The Day After: The Longitudinal Effect of COVID-19 Lockdown on Quality of Life of University Students and the Moderator Role of Mindfulness.

Background: The COVID-19 lockdown has been a major stressor for the general population, posing a considerable threat to quality of life (QoL), particularly among university students. Existing research highlights the protective role of dispositional mindfulness (DM) in mitigating stressors; however, its influence on moderating the impact of COVID-19 on QoL remains unknown. We used a longitudinal design to assess the QoL of undergraduate students before and after the COVID-19 lockdown, while also examining the potential moderating effect of DM on this impact. Methods: One hundred eleven Spanish undergraduate students were recruited in 2019, and 103 were followed-up in 2020. Instruments comprised a demographic questionnaire, the World Health Organization Quality of Life BREF (WHOQOL-BREF) inventory to assess QoL, and the Five Facets Mindfulness Questionnaire (FFMQ) to assess DM. Results: Analyses revealed statistically significant differences between the two time points in WHOQOL-BREF: Psychological, Social Relationships, and Environmental. Moderation analyses revealed that the impact of COVID-19 on WHOQOL-BREF Psychological scores was moderated by FFMQ-Observe and FFMQ-Non-judging. Conclusions: The COVID-19 lockdown resulted in a reduction of QoL among undergraduate students, yet this impact was moderated by DM. Specifically, present moment attention to experience (observe) and non-judgmental awareness attenuated the impact of COVID-19 on psychological well-being. Future research should focus on evaluating the protective role of preventive interventions designed to increase DM among undergraduate students.

Dispositional Mindfulness Mediates the Relationship between Psychotic Symptoms and Psychological Quality of Life / [El mindfulness disposicional media la relación entre los síntomas psicóticos y la calidad de vida psicológica]

Background: To assess the mediator effect of dispositional mindfulness on the relationship between psychotic symptoms and psychological quality of life of people experiencing psychosis. Method: One hundred thirty-eight participants with psychosis were recruited. Psychotic symptoms were assessed through the PANSS scale, dispositional mindfulness was assessed using the MAAS questionnaire, and psychological quality of life was tapped with the WHOQOL-BREF questionnaire. Mediational analysis was performed setting PANSS factors as independent variables, MAAS scores as mediator, and WHOQOL-BREF Psychological as dependent variable. Results: MAAS scores mediated the relationship between WHOQOL-BREF Psychological scores and PANSS Positive (b = -.246, BCa CI [-.345, -.153]), PANSS Negative (b = -.173, BCa CI [-.251, -.096]), and PANSS Depressed scores (b = -.227, BCa CI [-.31, -.148]). Conclusions: Dispositional mindfulness can ameliorate the negative impact of hallucinations, delusions, negative symptoms, and depression feelings on psychological quality of life of people experiencing psychosis.(AU)

Antecedentes: Evaluar el efecto mediador de la atención plena disposicional en la relación entre los síntomas psicóticos y la calidad de vida psicológica de las personas que experimentan psicosis. Método: Se reclutaron 138 participantes con psicosis. Los síntomas psicóticos se evaluaron mediante la escala PANSS, la atención plena disposicional se evaluó utilizando la escala MAAS y la calidad de vida psicológica se exploró con el cuestionario WHOQOL-BREF. Se realizó un análisis de mediación estableciendo los factores PANSS como variables independientes, los puntajes MAAS como mediador y WHOQOL-BREF Psicológico como variable dependiente. Resultados: Las puntuaciones en la MAAS mediaron la relación entre WHOQOL-BREF-Psicológico y PANSS Positivo (b = -.246, IC BCa [-.345, -.153]), PANSS Negativo (b = -.173, IC BCa [-.251, -.096]) y PANSS Depresión (b = -.227, IC BCa [-.31, -.148]). Conclusiones: El mindfulness disposicional puede reducir el impacto negativo de las alucinaciones, delirios, síntomas negativos y sentimientos de depresión en la calidad de vida psicológica de las personas que experimentan psicosis.(AU)

Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial

ResumenAntecedentes/Objetivo: La Terapia Cognitivo-Conductual para la psicosis (TCCp) es un trata-miento eficaz mediado por el afrontamiento del estrés. Las Intervenciones Basadas en Min-dfulness (IBM) han demostrado efectos positivos en psicosis por lo que combinarlas con TCCp podría mejorar el afrontamiento. El estudio compara el efecto de la TCCp con TCCp+IBM sobre el afrontamiento en psicosis. Método: Cincuenta y seis participantes con psicosis fue-ron reclutados y asignados aleatoriamente a TCCp o TCCp+IBM. Los protocolos fueron sincro-nizados con las rutinas de los participantes. Las medidas incluyeron la entrevista PANSS y el inventario COPE. Los datos se analizaron con ANOVA de medidas repetidas y se calculó el RCI. Resultados: No hubo diferencias estadísticamente significativas entre grupos en el pre-trata-miento, sí las hubo en la interacción Tratamiento x Tiempo en Desconexión mental (F = 5,65, p = 0,021, η2 = 0,102), Aceptación (F = 7,69, p = 0,008, η2 = 0,133) y Supresión de distractores (F = 4,62, p = 0,037, η2 = 0,085). Conclusiones: La IBM fomenta estilos de afrontamiento en psicosis que la TCCp en solitario no. TCCp+IBM mejoró la aceptación del estresor y redujo la desconexión mental. La intervención es eficaz y viable en un contexto asistencial.

AbstractBackground/Objective: Cognitive Behavior Therapy for psychosis (CBTp) is a recommended treatment for psychoses whose effect is mediated by coping. Mindfulness (MBI) have shown positive effects in psychosis. This study examines the hypothesis that combining CBTp+MBI could improve coping with day-to-day life in psychosis better than CBTp alone in people attending a public community rehabilitation center. Method: Fifty-six outpatients were recruited and randomly allocated either to CBTp or CBTp+MBI. Measures Halabícomprised PANSS interview and COPE Inventory. Data were analyzed using a repeated measures ANOVA and RCI calculation. Results: There were no statistical differences between groups at pre-treatment. Significant statistical differences were found for the interaction Treatment x Time in Mental disengagement (F = 5.65, p = .021, η2 = .102), Acceptance (F = 7.69, p = .008, η2 = .133), and Suppressing competing activities (F = 4.62, p = .037, η2 = .085). Conclusions: MBI promotes specific coping styles in people who experience psychosis that otherwise are not improved with CBTp. Only the MBI group improved acceptance of the presence of the stressor and reduced mental disengagement from the context. The intervention is feasible and effective for public healthcare settings.

Atención plena (mindfulness): por qué es posible que funcione y por qué es seguro que triunfe / [Mindfulness: Why It Might Work and Why It's Sure to Succeed]

La atención plena (mindfulness) ha desbordado el ámbito clínico y comienza a aplicarse con entusiasmo en la escuela, el deporte o la empresa. La sospecha de que estamos ante una intervención que, aunque probablemente eficaz, tenga un tamaño de efecto pequeño, lo que obliga a realizar investigaciones con gran rigor. Así, solo conociendo los procesos psicológicos implicados en la atención plena podremos tener una visión más realista de su utilidad ante los diferentes problemas. Ante esto, ¿cómo explicar el extraordinario éxito que está obteniendo en Occidente la atención plena, tanto a nivel académico como mundano? Se presentan tres principios conductuales que se practican durante el entrenamiento en atención plena y se denuncia su uso ideológico, que aparece enmarcado, no en la mística existencial ni en el conductismo contextual, sino en la psicología positiva y su agenda neoliberal.

Mindfulness has gone beyond clinical applications and is beginning to be enthusiastically applied in schools, sport, and business settings. It seems to be a type of intervention that, while probably effective, has a small effect size, which calls for rigorous research. Understanding the psychological processes involved in mindfulness is essential in order to achieve a more realistic picture of its usefulness for some behavioral disorders. How can we explain the extraordinary success of mindfulness in western societies, both in academia and in popular culture? We present three behavioral principles and ideological reasons for applying mindfulness. Nowadays, mindfulness is framed not by mystical existentialism or contextual behaviorism, but by positive psychology and its neoliberal agenda.

Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial.

Background/Objective: Cognitive Behavior Therapy for psychosis (CBTp) is a recommended treatment for psychoses whose effect is mediated by coping. Mindfulness (MBI) have shown positive effects in psychosis. This study examines the hypothesis that combining CBTp+MBI could improve coping with day-to-day life in psychosis better than CBTp alone in people attending a public community rehabilitation center. Method: Fifty-six outpatients were recruited and randomly allocated either to CBTp or CBTp+MBI. Measures comprised PANSS interview and COPE Inventory. Data were analyzed using a repeated measures ANOVA and RCI calculation. Results: There were no statistical differences between groups at pre-treatment. Significant statistical differences were found for the interaction Treatment x Time in Mental disengagement (F = 5.65, p = .021, η2 = .102), Acceptance (F = 7.69, p = .008, η2 = .133), and Suppressing competing activities (F = 4.62, p = .037, η2 = .085). Conclusions: MBI promotes specific coping styles in people who experience psychosis that otherwise are not improved with CBTp. Only the MBI group improved acceptance of the presence of the stressor and reduced mental disengagement from the context. The intervention is feasible and effective for public healthcare settings.

Antecedentes/Objetivo: La Terapia Cognitivo-Conductual para la psicosis (TCCp) es un tratamiento eficaz mediado por el afrontamiento del estrés. Las Intervenciones Basadas en Mindfulness (IBM) han demostrado efectos positivos en psicosis por lo que combinarlas con TCCp podría mejorar el afrontamiento. El estudio compara el efecto de la TCCp con TCCp+IBM sobre el afrontamiento en psicosis. Método: Cincuenta y seis participantes con psicosis fueron reclutados y asignados aleatoriamente a TCCp o TCCp+IBM. Los protocolos fueron sincronizados con las rutinas de los participantes. Las medidas incluyeron la entrevista PANSS y el inventario COPE. Los datos se analizaron con ANOVA de medidas repetidas y se calculó el RCI. Resultados: No hubo diferencias estadísticamente significativas entre grupos en el pre-tratamiento, sí las hubo en la interacción Tratamiento x Tiempo en desconexión mental (F = 5,65, p = 0,021, η2 = 0,102), Aceptación (F = 7,69, p = 0,008, η2 = 0,133), y Supresión de distractores (F = 4,62, p = 0,037, η2 = 0,085). Conclusiones: La IBM fomenta estilos de afrontamiento en psicosis que la TCCp en solitario no. TCCp+IBM mejoró la aceptación del estresor y redujo la desconexión mental. La intervención es eficaz y viable en un contexto asistencial.

Mindfulness improves theory of mind in people experiencing psychosis: A pilot randomized clinical trial.

Impaired Theory of Mind (ToM) ability is a core feature of psychotic disorders that challenges psychosis treatment. We aimed to explore the effect of a Mindfulness-Based Intervention (MBI) on ToM ability in a randomized clinical trial (RCT). A sample of 36 participants diagnosed with psychotic disorder were recruited from a community center and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT+MBI. ToM skills were assessed through the Hinting Test and the Reading the Mind in the Eyes Test (RMET). IRT+MBI scored higher in RMET than IRT at posttreatment. MBI is a promising tool for improving ToM ability in psychosis.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

Tratamientos Psicológicos Empíricamente Apoyados Para Adultos: Una Revisión Selectiva / Evidence-Based Psychological Treatments for Adults: A Selective Review

Antecedentes: los tratamientos psicológicos han mostrado su efi cacia, efectividad y efi ciencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científi co generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda. (AU)

Background: Psychological treatments have shown their effi cacy, effectiveness, and effi ciency in dealing with mental disorders. However, considering the scientifi c knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fi elds of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help. (AU)

Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial / ¿Mejora el mindfulness el control inhibitorio en la psicosis? Un ensayo clínico aleatorizado y controlado

BACKGROUND/OBJECTIVE: Impaired Inhibitory Control (IC) is a core feature of psychotic disorders and is related with impaired social functioning in people experiencing psychosis. Despite research showing the benefits of mindfulness over IC in the general population, no study has assessed its effects on IC in psychoses. The aim of our study was to assess the effectiveness of a mindfulness-based intervention combined with integrated rehabilitation treatment in a sample of people diagnosed of psychotic disorders. METHOD: Fifty-six patients diagnosed with psychotic disorder were recruited and randomly allocated either to integrated rehabilitation treatment or integrated rehabilitation treatment enhanced with 26 mindfulness group sessions. Measures comprised PANSS interview, MAAS scale, and Stroop Color Word Test (SCWT). The primary outcome variable was the performance in the non-congruent trials of the SCWT. RESULTS: There were no differences between groups at baseline. At post-treatment patients allocated to mindfulness group increased their scores in non-congruent trials of SCWT and in MAAS. At post-treatment mindfulness group scored higher than integrated rehabilitation treatment in MAAS. CONCLUSIONS: Data suggest that mindfulness added to integrated rehabilitation treatment may improve IC in psychosis. Results are convergent with prior works about the effect of mindfulness over cognitive performance in general population

ANTECEDENTES/OBJETIVO: Los déficits en el control inhibitorio (CI) son una característica central en trastornos psicóticos y se relaciona con funcionamiento social deteriorado en personas con síntomas psicóticos. A pesar de las investigaciones que muestran los beneficios del mindfulness sobre el CI, ningún estudio ha evaluado sus efectos en las psicosis. El objetivo de este estudio fue evaluar la eficacia de una intervención basada en mindfulness combinada con tratamiento rehabilitador integrado en una muestra de personas diagnosticadas con trastorno psicótico. MÉTODO: Cincuenta y seis pacientes diagnosticados con trastorno psicótico fueron reclutados y asignados aleatoriamente a tratamiento rehabilitador integrado o a tratamiento rehabilitador integrado mejorado con 26 sesiones grupales de mindfulness. Las medidas fueron la entrevista PANSS, la escala MAAS, y el Test Stroop de Palabras y Colores (TSPC). La variable resultado principal fue el rendimiento en los ensayos no congruentes del TSPC. RESULTADOS: No hubo diferencias entre grupos antes del tratamiento. En el postratamiento los pacientes del grupo de mindfulness incrementaron sus puntuaciones en TSPC y en MAAS. El grupo de mindfulness puntuó más alto que el de tratamiento rehabilitador integrado en MAAS. CONCLUSIONES: El mindfulness añadido al tratamiento rehabilitador integrado puede mejorar el CI en las psicosis. Los resultados son convergentes con los trabajos previos sobre el efecto del mindfulness en la población general

Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial.

Background/Objective: Impaired Inhibitory Control (IC) is a core feature of psychotic disorders and is related with impaired social functioning in people experiencing psychosis. Despite research showing the benefits of mindfulness over IC in the general population, no study has assessed its effects on IC in psychoses. The aim of our study was to assess the effectiveness of a mindfulness-based intervention combined with integrated rehabilitation treatment in a sample of people diagnosed of psychotic disorders. Method: Fifty-six patients diagnosed with psychotic disorder were recruited and randomly allocated either to integrated rehabilitation treatment or integrated rehabilitation treatment enhanced with 26 mindfulness group sessions. Measures comprised PANSS interview, MAAS scale, and Stroop Color Word Test (SCWT). The primary outcome variable was the performance in the non-congruent trials of the SCWT. Results: There were no differences between groups at baseline. At post-treatment patients allocated to mindfulness group increased their scores in non-congruent trials of SCWT and in MAAS. At post-treatment mindfulness group scored higher than integrated rehabilitation treatment in MAAS. Conclusions: Data suggest that mindfulness added to integrated rehabilitation treatment may improve IC in psychosis. Results are convergent with prior works about the effect of mindfulness over cognitive performance in general population.

Antecedentes/Objetivo: Los déficits en el control inhibitorio (CI) son una característica central en trastornos psicóticos y se relaciona con funcionamiento social deteriorado en personas con síntomas psicóticos. A pesar de las investigaciones que muestran los beneficios del mindfulness sobre el CI, ningún estudio ha evaluado sus efectos en las psicosis. El objetivo de este estudio fue evaluar la eficacia de una intervención basada en mindfulness combinada con tratamiento rehabilitador integrado en una muestra de personas diagnosticadas con trastorno psicótico. Método: Cincuenta y seis pacientes diagnosticados con trastorno psicótico fueron reclutados y asignados aleatoriamente a tratamiento rehabilitador integrado o a tratamiento rehabilitador integrado mejorado con 26 sesiones grupales de mindfulness. Las medidas fueron la entrevista PANSS, la escala MAAS, y el Test Stroop de Palabras y Colores (TSPC). La variable resultado principal fue el rendimiento en los ensayos no congruentes del TSPC. Resultados: No hubo diferencias entre grupos antes del tratamiento. En el postratamiento los pacientes del grupo de mindfulness incrementaron sus puntuaciones en TSPC y en MAAS. El grupo de mindfulness puntuó más alto que el de tratamiento rehabilitador integrado en MAAS. Conclusiones: El mindfulness añadido al tratamiento rehabilitador integrado puede mejorar el CI en las psicosis. Los resultados son convergentes con los trabajos previos sobre el efecto del mindfulness en la población general.

Contributions of executive functions components to affective and cognitive theory of mind in outpatients diagnosed with schizophrenia.

Aim was to use a well-stablished Executive Functions (EF) model to test if different EF domains predict performance in affective and cognitive Theory of Mind (ToM) in schizophrenia. Fifty-four outpatients diagnosed with DSM-IV-TR schizophrenia disorder were recruited. Assessment consisted in Trail Making Test Part B (TMT-B) to assess Shifting, WAIS Backwards Digits to assess Updating, Stroop Test Non-congruent trials to assess Inhibition, Reading the Mind in the Eyes Test (RMET), and Hinting Test. Stroop Test Non-congruent predicted RMET scores, while TMT-B predicted Hinting Test scores. Findings suggest that cognitive and affective ToM performance are associated to specific EF processes.

Psychotic symptoms and quality of life: A mediation analysis of daily-life coping.

Prior studies suggest the relationship between psychotic symptoms and Quality of Life (QoL) may be mediated by diverse constructs. QoL in schizophrenia-related disorders has been related with coping with daily stressors. Based on previous studies, our hypothesis was that coping mediates the relationship between psychotic symptoms and QoL. Therefore, the aim of the study was to test the hypothesis in a sample of people with schizophrenia-related disorders from a community rehabilitation center. Sixty-six patients were assessed using PANSS, WHOQOL-BREF questionnaire, and COPE Inventory. Regression analyses were performed for each WHOQOL-BREF dimension using PANSS and COPE factors as predictors. Mediation analysis was performed for each WHOQOL-BREF dimension using significant PANSS scales as predictors and significant COPE factors as mediators. Sobel test showed that Self-Sufficient (Problem-focused) coping mediates the relationship between PANSS Positive and WHOQOL-BREF Psychological and WHOQOL-BREF Environmental scores. Results suggest that coping style based on personal abilities and oriented to the stressors mediates the relationship between positive symptoms and QoL associated to well-being and environmental features. However, in our study no coping style mediated the relationship between negative symptoms and QoL. Depressive symptoms predicted each QoL dimension and were not mediated by any coping style.

Relación entre actividad física, gravedad clínica y perfil sociodemográfico en pacientes con Depresión Mayor / Physical activity, clinical severity and sociodemographic profile relationship in Major Depression patients

La actividad física está demostrando en los últimos años ser una buena estrategia antidepresiva complementaria para muchos pacientes. La asociación entre el grado de actividad física y las características clínicas y sociodemográficas en la Depresión aún no se ha estudiado suficientemente en muestras amplias y representativas de pacientes. Hacerlo es importante para obtener información que posibilite mejorar el diseño de programas destinados a promover la actividad física en estos pacientes. Se reclutaron 3374 pacientes con Depresión Mayor en tratamiento, que acudieron a consulta psiquiátrica por primera vez en Centros de Salud Mental distribuidos por toda España. Fueron clasificados en tres grupos de acuerdo con el nivel de actividad física semanal que declararon. En este estudio comparamos el grupo que comunicó mayor actividad física (n = 1033; 30.6%) con el que menos (n = 858; 25.4%). Los pacientes más activos tenían menor gravedad clínica de acuerdo con la puntuación en la escala Montgomery-Asberg Depression Rating Scale (MADRS). Además eran más jóvenes, con mejor nivel educativo y de empleo, menor aislamiento social y menor consumo de tabaco. Sin embargo, cuando todas estas variables fueron controladas, la diferencia en la puntuación en la MADRS seguía siendo estadísticamente significativa. De lo anterior deducimos que los pacientes depresivos con más edad o dificultades socioeconómicas tienden a hacer menos actividad física espontáneamente, por lo que probablemente necesiten un apoyo especial al recomendárselo

Physical activity is showing in recent years to be a good antidepressant complementary strategy for many patients. The association between the degree of physical activity and clinical and sociodemographic characteristics in depression has still not been studied sufficiently in large and representative patient samples. Doing so is important to improve the design of programs that promote physical activity in depressive patients. 3374 patients with Major Depression who first came to psychiatric consultation in mental health centres in Spain were recruited. They were classiffied into three groups according to the level of weekly physical activity declared. In this study we compared the most physical activity declared group (n = 1033; 30.6%) with less physical activity declared group (n = 858; 25.4%). Most physically active patients had lower clinical depression severity according to the Montgomery-Asberg Depression Rating Scale (MADRS) scale. They were also younger, with higher education level and employment status; do not tend to live alone and less tobacco use. However, when all these variables were controlled, diferences in MADRS Scores between groups remain statistically signi.cant. Older and with socioeconomic difficulties depressive patients tend to do less physical activity, for this reason, it is probably that they need a particular support to recommend do exercise

Gender differences in mental health during the economic crisis / Diferencias de género en salud mental durante la crisis económica

BACKGROUND: Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. METHOD: A total of 7,914 patients in 2006 and 5,876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders. RESULTS: Between 2006 and 2010 the prevalence of Major Depressive Disorder increased 155.7% in men and 104.9% in women; Generalized Anxiety Disorder increased 98.3% in men and 71.3% in women; and Multisomatoform Disorder increased 100.05% in men and 37% in women. The effect of the Employment confounder was significant across all comparisons: Major Depressive Disorder Generalized Odds Ratio=2.557 for Men (p<.001), 2.046 for Women (p=.002); Generalized Anxiety Disorder Generalized Odds Ratio= 2.153 (p<.001) for Men, 1.546 for Women (p<.001); and for Non-specific Multisomatoform Disorder Generalized Odds Ratio=1.680 for Men (p<.001) and 1.301 for women (p=.014). CONCLUSION: Overall prevalence of mental disorders increased significantly between 2006 and 2010, especially in males, who are more sensitive to the effect of the current economic recession than women

ANTECEDENTES: el impacto de las crisis económicas sobre la salud mental está bien documentado, pero hay poca evidencia sobre el efecto diferencial que pueda tener entre hombres y mujeres. El objetivo fue analizar las diferencias de género en la prevalencia de trastornos mentales en atención primaria durante la recesión económica en España. MÉTODO: 7.914 pacientes en 2006-2007 y 5.876 en 2010-2011 fueron encuestados para recoger datos sociodemográficos y completar la entrevista Primary Care Evaluation of Mental Disorders. RESULTADOS: entre 2006 y 2010 la prevalencia del Trastorno Depresivo Mayor incrementó 155,7% en hombres y un 104,9% en mujeres; el Trastorno de Ansiedad Generalizada aumentó 98,3% en hombres y 71,3% en mujeres; el Trastorno Multisomatomorfo incrementó 100,05% en hombres y 37% en mujeres. El desempleo fue significativo en todos los análisis: Trastorno Depresivo Odds Ratio Generalizados= 2.557 en hombres (p<.001), 2.046 en mujeres (p= .002); Trastorno de Ansiedad Generalizada Odds Ratio Generalizados= 2.153 (p<.001) en hombres, 1.546 en mujeres (p<.001); Trastorno Multisomatoformo indiferenciado Odds Ratio Generalizados= 1.680 en hombres (p<.001) y 1.301 en mujeres (p= .014). CONCLUSIONES: la prevalencia de los trastornos mentales se incrementó entre 2006 y 2010 en ambos sexos, pero especialmente en hombres, quienes son más sensibles a los efectos de la crisis económica

Gender differences in mental health during the economic crisis.

BACKGROUND: Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. METHOD: A total of 7,914 patients in 2006 and 5,876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders. RESULTS: Between 2006 and 2010 the prevalence of Major Depressive Disorder increased 155.7% in men and 104.9% in women; Generalized Anxiety Disorder increased 98.3% in men and 71.3% in women; and Multisomatoform Disorder increased 100.05% in men and 37% in women. The effect of the Employment confounder was significant across all comparisons:  Major Depressive Disorder Generalized Odds Ratio=2.557 for Men (p<.001), 2.046 for Women (p=.002); Generalized Anxiety Disorder Generalized Odds Ratio= 2.153 (p<.001) for Men, 1.546 for Women (p<.001); and for Non-specific Multisomatoform Disorder Generalized Odds Ratio=1.680 for Men (p<.001) and 1.301 for women (p=.014). CONCLUSION: Overall prevalence of mental disorders increased significantly between 2006 and 2010, especially in males, who are more sensitive to the effect of the current economic recession than women.

Alteraciones cognitivas y depresión: una revisión crítica / Cognitive impairments and depression: a critical review

Las alteraciones cognitivas constituyen un síntoma nuclear de los trastornos depresivos. Analizamos las revisiones sistemáticas y los metaanálisis publicados en los últimos 10 años (2004-2014) que estudian el rendimiento cognitivo de pacientes deprimidos teniendo en cuenta las variables de edad, características clínicas y demográficas, gravedad de la sintomatología, número de episodios previos, remisión clínica, subtipos depresivos y tratamiento farmacológico. Se incluyeron 12 trabajos tras la búsqueda en bases de datos internacionales. Las funciones afectadas en primeros episodios fueron la velocidad psicomotora, la atención, el aprendizaje y la memoria visual, así como las funciones ejecutivas. Los pacientes deprimidos en fase de remisión presentan una mejoría en las tareas de atención, aunque sin alcanzar los niveles de rendimiento de los controles sanos. El subtipo melancólico parece contribuir a las diferencias en los déficits cognitivos expresados. Pacientes tratados con fármacos antidepresivos clásicos obtienen peores resultados en las puntuaciones compuestas de inhibición, en las pruebas de fluidez verbal, en las puntuaciones de memoria de trabajo verbal y en las puntuaciones compuestas de memoria de trabajo viso-espacial. Futuros estudios deben explorar la naturaleza longitudinal y la relevancia clínica de los síntomas cognitivos, determinar la dirección etiopatogénica de los mismos y su impacto en la funcionalidad global. De manera particular será relevante analizar en los nuevos fármacos antidepresivos su capacidad de mejorar no solo la sintomatología afectiva sino también las alteraciones cognitivas

Cognitive disturbances are core symptoms of depressive disorders. We assess the systematic reviews and meta-analysis studies published over the last 10 years (2004-2014) that address cognitive performance of depressed patients and taking into account age; clinical and demographic features; symptom severity; number of previous episodes; clinical remission; depressive subtypes and pharmacological treatment. Twelve (12) papers were included after search in international databases. In first episode depression the cognitive domains affected were psychomotor speed, attention, visual learning and memory as well as executive functions. Depressive patients in remission phase improved their performance in attention tasks although they did not achieve similar performance levels as healthy controls. Melancholic patients seem to have a different pattern of cognitive impairment compared with non-melancholic depressive patients. Patients treated with the current antidepressants perform worse in inhibition tasks, verbal fluency, and working memory scores as well as on composite scores of visual and verbal working memory. Future research should study longitudinal outcome and clinical relevance of cognitive symptoms, determine their underlying etiopathogenesis and how they impact on clinical functioning. Specifically, it would be important to analyze the ability of the new antidepressant drugs to improve affective symptoms as well as cognitive dysfunctions

Cognitive impairments and depression: a critical review.

Cognitive impairments are core symptoms of depressive disorders. We assess the systematic reviews and meta-analysis studies published over the last 10 years (2004-2014) that address cognitive performance of depressed patients and taking into account age; clinical and demographic features; symptom severity; number of previous episodes; clinical remission; depressive subtypes and pharmacological treatment. Twelve (12) papers were included after search in international databases. In first episode depression the cognitive domains affected were psychomotor speed, attention, visual learning and memory as well as executive functions. Depressive patients in remission phase improved their performance in attention tasks although they did not achieve similar performance levels as healthy controls. Melancholic patients seem to have a different pattern of cognitive impairment compared with non-melancholic depressive patients. Patients treated with the current antidepressants perform worse in inhibition tasks, verbal fluency, and working memory scores as well as on composite scores of visual and verbal working memory. Future research should study longitudinal outcome and clinical relevance of cognitive symptoms, determine their underlying etiopathogenesis and how they impact on clinical functioning. Specifically, it would be important to analyze the ability of the new antidepressant drugs to improve affective symptoms as well as cognitive dysfunctions.

Cognitive impairment in remitted and non-remitted depressive patients: A follow-up comparison between first and recurrent episodes.

Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.

Mindfulness improves psychological quality of life in community-based patients with severe mental health problems: A pilot randomized clinical trial.

OBJECTIVE: To examine the effectiveness of group mindfulness-based intervention (MBI) in patients diagnosed with severe mental illness. The primary outcome was health-related psychological quality of life. Secondary measures were environmental, social and physical health related quality of life, frequency and intensity of psychotic symptoms and daily-life mindfulness. METHOD: Forty-four patients from a public community rehabilitation center for people with severe mental illness were recruited, and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT plus MBI. Measures included PANSS interview, WHOQOL-BREF, and Mindfulness Attention Awareness Scale. MBI comprised 26 one-hour weekly sessions. Intention-to-treat analysis was used. RESULTS: One patient did not complete IRT+MBI and two did not complete IRT. At baseline there were no statistical group differences in demographic characteristics or primary and secondary outcomes. At post-treatment interaction between treatment and time in health-related psychological quality of life was statistically significant, and simple effect analysis showed significant differences for between and within subject factor in favor of MBI. Interaction was also significant in PANSS negative symptoms, simple effects showed a statistical trend in within subject factor. Time factor was significant in environmental and physical quality of life. CONCLUSIONS: Data suggest mindfulness added to IRT may enhance psychological quality of life in people with severe mental illness from a public community center. Results also suggest that mindfulness may impact frequency and intensity of negative symptoms.