Hoarding behaviour: special features and complications in real-world clinical practice.

OBJECTIVE: Hoarding behaviour is a common but poorly characterised problem in real-world clinical practice. Although hoarding behaviour is the key component of Hoarding Disorder (HD), there are people who exhibit hoarding behaviour but do not suffer from HD. The aim of the present study was to characterise a clinical sample of patients with clinically relevant hoarding behaviour and evaluate the differential characteristics between patients with and without HD. METHODS: This study included patients who received treatment at the home visitation program in Barcelona (Spain) from January 2013 through December 2020, and scored ≥ 4 on the Clutter Image Rating scale. Sociodemographic, DSM-5 diagnosis, clinical data and differences between patients with and without an HD diagnosis were assessed. RESULTS: A total of 243 subjects were included. Hoarding behaviour had been unnoticed in its early stages and the median length in the sample was 10 years (IQR 15). 100% of the cases had hoarding-related complications. HD was the most common diagnosis in 117 patients (48.1%). CONCLUSIONS: The study found several differential characteristics between patients with and without HD diagnosis. Alcohol use disorder could play an important role among those without HD diagnosis. Home visitation programs could improve earlier detection, preventing hoarding-related complications.

[Suicidal attempt and suicidal ideation during the COVID-19 pandemic compared to previous years]. / Intentos e ideas de suicidio durante la pandemia por COVID-19 en comparación con los años previos.

INTRODUCTION: Since the COVID-19 pandemic began, warnings have been made about the impact on the mental health of the population and as occurred in previous pandemics, an increase in suicide rates had been anticipated. To date, studies differ with regard to whether suicide rates are being affected during the COVID pandemic. MATERIAL AND METHODS: All individuals registered for suicidal ideation or suicidal attempt in the Suicide Risk Code (CRS) from the city of Barcelona from January 1, 2018 to June 30, 2021 have been included. A bivariate analysis has been carried out between the 2018-2019 period and the pandemic period. The percentage increase in the monthly incidence of CRS cases has been calculated, using the average monthly incidence for the 2018-2019 period as a reference. RESULTS: A total of 3388 consultations for suicide ideation or suicidal attempt were registered. There has been an increase of 43.20% in the monthly incidence of suicidal ideation and suicidal attempts during the pandemic compared to the 2018-2019 period, reaching a maximum increase of 573.8% in young people under 18 years in the month of May 2021. CONCLUSIONS: During the COVID-19 pandemic period, consultations for suicidal ideation and suicidal attempts have increased compared to the previous 2 years in the city of Barcelona. It should be noted this growth especially in young people under 18 years.

Síntomas neuropsiquiátricos como factor de confusión en la detección de la demencia / No disponible

OBJETIVO: Valorar si los síntomas neuropsiquiátricos interfieren en la detección de deterioro cognitivo por los médicos de familia en atención primaria, así como describir cuáles generan más confusión. DISEÑO: Estudio observacional y descriptivo. Emplazamiento: Equipo de psiquiatría de intervención en domicilio en colaboración con la red de atención primaria de Barcelona. PARTICIPANTES: Un total de 104 pacientes mayores de 65 años derivados desde atención primaria por sus médicos de familia solicitando valoración psiquiátrica en el domicilio por sospecha de enfermedad mental. Mediciones principales: Todos los casos recibieron un diagnóstico según criterios DSM-IV-TR. Se incluyeron en el estudio el Mini Mental State Examination (MMSE), el Inventario Neuropsiquiátrico de Cummings, la escala de Gravedad de Enfermedad Psiquiátrica, la escala de Evaluación de la Actividad Global, la escala de Impresión Clínica Global y el Cuestionario de Evaluación de la Discapacidad de la Organización Mundial de la Salud. RESULTADOS: El 55,8% de los pacientes derivados desde atención primaria tenían el MMSE alterado. Los síntomas neuropsiquiátricos más frecuentemente asociados a la sospecha de deterioro cognitivo fueron los delirios, las alucinaciones, la agitación, la desinhibición, la irritabilidad y la conducta motora sin finalidad. CONCLUSIONES: Cuando se detecten síntomas psiquiátricos propios de trastorno mental severo (TMS) en individuos de edad avanzada sin antecedentes de TMS hay que sospechar un deterioro cognitivo y se debería administrar una prueba de cribado

OBJECTIVE: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN: Descriptive and observational study. LOCATION: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS: A total of 104 patients over 65 years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. MAIN MEASUREMENTS: All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. RESULTS: 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. CONCLUSIONS: When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done

Síntomas neuropsiquiátricos como factor de confusión en la detección de la demencia.

OBJECTIVE: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN: Descriptive and observational study. LOCATION: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS: A total of 104 patients over 65years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease. MAIN MEASUREMENTS: All patients received a DSM-IV-TR diagnosis. We included in the study the Mini Mental State Examination (MMSE), Neuropsichiatric Inventory, Severe Psychiatric Illness scale, Global Assessment of Functioning, Clinical Global Impression and Word Health Organisation Dissability Assessment Schedule. RESULTS: 55.8% of patients referred from primary care had altered MMSE score. Neuropsychiatric symptoms more frequently associated with suspected cognitive impairment were delusions, hallucinations, agitation, disinhibition, irritability and purposeless motor behavior. CONCLUSIONS: When psychiatric symptoms of Severe Mental Disorder (SMD) are detected in elderly individuals with no history of SMD, cognitive impairment should be suspected and a screening test be done.