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BACKGROUND: Barrett's esophagus (BE) is a diagnosis of esophageal intestinal metaplasia, which can progress to esophageal adenocarcinoma (EAC), and guidelines recommend endoscopic surveillance for early detection and treatment of EAC. However, current practices have limited effectiveness in risk-stratifying patients with BE. AIM: This study aimed to evaluate use of the TSP-9 test in risk-stratifying clinically relevant subsets of patients with BE in clinical practice. METHODS: TSP-9 results for tests ordered by 891 physicians for 8080 patients with BE with clinicopathologic data were evaluated. Orders were from nonacademic (94.3%) and academic (5.7%) settings for nondysplastic BE (NDBE; n=7586; 93.9%), indefinite for dysplasia (IND, n=312, 3.9%), and low-grade dysplasia (LGD, n=182, 2.3%). RESULTS: The TSP-9 test scored 83.2% of patients with low risk, 10.6% intermediate risk, and 6.2% high risk, respectively, for progression to HGD/EAC within 5 years. TSP-9 provided significant risk-stratification independently of clinicopathologic features, within NDBE, IND, and LGD subsets, male and female, and short- and long-segment subsets of patients. TSP-9 identified 15.3% of patients with NDBE as intermediate/high-risk for progression, which was 6.4 times more than patients with a pathology diagnosis of LGD. Patients with NDBE who scored intermediate or high risk had a predicted 5-year progression risk of 8.1% and 15.3%, respectively, which are similar to and higher than published progression rates in patients with BE with confirmed LGD. CONCLUSIONS: The TSP-9 test identified a high-risk subset of patients with NDBE who were predicted to progress at a higher rate than confirmed LGD, enabling early detection of patients requiring management escalation to reduce the incidence of EAC. TSP-9 scored the majority of patients with NDBE as low risk, providing support to adhere to 3- to 5-year surveillance per guidelines.
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Aim: To assess the surgical safety, postoperative outcomes, and the impact of PPK on corneal endothelial cell density through a retrospective analysis of 22 cases. Settings and Design. A retrospective cross-sectional observational study was executed at Hermanos Ameijeiras Hospital from February 2018 to December 2021, involving 22 patients (22 eyes) who were unresponsive to other medical treatments and had a corrected distance visual acuity of ≤0.1. Methods and Materials: Patients underwent PPK, with surgical procedures and postoperative care documented. Statistical analysis was performed on qualitative and quantitative variables to evaluate the surgical outcomes and the corneal endothelial cell density changes postoperation. Results: All surgeries demonstrated a significant improvement in postoperative visual acuity (p ≤ 0.001) and recorded a 9.2% decrease in the corneal endothelial cell density at 12 months. Noteworthy complications included one case of intraoperatively discovered haptic dislocation and one postoperative bacterial keratitis. Conclusions: PPK could potentially mitigate perioperative complications, ensure graft clarity, and reduce corneal endothelial cell loss, presenting itself as a viable alternative to traditional PK. Although the results are encouraging, larger-scale studies are essential to validate the benefits and applicability of PPK in broader clinical settings.
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BACKGROUND: Lyme disease (LD) and other tick-borne diseases are emerging across Canada. Spatial and temporal LD risk is typically estimated using acarological surveillance and reported human cases, the former not considering human behavior leading to tick exposure and the latter occurring after infection. OBJECTIVES: The primary objective was to explore, at the census subdivision level (CSD), the associations of self-reported tick exposure, alternative risk indicators (predicted tick density, eTick submissions, public health risk level), and ecological variables (Ixodes scapularis habitat suitability index and cumulative degree days > 0 °C) with incidence proportion of LD. A secondary objective was to explore which of these predictor variables were associated with self-reported tick exposure at the CSD level. METHODS: Self-reported tick exposure was measured in a cross-sectional populational health survey conducted in 2018, among 10,790 respondents living in 116 CSDs of the Estrie region, Quebec, Canada. The number of reported LD cases per CSD in 2018 was obtained from the public health department. Generalized linear mixed-effets models accounting for spatial autocorrelation were built to fulfill the objectives. RESULTS: Self-reported tick exposure ranged from 0.0 % to 61.5 % (median 8.9 %) and reported LD incidence rates ranged from 0 to 324 cases per 100,000 person-years, per CSD. A positive association was found between self-reported tick exposure and LD incidence proportion (ß = 0.08, CI = 0.04,0.11, p < 0.0001). The best-fit model included public health risk level (AIC: 144.2), followed by predicted tick density, ecological variables, self-reported tick exposure and eTick submissions (AIC: 158.4, 158.4, 160.4 and 170.1 respectively). Predicted tick density was the only significant predictor of self-reported tick exposure (ß = 0.83, CI = 0.16,1.50, p = 0.02). DISCUSSION: This proof-of-concept study explores self-reported tick exposure as a potential indicator of LD risk using populational survey data. This approach may offer a low-cost and simple tool for evaluating LD risk and deserves further evaluation.
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Ixodes , Enfermedad de Lyme , Mordeduras de Garrapatas , Animales , Humanos , Quebec/epidemiología , Autoinforme , Estudios Transversales , Enfermedad de Lyme/epidemiología , Canadá/epidemiologíaRESUMEN
Lactic acid bacteria and bifidobacteria (LAB and Bifido), isolated from the gastrointestinal tract of Apis mellifera intermissa (BGIT), honey (H), propolis (P) and bee bread (BB) of hives set in different vegetations (wildflowers, caraway, orange blossom, Marrubium vulgare, Eucalyptus and Erica cinerea), were subjected to analysis of their antibacterial potential. Isolates able to inhibit Staphylococcus aureus were selected and identified with MALDI-TOF MS leading to 154 strains representing 12 LAB and Bifido species. Lactiplantibacillus plantarum, Pediococcus pentosaceus and Enterococcus faecalis were predominantly found in all matrices. BGIT showed the highest LAB and Bifido diversity with exclusive occurrences of five species (including Bifidobacterium asteroides and Limosilactobacillus fermentum). Honey was the second origin harboring an important variety of LAB species of which Apilactobacillus kunkeei and Enterococcus mundtii were characteristic of both H and BGIT. Principal components analysis revealed associations between antibacterial activities of LAB and Bifido, matrices and honey bee forage plants. Inhibition trends of S. aureus and Citrobacter freundii were highlighted with: L. plantarum from BGIT, P, H of bees feeding on E. cinerea; Pediococcus pentosaceus from BGIT, P, BB associated with E. cinerea; and Bifidobacterium asteroides from BGIT/orange blossom system. However, Enterococcus faecium associated with BGIT/Eucalyptus system antagonized Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. Our findings highlighted noteworthy effects of bee forage plants on the antibacterial activity of LAB and Bifido. Our approach could be useful to identify multiple conditions promoting antibacterial potency of LAB and Bifido under the combined effects of feeding plants and living matrices.
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Eucalyptus , Lactobacillales , Própolis , Abejas , Animales , Túnez , Staphylococcus aureus , Antibacterianos/farmacología , Escherichia coliRESUMEN
El objetivo es realizar un análisis de redes de síntomas del trastorno de agorafobia (con o sin pánico) según la edad y el sexo, en una muestra representativa de 555 personas mayores de 65 años de la Comunidad de Madrid. La red se estimó utilizando el paquete InsingFit que implementa un procedimiento llamado eLasso. Los resultados revelan redes diferenciadas para hombres y mujeres, y para los grupos de edad de 65-74 y 75-84 años, encontrando un mayor porcentaje de ocurrencia en las mujeres tanto en las situaciones como en los síntomas de ansiedad y en las razones para sentir miedo. Las mujeres temen un mayor número de situaciones, mientras que los hombres parecen tener sus miedos más localizados y centralizados en situaciones relacionadas con el transporte y los viajes cuando los hacen solos. Estos resultados pueden ser interesantes para diseñar intervenciones que aborden los síntomas y sus relaciones mutuas más importantes, diferentes y características en función de la edad y el sexo. (AU)
The aim of this study is to conduct a network analysis of agoraphobia disorder symptoms (with or without panic) according to age and gender, in a representative sample of 555 people over 65 years of age in the Community of Madrid. The network was estimated using the InsingFit package that implements a procedure called eLasso. The results reveal differentiated networks for men and women, and for the age groups 65-74 and 75-84 years, finding a higher percentage of occurrence in women in both situations and symptoms of anxiety and reasons for fear. Women fear a greater number of situations, while men seem to have their fears more localized and centralized in situations related to transport and travel when travelling alone. These results may be of interest for designing interventions that address the symptoms and the most important, different and characteristic relationships among them according to age and gender. (AU)
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Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Agorafobia , Sexo , Trastornos de Ansiedad , Entrevistas como Asunto , Características HumanasRESUMEN
Introduction: Women have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender. Methods: A cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables. Results: Women in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma. Conclusion: Being female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested.
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The aim of this study was to explore the role of stigma in different diagnoses of mental illness. A cross-sectional study (N = 255) was developed in two groups: users of a rehabilitation network for people with severe mental illness (Group-I) and people with common diagnoses in an ambulatory psychiatric service (Group-II). Internalized stigma, social stigma, self-esteem, and sociodemographic variables were measured. Mean comparisons, ANOVAs, and independent linear regression models were carried out. Similar overall scores were obtained for the internalized stigma, but Group-I reported more discrimination and resistance to stigma and also had less social stigma. The regression model for Group-I revealed social stigma and self-esteem as predictors, while in Group-II only self-esteem was significant. The study reveals differences in internalized stigma according to the care resource and diagnoses, suggesting different intervention lines and underlining the importance of further research on this topic. (AU)
El objetivo de este estudio ha sido explorar el papel del estigma en los diferentes diagnósticos de la enfermedad mental. Se llevó a cabo un estudio transversal (N = 255) en dos grupos: usuarios de una red de rehabilitación para personas con enfermedad mental grave (grupo I) y personas con diagnósticos comunes en un servicio psiquiátrico ambulatorio (grupo II). Se midió el estigma internalizado, el social, la autoestima y las variables sociodemográficas. Se llevaron a cabo comparaciones medias, ANOVA y modelos de regresión lineal independientes. Se obtuvieron puntuaciones generales similares para el estigma internalizado, pero el grupo I manisfestó más discriminación y resistencia al estigma y también menor estigma social. El modelo de regresión para el grupo I mostró como predictores el estigma social y la autoestima, mientras que en el grupo II sólo la autoestima era significativa. El estudio muestra diferencias en el estigma internalizado según el recurso de atención y los diagnósticos, lo que sugiere diferentes líneas de intervención y subraya la importancia de seguir investigando en este tema. (AU)
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Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Estigma Social , Salud Mental , Autoimagen , Trastornos Mentales , Estudios Transversales , Servicios de Salud MentalRESUMEN
A symptom network analysis of specific phobia disorder (SPD) was conducted according to gender and age in 555 people over 65 in the Region of Madrid (Spain). The network was estimated using the InsingFit package that implements a procedure called eLasso. These results reveal differences in the strength, closeness, and betweenness of the different networks according to gender but not for the 65-74 and 75-84 age groups. The gender variable presents a greater presence of symptoms in women than in men. For all types of specific phobia, the symptom of greater occurrence for both groups was fear. The main difference between men and women over 65 with SPD lies in the situational type, where centrality is more distributed and where the most central symptoms are distress for women and fear for men. These differences in the networks seem to support the conceptualization of SPD from a dimensional point of view. (AU)
Se realizó un análisis de redes de síntomas del trastorno de fobia específica (TFE) según el género y la edad en 555 personas mayores de 65 años de la Comunidad de Madrid (España). La red se estimó utilizando el paquete InsingFit que implementa un procedimiento llamado eLasso. Los resultados presentan diferencias en la fuerza, cercanía e intermediación de las distintas redes según el género, pero no para los grupos de edad de 65-74 y 75-84 años. El análisis de la variable género muestra una mayor presencia de síntomas en las mujeres que en los hombres. Para todos los tipos de fobia específica, el síntoma de mayor presencia para ambos grupos fue el miedo. La principal diferencia entre hombres y mujeres mayores de 65 años con TFE radica en el tipo situacional, donde la centralidad está más distribuida y donde los síntomas más centrales son la angustia para las mujeres y el miedo para los hombres. Estas diferencias en las redes parecen reforzar la conceptualización del TFE desde un punto de vista dimensional. (AU)
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Humanos , Anciano , Anciano de 80 o más Años , Trastornos Fóbicos , Factores Sexuales , Envejecimiento , Miedo , Estudios Longitudinales , Calidad de VidaRESUMEN
This research aims to analyze age-related differences in the psychological impact of the Covid-19 confinement situation in a Spanish sample. A longitudinal study (N= 1,041) was conducted through an online survey with two measurements: at two and five weeks after the declaration of the alarm state in Spain. Post- traumatic stress disorder (PTSD), anxiety and depressive symptoms, spiritual well- being and perceived loneliness were evaluated by screening tests. Means and their confidence intervals (95%) were calculated for all variables in the study, for the three age groups: 18-30, 31-59, 60-80. Linear mixed models with random slopes (Time nested to Subjects) were calculated for each variable. The results indicate that the psychological impact caused by the pandemic persists over time, and even increases in some of the variables studied. The older age group (60-80 years) shows the least impact and the greatest well-being. They presented less depressive, anxious and PTSD symptoms and less loneliness. These results may be explained by the greater resilience of this group to recover from adverse situations, in addition to having a greater number of coping strategies.
Se analizan las diferencias relacionadas con la edad en el impacto psicológico del confinamiento a consecuencia de la Covid-19 en una muestra española. Se realizó un estudio longitudinal (N= 1.041) mediante una encuesta online con dos mediciones: a las dos y cinco semanas de la declaración del estado de alarma en España. Se evaluaron mediante cuestionarios de detección los síntomas de trastorno de estrés postraumático (TEPT), ansiedad y depresión, bienestar espiritual y soledad percibida. Se calcularon las medias y sus intervalos de confianza (95%) para todas las variables del estudio, para los tres grupos de edad: 18-30, 31-59, 60-80. Para cada variable se calcularon modelos lineales mixtos con pendientes aleatorias (tiempo anidado a los sujetos). El impacto psicológico persiste a lo largo del tiempo, aumentando en algunas de las variables. El grupo de mayor edad muestra menor impacto y mayor bienestar. Presentan menos síntomas de depresión, ansiedad y TEPT y menos soledad. Estos resultados pueden explicarse por la mayor resiliencia de este grupo para recuperarse de situaciones adversas, y el mayor número de estrategias de afrontamiento.
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Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Infecciones por Coronavirus , Distribución por Edad , Salud Mental , Bienestar Social , Evaluación en Salud , España , Estudios Longitudinales , Encuestas y CuestionariosRESUMEN
BACKGROUND: This study aims to longitudinally assess the psychological impact of the COVID-19 pandemic in the general Spanish population. It uses four assessment points: two weeks after the start of confinement, one month after, two months after, and one year after the first evaluation. METHODS: Evaluations were conducted through an online survey, with a sample of 3,480 people at the first data collection and 1,041, 569, and 550 people at successive evaluation points. Depressive symptoms (PHQ-2), anxiety (GAD-2), post-traumatic stress (PCL-C-2), social support (EMAS), loneliness (UCLA-3), and discrimination (InDI-d) were evaluated. RESULTS: Significant changes were found in the variables depression and anxiety with a greater presence of this kind of symptomatology after one year (p < .01). There were also significant changes in the variable social support, which showed a substantial reduction after one year (p < .001). Similarly, there were significant variations in the variable intersectional discrimination (p < .001), with greater levels of discrimination. The temporal models show no significant differences in terms of post-traumatic symptomatology (p = .12) or loneliness (p = .19). CONCLUSIONS: The pandemic had a negative impact on mental health and these effects were further exacerbated one year later.
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COVID-19 , Pandemias , Ansiedad , Depresión/epidemiología , Humanos , Estudios Longitudinales , SARS-CoV-2 , España/epidemiologíaRESUMEN
Background: This study aims to longitudinally assess the psychologicalimpact of the COVID-19 pandemic in the general Spanish population.It uses four assessment points: two weeks after the start of confinement,one month after, two months after, and one year after the first evaluation.Methods: Evaluations were conducted through an online survey, with asample of 3,480 people at the first data collection and 1,041, 569, and 550people at successive evaluation points. Depressive symptoms (PHQ-2),anxiety (GAD-2), post-traumatic stress (PCL-C-2), social support (EMAS),loneliness (UCLA-3), and discrimination (InDI-d) were evaluated.Results: Significant changes were found in the variables depression and anxiety witha greater presence of this kind of symptomatology after one year (p < .01).There were also significant changes in the variable social support, whichshowed a substantial reduction after one year (p < .001). Similarly, therewere significant variations in the variable intersectional discrimination (p <.001), with greater levels of discrimination. The temporal models show nosignificant differences in terms of post-traumatic symptomatology (p = .12)or loneliness (p = .19). Conclusions: The pandemic had a negative impacton mental health and these effects were further exacerbated one year later.
Antecedentes: el objetivo es evaluar el impactopsicológico de la pandemia generada por la COVID-19 en la poblacióngeneral española longitudinalmente en cuatro momentos: tras dos semanasdel inicio del confinamiento, al mes, a los dos meses y al año. Método: lasevaluaciones se realizaron mediante una encuesta online, se siguió a unamuestra de 3.480 personas en la primera recogida de datos y de 1.041, 569y 550 personas en los sucesivos momentos de evaluación. Se evaluó lapresencia de síntomas depresivos (PHQ-2), de ansiedad (GAD-2), de estréspostraumático (PCL-C-2), el apoyo social (EMAS), la soledad (UCLA-3)y la discriminación (InDI-D). Resultados: se han producido cambios significativos en las variables de depresión y ansiedad con una presenciamayor de dicha sintomatología al año (p < .01), así como en la variable deapoyo social, que muestra una reducción significativa un año después (p <.001), y en la discriminación interseccional, con una mayor discriminación (p < .001). Los modelos temporales no muestran diferencias significativasen cuanto a sintomatología postraumática (p = .12) ni soledad (p = .19).Conclusiones: la pandemia ha tenido un impacto negativo en la saludmental y estos efectos son todavía peores un año después.
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Humanos , Pandemias , Betacoronavirus , Cuarentena , España , Salud Mental , Depresión , Ansiedad , Trastornos Mentales , Muestreo , Estudios Retrospectivos , Estudios Transversales , PsicologíaRESUMEN
BACKGROUND: Despite presenting higher risk of dementia, mild cognitive impairment (MCI) is not well defined in Down syndrome population. OBJECTIVE: We aimed to describe cognitive and neuropsychological patterns associated with MCI in Down syndrome individuals. METHOD: Two groups of adults with Down syndrome (control and prodromal) were studied throughout 3 years. Two linear mixed models and a model including the variables that best predicted group membership were built. RESULTS: Behavioural Regulation Index (BRI) (Behaviour Rating Inventory of Executive Function test) and the model composed of BRI, abstraction and delayed verbal memory were the variable and model best predicting group membership, respectively. CONCLUSION: Suggest a diagnosis of MCI when BRI is the earliest change perceived by caregivers and this is combined with low scores in abstract thinking, and when an amnesic pattern in delayed verbal memory is observed, but adaptive skills are preserved.
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Disfunción Cognitiva , Síndrome de Down , Discapacidad Intelectual , Adulto , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Síndrome de Down/complicaciones , Síndrome de Down/diagnóstico , Función Ejecutiva/fisiología , Humanos , Discapacidad Intelectual/complicaciones , Pruebas NeuropsicológicasRESUMEN
BACKGROUND: Stigma and discrimination have been associated with different diseases and pandemics, with negative consequences for the people who suffered them and for their communities. Currently, COVID-19 has become a new source of stigmatization. AIMS: The aim of the present study is to analyze longitudinally the evolution of intersectional perceived discrimination and internalized stigma among the general population of Spain, at three points in time throughout the confinement. METHOD: Participants completed an online survey. RESULTS: Results show an increase in both variables from the first to the second evaluation, and a slight decrease from the second to the third evaluation. Moreover, these changes are explained by depression, anxiety and family support. CONCLUSIONS: These findings indicate the factors that need to be considered to reduce the perception of discrimination and the internalization of stigma, and their detrimental consequences, during an especially stressful event such as the current pandemic outbreak.
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COVID-19 , Control de Enfermedades Transmisibles , Depresión/epidemiología , Humanos , Discriminación Percibida , SARS-CoV-2 , Estigma Social , EspañaRESUMEN
In this study we intend to understand the impact of the COVID-19 crisis and the subsequent stay-at-home orders, on the Spanish population's sense of belonging at three moments in time: at the beginning of the lockdown, after one month of lockdown and with the return to the "new normality". A cross-sectional study was conducted through an online survey (N0 = 3480; N1 = 1041; N2 = 569). The sense of belonging was evaluated by means of four Likert-type items. These questions included membership in different groups: work/studies, friends, family and neighborhood or community. Sociodemographic and COVID-19-related data were collected. Additionally, mental health, spiritual well-being, loneliness, social support and discrimination were assessed. Descriptive analyses were carried out and linear regression models compiled. The sense of belonging increased significantly during confinement, dropping dramatically with the start of the return to the "new normality" process. The only variable that showed interaction with time and sense of belonging was discrimination. Work condition (not working providing the lowest sense of belonging scores), social support from friends and loneliness were the main predictors of the sense of belonging. The impact caused by the pandemic and the actions adopted during the first weeks regarding the sense of belonging is evident. It has been a key variable in dealing with COVID-19. Actions are now needed to increase our sense of belonging to face the post-epidemic crisis and avoid a greater impact in other areas.
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The objective of the present study was to evaluate whether declarative memory deficits are related to executive function deficits (EF), since they could be a consequence of a poor organization of the material to memorize. This interaction between both cognitive processes can be studied simultaneously in a single task such as the Test of Memory Strategies (TSM). 23 patients with paranoid schizophrenic disorder, 11 with bipolar disorder with psychotic symptoms, 13 with bipolar disorder without psychotic symptoms and 15 healthy subjects were evaluated with the TSM; with the memory test Texts A and B (subtest of the Barcelona neuropsychological assessment battery), which assesses short-term and immediate recall without the influence of EF; and with the Trail Making Test (TMT): Part A (sustained attention) and Part B (executive control). The patients groups and the control group showed an improvement in memory performance across each of the TSM conditions. However, this facilitating effect of the strategies differed among the groups (the patients with higher EF deficits showed less improvement). Regarding these results, we conclude that this cognitive process cannot be independent of EF. However, due to the pilot nature of this study, it would be recommended to replicate these findings in new studies.
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Trastorno Bipolar , Trastornos del Conocimiento , Función Ejecutiva , Humanos , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Proyectos Piloto , Esquizofrenia Paranoide , Psicología del EsquizofrénicoRESUMEN
COVID-19 disease control efforts and consequences are likely to be complicated by the impact of fear and stigmatization of the novel coronavirus. These complications may also worsen due to the potential compounding of COVID-19 related stigma with stigmatization associated with previously diagnosed conditions. This exploratory study analyzes the experiences of the stigma associated with COVID-19 lockdown in people with different previous diagnoses 2 and 5 weeks after the beginning of the state of emergency in Spain. Gender and age were controlled as covariables and 1,052 people participated in the study. The diagnosis groups were: Psychiatry and mental health (n = 71), Cardiovascular disease (n = 42), Neurological disease (n = 23), Lung disease (n = 53), and No diagnosis (n = 863). The instruments used to measure the stigma were the Intersectional Day-to-Day Discrimination Index and two items of the Internalized Stigma of Mental Illness scale. Analysis of covariance of repeated measures and analysis of variance, including Scheffe's post hoc test, were performed. We found significant differences in stigma among the first and second evaluation. Regarding the previous diagnosis, no differences were found at Time 1, but significant differences were found at Time 2, with those having a previous psychiatric or mental health diagnosis reporting higher levels of perceived discrimination and internalized stigmatization. Our results suggest that people with previous stigmatizing conditions might be more vulnerable to experiencing stigma in a confinement situation. In order to reduce the burden of the COVID-19 stigma, health interventions should also consider the resulting intersection of effects on internalized stigma and perceived discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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COVID-19 , Trastornos Mentales/psicología , Cuarentena , Discriminación Social/psicología , Estigma Social , Adulto , Femenino , Humanos , Masculino , España , Encuestas y CuestionariosRESUMEN
Major depressive disorder (MDD) is one of the most prevalent conditions among mental disorders in individuals over 65 years. People over 65 who suffer from MDD are often functionally impaired, chronically physically ill, and express cognitive problems. The concordance between a clinician-assessed MDD diagnosis in a primary care setting and MDD assessed with a structured clinical interview in older adults is only approximately 18%. Network analysis may provide an alternative statistical technique to better understand MDD in this population by a dimensional approach to symptomatology. The aim of this study was to carry out a network analysis of major depressive disorder (MDD) in people over 65 years old. A symptom network analysis was conducted according to age and gender in 555 people over 65, using a sample from the MentDis_ICF65+ Study. The results revealed different networks for men and women, and for the age groups 65-74 and 75-84. While depressive mood stood out in women, in men the network was more dispersed with fatigue or loss of energy and sleep disturbances as the main symptoms. In the 65-74 age group, the network was complex; however, in the 75-84 age group, the network was simpler with sleep disturbances as the central symptom. The gaps between the networks indicate the different characteristics of MDD in the elderly, with variations by gender and age, supporting the idea that MDD is a complex dynamic system that has unique characteristics in each person, rather than a prototypical classification with an underlying mental disorder. These unique characteristics can be taken into account in the clinical practice for detection and intervention of MDD.
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Trastorno Depresivo Mayor , Anciano , Trastorno Depresivo Mayor/epidemiología , Femenino , Humanos , Masculino , Factores Sexuales , España/epidemiologíaRESUMEN
Background: Covid-19 remains a pandemic that most countries in the world are still dealing with. This is study aims to report the psychological impact of Covid-19 over time on the Spanish population. Methods: A longitudinal study (N = 1041) was carried out with two measurements: after 2 and 5 weeks starting from the declaration of the state of emergency in Spain. The presence of depressive symptoms, anxiety, and posttraumatic stress disease (PTSD) was evaluated by means of screening tests. Sociodemographic data, variables about Covid-19, loneliness, spiritual well-being, social support, discrimination, and a sense of belonging were collected. Results: The data showed how depressive symptomatology increased significantly over time, while anxiety and PTSD did not show statistically significant changes. Spiritual well-being and loneliness were the main predictors of psychological impact. A younger age was a significant predictor of depression and anxiety, while female gender was associated with anxiety and PTSD. Conclusions: The impact of the pandemic is sustained over time, even increasing in depression, and vulnerable groups that need greater psychological health support could be identified.
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The classical gene and species tree reconciliation, used to infer the history of gene gain and loss explaining the evolution of gene families, assumes an independent evolution for each family. While this assumption is reasonable for genes that are far apart in the genome, it is not appropriate for genes grouped into syntenic blocks, which are more plausibly the result of a concerted evolution. Here, we introduce the Super-Reconciliation problem which consists in inferring a history of segmental duplication and loss events (involving a set of neighboring genes) leading to a set of present-day syntenies from a single ancestral one. In other words, we extend the traditional Duplication-Loss reconciliation problem of a single gene tree, to a set of trees, accounting for segmental duplications and losses. Existency of a Super-Reconciliation depends on individual gene tree consistency. In addition, ignoring rearrangements implies that existency also depends on gene order consistency. We first show that the problem of reconstructing a most parsimonious Super-Reconciliation, if any, is NP-hard and give an exact exponential-time algorithm to solve it. Alternatively, we show that accounting for rearrangements in the evolutionary model, but still only minimizing segmental duplication and loss events, leads to an exact polynomial-time algorithm. We finally assess time efficiency of the former exponential time algorithm for the Duplication-Loss model on simulated datasets, and give a proof of concept on the opioid receptor genes.
RESUMEN
The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.