Relationship Between Exposure to Emotional Neglect and the Inflammatory Biomarkers Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, and Platelet-to-Lymphocyte Ratios in Patients With First-Episode Psychosis.

Aim: To assess whether exposure to childhood traumatic experiences is linked to the inflammatory markers neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in people with a first-episode psychosis.Methods: A cross-sectional study was performed in 83 patients (21 females and 62 males) with a diagnosis of a first psychotic episode. All participants completed the self-reported Spanish version of the Childhood Trauma Questionnaire (CTQ). NLR, MLR, and PLR were calculated in each patient.Results: Highest CTQ scores were noted on the emotional neglect and abuse domains (mean ± SD = 10.92 ± 4.41; mean ± SD = 10.93 ± 4.78, respectively), being lowest for the sexual abuse domain (mean ± SD = 6.12 ± 2.41). Backward stepwise linear regressions showed that high emotional neglect significantly predicted increased PLR (ß = 0.452, P = .036), older age and high emotional neglect predicted increased NLR (ß = 0.483, P = .036; ß = 0.442, P = .06, respectively), and high emotional neglect, low physical neglect, high total Positive and Negative Syndrome Scale (PANSS) score, and cannabis and alcohol use predicted increased MLR (ß = 0.698, P = .003; ß = 0.672, P = .033; ß = 0.296, P = .027; ß = 0.390, P = .069; ß = 0.560, P = .078, respectively).Conclusions: Our results highlight the relationship between the exposure to emotional neglect and the inflammatory biomarkers NLR, MLR, and PLR in patients with a first-episode psychosis. This study has benefitted from controlling for confounders such as body mass index, smoking status, symptom severity, and alcohol and cannabis use.

Association of perceived social support with sociodemographic, clinical, and psychosocial variables in patients with first-episode psychosis.

Patients with first-episode psychosis (FEP) report deficits in social support (SS) and diminished and less satisfactory social networks than healthy controls (HC). These SS difficulties are linked with symptomatology. The study objectives were to: (a) compare perceived SS between patients with FEP and HC; (b) study sex differences regarding perceived SS in patients with FEP and HC; and (c) explore which sociodemographic, clinical and psychosocial variables are related to perceived SS in the onset of FEP. A total of 146 participants were included: 76 patients with FEP (24 females, 52 males) and 70 HC (20 females, 50 males). Perceived SS was assessed with the DUKE-UNK instrument, which is divided into two subscales: confidant support (CS) and affective support (AS). Significant differences regarding perceived SS were observed between the samples. No sex differences were found concerning perceived SS in each group. For the group with FEP, more years of education, less anxiety/depressive symptoms and better functioning were the most relevant variables for more overall perceived SS and perceived CS. Also, less suicidal risk was the only important indicator for more perceived AS. Interventions in perceived SS could contribute to a good evolution of FEP.

Recent stressful life events and stress sensitivity in children and adolescents at clinical risk for psychosis.

Although psychosocial stress is consistently described as a casual factor for psychosis, the role of recent stressful life events (SLEs) is inconclusive. Studies with subjects with psychosis risk syndrome (PRS), fail to show a large number of SLEs but suggest greater stress sensitivity in these populations. We evaluate the presence of recent SLEs and stress sensitivity, and their relationship with symptoms and functionality in a sample consisting exclusively of help-seeking children and adolescents. Seventy-two 10- to 17-year-old help-seeking subjects who met PRS criteria and forty-two healthy control (HC) subjects participated in a naturalistic multi-site study. Measures of stress included the Stressful Life Events Schedule (SLES) and the G4 item of the Scale for Prodromal Syndromes (SOPS) scale. Child and adolescent PRS subjects presented greater number of SLEs during the previous year, greater total accumulated stress, greater sensitivity to stress, and more impaired tolerance to normal stress than did HC subjects. Stress measures showed a relationship with positive and negative attenuated symptoms, clinical variables and functionality. Our results support the role of stress in the PRS status. It reinforces the suggested differences for clinical presentation of PRS in terms of age, highlighting the importance of gathering data on the under-18 population.

Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use.

Most of the studies examining the impact of cannabis use in first episode psychosis (FEP) have been carried out in samples with adult-onset FEP. Data in persons with early onset psychosis (EOP) is scarce. The aims of the study were: To describe the prevalence of lifetime cannabis use, current use, and daily use in patients with EOP compared to healthy controls. To study the differences in clinical presentation between cannabis users and non-users. To examine the risk of presenting an EOP associated with cannabis use and the effect of doses and age of onset of use. An observational cross-sectional study was performed in 90 EOP cases and 62 healthy controls, aged between 7 and 17 years. Our results show a higher prevalence of lifetime use (p = 0002), current use (p < 0.001), and daily use (p < 0.001) in EOP cases in comparison with healthy controls. Regarding clinical presentation, we did not find significant differences in any subscale of the Positive and Negative Syndrome Scale (PANSS). Non-user patients presented more severe depressive symptoms (p = 0002) and worse social functioning than cannabis users (p = 0026). Compared with subjects who never used cannabis, the risk of an EOP was significantly higher for those with a lifetime use (OR = 2.88, p = 0.002)current use (O.R = 6.09, p < 0001), and especially in those with daily use (O.R = 42.77, p = <0001). We found a higher risk of EOP in patients that have used cannabis before 15 years of age. In conclusion, it is necessary to develop early- detection and specific treatment programs for adolescents with cannabis use.

Depressive symptoms and their relationship with negative and other psychotic symptoms in early onset psychosis.

The importance of depression in adult people with first-episode psychosis (FEP) has been demonstrated. However, it has hardly been studied in children and adolescents. There is a need to broaden knowledge of the relationship between psychotic symptoms and specific depression symptomatology. The aims of study were (a) to examine the frequency of presence and type of depressive symptoms in early onset FEP, and (b) to assess the relationship between depressive symptoms and psychotic symptomatology, and specifically negative symptoms. An observational cross-sectional study was performed in 62 FEP cases. Inclusion criteria were two or more psychotic symptoms, age 7-17 years old, first mental health service consultation, and fewer than 6 months from the first contact with the service. Participants were assessed with clinical and socio-demographic questionnaires: the Positive and Negative Syndrome Scale (PANSS) and the Children Depression Inventory (CDI). A Student t test was performed to compare psychotic symptoms in both groups: presence of depression and the absence of depression. A Pearson correlation was performed in order to relate subscales of the PANSS and each of the depression subscales and factors, as well the relation between negative and depressive symptoms. Our results show that a high percentage of people with an early onset of a FEP scored positively for depression. The most prevalent depressive symptoms were associated with schooling. The presence of depression was associated with negative, affective, and excited symptoms. Self-esteem, school problems, negative affect, and biological dysregulation were associated with psychotic symptoms. Finally, depressive items related to social functioning were more closely associated with negative symptoms of the PANSS. In conclusion, owing to the high incidence of depression in FEP in those suffering early onset of psychosis, there is a need for instruments to measure the depression more specifically in children and adolescent, and to uncover the clinical characteristics of depression in this population.

Diagnostic Distribution of eating disorders: Comparison between DSMIV- TR and DSM-5.

INTRODUCTION: The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria. METHODOLOGY: One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression. RESULTS: Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria. DISCUSSION: Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population.

Distribución diagnóstica de los trastornos de la conducta alimentaria: comparativa entre el DSM-IV-TR y el DSM-5 / Diagnostic Distribution of eating disorders: Comparison between DSM-IV-TR and DSM-5

Introducción. La quinta edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) incluye una significativa revisión de los Trastornos de la Conducta Alimentaria (TCA). El objetivo de este estudio es comparar la distribución diagnóstica en adolescentes con TCA según los criterios de la 4ª edición revisada del DSM (DSM-IV-TR) y del DSM-5. Un segundo objetivo es estudiar las diferencias psicopatológicas entre los pacientes con TCA (DSM-IV-TR) y los que cambian de diagnóstico al aplicar los criterios del DSM-5. Metodología. Se evaluaron a 101 pacientes con TCA (Media: 14.68 años; DE: 1.46) a través de entrevista clínica y escalas de psicopatología alimentaria, perfeccionismo, ansiedad y depresión. Resultados. Se observa una disminución significativa de los casos diagnosticados de TCA-No Especificado (TCANE) aplicando los criterios DSM-5 (34.7% frente a 23.8%; p<0.001) y un aumento significativo de los casos de Anorexia Nerviosa (AN) (58.4% frente a 66.3%; p<0.001) y Bulimia Nerviosa (BN) (6.9% frente a 8.9%; p<0.001). No se encontraron diferencias significativas a nivel psicopatológico entre los pacientes diagnosticados de AN y BN según criterios DSM-IV-TR y los nuevos casos diagnosticados de AN y BN con el DSM-5. Conclusiones. La aplicación de los criterios DSM-5 en adolescentes con TCA hace disminuir de forma significativa la frecuencia del diagnóstico de TCA-NE. Las similares características psicopatológicas entre los pacientes con TCA según el DSM-IV-TR y los nuevos casos que pasan de TCA-NE a AN y BN (DSM-5) apoyaría la validez de los nuevos criterios de los TCA del DSM-5 en población adolescente

Introduction. The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria. Methodology. One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression. Results. Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria. Discussion. Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population

Sexual dysfunctions in people with first-episode psychosis assessed according to a gender perspective.

AIM: Patients with chronic mental disorders often can suffer from sexual dysfunction. Nevertheless, the sexual functioning of new patients with first-episode psychosis has been little explored. The aim of this study was to investigate gender differences in sexual functioning in people with first-episode psychosis. METHODS: A group of 40 males and 37 females with first-episode psychosis took part in the research. We administered a psychiatric protocol composed of the PANSS, UKU and SCID-DSM-IV diagnosis. RESULTS: We found that the 42.5% of the male group had sexual dysfunctions while the percentage of the female group was 37.8%. The correlation between sexual dysfunctions and psychopathology did not reveal any association in males. However, in females, general psychopathology and positive symptoms are linked to the alteration of vaginal lubrication: (r=0.547; p=0.003) and (r=0.485; p=0.011), although orgasm alteration was also associated with general psychopathology (r=0.500; p=0.013). Moreover, we found a relation between the alteration of vaginal lubrication with depression(r=0.627; p<0.0001) and disorder of volition (r=0.600; p<0.001). DISCUSSION AND CONCLUSIONS: These data suggest that the association between sexual dysfunctions and psychopathology regarded only women. Therefore, during the taking charge of patients it is fundamental to consider the gender-specific relationship between psychopathology and sexual problems.

Spanish validation of the Premorbid Adjustment Scale (PAS-S).

BACKGROUND: The Premorbid Adjustment Scale (PAS) has been the most widely used scale to quantify premorbid status in schizophrenia, coming to be regarded as the gold standard of retrospective assessment instruments. AIMS: To examine the psychometric properties of the Spanish version of the PAS (PAS-S). METHOD: Retrospective study of 140 individuals experiencing a first episode of psychosis (n=77) and individuals who have schizophrenia (n=63), both adult and adolescent patients. Data were collected through a socio-demographic questionnaire and a battery of instruments which includes the following scales: PAS-S, PANSS, LSP, GAF and DAS-sv. The Cronbach's alpha was performed to assess the internal consistency of PAS-S. Pearson's correlations were performed to assess the convergent and discriminant validity. RESULTS: The Cronbach's alpha of the PAS-S scale was 0.85. The correlation between social PAS-S and total PAS-S was 0.85 (p<0.001); while for academic PAS-S and total PAS-S it was 0.53 (p<0.001). Significant correlations were observed between all the scores of each age period evaluated across the PAS-S scale, with a significance value less than 0.001. There was a relationship between negative symptoms and social PAS-S (0.20, p<0.05) and total PAS-S (0.22, p<0.05), but not with academic PAS-S. However, there was a correlation between academic PAS-S and general subscale of the PANSS (0.19, p<0.05). Social PAS-S was related to disability measures (DAS-sv); and academic PAS-S showed discriminant validity with most of the variables of social functioning. PAS-S did not show association with the total LSP scale (discriminant validity). CONCLUSION: The Spanish version of the Premorbid Adjustment Scale showed appropriate psychometric properties in patients experiencing a first episode of psychosis and who have a chronic evolution of the illness. Moreover, each domain of the PAS-S (social and academic premorbid functioning) showed a differential relationship to other characteristics such as psychotic symptoms, disability or social functioning after onset of illness.

Effectiveness of family work interventions on schizophrenia: evidence from a multicentre study in Catalonia.

BACKGROUND: Despite their proven efficacy, family work interventions on families of patients with schizophrenia are not being implemented in routine clinical practice in contexts where expressed emotion levels among caregivers are relatively high. AIMS: This study aimed to explore the effectiveness of a family work intervention in a Mediterranean environment in Catalonia, Spain. METHOD: Participants were 23 patients and 35 key relatives in five different clinical settings. The family intervention was provided by 10 trained health care professionals during a nine-month period. A six-month follow-up was also conducted. RESULTS: Statistically significant improvements were found in patients' clinical status, global functioning and social functioning levels, as well as in caregivers' burden of care. These results were maintained during follow-up. CONCLUSION: This is the first study to explore the effectiveness of family intervention in a high-expressed emotion context in Catalonia. The findings add weight to the growing literature supporting these interventions in different cultural settings.

Variability in the COMT gene and modification of the risk of schizophrenia conferred by cannabis consumption.

INTRODUCTION: The risk of schizophrenia conferred by cannabis has recently been proposed to be modulated by the Val158Met polymorphism (rs4680) at the COMT gene. To date, these findings have not been replicated in independent samples. MATERIAL AND METHODS: We tested the potential gene-by-environment interaction between Val158Met genotype at the COMT gene and previous use of cannabis in schizophrenia in 192 healthy controls and 91 inpatients with DSM-IV schizophrenia. The functional COMT Val158Met polymorphism was analyzed using TaqMan technology. Cannabis use was measured by taking into account the frequency of intake during the previous month. Logistic regression models were used to test the interaction between genetic and environment factors. RESULTS: Cannabis use was strongly associated with the case condition (p<0.0001). The Val158Met polymorphism at the COMT gene was not associated with schizophrenia, although Val/Val homozygosity tended to be more frequent in the case group than in the control group (34% vs 27%; OR=1.39; 95% CI, 0.78-2.47). Finally, in women we found a non-significant trend toward the association when we tested for the interaction between cannabis use, the number of Val alleles and susceptibility to schizophrenia (p=0.152). CONCLUSIONS: Our results tend to support recent findings suggesting that the Val158Met polymorphism at the COMT gene modifies the risk of schizophrenia conferred by cannabis use. In our study, this possible effect was only detected in women.

Edad de inicio del primer episodio psicótico: ¿hay diferencias clínicas entre varones y mujeres? / Age of onset of a first psychotic episode: are there any clinical differences between men and women?

Introducción: En la última década, los estudios sobre primeros episodios psicóticos han alcanzado relevancia. En nuestro estudio se analizan las diferencias por sexo en la edad de inicio, así como las diferencias en el tipo y la gravedad de los síntomas psicóticos en función de la edad de inicio, en varones y mujeres con un primer episodio psicótico. Material y método: Estudio transversal de 24 casos consecutivos con un primer episodio psicótico. Criterios de inclusión: dos o más síntomas psicóticos; edad comprendida entre 7 y 65 años; primera consulta en el centro de estudio; menos de 6 meses desde el primer contacto con los servicios. Los instrumentos utilizados fueron un cuestionario clínico y sociodemográfico, la PANSS y la ICG-ESQ. Para el análisis de los datos se ha utilizado la prueba de U Mann-Whitney para datos no paramétricos, del SPSS. Resultados: En nuestra muestra, el 66,7% eran varones y el 41,7% tenía una edad < 18 años. No se observan diferencias por sexo significativas en la edad de inicio del episodio (p = 0,580). Se obtienen resultados significativos en la dimensión excitativa (p = 0,015) y tendencias en la dimensión positiva de la PANSS (p = 0,079) en los varones adultos respecto a los adolescentes. Además encontramos diferencias significativas en adultos frente a adolescentes en los ítems de la PANSS negativa: retraimiento emocional (p = 0,021) y contacto pobre (p = 0,036); sin embargo, sólo encontramos tendencia a la significación en la dimensión negativa de la PANSS (p = 0,080) en varones adolescentes respecto a adultos. Conclusiones: Se evidencia un patrón de inicio del episodio psicótico en varones adolescentes con predominio de sintomatología negativa. Este patrón de inicio con síntomas negativos se suma a las evidencias encontradas en otros estudios a lo largo de los años que apoyan la hipótesis del neurodesarrollo (AU)

Introduction: In the past decade, studies of first psychotic episodes have become increasingly important. In the present study, we analyzed gender differences in age of onset, as well as differences in the type and severity of psychotic symptoms according to age of onset, in men and women with a first psychotic episode. Material and method: We performed a cross-sectional study of 24 consecutive patients with a first psychotic episode. Inclusion criteria consisted of two or more psychotic symptoms, age from 7 to 65 years, first visit to a center participating in the study, and a less than 6-month time lapse since the first contact with services. The instruments used were a clinical and sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Schizophrenia (CGI-SCH) scale. Data were analyzed using the Mann-Whitney U-test for non-parametric data with the SPSS statistical package. Results: In our sample, 66.7% of the sample were male and 41.7% were < 18 years old. No significant gender differences in age at onset of a first psychotic episode were observed (p = 0.580). Significant differences were obtained in the excitative dimension (p = 0.015) and a tendency was found in the positive dimension of the PANSS (p = 0.079) between adult males and adolescents. Significant differences were also found between adult males and adolescents in the negative PANSS items: emotional withdrawal (p = 0.021) and poor rapport (p = 0.036); however only a tendency towards significance was found in the negative dimension of the PANSS (p = 0.080) between adolescent males and adults. Conclusions: A pattern of onset of first psychotic episodes emerged in male adolescents with a predominance of negative symptoms. This pattern of onset with negative symptoms can be added to the evidence found in other studies over the years supporting the neurodevelopment hypothesis (AU)

[Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study]. / Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España.

BACKGROUND AND OBJECTIVE: The ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. 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. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. RESULTS: 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime-prevalence) and 8.4% in the last 12 months (12 month-prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime-prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and dysthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. CONCLUSIONS: The ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain.

Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España / Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study

Fundamento y objetivo: El proyecto ESEMeD-España es un estudio epidemiológico sobre los trastornos mentales en nuestro país. Se presentan la prevalencia-año y prevalencia-vida de los principales trastornos del estado de ánimo, de ansiedad y de abuso de alcohol, así como la influencia de los factores de riesgo sociodemográficos en su presencia y la edad de inicio de los trastornos. Sujetos y método: Encuesta personal domiciliaria realizada a una muestra representativa de la población española mayor de 18 años de 5.473 individuos. El instrumento utilizado fue la versión del Composite International Diagnostic Interview (WMH-CIDI) desarrollada para la iniciativa Encuestas de Salud Mental de la Organización Mundial de la Salud (WHO World Mental Health Surveys). La tasa de respuesta fue del 78,6%. Los resultados se presentan ponderados a la población española. Resultados: Un 19,5% de las personas presentaron un trastorno mental en algún momento de su vida (prevalencia-vida) y un 8,4% en los últimos 12 meses (prevalencia-año). El trastorno mental más frecuente es el episodio depresivo mayor, que tiene un 3,9% de prevalencia-año y un 10,5% de prevalencia-vida. Después del episodio depresivo mayor, los trastornos con mayor prevalencia-vida son la fobia específica, el trastorno por abuso de alcohol y la distimia. Los factores asociados a padecer un trastorno mental son el sexo femenino, estar separado, divorciado o viudo, y estar desempleado, de baja laboral o con una incapacidad. La fobia social, la agorafobia y la fobia específica aparecen a edades más tempranas. Los trastornos del estado de ánimo (episodio de depresión mayor y distimia), junto con el trastorno de angustia, muestran una aparición más tardía. Conclusiones: El estudio ESEMeD-España puede proporcionar resultados necesarios para conocer el impacto de los trastornos mentales en España

Background and objective: The ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. 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. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results: 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime-prevalence) and 8.4% in the last 12 months (12 month-prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime-prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and disthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. Conclusions: The ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain