Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report

AbstractBackground/Objective: Emotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. Method: We examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. Results: In each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. Conclusions: Although the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

ReportResumenAntecedentes/Objetivo: La desregulación emocional (DE) es un ámbito dimensional en Psicología, previamente operacionalizado por los instrumentos del Achenbach System of Empirically Based Assessment (ASEBA) para niños y adolescentes; sin embargo, aún se desconocen sus características interculturales y su enfoque ascendente en su aplicación a la población adulta. Método: Examinamos las puntuaciones obtenidas en el Adult Self-Report (ASR) por 9.238 personas de 18 a 59 años pertenecientes a diez sociedades que diferían en cuanto a sus características sociales, económicas, geográficas y de otro tipo. Se realizó un análisis de clases latentes con los datos de cada sociedad. Resultados: En cada sociedad se identificó una clase desregulada (DES), que se caracterizaba por pun-tuaciones elevadas en la mayoría de los síndromes ASR. La prevalencia media de DES fue del 9,2% (6,1-12,7%). Los mejores modelos oscilaron entre tres y cinco clases latentes en las diferentes sociedades. Conclusiones: Aunque el número de clases identificadas y la prevalencia de DE variaron entre las diversas sociedades, se encontró una clase DES en cada sociedad, lo que sugiere la necesidad de adoptar una visión dimensional de la psi-copatología y una perspectiva intercultural también en las poblaciones adultas.

Neural Indicator of Altered Mismatch Detection Predicts Atypical Cognitive-Perceptual Experiences in Psychotic Psychopathology.

BACKGROUND: Atypical auditory processing (AAP) in psychotic psychopathology is evident in early (N1), mid-latency (P2/N2/mismatch negativity), and late (P3) neural responses. The influence of attention on AAP, and how temporal stages of AAP are associated with phenomenology of psychotic psychopathology are not well understood. METHODS: We used a directed attention oddball task to characterize stages of AAP in psychosis and to examine the influence of selective attention. Ninety patients with schizophrenia (SCZ), 53 patients with bipolar disorder (BP), 90 healthy controls and 72 first-degree relatives of SCZ (SREL) were studied. We used principal components analysis to decompose average-reference 64-channel subject-level ERPs. RESULTS: Altered attentional modulation was evident in SCZ at early (N1 factor) and late (P3 factor) stages of AAP, but not at mid-latency P2 factor. Irrespective of condition, N1 and P3 were reduced in SCZ, which predicted greater psychopathology and schizotypal personality traits. Diminished mid-latency mismatch detection (P2 factor) was evident in SCZ, BP, and SREL and was associated with greater positive symptoms of psychosis as well as self-reported atypical cognitive-perceptual experiences. CONCLUSIONS: Attentional modulation of early N1, and later P3 neural responses was atypical in patients, but the degree of attentional modulation did not relate to symptom severity or schizotypal traits. Our findings suggest the link between mid-latency mismatch detection and atypical cognitive/perceptual experiences is not driven by attentional deficits alone and point to the promise of mid-latency mismatch detection as a candidate endophenotype and intervention target.

Da psicodinâmica à psicopatologia do trabalho no Brasil: (in)definições e possibilidades / De la psicodinámica a la psicopatología del trabajo em Brasil: (in)definiciónes y posibilidades / From psychodynamics to psychopathology of work in Brazil: (in)definitions and possibilities

RESUMO. O presente artigo analisou o estado da arte da psicopatologia do trabalho no Brasil, como objeto de pesquisa e como disciplina, a partir de revisão bibliográfica sistemática integrativa. Foi realizado levantamento em bases de dados virtuais utilizando os descritores 'psicopatologia do trabalho' e 'psicopatologia' (AND) 'trabalho'. Foram incluídos artigos disponibilizados integralmente em português publicados em revistas com revisão cega de pares contendo os descritores no título, resumo, palavras-chave e/ou corpo do texto. O conjunto final dos textos analisados se constituiu de 28 artigos publicados entre 1992 e 2019 majoritariamente em periódicos da psicologia com psicodinâmica do trabalho como referencial teórico e/ou metodológico. Foram ainda identificadas três tendências no uso do termo 'psicopatologia do trabalho' nos artigos: 1) psicopatologia do trabalho como objeto de estudo; 2) como disciplina; e 3) para debater as compreensões das relações entre trabalho e patologias e suas implicações na prática. Enquanto objeto de estudo, as relações entre trabalho e doença mental são negligenciadas. Como disciplina, identificaram-se imprecisões que flexibilizam ou ignoram os limites entre psicopatologia e psicodinâmica do trabalho. Ambas as tendências da literatura podem estar relacionadas com a desconsideração de fatores históricos na determinação da construção dos campos de estudo.

RESUMEN. El presente artículo analizó el estado del arte de la Psicopatología del Trabajo en Brasil, como objeto de investigación y como disciplina, a partir de revisión bibliográfica sistemática integrativa. Se realizó un levantamiento en bases de datos virtuales utilizando los descriptores 'psicopatología del trabajo' y 'psicopatología' (AND) 'trabajo'. Se incluyeron artículos disponibles integralmente en portugués publicados en revistas con revisión ciega de pares conteniendo los descriptores en el título, resumen, palabras clave y/o cuerpo del texto. El conjunto final de textos analizados se constituyó de 28 artículos publicados entre 1992 y 2019 mayoritariamente en periódicos de Psicología con Psicodinámica del Trabajo como referencial teórico y/o metodológico. Se identificaron tres tendencias en el uso del término 'psicopatología del trabajo' en los artículos: 1) psicopatología del trabajo como objeto de estudio; 2) como disciplina; y 3) para debatir las comprensiones de las relaciones entre trabajo y patologías y sus implicaciones en la práctica. En cuanto objeto de estudio, las relaciones entre el trabajo y la enfermedad mental son poco estudiadas. Como disciplina, se identificaron imprecisiones que flexibilizan o ignoran los límites entre Psicopatología y Psicodinámica del Trabajo. Ambas tendencias de la literatura pueden estar relacionadas con la desconsideración de factores históricos en la determinación de la construcción de los campos de estudio.

ABSTRACT. This article analyzed the state of the art of psychopathology of work in Brazil, as an object of study and as a subject, by performing an integrative systematic literature review. A search was conducted in virtual databases using the descriptors 'psychopathology of work' and 'psychopathology' (AND) 'work'. We included articles available in full in Portuguese, published in blind peer-reviewed journals containing the descriptors in the title, abstract, keywords and/or body of the text. The final set of texts consisted of 28 articles published between 1992 and 2019, mostly in psychology journals using psychodynamics of work as theoretical and/or methodological reference. Three trends were also identified in the use of the term 'psychopathology of work' in the articles: 1) psychopathology of work as an object of study; 2) as a subject; and 3) to discuss the understandings of the relationships between work and pathologies and their practical implications. As an object of study, the relationship between work and mental illness is neglected. As a subject, inaccuracies that flexibilize or ignore the limits between psychopathology of work and psychodynamics of work were identified. Both trends in the literature may be related to the lack of reflections that consider the Brazilian context to understand the relations between work and pathology.

The generalizability of empirically derived syndromes of collateral-reported elder psychopathology across 11 societies.

The purpose of this study was to test whether a syndrome model of elder psychopathology derived from collateral ratings, such as from spouses and adult children, in the United States would be generalizable in 11 other societies. Societies represented South America, Asia, and Europe. The Older Adult Behavior Checklist (OABCL) was completed by collateral informants for 6141 60- to 102-year-olds. The tested model comprised syndromes designated as Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited. The model was tested using confirmatory factor analyses in each society separately. The primary model fit index showed a good fit for all societies, while the secondary model fit indices showed acceptable to a good fit for all societies. The items loaded strongly on their respective factors, with a median item loading of 0.69 across the 11 societies. By syndrome, the overall median item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment. The OABCL syndrome structure was thus generalizable across the tested societies. The OABCL can be used for broad assessment of psychopathology for elders of diverse backgrounds in nursing services and research.

Problem Gambling Associated with Aripiprazole: A Nested Case-Control Study in a First-Episode Psychosis Program.

BACKGROUND: Aripiprazole has been linked to cases of problem gambling (PBG), but evidence supporting this association remains preliminary. Additionally, data specific to PBG in individuals with first-episode psychosis (FEP) receiving aripiprazole are limited to a few case reports, even though aripiprazole is widely used among this population that might be especially vulnerable to PBG. METHODS: To examine this association, a nested case-control study was conducted in a cohort of 219 patients followed at a FEP program located in the Quebec City, Quebec, Canada, metropolitan area. Fourteen cases meeting the PBG criteria according to the Problem Gambling Severity Index were identified and matched for gender and index date to 56 control subjects. RESULTS: In the univariable conditional logistic regression analysis, the use of aripiprazole was associated with an increased risk of PBG (odds ratio [OR] 15.2; 95% confidence interval [CI] 2.1-670.5). Cases were more likely to have a prior gambling history (either recreational or problematic) than controls at admittance in the program; they were also more frequently in a relationship and employed. After adjustment for age, relationship status, employment and Cluster B personality disorders, the use of aripiprazole remained associated with an increased risk of PBG (OR 8.6 [95% CI 1.5-227.2]). CONCLUSIONS: Findings from this study suggest that FEP patients with a gambling history, problematic or not, may be at increased risk of developing PBG when receiving aripiprazole. They also highlight the importance of systematically screening for PBG all individuals with psychotic disorders, as this comorbidity hinders recovery. While the results also add credence to a causal association between aripiprazole and PBG, further prospective studies are needed to address some of the limitations of this present study.

Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: a retrospective cohort analysis of Korean conscription data.

BACKGROUND: The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service. METHODS: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory (MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS (19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at < 15 months (n = 30) versus ≥15 months (n = 33). Binary MPI results (normal-abnormal) were also compared between the two groups. RESULTS: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio (OR) at 1.05 for every 1-month increase (95% confidence interval (CI) 1.02-1.08; P = 0.002). Subjects with pain duration at ≥15 months have lower faking good response score (P < 0.001 vs. those with pain duration at < 15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores (P < 0.05). Pain duration was significantly associated with the MPI variables. CONCLUSIONS: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.

Female psychopathy: A descriptive national study of socially dangerous female NGRI offenders.

Understudied is psychopathy in females, particularly socially dangerous NGRI females, where the construct could be of forensic, clinical and criminologic significance. Italy's recent transformation of its mental health system created the context for studying such a population on a national level. Throughout the twentieth century until their closure in 2015, offenders found to be not guilty by reason of insanity (NGRI) and socially dangerous were placed in one of the the six high security hospitals in Italy (OPGs). Only one hospital, the Castiglione delle Stiviere maximum security hospital (OPG) in North Italy, treated female offenders, who came from all parts of Italy. The authors studied 66 of all 86 women in Castiglione delle Stiviere OPG. The aims of this study were to identify the prevalence of psychopathy in NGRI female offenders and eventually to identify any phenotypic gender-specific features of psychopathy. The SCID I and II interviews and other tests (MMPI-2, MCMI-III, R-Bans) were administered to all the women. Clinical historical information was obtained. Finally for all women who consented to participate in the study, the researchers administered the PCL-R version validated for the Italian population. The final sample consisted of 66 women, who were deemed NGRI and socially dangerous. Here the authors present the final results as well as limitations of the research.

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies.

OBJECTIVES: As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies. METHODS/DESIGN: The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes. RESULTS: In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies. CONCLUSIONS: The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

Extended Nicotine Patch Treatment Among Smokers With and Without Comorbid Psychopathology.

INTRODUCTION: Individuals with psychiatric conditions smoke at higher rates than the general population and may need more intensive treatment to quit. We examined whether or not extended treatment with nicotine patch, combined with behavior counseling, would disproportionally benefit smokers with versus without a lifetime psychiatric condition. METHODS: We conducted a secondary analysis of data from an effectiveness trial of treatment with 12 counseling sessions (48 weeks) and 21-mg nicotine patch (8, 24, or 52 weeks) among 525 adult daily smokers. A structured clinical interview assessed past and current psychiatric disorders (major depression, generalized anxiety disorder, alcohol abuse and/or dependence, and substance abuse and/or dependence), as described in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Abstinence was bioverified at week 52. Logistic regression evaluated the effect of the psychiatric status × treatment duration interaction on abstinence at week 52, covarying for sociodemographics, baseline psychological symptoms, and treatment adherence. RESULTS: At baseline, 115 (21.9%) participants were diagnosed with one or more psychiatric conditions. The psychiatric status × treatment duration interaction was significant for week 52 abstinence (p = .027). Abstinence rates between smokers with versus without a psychiatric condition in the 24-week treatment arm (9.3% vs. 31.5% abstinent) significantly differed from the 8-week treatment arm (18.8% vs. 22.3%), p = .017. Abstinence rates for smokers with (22.5%) versus without a psychiatric condition (19.7%) in the 52-week treatment arm did not differ from those in the 8-week arm. CONCLUSIONS: Targeted smoking cessation treatment, rather than extending treatment duration, may be especially warranted to optimize treatment for smokers with comorbid mood, anxiety, and substance use disorders. IMPLICATIONS: Individuals with psychiatric conditions smoke at higher rates and have greater difficulty quitting compared to those in the general population, but little is known about how to best optimize treatment for this high tobacco burden population. The present study found that cessation response to extended duration treatment with the transdermal nicotine patch did not differ for smokers with versus without comorbid anxiety, mood, and substance use disorders in a large-scale clinical effectiveness trial. Development of targeted behavioral treatments may be required to optimize abstinence outcomes for this high-risk population, rather than simply extending the duration of pharmacotherapy treatments.

Hair cortisol levels, psychological stress and psychopathological symptoms prior to instrumental deliveries.

OBJECTIVE: To determine whether psychological variables (perceived stress, pregnancy-specific stress and psychopathology symptoms) and physiological variables (hair cortisol levels) are related to type of delivery (eutocic or instrumental delivery; spontaneous or induced labor). DESIGN: This was a longitudinal study. SETTING: Spain. PARTICIPANTS: A total sample of 88 pregnant women. MEASUREMENT AND FINDINGS: Perceived stress, pregnancy-specific stress, psychopathology symptoms and hair cortisol level were assessed in pregnant women throughout the third trimester of pregnancy until they gave birth. Participants were grouped by type of delivery (eutocic or instrumental delivery; spontaneous or induced labor). ANOVA tests were performed in order to determine differences between groups. We found differences between the eutocic and instrumental delivery groups in the SCL-90-R subscales somatisation (t = 6.98; p = 0.01), anxiety (t = 3.42; p < 0.05), depression (t = 5.20; p < 0.02) and psychoticism (t = 5.28; p < 0.01), and in the general indices global severity index (t = 5.57; p < 0.05) and positive symptoms (t = 5.21; p < 0.01). No differences were found between groups for the other variables. KEY CONCLUSIONS: Maternal psychological status could have an impact on delivery, since women who had an instrumental delivery presented more psychopathology symptoms in the third trimester. IMPLICATIONS FOR RESEARCH: The psychological assessment and treatment of pregnant women could play a key role in enhancing maternal mental health and preventing the processes and outcomes associated with poor psychological status.

Manifestaciones psiquiátricas del síndrome de deleción 22q11.2: una revisión de la literatura / Psychiatric manifestations of 22q11.2 deletion syndrome: a literature review

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A Study of Selected Ethnic Affiliations in the Development of Post-traumatic Stress Disorder and Other Psychopathology After a Terrorist Bombing in Nairobi, Kenya.

OBJECTIVES: Despite the frequency of disasters in Africa, almost nothing is known about ethnic affiliations in relation to psychopathology after such incidents. This study examined the mental health outcomes of members of 7 major ethnic groups exposed to the 1998 terrorist bombing of the US Embassy in Nairobi, Kenya. METHODS: Approximately 8 to 10 months after the disaster, 229 civilian employees, 99 locally engaged staff workers of the US State Department and the US Agency for International Development, and 64 workers of the Kenyan Red Cross Society (total N=392) were assessed with the Diagnostic Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Additional data were gathered on demographic characteristics, disaster exposures and injuries, and ethnic affiliations. RESULTS: Disaster-related post-traumatic stress disorder (PTSD) was significantly less prevalent among members of the Kikuyu group (28%) and post-disaster major depression was significantly more prevalent among members of the Meru group (64%), compared with all others in the sample. Preexisting psychopathology and disaster injury were independently associated with bombing-related psychopathology. CONCLUSIONS: Further study of disaster-related psychopathology in relation to African ethnic affiliations is needed to better understand these associations and to assist in planning resources and interventions for African disaster survivors. (Disaster Med Public Health Preparedness. 2018; 12: 360-365).

Fear of Fear and Broad Dimensions of Psychopathology over the Course of Cognitive Behavioural Therapy for Panic Disorder with Agoraphobia in Japan.

OBJECTIVE: To examine the relationship of fear of fear and broad dimensions of psychopathology in panic disorder with agoraphobia over the course of cognitive behavioural therapy in Japan. METHODS: A total of 177 Japanese patients with panic disorder with agoraphobia were treated with group cognitive behavioural therapy between 2001 and 2015. We examined associations between the change scores in Agoraphobic Cognitions Questionnaire or Body Sensations Questionnaire and the changes in subscales of Symptom Checklist-90 Revised during cognitive behavioural therapy controlling the change in panic disorder severity using multiple regression analysis. RESULTS: Reduction in Agoraphobic Cognitions Questionnaire score was related to a decrease in all Symptom Checklist-90 Revised (SCL-90-R) subscale scores. Reduction in Body Sensations Questionnaire score was associated with a decrease in anxiety. Reduction in Panic Disorder Severity Scale score was not related to any SCL-90-R subscale changes. CONCLUSIONS: Changes in fear of fear, especially maladaptive cognitions, may predict broad dimensions of psychopathology reductions in patients of panic disorder with agoraphobia over the course of cognitive behavioural therapy. For the sake of improving a broader range of psychiatric symptoms in patients of panic disorder with agoraphobia, more attention to maladaptive cognition changes during cognitive behavioural therapy is warranted.

Procedimiento bioético para la toma de decisiones en salud mental / Bioethical procedure for decision-making in mental health

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Patterns of Comorbidity Among Girls With ADHD: A Meta-analysis.

CONTEXT: Although children with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for comorbid psychopathology, the clinical correlates of ADHD in girls are far less understood relative to boys, despite ADHD being one of the most common childhood disorders in girls. OBJECTIVE: To meta-analytically summarize rates of comorbid internalizing (anxiety, depression) and externalizing (oppositional defiant disorder [ODD], conduct disorder [CD]) psychopathology among girls with and without ADHD. DATA SOURCES: Literature searches (PubMed, Google Scholar) identified published studies examining comorbid psychopathology in girls with and without ADHD. STUDY SELECTION: Eighteen studies (1997 participants) met inclusion criteria and had sufficient data for the meta-analysis. DATA EXTRACTION: Odds ratios for each comorbid disorder were calculated from available data. Demographic (eg, age, race/ethnicity) and study characteristics (eg, referral source, diagnostic method) were also coded. RESULTS: Compared with girls without ADHD, girls with ADHD were significantly more likely to meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for each comorbid disorder assessed. Relative odds were higher for externalizing (ODD: 5.6×; CD: 9.4×) relative to internalizing disorders (anxiety: 3.2×; depression: 4.2×). Meta-regression revealed larger effect sizes of ADHD on anxiety for studies using multiple diagnostic methods, featuring younger children, and including clinic-referred (versus community-referred) girls; the effect of ADHD on ODD varied based on diagnostic informant. LIMITATIONS: Findings were derived from cross-sectional studies, precluding causal inferences. CONCLUSIONS: Girls with ADHD frequently exhibit comorbid externalizing and internalizing disorders. We discuss future research priorities and consider intervention implications for ADHD and comorbid psychopathology in girls.

Psychopathological Variables and Sleep Quality in Psoriatic Patients.

Psoriasis is an inflammatory disease frequently associated with psychiatric disturbances and sleep disorders. The aim of the study was to assess the prevalence of depression, interaction anxiety, audience anxiety, and sleep quality in psoriatic patients. One hundred and two psoriatic patients were enrolled and underwent the following questionnaires: Zung Self-Rating Depression Scale (SDS), Interaction Anxiousness Scale (IAS), Audience Anxiousness Scale (AAS), Pittsburgh Sleep Quality Index (PSQI). The severity of skin lesions was assessed by Psoriasis Area Severity Index (PASI). The presence of a link between clinical variables and with demographic data has been investigated. Psoriasis was linked to depression, interaction and audience anxiety, as well as to poor sleep quality; 37.5% of patients were depressed, 46.1% scored above 37 at the IAS, 47.1% scored above 33 at the AAS. Thirty-nine subjects (38.2%) presented a PSQI ≥ 5. An association between interaction anxiety and lower limbs psoriasis-related erythema as well as between PSQI and head psoriasis-related erythema was found, particularly among male patients. Hence, psoriatic patients should be assessed from a holistic point of view, in order to identify associated disorders that could benefit from targeted treatments.

Factores explicativos del funcionamiento en memoria en pacientes con síndrome de fibromialgia / Explanatory factors in memory performance in patients with fibromyalgia syndrome

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The aim of this study was to contribute to the knowledge of the variables that may be associated with memory performance in a group of patients with fibromyalgia (FM). The study examines the relationship among memory performance and socio-demographic, psychological and somatic variables; it also attempts to estimate the explanatory power of the studied variables in memory performance. A total of 20 participants diagnosed with FM completed various measures of memory performance (immediate recall, delayed recall, recognition and working memory), and different psychological (attentional span, anxious-depressive symptoms and personality) and somatic measures (somatic symptoms and pain intensity). Significant correlations were found among memory performance capacities and the different types of variables evaluated. The subsequent regression analysis showed that only the variables years of study, pain intensity and attentional span were independently associated with immediate recall, recognition memory and working memory. These findings suggest that in this sample the examined psychosocial and somatic variables are associated differentially with different memory capacities. This study contributes to learning more about variables associated with memory performance on FM (AU)

Transtornos depressivos em pacientes que buscam cirurgia plástica estética: uma visão ampla e atualizada / Depressive disorders in patients who seek cosmetic surgery: a broad and updated view

INTRODUÇÃO: A cirurgia estética pode melhorar a qualidade de vida de pacientes, porém alguns que se apresentam para o procedimento são portadores de transtornos depressivos (TD) e podem evoluir, no pós-operatório, de forma desastrosa do ponto de vista psicológico e até mesmo evoluir para o suicídio. A prevalência de TD em pacientes de cirurgia plásticaestética é em média de 20%, podendo chegar até 70%. Este artigo tem por objetivo fazer uma revisão sobre depressão e cirurgia estética bem como alertar e conscientizar os cirurgiões plásticos sobre o crescente aumento destes pacientes nos consultórios. Objetiva, ainda, orientar os cirurgiões quanto a abordagem adequada e condutas específicas perante estes. MÉTODOS: Realizou-se busca nos bancos de dados MEDLINE/PubMed e Embase e cruzamento de palavras chaves, incluindo "cirurgia plástica estética", "depressão"; "transtornos de humor", "transtorno depressivo", "sintomas depressivos", "suicídio e cirurgia plástica". RESULTADOS: O sucesso de uma cirurgia plástica depende em muito da seleção dos pacientes para o procedimento. Pacientes suspeitos, pacientes com sintomas depressivos elevados nos questionários (como o BDI) e pacientes com "marcadores" de psicopatologia deverão ser encaminhados ao psiquiatra para avaliação adequada. CONCLUSÃO: Pela elevada prevalência de TD em cirurgia plástica estética, todo paciente de cirurgia plástica deverá ser avaliado adequadamente para identificação daqueles com possíveis TD no pré-operatório e encaminhado ao psiquiatra, para assim tentar se evitar evolução psicológica desfavorável pós-operatória.

INTRODUCTION: Aesthetic surgery can improve the quality of life of patients, but some candidates for the procedure have depressive disorders (DDs) that may develop, in the postoperative period, in a disastrous manner from a psychological point of view and even progress to suicide. The prevalence of DDs in cosmetic surgery patients is 20% on average and reaches 70%. This article aims to review depression and aesthetic surgery as well as to alert and educate plastic surgeons on the growing number of these patients in clinical settings. It also aims to guide surgeons to the appropriate approach and specific behaviors with these patients. METHODS: A search was performed in MEDLINE/PubMed and Embase, and key words were entered, including "cosmetic surgery," "depression," "mood disorders," "depressive disorder," "depressive symptoms," and "suicide and plastic surgery." RESULTS: The success of plastic surgery depends a great deal on the selection of patients for the procedure. Suspect patients, patients with elevated depressive symptoms in questionnaires (such as the BDI), and patients with psychopathology "markers" should be forwarded to a psychiatrist for proper evaluation. CONCLUSION: Due to the high prevalence of DDs in aesthetic plastic surgery patients, every plastic surgery patient should be evaluated properly to identify those with possible DDs in the preoperative period, and those should be forwarded to a psychiatrist, thus avoiding an unfavorable postoperative psychological evolution.

Estudio descriptivo del perfil neuropsicológico y psicopatológico en pacientes con distrofia miotónica tipo 1 / A descriptive study of the neuropsychological and psychopathological profile in patients with type 1 myotonic dystrophy

Introducción. La distrofia miotónica tipo 1 (DM-1) o enfermedad de Steinert es un trastorno multisistémico y progresivo. Se han encontrado déficits cognitivos, clínica depresiva y alta incidencia de rasgos de personalidad ansiosos con afectación tanto en la funcionalidad como en la calidad de vida de estos pacientes. Objetivo. Describir el perfil cognitivo y psicopatológico de una muestra de pacientes con la variante adulta de DM-1. Pacientes y métodos. Se seleccionó una muestra de 27 pacientes con diagnóstico de DM-1 en seguimiento en el Servicio de Neurología del Complejo Hospitalario de Navarra. Los criterios de inclusión fueron tener menos de 50 años y descartar cualquier otra patología o condición física que impidiese realizar la evaluación psicológica. Se utilizó una batería de evaluación neuropsicológica específicamente diseñada para este tipo de patología, además de medidas de psicopatología y funcionalidad. Resultados. La evaluación neuropsicológica reflejó, principalmente, déficits en habilidades visuoconstructivas, visuoespaciales, atención alternante y en sintomatología disejecutiva heteroinformada. El grupo de pacientes no presentó sintomatología depresiva ni ansiosa clínicamente significativa, pero sí puntuaciones elevadas en obsesión-compulsión, sensibilidad interpersonal, ideación paranoide y psicoticismo. Los resultados orientaron hacia un deterioro en la funcionalidad. Conclusiones. En el abordaje integral de la DM-1, la caracterización y el seguimiento evolutivo del perfil cognitivo, psicopatológico y de personalidad, así como del nivel de funcionalidad, contribuyen a la mejora de la calidad de vida de estos pacientes (AU)

Introduction. Type 1 myotonic dystrophy (MD-1) or Steinert disease is a multisystemic progressive disorder. Studies have shown cognitive deficits, depressive symptoms and a high incidence of anxiety personality traits that compromise both the functionality and the quality of life of these patients. Aim. To describe the cognitive and psychopathological profile of a sample of patients with the adult variant of MD-1. Patients and methods. A sample of 27 patients diagnosed with MD-1 was selected from those being followed up in the neurology service of the Complejo Hospitalario de Navarra. Eligibility criteria were age under 50 years and the absence of any other pathology or physical condition that prevented them from performing the psychological evaluation. A neuropsychological evaluation battery specifically designed for this kind of pathology was used, together with psychopathological and functionality measures. Results. The neuropsychological evaluation revealed mainly deficits in visual-constructional and visuospatial skills, alternating attention and in other-reported dysexecutive signs and symptoms. The group of patients did not present any clinically significant symptoms of depression or anxiety, but did score high on obsession-compulsion, interpersonal sensitivity, paranoid ideation and psychoticism. The results point towards a deterioration in functionality. Conclusions. In the integral approach to MD-1, the characterisation and developmental monitoring of the cognitive, psychopathological and personality profile, as well as the level of functionality, all contribute to an improvement in the quality of life of these patients (AU)