RESUMO
BACKGROUND: Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD: A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS: Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS: MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Remediação Cognitiva/métodos , Metacognição/fisiologia , Avaliação de Resultados em Cuidados de Saúde , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/terapia , Teoria da Mente/fisiologia , Pensamento/fisiologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Método Simples-Cego , Adulto JovemRESUMO
El presente estudio intenta analizar las características demográficas y clínicas (edad, sexo, estado civil, edad de inicio, número y características de ingresos previos, derivación, nivel cultural, antecedentes familiares), de los pacientes diagnosticados de trastorno de personalidad según la DSM-IV que asisten al Servicio de Urgencias del Hospital de Jaén durante el año 2003. Pretendemos determinar si existen diferencias entre los distintos tipos de trastorno de personalidad y los motivos de demanda de asistencia, como son intentos autolíticos, cuadros de ansiedad, depresión, pánico, episodios psicóticos, consumo de tóxicos, trastornos de conducta, etc. De igual modo se comparan las características de los ingresos de estos pacientes con los de la población total de enfermos atendidos en la Unidad de Agudos de Psiquiatría del Hospital de Jaén (AU)
Assuntos
Adolescente , Adulto , Feminino , Masculino , Humanos , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/diagnóstico , Serviços de Emergência Psiquiátrica , Serviços Médicos de Emergência/métodos , Comorbidade , Estudos Transversais , Depressão/complicações , Psicofarmacologia/métodos , Transtornos da Personalidade/tratamento farmacológico , Ansiolíticos/administração & dosagemRESUMO
Los medios de contención mecánica son utilizados en las Unidades de Psiquiatría de los Hospitales Generales como tratamiento de crisis a pesar de los avances en la psicofarmacología realizados en las últimas décadas. La Unidad de Psiquiatría del Hospital Neurotraumatológico de Jaén no es una excepción. En nuestro trabajo se especifican factores demográficos, los motivos más frecuentes de contención, la duración (el número de horas de contención), diagnósticos más frecuentes asociados a su uso, principales circunstancias que motivan su prescripción, y la proporción de pacientes de la Unidad que lo han precisado. Nuestros datos se refieren a los ingresos producidos durante el año 2000.La contención es más frecuente en varones, jóvenes, con diagnóstico de psicosis o manía. En nuestra Unidad no se encuentran diferencias entre los distintos turnos del día ni en los días de la semana (AU)
Assuntos
Adolescente , Adulto , Idoso , Feminino , Masculino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Humanos , Transtornos Mentais/terapia , Imobilização , Distribuição por SexoRESUMO
The radiologic changes that ocurred in 37 cases of histiocytosis are reported. According to established clinical types, they are grouped and analyzed stressing in bone lesions their aspect, characteristics and distribution, together with the evident differential diagnosis and the X-ray guideline to be followed to determine the course. The importance of plain X-ray is stressed and other less frequent changes are mentioned in those cases with diagnostic problems.