Gender differences in adolescents with suicidal behaviour: Personality and psychopathology / Diferencias de género en adolescentes con conducta suicida: Personalidad y psicopatología

This study evaluates the relationship between gender, personality, psychopathology and suicidal behaviour among adolescents. For this purpose, across-sectional study with adolescent inpatients (N = 92) displaying suicidal behaviour was designed. Sociodemographic characteristics and datarelated to suicidal behaviour were collected. In addition, personality and clinical severity were assessed by administering the Millon Adolescent Clinical Inventory (MACI). Results revealed that the most prevalent personality dimensions for both genders were Introversive, Self-demeaning, Doleful,Oppositional, Borderline tendency and Inhibited. However, men scored higher in Inhibited (p = 0.02, Cohen’s d = 0.45) and women in Egotistic(p = 0.03, Cohen’s d = 0.40). Concerning clinical severity of syndromes, women scored higher in Delinquent Predisposition (p = 0.04, Cohen’sd = 0.45) and men in Anxious Feelings (p = 0.02, Cohen’s d = 0.51), Depressive Affect (p = 0.04, Cohen’s d = 0.41) and Suicidal Tendency (p= 0.03, Cohen’s d = 0.37), with men reporting more frequently Childhood Abuse (p < 0.001, Cohen’s d= 0.70). Results highlight the importanceof universal interventions to promote a change in attitudes towards seeking psychological help, specially in men, and the need to designeffective tailored treatments to acquire emotional management skills for both genders. (AU)

Este estudio evalúa la relación entre el género, lapersonalidad, la psicopatología y la conducta suicida entre los adolescentes. Para ello, se diseñó un estudio transversal con adolescentes hospitalizados (N = 92) que presentaban conductas suicidas. Se recogieron características sociodemográficas y datos relacionados con la conductasuicida. Además, se evaluó la personalidad y la gravedad clínica mediante la administración del Inventario Clínico de Adolescentes de Millon (MACI).Los resultados revelaron que las dimensiones de personalidad más prevalentes para ambos géneros fueron Introversivo, Auto-punitivo, Pesimista,Oposicionista, Tendencia límite e Inhibido. Sin embargo, los hombres puntuaron más alto en Inhibido (p = 0,02, d de Cohen = 0,45) y las mujeresen Egocéntrica (p = 0,03, d de Cohen = 0,40). En cuanto a la gravedad clínica de los síndromes, las mujeres puntuaron más alto en PredisposiciónDelictiva (p = 0,04, d de Cohen = 0,45) y los hombres en Sentimientos Ansiosos (p = 0,02, d de Cohen = 0. 51), Afecto Depresivo (p = 0,04, dde Cohen = 0,41) y Tendencia Suicida (p = 0,03, d de Cohen = 0,37), y los hombres informaron con mayor frecuencia de Abuso en la Infancia(p < 0,001, d de Cohen = 0,70). Los resultados ponen de manifiesto la importancia de las intervenciones universales para promover un cambiode actitud hacia la búsqueda de ayuda psicológica, especialmente en los hombres, y la necesidad de diseñar tratamientos eficaces a medidapara adquirir habilidades de gestión emocional para ambos géneros. (AU)

[Spanish validation of the Autonomic Standards Assessment Form in spinal cord injuries]. / Validación española del cuestionario Autonomic Standards Assessment Form en la lesión medular.

INTRODUCTION AND OBJECTIVES: Autonomic nervous system (ANS) dysfunction in patients with spinal cord injury (SCI) severely impacts morbidity and mortality. However, research initiatives aiming to gain insight into the direct impact of ANS dysfunction on health outcomes in persons with SCI are still lacking. Thus, this study had 2main objectives: 1) to translate into Spanish the revised edition of the International Standards on documentation of remaining Autonomic Function after SCI (ISAFSCI), and 2) to describe the impact of ANS dysfunction in a sample of SCI patients. MATERIAL AND METHODS: Cross-sectional observational pilot study in 51 traumatic SCI patients (> 1 year after injury). Demographic, medical and ISAFSCI data were studied. RESULTS: The Spanish version of the ISAFSCI showed that the most altered systems in the sample were sweating control (above-lesion hyperhidrosis in 33.3%; below-lesion hyperhidrosis in 17.6%; below-lesion hypohidrosis in 21.6%) and temperature control (hyperthermia in 76.5%). In addition, 74.5% of the sample had complete loss of control of the lower urinary tract, and 82.4% had no control of the bowel. Finally, genital arousal was reflex in 47.1% and orgasm and ejaculation were reduced or altered in most of the patients (92.2% and 84.3%, respectively). CONCLUSION: The Spanish version of the ISAFSCI is a useful and practical tool, and can be employed in clinical practice to assess ANS function in patients with SCI. Understanding the role of ANS in persons with SCI is crucial to improve their health status and reduce secondary complications post-SCI, and consequently help to improve the clinical management in these individuals.

Validación española del cuestionario Autonomic Standards Assessment Form en la lesión medular / Spanish validation of the Autonomic Standards Assessment Form in spinal cord injuries

Introducción y objetivos: Las disfunciones del sistema nervioso autónomo (SNA) en pacientes con lesión medular (LM) impactan de forma severa su morbimortalidad. Sin embargo, siguen siendo escasas las iniciativas de investigación destinadas a conocer dicha patología. Por ello, este artículo tiene como objetivos: 1) traducir al español el documento International Standards on documentation of remaining Autonomic Function after SCI (ISAFSCI), y 2) describir la influencia de la alteración del SNA en una muestra de pacientes con LM. Material y métodos: Estudio piloto observacional de tipo transversal, en 51 pacientes con LM traumática (> 1 año de evolución). Se recogiero datos sociodemográficos, médicos, ISAFSCI. Resultados: La versión española del ISAFSCI mostró que los sistemas más alterados fueron el control de la sudoración (hiperhidrosis supralesional 33,3%, hiperhidrosis infralesional 17,6%, hipohidrosis infralesional 21,6%) y de la temperatura (hipertermia 76,5%). El 74,5% tenía ausencia completa de control urinario inferior y el 82,4% no tenía control del intestino. La excitación genital fue refleja en el 47,1% de la muestra y el orgasmo y la eyaculación estaban alterados o reducidos en la mayoría de los casos (92,2% y 84,3%, respectivamente). Conclusiones: La versión española del ISAFSCI es una herramienta práctica y de gran utilidad en contextos clínicos para la evaluación de la función del SNA en personas con una LM. Entender el papel del SNA en personas con una LM es crucial para mejorar su estado de salud general y reducir complicaciones secundarias derivadas de la LM, y consecuentemente contribuye a un mejor manejo clínico

Introduction and objectives: Autonomic nervous system (ANS) dysfunction in patients with spinal cord injury (SCI) severely impacts morbidity and mortality. However, research initiatives aiming to gain insight into the direct impact of ANS dysfunction on health outcomes in persons with SCI are still lacking. Thus, this study had 2main objectives: 1) to translate into Spanish the revised edition of the International Standards on documentation of remaining Autonomic Function after SCI (ISAFSCI), and 2) to describe the impact of ANS dysfunction in a sample of SCI patients. Material and methods: Cross-sectional observational pilot study in 51 traumatic SCI patients (> 1 year after injury). Demographic, medical and ISAFSCI data were studied. Results: The Spanish version of the ISAFSCI showed that the most altered systems in the sample were sweating control (above-lesion hyperhidrosis in 33.3%; below-lesion hyperhidrosis in 17.6%; below-lesion hypohidrosis in 21.6%) and temperature control (hyperthermia in 76.5%). In addition, 74.5% of the sample had complete loss of control of the lower urinary tract, and 82.4% had no control of the bowel. Finally, genital arousal was reflex in 47.1% and orgasm and ejaculation were reduced or altered in most of the patients (92.2% and 84.3%, respectively). Conclusion: The Spanish version of the ISAFSCI is a useful and practical tool, and can be employed in clinical practice to assess ANS function in patients with SCI. Understanding the role of ANS in persons with SCI is crucial to improve their health status and reduce secondary complications post-SCI, and consequently help to improve the clinical management in these individuals

Perfiles psicológicos del adolescente con conducta suicida / Psychological profiles of adolescents with suicidal behavior

La necesidad de prevenir muertes evitables y contener el impacto emocional que genera la conducta suicida requiere de estudios que permitan entender mejor el fenómeno, con el fin de incrementar la eficacia de las estrategias preventivas e interventivas. Clasificar la conducta suicida permitiría un mejor abordaje de esta problemática tan heterogénea, con influencias culturales, evolutivas y de género. Este trabajo pretende describir diferentes perfiles psicológicos prototípicos del adolescente con conducta suicida, a partir de una propuesta de clasificación ya existente que se amplía con otras variables clínicas de relevancia. Para ello, se diseñó un estudio transversal descriptivo-correlacional con pacientes de entre 8-17 años, visitados en Urgencias por conducta suicida entre noviembre del 2013 y diciembre del 2014. Los datos se obtuvieron a partir de entrevistas clínicas. La propuesta de clasificación mostró que los adolescentes del grupo I, el más prevalente (60%), se caracterizaron por presentar mayor prevalencia de rasgos desadaptativos de personalidad, trastorno de conducta, más ingresos hospitalarios y autolesiones y la mitad de ellos presentaron antecedentes de conducta suicida. Los del grupo II (30%), presentaron mayor prevalencia de trastornos del estado de ánimo. El grupo III (10%), mostró un alto porcentaje de tentativas autolíticas (>75%) respecto a otras conductas suicidas, identificando los conflictos relacionales como desencadenantes más frecuentes. La obtención de estos perfiles prototípicos y sus correspondientes características clínicas y psicopatológicas, permite sugerir diferentes procesos de tratamiento ajustados a cada uno de los procesos descritos

The need to prevent avoidable deaths and to contain the emotional impact of suicidal behavior requires studies to better understand the phenomenon and to increase the effectiveness of prevention and intervention strategies. Suicidal behavior has a very heterogeneus characterization, which is influenced by cultural, evolutionary, and gender features, and its classification could facilitate a better approach to this problem. This study was intended to describe the different prototypical psychological profiles of the adolescent with suicidal behavior, based on an existing classification proposal that is extended with other relevant clinical variables. A cross-sectional and descriptive design was employed in a sample of patients between 8-17 years old attended in a pediatric emergency unit between November 2013 and December 2014. Data was collected by means of semistructured interviews. The classification showed that adolescents in group I, the most prevalent (60%), were characterized by a higher prevalence of maladaptive personality traits, behavioral disorders, more mental health hospital admissions, self-harm behaviors, and half of them had a history of previous suicidal behavior. Those in group II (30%) had a higher prevalence of mood disorders. Group III (10%) showed a high percentage of autolysis attempts (>75%) when compared to other type of suicidal behavior, identifying relational conflicts as the most frequent triggers. To obtain these prototypic profiles and their corresponding clinical and psychopathological characteristics in the study sample suggests different treatments tailored to each specific profile

Physical and Psychosocial Functions of Adults with Lower Limb Congenital Deficiencies and Amputations in Childhood.

Objectives. (1) To describe the epidemiological and medical features of a sample with LLA and LLD in childhood and (2) to explore their relationship with subsequent physical and psychosocial functions in adulthood. Methods. Cross-sectional survey. Demographics, medical data, Locomotor Capabilities Index (LCI), and Discomfort-Engagement in Everyday Activities Involving Revealing the Body Scale (D-EEARB) were collected from thirty-two adults who suffered from LLA in childhood or LLD. Results. Most of the sample (53.1% males) was working (84.4%), living independently (75%), and single (75%). Mean age was 33.16 (SD = 7.64, range 18-50). Leading causes for LLA were traumatic (40.6%) and oncologic (25%). LLD was present in 6 cases (18.8%). LCI scores revealed a high performance among males (t 17,464 = 2.976, p = .008). D-EEARB scores showed that 56.25% stated feeling "quite" or "totally comfortable" in situations which involved revealing their body, but 43.75% stated the contrary ("uncomfortable" or "very uncomfortable"). LLD and traumatic LLA show higher scores in D-EEARB than vascular and oncological LLA (χ (2) = 7.744, df = 3, p = .05). Conclusions. Adults suffering from LLDs and LLAs during childhood seem to perform well once they are adults. However, 43.75% of patients express considerable discomfort in situations that involve revealing the body.

Programa de entrenamiento en coherencia cardiaca para la reducción del estrés en personal sanitario con cervicalgia crónica: un estudio piloto / Training program in cardiac coherence for stress reduction in healthcare personnel with chronic neck pain: a pilot study

La presente nota clínica tiene por objetivo divulgar los resultados de un trabajo piloto para valorar las potencialidades de un entrenamiento en coherencia cardiaca (CC) para la reducción del estrés en personal sanitario con cervicalgia crónica. Para ello, 8 enfermeras participaron en un programa de entrenamiento en CC y se evaluadas pre/post en los siguientes factores: dolor (EVA), inteligencia emocional (TMMS-24), sintomatología ansioso-depresiva (escalas Hamilton y Goldberg) y estrés laboral (NSS). Tras el entrenamiento se observó una disminución significativa en las puntuaciones de dolor y su sintomatología asociada (contracturas, dolor por movilidad y parestesias), así como en la sintomatología depresiva. Asimismo, se observaron mayores puntuaciones en inteligencia emocional (escala de percepción) (AU)

This case report aims to disseminate the results of a pilot study exploring the potentialities of training program in cardiac coherence (CC) for reducing stress in nurses with chronic neck pain. For this purpose, 8 nurses participated in a training program in CC and were evaluated pre/post on the following factors: pain (VAS), emotional intelligence (TMMS-24), anxious depressive symptoms (Hamilton & Goldberg scales) and job related stress (NSS). After the training, a significant decrease in pain scores and associated symptoms (spasms, pain due to mobility and paresthesias) as well as depressive symptoms was observed. Also, higher scores were observed in emotional intelligence (perception scale) (AU)

Type of tumour, gender and time since diagnosis affect differently health-related quality of life in adolescent survivors.

Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12-20 years) who were ≥ 1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors.

Calidad del sueño en pacientes con lumbalgia crónica inespecífica / Sleep quality in a sample of patients with nonspecific chronic low back pain

Introducción. El presente trabajo tiene por objetivo describir la calidad del sueño en pacientes con dolor lumbar crónico inespecífico (DLCI), así como la asociación de este con la percepción de dolor, la edad y/o el género. Material y métodos. Para ello, 93 pacientes con DLCI contestaron el Índice de Calidad del Sueño de Pittsburg (ICSP) y una escala visual análoga (EVA) de dolor. A partir de estos datos, se llevó a cabo un análisis descriptivo-correlacional y un análisis factorial exploratorio. Resultados. Pese a presentar puntuaciones medias moderadas-altas (M = 6,31, SD = 2,10) en la EVA, la percepción de dolor no guardaba relación estadísticamente significativa con la calidad global del sueño de la muestra de estudio. Tampoco lo hizo la edad o el género de los participantes. Aunque un 59,1% describió su calidad global del sueño como «buena» o «bastante buena», el 40,9% restante lo hizo como «bastante mala» o «mala». El análisis factorial reveló la existencia de 6 factores principales para el ICSP, que lograban explicar el 67,56% de la varianza (explicando los 3 primeros un 44,45% del total). Conclusiones. Globalmente, la calidad del sueño de pacientes con DLCI es satisfactoria y no guarda relación ni con el dolor percibido, ni con la edad o el género del participante. No obstante, casi un tercio de la muestra (26,9%) presentaba alteraciones de mantenimiento del sueño (principalmente, mujeres). El análisis factorial reveló la utilidad del ICSP como instrumento válido y aceptable para el estudio del sueño en pacientes con DLCI (AU)

Introduction: The aim of the present study was to describe sleep quality in patients with nonspecific chronic low back pain (CLBP) and its association with perceived pain, age, and/or gender. Material and methods: A total of 93 CLBP patients completed the Pittsburg Sleep Quality Index (PSQI) and a Visual Analogue Scale (VAS) for pain. Descriptive-correlational analyses and factor structure for the PSQI were calculated for these data. Results: Despite showing moderate-to-high mean scores on the VAS (mean = 6.31, SD = 2.10), pain perception, gender, and participants' age were not significantly related to global sleep quality. Overall sleep quality was described as «good» or «quite good» by 59.1% of the sample but as «quite bad» or «bad» by the remaining 40.9%. Factor analysis of the PSQI revealed six main factors that explained 67.56% of the variance (the first three accounted for 44.45% of the total variance). Conclusions: Globally, the quality of sleep in CLBP patients is satisfactory and is not related to perceived pain, age, or gender. However, almost a third of the sample (26.9%) reported impaired sleep maintenance (mainly women). Factor analysis revealed the suitability of the PSQI to study sleep quality in CLBP patients (AU)