Reliability and Validity of the List of Mental Health Items (LISMEN).

BACKGROUND: The detection of risk factors is a key element in the prevention of mental health disorders. It is widely known that in the formation of personality and its disorders, relational experiences (vital events) in childhood condition both neurological and emotional development. The accumulation of these circumstances brings about altered life trajectories, which make people more vulnerable to mental health disorders. METHOD: A structured interview called LISMEN was designed based on the scientific literature to detect the risk of developing mental health disorders. A descriptive, reliability, and validity statistical study was carried out on four samples, one of which was the control group. There were 372 subjects in total. RESULTS: The technique was highly reliable (kappa coefficient 0.7 [p<0.05]) and internally consistent (Cronbach's alpha between 0.80 and 0.98). Sensitivity and specificity were high (AUC [Area Under Curve] OR =1.18 [1]), with the cut-off point between 9 and 10. CONCLUSIONS: LISMEN is a useful tool for detecting the risk of developing mental health disorders. A score of 10 or higher indicates that the subject belongs to the most sensitive or vulnerable population group at risk.

El lenguaje y la maduración emocional, ¿Cómo lo trabajamos en grupo? / Language and emotional evolution: How to work on this area in groups?

En este artículo se expone el tratamiento de problemas de lenguaje y maduración emocional a través de grupos. En el CDIAP del Maresme, a menudo la demanda viene focalizada en el retraso de lenguaje, pero observamos que un grupo importante está relacionado con alteraciones en la vinculación. Estos casos se tratan en grupos de niños y padres. Se presentan dos experiencias: grupo de niños y padres con las mismas terapeutas y grupo paralelo de padres. Los beneficios terapéuticos se concretan en la mejor integración de las emociones y su reflejo en el avance en las relaciones con los iguales y en los aprendizajes Maltrato en la infancia y la adolescencia: Características y psicopatología asociada en un Centro de Salud Mental Infanto-Juvenil

In this article we deal with the treatment of language and emotional maturation problems through groups. In CDIAP Maresme, demand it is often focused on problems of language delay, but we have noted that a significant number of cases are related to alterations in entailment. These cases can be treated in groups of children and parents. Two experiences are presented: a group of children and parents with the same therapists, and a parallel group of parents. The therapeutic benefits take the form of improved integration of emotions and their reflection in the progress in relations with peers and learning

Una revisión sobre los factores de riesgo en la infancia para la esquizofrenia y los trastornos mentales graves del adulto / Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood

OBJETIVO: A través de la revisión bibliográfica sobre los factores de riesgo psicosociales en salud mental se pretende demostrar la existencia de una asociación entre la acumulación de factores estresantes en la infancia y el incremento del riesgo de aparición de un trastorno mental en la vida adulta. DISEÑO: Búsqueda bibliográfica, realizada hasta diciembre del 2011, en las bases de datos electrónicas de Medline y de las universidades Autónoma y central de Barcelona. Las palabras clave utilizadas fueron: infancia, prenatal, vulnerabilidad, riesgo, abusos, negligencia, trastorno mental en la infancia, esquizofrenia, prevención. Selección de estudios: Los incluidos fueron aquellos que cumplían las siguientes condiciones: a) estudios prospectivos sobre acontecimientos vitales adversos en la gestación, parto o infancia; b) estudios que incluyan grupo control; c) estudios con información estadística el riesgo de aparición de trastornos mentales, y d) estudios de tamaño de la muestra superior a 30 sujetos. RESULTADOS: Existe una amplia variedad de factores de riesgo fáciles de identificar en la infancia y que pueden ayudar a prevenir la aparición de un trastorno mental grave. Se pueden agrupar en: a) embarazo, parto y puerperio; b) alteración de los vínculos con las figuras paternas; c) los 2 primeros años de vida, y d) dificultades en los aprendizajes y en las relaciones en la escuela. CONCLUSIONES: Existen acontecimientos vitales que pueden ser considerados de riesgo para la salud mental de un niño. Se ha demostrado que la acumulación de estas circunstancias genera una trayectoria de vida alterada que hace más vulnerables a las personas ante la posibilidad de presentar un trastorno mental (AU)

AIM: To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adult hood,. DESIGN: A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with ''n'' participants equal to o more than30 persons. RESULTS: There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. CONCLUSIONS: There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders

[Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood]. / Una revisión sobre los factores de riesgo en la infancia para la esquizofrenia y los trastornos mentales graves del adulto.

AIM: To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adulthood,. DESIGN: A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with "n" participants equal to o more than 30 persons. RESULTS: There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. CONCLUSIONS: There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders.

Estudio de la calidad de vida en pacientes con psicosis incipiente / Study of the quality of life of patients in early psichosis

Introducción: La descripción de las características de personas diagnosticadas de Estado Mental de Alto Riesgo (EMAR), que son susceptibles de convertirse en un Primer Episodio Psicótico (PEP), es el primer paso para la prevención primaria y secundaria efectuada en los servicios de nuestro sistema sociosanitario. Material: 23 pacientes diagnosticados de EMAR y otros 23 de PEP que han sido atendidos en el Equipo de Atención Precoz a Pacientes en riesgo de Psicosis (EAPPP) de Barcelona, durante el período 2006-2011. Método: Estudio transversal descriptivo para determinar la percepción subjetiva de la calidad de vida, condiciones psicosociales y clínicas de pacientes según presenten un EMAR o un PEP. Resultados: Se observa que los pacientes con EMAR y PEP tienen una percepción subjetiva de la calidad de vida y un Funcionamiento Global (GAF) similar, a pesar de obtener puntuaciones diferentes en la escala PANSS. Conclusiones: A la vista de los resultados, es importante diagnosticar a las personas que presentan un EMAR, cuyas características psicosociales son similares a las que presentan un PEP, para así evitar una posible evolución hacia un trastorno psicótico (AU)

The description of the characteristics of persons diagnosed with Ultra High Risk (UHR) of psychosis, which are likely to become a First Episode of Psychosis (FEP), is the first step primary and secondary prevention made in our health service system. Material: 23 patients diagnosed EMAR and 23 of PEP who have been treated in the Early Care Team for Patients at risk of psychosis (EAPPP) of Barcelona, between the years 2006-2011. Method: Descriptive cross-sectional study to determine the subjective perception of quality of life, psychosocial and clinical conditions of patients by presenting At-Risk Mental State of psychosis (EMAR) or a First Episode of Psychosis (PEP). Results: Patients with EMAR and PEP have a subjective perception of quality of life and a similar Global Functioning despite getting different scores on the PANSS scale. Conclusions: It is important to diagnose people with EMAR, whose psycho-social characteristics are similar to PEP, in order to avoid a possible evolution towards a psychotic disorder (AU)

Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis.

AIM: Insecure attachment may influence vulnerability to and outcome of psychotic symptomatology. The present study examined whether attachment style predicted symptoms and functioning of at-risk mental state (ARMS) patients after 6 months of psychosocial intervention, over and above the effects of initial clinical severity and premorbid social adjustment (PSA). METHODS: Symptoms and functioning were assessed at baseline and 6 months later in 31 ARMS patients (mean age = 15.7). No patient received antipsychotic medication, but all engaged in intense psychosocial needs-adapted treatment. Clinicians (unaware of the aims of the study) rated attachment, PSA, symptoms, and functioning. RESULTS: Attachment was not related to baseline clinical severity. However, improvement in psychoticism was predicted by attachment (in particular by secure, preoccupied and dismissing) beyond the effects of baseline clinical severity and PSA. Secure attachment also predicted improvements in disorganization and functioning. Poor PSA predicted less improvement in disorganization and negative symptoms but did not impact psychoticism. CONCLUSIONS: The three attachment prototypes that predicted improvement in psychoticism (secure, preoccupied and dismissing) share the existence of at least one positive psychological model (either about self or about others). It may be that the psychosocial intervention helped ARMS patients to disconfirm negative models and/or reinforce positive ones. Patients' attachment styles were not related to baseline clinical severity but impacted improvement of positive symptoms. These findings appear consistent with evidence that impaired self-esteem and dysfunctional self and others schemas constitute risk factors for reality distortion.

At-risk mental state (ARMS) detection in a community service center for early attention to psychosis in Barcelona.

AIM: To describe the strategy and some results in at-risk mental state (ARMS) patient detection as well as some of the ARMS clinical and socio-demographical characteristics. The subjects were selected among the patients visited by an Early Care Equipment for patients at high risk of psychoses, in Barcelona (Spain) during its first year in operation. METHODS: Descriptive study of the community-team relations, selection criteria and intervention procedure. Description of patient's socio-demographic and symptomatic characteristics according to the different instruments used in detection and diagnoses, taking account of four principal origins of referrals: mental health services, primary care services, education services and social services. RESULTS: Twenty of 55 referred people fulfilled the at-risk mental state criteria, showing an incidence of 2.4 cases per 10,000 inhabitants. They were mainly adolescent males referred from health, education and social services. Overall, negative symptoms were predominant symptoms and the more frequent specific symptoms were decrease of motivation and poor work and school performance, decreased ability to maintain or initiate social relationships, depressed mood and withdrawal. CONCLUSIONS: It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community--including the social services--contributes to the process. The utilization of a screening instrument and a two-phase strategy--the second carried out by the specialized team--seems to be an appropriate approach for early psychosis and ARMS detection.

Psicosis y diferencias sociales: comparando la prevalencia de las psicosis en dos medios urbanos diferenciados / Psychosis and social differences: comparing psychosis prevalence between two socially differentiated urban settings

Objetivos: Contribuir a la reflexión sobre la etiología y/o los factores de riesgo para las psicosis comparando la prevalencia en población general y población de riesgo de la esquizofrenia y otras psicosis en dos barrios de Barcelona (España). Método: Nuestras aportaciones en este trabajo se apoyan sobre todo en un estudio descriptivo transversal de todos los pacientes con psicopatología detectados en la USM de Sant Martí-La Mina: un territorio geodemográfica y asistencialmente delimitado formado por 5 Áreas Básicas de Salud (103.615 habitantes. Resultados: Sobre un total de 21.536 pacientes con registro de casos abierto desde el año 1982 hasta el año 2000, se halló que 838 cumplían los criterios restrictivos para ser diagnosticados como «esquizofrénicos» (N=476) o «afectados por otras psicosis» (N=362). Sin embargo, las prevalencias de esquizofrenia y otras psicosis en el barrio sujeto a más factores de riesgo psicosociales eran alrededor de 2 veces mayores que las encontradas en el barrio colindante por el mismo equipo y en el mismo período temporal. Conclusión: Es necesario tener en cuenta el gran peso de los factores de sociales y psicosociales para poderse explicar las diferencias de prevalencia de la esquizofrenia y otras psicosis entre diferentes poblaciones (AU)

Objectives: To contribute to the discussion about aetiology and risk factors of psychosis comparing the prevalence in general population and in «age of risk population» for schizophrenias and other psychoses on two neighbourhoods of Barcelona (Spain). Method: We base our reflections in a transversal study about the results of an informatized case register of all the patients' with detected psychopathology in this geodemographic and assistencially differentiated area: 5 Basic Areas of Health (103.615 inhabitants). Results: The total «psychopathological patients» detected were 21.536. From them, 838 completed the restrictive criteria to be diagnosed as «schizophrenics» (476) or «affected by other psychoses» (362). Among the neighborhood charged with psychosocial risk factors and the other 4 adjacent basic areas of health, assisted for the same team, so much clinical as investigator, the incidence and the prevalence of the schizophrenia and other psychoses is twice as much, almost in each group diagnosis. Conclusion: It seems necessary to keep in mind the great weight of the social and psychosocial factors to explain those differences of incidence and prevalence of the schizophrenia and the psychoses in different populations (AU)

Neighborhood differences in psychoses: prevalence of psychotic disorders in two socially-differentiated metropolitan areas of Barcelona.

INTRODUCTION: The prevalence of schizophrenia and other psychoses can vary between close geographic locations and can be biased by the use of epidemiological designs. With data derived from a public mental health centre with close relations to primary care teams we have compared the distribution of psychotic disorders in two neighborhoods in Barcelona with marked psycho-social differences. METHODS: Using a computerized database from Barcelona's National Health Service covering 5 basic health-care areas with a total population of 103,615 inhabitants, we have accessed case records showing any psycho-pathology between the years of 1982 and 2000. RESULTS: From the case records of 21,536 registered patients showing any psycho-pathology, and using strict diagnostic, clinical and assistance criteria, we found that there were 476 patients diagnosed as "schizophrenic" and 362 that were "affected by other psychoses." Despite being evaluated by the same mental health personal, the same research team using identical criteria and over the same period of time (thus precluding operator and selection bias) the prevalence of these disorders was twice as high in La Mina (a district with a marked accumulation of psycho-social risk-factors) as compared to the neighboring district of La Verneda. CONCLUSIONS: When assessing prevalence of psychoses, it is necessary to consider the impact of social and psycho-social factors, even in neighboring communities.

Factores de riesgo para padecer trastornos psicóticos: ¿es posible realizar una detección preventiva? / Psychosis risk factors: is there a chance for preventive identification?

Introducción: Revisión de los factores de riesgo para las psicosis desde la perspectiva de la literatura internacional y desde la perspectiva de la experiencia clínica e investigadora del equipo. Objetivo principal: Se presenta el diseño y las primeras pruebas de un instrumento de exploración y cribaje de señales de alarma y factores de riesgo de trastornos mentales severos, y en especial trastornos psicóticos, aplicable en los primeros años de vida por parte de los servicios de atención primaria de salud y los equipamientos de salud mental vinculados con ellos. Se trata del LISMEN(Listado de ítems de Salud Mental en edades preescolares y escolares). Metodología: 5 muestras diferentes, tanto de edad infantil como de adultos. El trabajo se centra en la muestra A del Proyecto LISMEN: Se trata de un estudio descriptivo retrospectivo de los dossieres de los pacientes que han desarrollado una psicosis (N=838) y se habían visitado previamente, ya durante la infancia, en la misma Unidad de Salud Mental (N=120). Resultados: Se utilizan los resultados de las muestras anteriormente estudiadas para encuadrar el tema y presentar los primeros resultados de la muestra A: Estos señalan una constelación de factores de riesgo que aparecen ya en las historias o dossiers clínicos de la infancia de los pacientes que van a desarrollar una psicosis postpuberal. Conclusiones: Aunque hoy poseemos un amplio acervo de conocimientos sobre factores de riesgo de la esquizofrenia y otras psicosis, eso no implicaque podamos predecir el trastorno en base a los mismos. El LISMEN es un intento en ese sentido (AU)

This paper reviews risk factors associated with psychosis from both a literatureperspective and the clinical and research practice. The development of atool for the diagnosis and screening of alarm signs and risk factors of severemental disorders is described along with preliminary tests. The tool is aimedto be administered by primary health care systems and associated mentalhealth teams during a person’s early years. The tool is called LISMEN–standing for “list of mental health items at pre-school and school ages”.The list was administered to 5 different samples including children andadults. This paper focuses on Project LISMEN sample A. It is an investigationof medical records of patients who had developed a psychosis (N = 838). Anumber of them (N = 120) had already been assisted by the same MentalHealth Unit during their childhood. Samples already assisted were used as abenchmark for sample A preliminary results. A constellation of risk factors hadalready been identified in medical records during the childhood of people whowould develop a psychosis after their adolescence.Even though there is a broad pool of knowledge on risk factors associatedwith schizophrenia and other psychoses, this does not mean that prediction ofthe disorder can be made on this base. Nevertheless, LISMEN is a contributionin this direction (AU)

[Schizophrenic disorders in primary care mental health]. / Trastornos esquizofrénicos en la atención primaria a la salud mental.

OBJECTIVES: To determine the prevalence and incidence of schizophrenia and other psychoses in a mental health unit (MHU) closely connected to primary health care. DESIGN: Retrospective longitudinal study of the register of all patients with psychiatric illnesses detected in a specific geo-demographic and health care area. SETTING: Five basic health care areas of Barcelona (103 615 inhabitants). PARTICIPANTS: MHU patients who had attended clinics due to mental health disorders during the period from 1982-2000 (N=21 236). Strict health and diagnostic criteria based on the DSM-4 classification were applied. All cases were validated using clinical history review and concensus. MEASUREMENTS: Incidence (in the last 3 years) and prevalence of schizophrenia and other psychoses in the whole period of study, both in the general population and in the risk population age group (15-54 years). RESULTS: In total, 838 patients complied with the diagnosis of suffering from schizophrenia (N=476) or other psychoses (N=362). The incidence of schizophrenia was 3.47/10,000 (95% confidence interval [CI], 2.3-4.6) in the general population and 5.09/10,000, 95% CI, 3.2-6.9) in the population at risk, and the prevalence of schizophrenia was 54.9/10,000 (95% CI, 41.8-50.1) in the general population and 80.7/10,000 (95% CI, 73.5-88) in the population at risk. CONCLUSIONS: The MHU-primary health care interface can be a good place to detect and study schizophrenic syndromes and other psychoses, as long as they comply with the agreed health and research criteria.

Trastornos esquizofrénicos en la atención primaria a la salud mental / Schizophrenic disorders in primary care mental health

Objetivos. Determinar la prevalencia y la incidencia de la esquizofrenia y otras psicosis en una unidad de salud mental (USM) estrechamente vinculada con la atención primaria de salud. Diseño. Estudio longitudinal, retrospectivo, del registro de todos los pacientes con psicopatología detectados en un área geodemográfica y asistencialmente delimitada. Emplazamiento. Cinco áreas básicas de salud de Barcelona (103.615 habitantes). Participantes. Pacientes de la USM que habían consultado por trastornos de salud mental durante el período 1982-2000 (n = 21.236). Se aplicaron criterios asistenciales y diagnósticos estrictos basados en la clasificación DSM-4. Todos los casos fueron validados mediante consulta de la historia clínica y el censo. Mediciones. Incidencia (en los últimos 3 años) y prevalencia de esquizofrenia y otras psicosis, en todo el período del estudio, tanto en población general como en la población en edad de riesgo (15-54 años). Resultados. En total, 838 pacientes cumplían los criterios para ser diagnosticados como esquizofrénicos (n = 476) o afectados por otras psicosis (n = 362). La incidencia de esquizofrenia es de 3,47/10.000 (intervalo de confianza [IC] del 95%, 2,3-4,6) en la población general y de 5,09/10.000/IC del 95%, 3,2-6,9) en la población en riesgo, y la prevalencia de esquizofrenia es de 54,9/10.000 (IC del 95%, 41,8-50,1) en la población general y de 80,7/10.000 (IC del 95%, 73,5-88) en la población en riesgo. Conclusiones. La interfase USM comunitaria-atención primaria de salud puede ser un buen lugar para la detección y el estudio de los síndromes esquizofrénicos y otras psicosis, siempre que se cumplan determinados criterios asistenciales y de investigación

Objectives. To determine the prevalence and incidence of schizophrenia and other psychoses in a mental health unit (MHU) closely connected to primary health care. Design. Retrospective longitudinal study of the register of all patients with psychiatric illnesses detected in a specific geo-demographic and health care area. Setting. Five basic health care areas of Barcelona (103 615 inhabitants). Participants. MHU patients who had attended clinics due to mental health disorders during the period from 1982-2000 (N=21 236). Strict health and diagnostic criteria based on the DSM-4 classification were applied. All cases were validated using clinical history review and concensus. Measurements. Incidence (in the last 3 years) and prevalence of schizophrenia and other psychoses in the whole period of study, both in the general population and in the risk population age group (15-54 years). Results. In total, 838 patients complied with the diagnosis of suffering from schizophrenia (N=476) or other psychoses (N=362). The incidence of schizophrenia was 3.47/10 000 (95% confidence interval [CI], 2.3-4.6) in the general population and 5.09/10 000, 95% CI, 3.2-6.9) in the population at risk, and the prevalence of schizophrenia was 54.9/10 000 (95% CI, 41.8-50.1) in the general population and 80.7/10 000 (95% CI, 73.5-88) in the population at risk. Conclusions. The MHU-primary health care interface can be a good place to detect and study schizophrenic syndromes and other psychoses, as long as they comply with the agreed health and research criteria

Hijos de pacientes psicóticos en el proyecto SASPE: investigar para cuidar un futuro comprometido / Children of psychotic patients in the SASPE projects: research for a future of commitment

Objetivos: Contribuir al conocimientod e la fertilidad y la fecundidad de una muestra urbana de pacientes diagnosticados bajo los rótulos de «trastorno esquizofrénico» y «otras psicosis» (estudio SASPE), así como de la psicopatología de su descendencia. Diseño:Estudio retrospectivo fundamentado en el procesamiento informático de los datos del Proyecto SASPE, en el vaciado de historias clínicas de cinco Equipos deSalud Mental Comunitaria estrechamente vinculada con la Atención Primaria a la Salud (APS) y en entrevistas con pacientes, hijos de pacientes y profesionales de losEquipos de Atención Primaria (EAP) y de Pediatría de AP. Emplazamiento del Proyecto: Unitat de Salut Mental (USM) de Sant Martí-La Mina, cinco Áreas Básicas de Salud (ABS) de Barcelona y Sant Adria (provincia de Barcelona),además de la Unidad Funcional de Atención a la Primera Infancia de Sant Martí(Institut Catalá de la Salut).Sujetos: 838 pacientes esquizofrénicos y con «otras psicosis» detectados por la USM. 917 descendientedse los mismos. Personal asistencial de la USM,5 ABS y de la Unidad Funcional de Atención a la Primera Infancia ( UFAP1).N iños con señalesd e alerta detectadase n los diversosC entrosd e la USM,y niños con señalesd e alerta o factoresd e riesgo detectadose n los EAP y en los Equiposd e Pediatríad e APS. Metodologíae instrumentos:D iagnósticosD SM-1V.E ntrevistase structuradasE RIElRAOS. E scalaso sistemasd e cribado en la infancia: cribadosA RBB-ADBB,C BCL y USMEP. Based e datos informatizadosd e la USM-SASPE

Objectives: To contribute to the knowledge of the fertility and fecundity of an urban sample of patients diagnosed with schizophrenic disorder or «other psychoses» (SASPE study), as well as of the offspring's psychopathology. Design: A retrospective study based in the computer treatment of the data of Project SASPE, in the casting of clinical histories of five Units of Community Mental Health closely linked with the Primary Health CaTe (PHC) and in interviews with patients, patient's offspring and professionals of the PHC and of Pediatrics of PHC. Location of the Project: Mental Health Unir (USM) of Sant Martí -The Mine, five Basic Health Areas of Barcelona and Sant Adria (Barcelona), besides the Functional Unir of Attention to the Early Childhood of Sant Martí (Catalan lnstitute of Health). Participants: 838 schizophrenic patients and with «delirant psychoses» detected by the USM. 917 descendants of the same ones. Staff of the USM, 5 Basic Health Areas and of the Functional Unir of Attention to the Early Childhood (UFAPI). Children with alert signs detected in the diverse Centers of the USM, and children with signs of alert or factors of risk detected in the PHC Teams and Pediatrics PHC teams. Methodology and instruments: Diagnoses DSM-IV. Structured'interview ERIE-lRAOS. Screening for childhood mental health ARBB-ADBB, CBCL and LISMEP. Informatized Data Base USM-SASPE