Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients: Results from a randomized controlled trial.

INTRODUCTION: Few controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment. MATERIAL AND METHODS: Randomized, prospective, multicenter, single-blinded trial that included BP-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation. RESULTS: Eighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either. CONCLUSIONS: In our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning.

Effect of mindfulness-based cognitive therapy vs. psychoeducational intervention on plasma brain-derived neurotrophic factor and cognitive function in bipolar patients: a randomized controlled trial.

Introduction: Few controlled trials have assessed the benefits of Mindfulness Based Cognitive Therapy (MBCT) on cognitive functions and brain-derived neurotrophic factor (BDNF) in bipolar disorder (BD). This study aims to evaluate the impact of MBCT adjunctive treatment on these variables. Main hypothesis was that MBCT would improve cognitive functioning and BDNF more than Psychoeducation and TAU. Methods: Randomized, multicenter, prospective and single-blinded trial. Included BD outpatients randomly assigned to three treatment arms: MBCT plus treatment as usual (TAU), Psychoeducation plus Tau and TAU. Cognitive functions were assessed with Continuous Performance Test-III, Stroop Test, Trail Making Test, Digit Span and Letter-Number Sequencing from Wechsler Adult Intelligence Scale III, Face Emotion Identification Task and Face Emotion Discrimination Task. BDNF serum level was measured with ELISA. Patients were assessed at baseline, 8 weeks and 6 months. Results: Eighty-four patients were recruited (TAU = 10, Psychoeducation = 34, MBCT = 40). No significant differences between treatment groups were found. MBCT does not achieve better results than Psychoeducation or TAU. Discussion: Being Psychoeducation and TAU efficient interventions, as well as the scarce duration of a more complex intervention, such as MBCT, are suggested as explanatory variables of these results. Trial registration: ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.

Mental health interventions for healthcare workers during the first wave of COVID-19 pandemic in Spain.

OBJECTIVE: In order to reduce distress associated with working with COVID-19 patients, several psychological intervention programmes for healthcare workers have been developed in Spain. We aimed to describe the main characteristics and components of these programmes for healthcare workers treating COVID-19 patients in Spanish hospitals. MATERIAL AND METHODS: An online survey was designed to evaluate the main characteristics of psychological intervention programmes for healthcare workers during the first wave of COVID-19 pandemic. RESULTS: Valid responses were received from 36 hospitals. Most of these programmes offered both in-person and online therapy. The most common aim of these interventions was emotional regulation, which was treated by psychoeducational and cognitive-behavioural techniques in individual interventions. Group interventions mainly used psychoeducation and mindfulness. Only half of the teams that offered in-person interventions received training in the proper use of personal protective equipment. CONCLUSIONS: Several hospitals in Spain have developed mental health interventions for healthcare workers during the COVID-19 pandemic, deploying a wide range of therapeutic modalities and techniques. The rapid implementation of these programmes during the pandemic suggests that safety may not have received sufficient attention. The planning and development of interventions for healthcare workers during pandemics merits greater attention by national and regional authorities and institutions.

Mental health interventions for healthcare workers during the first wave of COVID-19 pandemic in Spain

Objective: In order to reduce distress associated with working with COVID-19 patients, several psychological intervention programmes for healthcare workers have been developed in Spain. We aimed to describe the main characteristics and components of these programmes for healthcare workers treating COVID-19 patients in Spanish hospitals.Material and methodsAn online survey was designed to evaluate the main characteristics of psychological intervention programmes for healthcare workers during the first wave of COVID-19 pandemic.ResultsValid responses were received from 36 hospitals. Most of these programmes offered both in-person and online therapy. The most common aim of these interventions was emotional regulation, which was treated by psychoeducational and cognitive-behavioural techniques in individual interventions. Group interventions mainly used psychoeducation and mindfulness. Only half of the teams that offered in-person interventions received training in the proper use of personal protective equipment.ConclusionsSeveral hospitals in Spain have developed mental health interventions for healthcare workers during the COVID-19 pandemic, deploying a wide range of therapeutic modalities and techniques. The rapid implementation of these programmes during the pandemic suggests that safety may not have received sufficient attention. The planning and development of interventions for healthcare workers during pandemics merits greater attention by national and regional authorities and institutions. (AU)

Objetivo: Para reducir el malestar psicológico asociado a tratar pacientes con COVID-19, se han desarrollado numerosos programas de intervención en España. Este estudio pretende describir las principales características y componentes de los programas para trabajadores sanitarios que atienden COVID-19 en hospitales españoles.Material y métodosSe elaboró y distribuyó una encuesta online para evaluar las principales características de los programas de intervención psicológica para trabajadores sanitarios durante la primera ola de la pandemia de COVID-19.ResultadosSe recibieron respuestas válidas de 36 hospitales. La mayoría de los programas ofrecían intervención presencial y online/telefónica. El principal objetivo de estos programas fue mejorar la regulación emocional. Las intervenciones individuales emplearon principalmente psicoeducación y técnicas cognitivo-conductuales, mientras que las grupales emplearon psicoeducación y mindfulness. Solo la mitad de los equipos que ofrecían intervenciones presenciales habían recibido la formación adecuada para usar equipos de protección individual.ConclusionesNumerosos hospitales en España han desarrollado intervenciones de salud mental para trabajadores sanitarios durante la pandemia por COVID-19, empleando una gran variedad de modalidades terapéuticas. La rápida implementación de estos programas durante la pandemia sugiere que la necesidad de seguridad ha podido subestimarse. La planificación y desarrollo de intervenciones psicológicas durante las pandemias merece mayor atención por parte de las autoridades competentes. (AU)

Mental health interventions for healthcare workers during the first wave of COVID-19 pandemic in Spain.

OBJECTIVE: In order to reduce distress associated with working with COVID-19 patients, several psychological intervention programmes for healthcare workers have been developed in Spain. We aimed to describe the main characteristics and components of these programmes for healthcare workers treating COVID-19 patients in Spanish hospitals. MATERIAL AND METHODS: An online survey was designed to evaluate the main characteristics of psychological intervention programmes for healthcare workers during the first wave of COVID-19 pandemic. RESULTS: Valid responses were received from 36 hospitals. Most of these programmes offered both in-person and online therapy. The most common aim of these interventions was emotional regulation, which was treated by psychoeducational and cognitive-behavioural techniques in individual interventions. Group interventions mainly used psychoeducation and mindfulness. Only half of the teams that offered in-person interventions received training in the proper use of personal protective equipment. CONCLUSIONS: Several hospitals in Spain have developed mental health interventions for healthcare workers during the COVID-19 pandemic, deploying a wide range of therapeutic modalities and techniques. The rapid implementation of these programmes during the pandemic suggests that safety may not have received sufficient attention. The planning and development of interventions for healthcare workers during pandemics merits greater attention by national and regional authorities and institutions.

Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente / Emotional impact on patients and families during the COVID-19 pandemic. A different kind of bereavement

OBJETIVO: Favorecer que cada persona elabore su duelo de forma natural, prevenir factores de riesgo e identifi car a los deudos que necesiten una atención específica. MÉTODO: Estudio descriptivo. Doscientas ocho familias fueron atendidas entre el 11 de marzo y el 20 de mayo de 2020 por duelo por la COVID-19, de acuerdo con un protocolo establecido. RESULTADOS: La edad media de los fallecidos fue de 76 años. El 58 % eran hombres. Los familiares atendidos fueron hijo/a (54 %), cónyuge o pareja (20 %), hermano/a (2 %). En relación con el lugar de fallecimiento, el 41 % en plantas de hospitalización, el 27 % en Urgencias, el 22 % en la planta de cuidados paliativos y el 10 % en UCI. El tipo de atención fue en el 53 % de los casos telefónica, en el 16 % presencial, en el 12 % telefónica y presencial y en el 3 % a través de videollamada. En un 63 % de las veces se realizó apoyo, asesoramiento puntual o atención específica mientras que en el 37 % se ofreció apoyo y disponibilidad. En lo referente "despedida final", el 49 % de los familiares pudieron despedirse, el 31 % no pudo. El tipo de duelo de los familiares atendidos fue inicialmente normal en el 71 %, mientras que un 16 % fue clasificado como de riesgo. CONCLUSIONES: La información y comunicación efectiva con los familiares afectados, la formación en la muerte y el duelo de los profesionales implicados y la disponibilidad de atención psicológica se consideran de gran importancia en una situación COVID-19. La experiencia muestra que la "Atención al duelo" debe estar a disposición de la población general afectada. Una buena organización y planificación ha de incorporar protocolos de actuación y seguimiento que incluyan una adecuada valoración y atención en los diferentes niveles desde el apoyo, la prevención y la detección precoz de posibles complicaciones en el duelo, y si es necesario la intervención especializada

OBJECTIVE: To allow each individual to undergo bereavement in a natural way, to prevent risk factors, and to identify bereaved people who need specific attention. METHOD: A descriptive study. Two hundred and eight families were attended to between March 11 and May 20, 2020 for Covid-19 according to an established protocol. RESULTS: Average age of the deceased relatives was 76 years. Fifty-eight percent were men. The family members who were cared for included: son or daughter (54 %), spouse or partner (20 %), brother or sister (2 %). Regarding the place of death, 41 % were in hospitalization wards, 27 % in the emergency room, 22 % in the palliative care ward, and 10 % in the ICU. The method of care was in 53 % of cases over the telephone, in 16 % in person, and in 12 % both over the telephone and in person; in 3 % of cases it was by video call. In 63 % of cases, support, specific advice or care was provided, whereas in 37 % support and availability were offered. In terms of "final goodbye", 49 % of all family members were able to say goodbye, while 31 % were unable to do so. The type of grief observed in the family members attended to was initially considered to be normal for 71 % of cases, whereas 16 % were classified as at risk. DISCUSSION: Effective information to and communication with affected relatives; that involved professionals be trained in dealing with death and grief so as not to cause harm, as well as in palliative care; and availability of psychological care are deemed of great importance in a COVID-19 scenario. Experience shows that "bereavement care" should be available to the general affected population. Proper organization and planning must incorporate action and follow-up protocols that include adequate assessment and care at different levels, from support, prevention and early detection of possible complications of bereavement to specialist intervention when necessary