Adulto , Niño , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Trastorno de Adicción a Internet , Aprendizaje Automático
7.
Eur Addict Res ; 27(1): 58-66, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33120393

RESUMEN

BACKGROUND: Cyberchondria denotes excessive and repeated online health-related searches associated with an increase in health anxiety. Such searches persist in those with cyberchondria, despite the negative consequences, resembling a pattern of compulsive Internet use. OBJECTIVES: The aim of the present study was to assess compulsive health-related Internet use in relation to cyberchondria while controlling for related variables. METHOD: Adult participants (N = 749) were recruited from an online platform. They completed questionnaires assessing the severity of cyberchondria (via the Cyberchondria Severity Scale [CSS]), compulsive Internet use adapted for online health-related seeking (via the adapted Compulsive Internet Use Scale [CIUS]), and levels of intolerance of uncertainty and anxiety, as well as depressive, somatic, and obsessive-compulsive symptoms. A logistic regression analysis was carried out to identify predictors of scores above a cutoff value on the CIUS, indicating compulsive health-related Internet use. RESULTS: The regression output showed that only the CSS total score and sex made a unique, statistically significant contribution to the model, leading to the correct classification of 78.6% of the cases. Of the CSS subscales, compulsion and distress were the most strongly associated with compulsive health-related Internet use. CONCLUSIONS: The finding that the adapted CIUS scores are associated with cyberchondria indicates that cyberchondria has a compulsive component, at least in terms of health-related Internet use. It also suggests that compulsive health-related Internet use persists despite the distress associated with this activity. Males may engage in cyberchondria more compulsively than females. These findings have implications for research and clinical practice.


Asunto(s)
Uso de Internet , Adolescente , Adulto , Anciano , Ansiedad , Trastornos de Ansiedad , Femenino , Humanos , Hipocondriasis , Internet , Masculino , Persona de Mediana Edad , Incertidumbre , Adulto Joven
8.
J Pers ; 89(6): 1252-1262, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34114654

RESUMEN

AIMS: Negative and positive urgency are emotion-related impulsivity traits that are thought to be transdiagnostic factors in psychopathology. However, it has recently been claimed that these two traits are closely related to each other and that considering them separately might have limited conceptual and methodological value. The present study aimed to examine whether positive and negative urgency constructs constitute separate impulsivity traits. METHODS: In contrast to previous studies that have used latent variable approaches, this study employed an item-based network analysis conducted in two different samples: a large sample of non-clinical participants (N = 18,568) and a sample of clinical participants with psychiatric disorders (N = 385). RESULTS: The network analysis demonstrated that items denoting both positive and negative urgency cohere as a single cluster of items termed "general urgency" in both clinical and non-clinical samples, thereby suggesting that differentiating positive and negative urgency as separate constructs is not necessary. CONCLUSION: These findings have important implications for the conceptualization and assessment of urgency and, more broadly, for future research on impulsivity, personality, and psychopathology.


Asunto(s)
Conducta Impulsiva , Trastornos Mentales , Humanos , Personalidad , Psicopatología
9.
J Med Libr Assoc ; 109(1): 75-83, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33424467

RESUMEN

OBJECTIVE: There are concerns about nonscientific and/or unclear information on the coronavirus disease 2019 (COVID-19) that is available on the Internet. Furthermore, people's ability to understand health information varies and depends on their skills in reading and interpreting information. This study aims to evaluate the readability and creditability of websites with COVID-19-related information. METHODS: The search terms "coronavirus," "COVID," and "COVID-19" were input into Google. The websites of the first thirty results for each search term were evaluated in terms of their credibility and readability using the Health On the Net Foundation code of conduct (HONcode) and Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Gunning Fog, and Flesch Reading Ease Score (FRE) scales, respectively. RESULTS: The readability of COVID-19-related health information on websites was suitable for high school graduates or college students and, thus, was far above the recommended readability level. Most websites that were examined (87.2%) had not been officially certified by HONcode. There was no significant difference in the readability scores of websites with and without HONcode certification. CONCLUSION: These results suggest that organizations should improve the readability of their websites and provide information that more people can understand. This could lead to greater health literacy, less health anxiety, and the provision of better preventive information about the disease.


Asunto(s)
COVID-19/enfermería , Comprensión , Información de Salud al Consumidor/métodos , Exactitud de los Datos , Bases de Datos Factuales/estadística & datos numéricos , Alfabetización en Salud/métodos , Internet , Autocuidado/métodos , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2
10.
Rev Med Suisse ; 17(742): 1111-1114, 2021 Jun 09.
Artículo en Francés | MEDLINE | ID: mdl-34106535

RESUMEN

The choice of opioid-assisted treatments for patients with heroin dependence is particularly diverse in Switzerland. Since 1994, diacetylmorphine assisted treatments are available. The rules for prescribing and dispensing diacetylmorphine, as laid down by the FOPH, are particularly strict, requiring patients to attend the treatment center several times a day. Thanks to a legislative amendment by the Federal Council, it became possible to extend the dispensing of diacetylmorphine during the Covid-19 epidemic, allowing patients to take the treatment with them for longer periods and thus reducing the number of visits to the clinic. The time freed up could then be invested in other activities, allowing therapies to be refocused more on the patients' life project.


L'offre des traitements assistés par opioïdes pour les personnes avec dépendance à l'héroïne est particulièrement diversifiée en Suisse. Les traitements basés sur la prescription de diacétylmorphine y sont ainsi proposés depuis 1994, dont les règles de prescription et de remise au patient régies par l'Office fédéral de la santé publique sont particulièrement strictes, imposant aux patients un passage au centre de soins plusieurs fois par jour. Grâce aux modifications législatives du Conseil fédéral, permettant aux patients d'emporter le traitement pour des durées plus longues pendant la pandémie de Covid-19, les passages à la consultation ont été réduits. Cela a eu pour effet indirect de libérer du temps, qui a pu être investi dans d'autres activités, notamment le recentrage des thérapies davantage autour des projets de vie des patients.


Asunto(s)
COVID-19 , Dependencia de Heroína , Heroína , Dependencia de Heroína/tratamiento farmacológico , Humanos , SARS-CoV-2 , Suiza
11.
Rev Med Suisse ; 17(761): 2105-2109, 2021 Dec 01.
Artículo en Francés | MEDLINE | ID: mdl-34851059

RESUMEN

Primary care physicians are in an excellent position to address smoking during routine consultations. To this end, physicians have assessment tools and brief interventions appropriate for the duration of consultations. However, these tools are difficult to use consistently in practice. Mobile applications (apps) aimed at stopping smoking could help solve this problem, provided they meet certain quality criteria. This article provides criteria for evaluating these apps to facilitate their identification and use by clinicians. Five French-speaking apps are described. If integrated into routine Primary Care, these apps could facilitate smoking cessation.


Le médecin de premier recours a une place privilégiée pour aborder le problème du tabagisme en consultation de routine. Il dispose, à cet effet, d'outils d'évaluations et d'interventions brèves compatibles avec le temps de consultation. Ces outils sont difficiles à implémenter systématiquement. Les applications mobiles (apps) visant à l'arrêt du tabac pourraient contribuer à résoudre ce problème pour autant qu'elles satisfassent à certains critères de qualité. Le présent article propose des critères d'évaluation de ces apps pour faciliter leur identification et leur utilisation par le clinicien. Cinq apps francophones sont décrites. Intégrées à la consultation de médecine générale, de telles apps, pourraient faciliter la désaccoutumance au tabac.


Asunto(s)
Aplicaciones Móviles , Cese del Hábito de Fumar , Humanos , Atención Primaria de Salud , Fumar , Fumar Tabaco
12.
Rev Med Suisse ; 17(754): 1754-1759, 2021 Oct 13.
Artículo en Francés | MEDLINE | ID: mdl-34644020

RESUMEN

The management of patients who have become dependent on benzodiazepines and analogues is a problem frequently encountered in both somatic and psychiatric medicine. No pharmacological treatment is currently recognized as effective in the management of these addictions, apart from a gradual reduction of doses. We propose practical strategies for the implementation of gradual dose reduction and choice of molecules while promoting individual adaptation to the withdrawal symptoms presented by the patient.


La prise en charge de patients ayant développé une dépendance aux benzodiazépines et analogues est une problématique rencontrée fréquemment tant en médecine somatique que psychiatrique. Aucun traitement pharmacologique n'est actuellement reconnu comme efficace dans la prise en charge de ces dépendances, en dehors d'une réduction progressive des doses. Nous proposons des stratégies pratiques de mise en œuvre de réduction progressive des doses et de choix de molécules tout en favorisant une adaptation individuelle aux symptômes de sevrage présentés par le patient.


Asunto(s)
Conducta Adictiva , Síndrome de Abstinencia a Sustancias , Trastornos Relacionados con Sustancias , Benzodiazepinas/uso terapéutico , Humanos , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Trastornos Relacionados con Sustancias/terapia
13.
Rev Med Suisse ; 17(720-1): 85-89, 2021 Jan 13.
Artículo en Francés | MEDLINE | ID: mdl-33443837

RESUMEN

The Covid-19 pandemic has a major impact on psychiatry by its social consequences and possible direct effect of certain forms of Covid-19 on mental health. During this crisis, the accessibility of technology meets a state of necessity, which has propelled telepsychiatry from the shadows into the light. The contribution of several technologies (i.e. virtual reality, actigraphy, computational psychiatry) combining clinical data and neuroscience underlines the great neurobehavioural variability even within the same diagnostic category, calling for greater precision in therapeutic offers as suggested e.g. by developments in neurofeedback. The place of intranasal esketamin in the panoply of antidepressent drug treatments for resistant depression has not yet been defined.


La pandémie de Covid-19 bouleverse la psychiatrie par ses conséquences sociales et par de possibles séquelles psychiatriques. La crise actuelle révèle l'accessibilité de technologies digitales telles que la télépsychiatrie. Des technologies comme la réalité virtuelle, l'actigraphie, la psychiatrie computationnelle combinées aux données cliniques et aux neurosciences révèlent une importante variabilité neurocomportementale même au sein d'une catégorie diagnostique donnée, invitant à une plus grande précision des traitements comme suggéré par les recherches en neurofeedback. La place de l'eskétamine intranasale dans la panoplie thérapeutique médicamenteuse de la dépression résistante doit encore être définie.


Asunto(s)
Psiquiatría/tendencias , Telemedicina , COVID-19 , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológico , Humanos , Ketamina/administración & dosificación , Neurorretroalimentación , Pandemias
14.
Rev Med Suisse ; 17(763): 2206-2208, 2021 Dec 15.
Artículo en Francés | MEDLINE | ID: mdl-34910408

RESUMEN

Cases of addictions and misuses on gabapentinoids are increasingly reported. But the underlying pharmacological mechanism is not completely understood. Here is an uptodate of the current knowledges on this dependence and its management.


Des cas de mésusages et d'addictions aux gabapentinoïdes sont de plus en plus fréquemment rapportés, sans que le mécanisme pharmacologique sous-jacent ne soit complètement compris. Nous faisons un état des lieux des connaissances sur cette dépendance et sa prise en charge.


Asunto(s)
Conducta Adictiva , Gabapentina , Humanos
15.
BMC Psychiatry ; 20(1): 431, 2020 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-32883239

RESUMEN

BACKGROUND: This longitudinal study identified risk factors for frequency of hospitalization among patients with any medical condition who had previously visited one of six Quebec (Canada) emergency departments (ED) at least once for mental health (MH) conditions as the primary diagnosis. METHODS: Records of n = 11,367 patients were investigated using administrative databanks (2012-13/2014-15). Hospitalization rates in the 12 months after a first ED visit in 2014-15 were categorized as no hospitalizations (0 times), moderate hospitalizations (1-2 times), and frequent hospitalizations (3+ times). Based on the Andersen Behavioral Model, data on risk factors were gathered for the 2 years prior to the first visit in 2014-15, and were identified as predisposing, enabling or needs factors. They were tested using a hierarchical multinomial logistic regression according to the three groups of hospitalization rate. RESULTS: Enabling factors accounted for the largest percentage of total variance explained in the study model, followed by needs and predisposing factors. Co-occurring mental disorders (MD)/substance-related disorders (SRD), alcohol-related disorders, depressive disorders, frequency of consultations with outpatient psychiatrists, prior ED visits for any medical condition and number of physicians consulted in specialized care, were risk factors for both moderate and frequent hospitalizations. Schizophrenia spectrum and other psychotic disorders, bipolar disorders, and age (except 12-17 years) were risk factors for moderate hospitalizations, while higher numbers (4+) of overall interventions in local community health service centers were a risk factor for frequent hospitalizations only. Patients with personality disorders, drug-related disorders, suicidal behaviors, and those who visited a psychiatric ED integrated with a general ED in a separate site, or who visited a general ED without psychiatric services were also less likely to be hospitalized. Less urgent and non-urgent illness acuity prevented moderate hospitalizations only. CONCLUSIONS: Patients with severe and complex health conditions, and higher numbers of both prior outpatient psychiatrist consultations and ED visits for medical conditions had more moderate and frequent hospitalizations as compared with non-hospitalized patients. Patients at risk for frequent hospitalizations were more vulnerable overall and had important biopsychosocial problems. Improved primary care and integrated outpatient services may prevent post-ED hospitalization.


Asunto(s)
Servicio de Urgencia en Hospital , Salud Mental , Canadá , Hospitalización , Humanos , Estudios Longitudinales , Quebec/epidemiología , Factores de Riesgo
16.
Int J Psychiatry Clin Pract ; 24(1): 3-9, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31613166

RESUMEN

Objectives: The Convention on the Rights of Persons with Disabilities (CRPD) was adopted at the United Nations Assembly in 2006. The main aim of the convention is to ensure equal rights for people with disabilities including the expression of people's own "will and preferences" concerning health treatment. Article 12 demands the respect of a person's "rights, will and preferences" (CRPD) and suggests supported decision making (SDM) when possible. The aim of this review was to gather information regarding the SDM implementation from a clinical perspective for people with mental health disorders.Methods: A systematic literature search was performed on electronic databases MEDLINE, PsycARTICLES, and PsycINFO using the keywords "supported decision making" and "UN convention on the rights of persons with disabilities" in March 2018.Results: Eleven articles were included in the final review, which focussed on three themes: (1) different models of SDM, (2) stakeholder views, and (3) challenges for implementation. A limited number of papers described clinical models that had good theoretical consistency with SDM. The main challenges of implementation related to critical situations when "will and preferences" are poorly understood or appear contradictory. Future studies should assess specific models of SDM implementation, including related outcomes and process measures.


Asunto(s)
Toma de Decisiones Conjunta , Trastornos Mentales/terapia , Enfermos Mentales , Derechos del Paciente , Humanos , Enfermos Mentales/legislación & jurisprudencia , Derechos del Paciente/legislación & jurisprudencia
17.
Rev Med Suisse ; 16(678): 144-147, 2020 Jan 22.
Artículo en Francés | MEDLINE | ID: mdl-31967758

RESUMEN

Living in an urban environment increases the risk to develop psychosis. An interdisciplinary research project has allowed a better definition of urban stress components and the adaptation strategies applied by patients to face it. On this basis, the concept of « urban remediation ¼ has emerged as a strategy to help patients regain access to the city. Among the other new treatment approaches, we also discuss therapy through games, which, due to their flexibility and variety, can suit many different needs. These approaches allow the reinforcement of coping capacities through diverse strategies, ranging from the promotion of social interactions to cognitive restructuration or behavioral activation. In addition, the engaging nature of these games may facilitate access and adherence to treatment.


Vivre en milieu urbain augmente le risque de développer un trouble psychotique. Une recherche interdisciplinaire a permis d'identifier plus précisément les éléments qui composent le stress urbain et les stratégies des patients pour s'y adapter, et de développer la remédiation urbaine, stratégie thérapeutique visant à faciliter la reconquête de l'espace urbain. Les thérapies par le jeu, qui, du fait de leur flexibilité, peuvent quant à elles s'adapter à toutes sortes de besoins, et permettent de renforcer les stratégies d'adaptation des patients, en s'appuyant sur des stratégies de changements variées, allant du renforcement des interactions sociales à la restructuration cognitive ou à l'activation comportementale. De plus, l'attractivité des jeux pourrait faciliter l'entrée ou le maintien dans les soins.


Asunto(s)
Psiquiatría , Trastornos Psicóticos , Adaptación Psicológica , Humanos , Relaciones Interpersonales , Psiquiatría/tendencias
18.
Eur Addict Res ; 25(2): 56-67, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30699412

RESUMEN

PURPOSE: Substance use disorders (SUD) are an important health issue internationally. Traditional outpatient programmes often do not adequately address the substantial medical and social needs and in addition many patients have difficulties accessing the care needed. The assertive community treatment (ACT) model was originally developed for patients with a severe mental illness but has been adapted for patients with SUD by integrating specific SUD treatments into the traditional ACT model. This paper aims to assess the effectiveness of ACT for patients with SUD on a number of measures. METHODS: We performed a systematic review of ACT interventions for patients with SUD by analyzing randomized controlled studies published before June 2017 found on the electronic databases PsychINFO, MEDLINE, PsychARTICLES. Eleven publications using 5 datasets were included in the analysis. Quality of studies was analyzed using the JADAD scale or Oxford quality scoring system. Outcome measures used were substance use, treatment engagement, hospitalization rates, quality of life, housing status, medication compliance and legal problems. Patients included in the studies had a diagnosis of SUD. Two datasets included homeless patients and 2 datasets included patients with high service use. RESULTS AND CONCLUSIONS: The results of the very few existing randomized control studies are mixed. Treatment engagement was higher for ACT in 4 datasets. One dataset reported higher service contact rates for the ACT group than for controls. In 2 datasets a positive effect on hospitalization rates was found. Higher fidelity to the ACT model appears to improve outcomes. Substance use reduced only in half of the datasets, of which only one showed a significant reduction in the ACT group. Overall, ACT is a promising approach that may be useful for promoting treatment engagement for patients with SUD. According to earlier studies on patients with severe mental illness, patients with high inpatient service use benefit most from this assertive approach. We hypothesize that a similar high need user group among patients with SUD might benefit most from ACT. Further research is needed to examine which types of clinical interventions might help difficult-to-engage patients with addictions.


Asunto(s)
Servicios Comunitarios de Salud Mental , Trastornos Relacionados con Sustancias/terapia , Humanos , Resultado del Tratamiento
20.
Psychiatr Q ; 90(3): 491-505, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31098922

RESUMEN

Cyberchondria denotes repeated online searches for health information that are associated with increasing levels of health anxiety. The aims of this study were to apply network analysis to investigate the extent to which cyberchondria is a distinct construct, ascertain which of the related constructs have the strongest relationships with cyberchondria and investigate whether some of the symptoms of cyberchondria are more central to the construct of cyberchondria. Questionnaires assessing the severity of cyberchondria, health anxiety, obsessive-compulsive disorder symptoms, intolerance of uncertainty, problematic Internet use, anxiety, depression and somatic symptoms were administered to 751 participants who searched for health information online during a previous 3-month period and were recruited from an online crowdsourcing platform. Network analyses were used to compute the networks, perform community detection tests and calculate centrality indices. Results suggest that cyberchondria is a relatively specific syndrome-like construct, distinct from all related constructs and consisting of interrelated symptoms. It has the strongest relationships with problematic Internet use and health anxiety. No symptom of cyberchondria emerged clearly as more central to the construct of cyberchondria. Future research should aim to deepen our understanding of cyberchondria and its links with psychopathology, especially its close relationship with problematic Internet use.


Asunto(s)
Ansiedad/psicología , Información de Salud al Consumidor , Hipocondriasis/psicología , Internet , Ansiedad/complicaciones , Conducta Adictiva/psicología , Análisis por Conglomerados , Depresión/complicaciones , Depresión/psicología , Humanos , Hipocondriasis/complicaciones , Trastorno Obsesivo Compulsivo/complicaciones , Trastorno Obsesivo Compulsivo/psicología , Encuestas y Cuestionarios , Incertidumbre
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