Spirituality, Religiosity and Mental Health: A Clinical-care Approach.

No abstract present.

[Relationship between healthy lifestyle behaviours and subjective wellbeing: an european observational study.] / Relación entre los estilos de vida saludables y el bienestar subjetivo: estudio observacional europeo.

OBJECTIVE: A healthy lifestyle is related to physical and mental health. The aim of this study was to assess whether different healthy lifestyle behaviours are associated with experiential and evaluative well-being. METHODS: A total of 10,800 participants from Finland, Poland and Spain were interviewed in 2011-2012. Physical activity, fruit and vegetable consumption, smoking, alcohol use, and sleep quality were self-reported. Life satisfaction was measured with the Cantril Self-Anchoring Striving Scale. Positive and negative affect were assessed using an abbreviated version of the Day Reconstruction Method. Multivariate regression analyses were performed. RESULTS: Healthy lifestyle behaviours (consumption of five or more servings of fruit and vegetables per day, moderate or high physical activity, being a non-daily smoker, and having a good sleep quality) were positively associated with evaluative well-being (ß=0.23 p<0.001; ß=0.16, p<0.001; ß=0.26, p<0.001; ß=0.23, p<0.001, respectively), after controlling for confounding variables such as health and depression. Good sleep quality was related with higher positive affect (ß=0.29, p<0.001), lower negative affect (ß=-0.15, p<0.001) and higher life satisfaction (ß=0.23, p<0.001), after adjusting for those confounding variables. CONCLUSIONS: A healthy lifestyle is an important correlate of well-being independently of its effects on health. Healthy lifestyles could be considered when developing strategies to improve not only the physical health, but also the well-being of the population.

OBJETIVO: Un estilo de vida saludable está relacionado con la salud física y mental. El objetivo de este trabajo fue evaluar si diferentes comportamientos de estilo de vida saludable estaban asociados con el bienestar subjetivo. METODOS: Se entrevistó a un total de 10.800 participantes de Finlandia, Polonia y España en 2011-2012. La actividad física, el consumo de frutas y verduras, el tabaco, el alcohol y la calidad del sueño fueron autoinformados. La satisfacción con la vida se midió con la Cantril Self-Anchoring Striving Scale. El afecto positivo y negativo se evaluaron utilizando una versión abreviada del Método de Reconstrucción del Día. Se llevaron a cabo análisis de regresión múltiple. RESULTADOS: Las conductas de estilo de vida saludable (consumo de cinco o más frutas y verduras al día, actividad física moderada o alta, no fumar a diario y tener una buena calidad del sueño) se asociaron positivamente con el bienestar evaluativo (ß=0,23, p<0,001; ß=0,16, p<0,001; ß=0,26, p<0,001; ß=0,23, p<0,001, respectivamente), después de controlar por variables de confusión como la salud y la depresión. La buena calidad del sueño se relacionó con mayor afecto positivo (ß=0,29, p<0,001), menor afecto negativo (ß=-0,15, p<0,001) y mayor satisfacción con la vida (ß=0,23, p<0,001), después de ajustar por dichas variables de confusión. CONCLUSIONES: Un estilo de vida saludable se correlaciona de manera importante con el bienestar, independientemente de sus efectos en la salud. Los estilos de vida saludables podrían ser considerados a la hora de desarrollar estrategias que mejoren no solo la salud física, sino también el bienestar de la población.

Are younger cohorts in the USA and England ageing better?

BACKGROUND: Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. METHODS: The sample comprised 55 684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. RESULTS: Similar ageing trends were found in ELSA (ß = -0.311; p < 0.001) and HRS (ß = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (ß = -0.082; p < 0.05) and HRS (ß = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (ß = 0.125; p < 0.001) and HRS (ß = 0.170; p < 0.001). CONCLUSIONS: Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society.

Diez años de investigación traslacional colaborativa en enfermedades mentales: el CIBERSAM / CIBERSAM: Ten years of collaborative translational research in mental disorders

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Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys.

Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12-month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality ("minimally adequate treatment"). Among the 70,880 participants, 2.6% met 12-month criteria for substance use disorders; the prevalence was higher in upper-middle income (3.3%) than in high-income (2.6%) and low/lower-middle income (2.0%) countries. Overall, 39.1% of those with 12-month substance use disorders recognized a treatment need; this recognition was more common in high-income (43.1%) than in upper-middle (35.6%) and low/lower-middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper-middle, and 8.6% in low/lower-middle income countries). Overall, only 7.1% of those with past-year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper-middle income and 1.0% in low/lower-middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.

Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys.

BACKGROUND: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross-national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues. METHODS: Data from 19 WMH surveys (n = 78,023; 70.1% weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall model strength in targeting individuals at highest PTSD risk. RESULTS: PTSD prevalence after UD averaged 5.2% across surveys and did not differ significantly between high-income and low-middle income countries. Significant multivariate predictors included the deceased being a spouse or child, the respondent being female and believing they could have done something to prevent the death, prior trauma exposure, and history of prior mental disorders. The final model was strongly predictive of PTSD, with the 5% of respondents having highest estimated risk including 30.6% of all cases of PTSD. Positive predictive value (i.e., the proportion of high-risk individuals who actually developed PTSD) among the 5% of respondents with highest predicted risk was 25.3%. CONCLUSIONS: The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions.

Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis.

This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress.

Effects of caffeine intake and smoking on neurocognition in schizophrenia.

Although most studies support the beneficial effects of caffeine on neurocognition, its effects have never been assessed in psychiatric patients. In addition, results from studies in smokers are contradictory. Moreover, there are no data available about the neurocognitive effects of caffeine and tobacco together. We explored the concomitant effects of regular caffeine and tobacco intake on neurocognition in 52 schizophrenic patients and 61 healthy controls. Verbal fluency, processing speed, and working, visual and verbal memory were assessed. For each measurement, two tasks with two levels of complexity were administered. Our results showed that caffeine intake had beneficial effects on male schizophrenic patients only in complex tasks requiring deeper cognitive processing (semantic fluency, cognitive speed, working memory, and visual memory). Female patients and controls were unaffected. In contrast, smoking had a negative effect on male, but not on female, schizophrenic patients in semantic fluency. The effects of smoking in controls were inconsistent. In conclusion, our data showed, for the first time, beneficial effects of caffeine intake on neurocognition in male schizophrenic patients. These data suggest that further research of therapeutics based on caffeine is needed, as this could be beneficial for schizophrenic patients. In contrast, smoking appears to be detrimental.

Associations between mental disorders and subsequent onset of hypertension.

BACKGROUND: Previous work has suggested significant associations between various psychological symptoms (e.g., depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remain unclear. Further, there are few data available on how such associations vary by gender or over life course. METHODS: Data from the World Mental Health Surveys (comprising 19 countries and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated. RESULTS: After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse and drug abuse were significantly associated with subsequent diagnosis of hypertension (with odds ratios ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier-onset hypertension. CONCLUSIONS: Depression, anxiety, impulsive eating disorders and substance use disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.

The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys.

BACKGROUND: Little population-based data exist outside the United States on the epidemiology of binge eating disorder (BED). Cross-national BED data are presented here and compared with bulimia nervosa (BN) data in the World Health Organization (WHO) World Mental Health Surveys. METHODS: Community surveys with 24,124 respondents (ages 18+) across 14 mostly upper-middle and high-income countries assessed lifetime and 12-month DSM-IV mental disorders with the WHO Composite International Diagnostic Interview. Physical disorders were assessed with a chronic conditions checklist. RESULTS: Country-specific lifetime prevalence estimates are consistently (median; interquartile range) higher for BED (1.4%; .8-1.9%) than BN (.8%; .4-1.0%). Median age of onset is in the late teens to early 20s for both disorders but slightly younger for BN. Persistence is slightly higher for BN (6.5 years; 2.2-15.4) than BED (4.3 years; 1.0-11.7). Lifetime risk of both disorders is elevated for women and recent cohorts. Retrospective reports suggest that comorbid DSM-IV disorders predict subsequent onset of BN somewhat more strongly than BED and that BN predicts subsequent comorbid disorders somewhat more strongly than does BED. Significant comorbidities with physical conditions are due almost entirely to BN and to a somewhat lesser degree BED predicting subsequent onset of these conditions. Role impairments are similar for BN and BED. Fewer than half of lifetime BN or BED cases receive treatment. CONCLUSIONS: Binge eating disorder represents a public health problem at least equal to BN. Low treatment rates highlight the clinical importance of questioning patients about eating problems even when not included among presenting complaints.

Comparing the efficacy of long-acting pharmaceutical forms (depot) versus oral pharmaceutical forms of atypical and conventional antipsychotics used in Spain for treating patients with schizophrenia.

INTRODUCTION AND OBJECTIVES: Currently in Spain, 4 depot antipsychotics are available: flufenazine, pipotiazine, zuclopentixol and risperidone. The objectives of the present study are: a) to evaluate the efficacy of depot vs. oral forms of typical and atypical antipsychotics available in Spain for treating patients with schizophrenia; b) to compare the efficacy of different depot antipsychotics; c) to evaluate cost-effectiveness of typical and atypical depot and oral antipsychotics. METHODS: Systematic review of the literature between January 1980 and March 2007. Pharmaceutical companies of depot preparations were contacted aiming to include unpublished material. RESULTS: A total of 15 studies were included (13 journal manuscripts and 2 posters provided by the industry). Concordance between evaluators was moderate-high. The quality of selected studies was moderate-low. There were no differences in the efficacy between depot and oral risperidone. Efficacy of depot risperidone was higher than oral olanzapine (there were no differences regarding tolerability) and higher and better tolerated than oral zuclopentixol. The evidence was controversial when comparing the efficacy of depot and oral flufenazine. There were no differences when comparing the efficacy between depot flufenazine and oral pimozide. Depot zuclopentixol was more efficient than the oral preparation for treating patients with schizophrenia and violent behaviour. Finally, there were no differences regarding the efficacy and tolerability between depot pipotiazine and depot flufenazine and between depot clopentixol and depot flufenazine. CONCLUSIONS: There is few high-quality scientific evidence comparing depot and oral antipsychotics or different depot antipsychotics available in Spain. Selected evidence does not allow to conclude that depot antipsychotics are more effective and better tolerated than oral ones.

Prevalencia y comorbilidad física y mental del dolor dorsal y cervical crónicos en España: resultados del estudio ESEMeD / Prevalence and physical-mental comorbidity of chronic back and neck pain in Spain: results from the ESEMeD Study

Fundamento y objetivo: El dolor dorsal (DD) y el dolor cervical (DC) crónicos son muy prevalentes en la población adulta. Sin embargo, poco se sabe respecto de su comorbilidad con otros procesos y su impacto sobre el funcionamiento global del individuo. El siguiente trabajo, que forma parte del estudio ESEMeD-España, tiene por objetivos estimar la prevalencia del DD-DC crónico en la población española, su comorbilidad con otras enfermedades y trastornos físicos y mentales, además de su impacto sobre el funcionamiento global. Sujetos y método: Se realizó una encuesta personal domiciliaria a una muestra representativa de la población española mayor de 18 años compuesta por 5.473 individuos. Los entrevistados informaron de la presencia de DD-DC crónico y las enfermedades y trastornos comórbidos. Los trastornos mentales se evaluaron con la Composite International Diagnostic Interview y el funcionamiento global con la WHO Dissability Assessment Schedule. La tasa de respuesta fue del 78,6%. Resultados: El DD-DC crónico presentó una prevalencia-año del 14,7%. Un 65,7% de las personas que lo presentaban refirió al menos una enfermedad/trastorno comórbido, ya fuesen otras enfermedades que implicaban dolor crónico (49,4%), enfermedades físicas crónicas (40,7%), algún trastorno del estado de ánimo (7,9%), trastorno de angustia (1,3%), trastorno por estrés postraumático (1,5%) o ansiedad generalizada (1,4%). Además, el DD-DC crónico mostró un impacto negativo sobre el funcionamiento global. Sin embargo, las enfermedades y trastornos comórbidos explicaron casi un tercio de la asociación entre DD-DC y funcionamiento global. Conclusiones: El DD-DC crónico presenta una elevada prevalencia y comorbilidad con otras enfermedades y trastornos físicos y mentales. Esta comorbilidad afecta negativamente al funcionamiento global de los individuos

Background and objective: Chronic back pain (CBP) and chronic neck pain (CNP) are highly prevalent among the adult population. However, less is known about its comorbidity with other diseases and its impact on global functioning. The objectives of following study, that is part of the ESEMeD-Spain study, are to estimate CBP-CNP prevalence among Spanish population, its comorbidity with other physical and mental conditions, and its impact on global functioning. Subjects and method: Cross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5,473 individuals. CBP-CNP and comorbid conditions were ascertained by self-report. Mental disorders were ascertained with the Composite International Diagnostic Interview and global functioning with the WHO Dissability Assessment Schedule. Response rate was 78.6%. Results: The one year prevalence of chronic CBP-CNP was 14.7%. A 65.7% of people with CBP-CNP reported at least one other comorbid condition, including other chronic pain conditions (49.4%), chronic physical conditions (40.7%), any mood disorders (7.9%), panic disorder (1.3%), posttraumatic stress disorder (1.5%) or generalized anxiety disorder (1.4%). Additionally, CBP-CNP negatively affected global functioning. However, comorbid conditions explained about one-third of the association between CBP-CNP and global functioning. Conclusions: CBP-CNP is highly prevalent and comorbid with other physical and mental conditions. Comorbidity negatively affects individuals global functioning