Family cohesion, burden, and health-related quality of life among Parkinson's disease caregivers in Mexico.

BACKGROUND: Informal caregivers of individuals with Parkinson's disease face a range of responsibilities that increase as the disease progresses. As a result of these stressors, caregivers are vulnerable to decreased health-related quality of life (HRQOL). Guided by the stress process model of caregiving, the present study examined the relations between family cohesion, perceived burden, and mental and physical HRQOL among Parkinson's disease caregivers in Mexico. It was hypothesized that perceived burden would mediate the relations of family cohesion and mental and physical HRQOL. METHODS: Ninety-five family caregivers of individuals with Parkinson's disease in Mexico City, Mexico, participated in the study. Multiple regression was utilized to conduct mediation analyses. RESULTS: Results indicated that burden fully mediated the relation between family cohesion and mental HRQOL, and family cohesion was not associated with physical HRQOL. CONCLUSIONS: Findings extend the stress process model cross-culturally and lend support for the importance of family cohesion and perceived burden in determining caregiver mental HRQOL. Clinical health promotion interventions should target perceived burden and family cohesion together to improve mental HRQOL among familial caregivers in Mexico.

Mediating role of caregiver burden among family caregivers of patients with Parkinson's disease in Mexico.

OBJECTIVE: This study examined the mediating role of caregiver distress on family factors and caregiver life satisfaction among an understudied population of Parkinson's disease caregiver in Mexico. METHODS: A cross-sectional design was used to examine psychosocial factors pertinent to caregiver of individuals with Parkinson's disease ( n = 95). Guided by a caregiver stress process model, relations among family factors (e.g., cohesion, flexibility, quality of functioning), gender, distress, and satisfaction with life among caregiver were examined. Mediation analyses were performed to test the role of caregiver distress on the associations between family factors, gender, and caregiver satisfaction with life. RESULTS: Mediation models demonstrated that caregiver distress fully mediated the relation between quality of family functioning and caregiver satisfaction with life and partially mediated the association between family flexibility and caregiver satisfaction with life. Caregiver gender did not emerge as a significant covariate, and null results were found in the model examining family cohesion as a predictor. CONCLUSION: These results underscore the critical role of caregiver distress and family factors on features of caregiver well-being, notably satisfaction with life. This evidence also offers cross cultural evidence for the caregiver stress process model, which has primarily been observed in Western samples. Accordingly, the need to build and disseminate empirically supported family-based treatments that emphasize caregiver distress is warranted.

Impact of COMT, PRODH and DISC1 Genetic Variants on Cognitive Performance of Patients with Schizophrenia.

BACKGROUND: Cognitive impairment in schizophrenia (SCZ) is a core feature, relevant for the disease prognosis and functional capacity of the patients. It has also been identified as an endophenotype and proposed as a genetic mechanism of risk for schizophrenia. AIM OF THE STUDY: We aimed to evaluate the association of genetic variants in COMT, PRODH, and DISC1 with the cognitive performance of Mexican-Mestizo adult patients with SCZ in order to identify endophenotypes. SUBJECTS AND METHODS: The association of seven variants in COMT, 15 in PRODH, and three in DISC1 was evaluated in 150 patients and 150 control volunteers. The MATRICS Consensus Cognitive Battery was administered to a subset of 44 patients and 42 controls. RESULTS: COMT rs4633 was related to MATRICS global assessment, while in the multi-phenotype analysis, PRODH rs2870984 was associated with processing speed, working memory, verbal learning, and social cognition. In addition, the association of variants in COMT and PRODH with the risk for SCZ was also found in Mexican-Mestizo patients. CONCLUSION: COMT might be a potential biomarker of cognitive impairment in Mexican-Mestizo patients with SCZ, supporting the relevance of this gene for drug design.

Perceived stress, resilience, and health-related quality of life among Parkinson's disease caregivers in Mexico.

The stress process model of caregiving posits that caregivers' internal psychosocial resources may serve as buffers between the stress associated with caregiving and well-being. Empirical support for the stress process model exists for several caregiving contexts, but little research has investigated the Parkinson's disease caregiving experience in Mexico. Using a cross-sectional, correlational design, the objective of this study was to examine whether resilience moderates the relation between perceived stress and health-related quality of life (HRQOL) among Parkinson's disease caregivers in Mexico. Data were collected from April 2015 to February 2016 during outpatient neurology appointments in Mexico City, Mexico. Participants included informal caregivers (N = 95) for a family member with Parkinson's disease. Participants completed a battery of questionnaires assessing their level of perceived stress, resilience, and HRQOL. Regression analyses indicated that resilience moderated the inverse relation between perceived stress and mental HRQOL. However, contrary to hypotheses, resilience did not moderate the relation between stress and physical HRQOL. Findings shed light on resilience as a potential protective factor for mental HRQOL among Parkinson's disease caregivers in Mexico and indicate that resilience may be beneficial to target in mental health promotion interventions.

Estudio de traducción y validez del Sistema de Codificación Etológica para Entrevistas ECSI (Ethological Coding System for Interviews) / Study of the application and validation of the Ethological Coding System for Interviews (ECSI)

Antecedentes El diagnóstico psicoterapéutico se fundamenta en exploraciones verbales y/o pruebas psicológicas. En contraste, a menudo se descuida la relevancia de la comunicación no-verbal. El objetivo del presente artículo es aportar una herramienta para medir y evaluar conductas no-verbales en entrevistas clínicas, basado en el Ethological Coding System for Interviews (ECSI), desarrollado por Troisi (1999), el cual se tradujo y validó en español. Un etograma es un catálogo de conductas o patrones conductuales, operacionalizados y agrupados en categorías, como afiliación, evasión, asertividad, relajación, entre otras. Método Estudio 1. El etograma ECSI fue traducido al español. Tres observadores "ciegos" registraron las frecuencias de los patrones conductuales del paciente. Los registros se realizaron en intervalos de 15 segundos durante los primeros y últimos 10 minutos de la entrevista clínica. Se obtuvo una validez interobservador de r=0.989, p<0.001. Estudio 2. Con base en el primer estudio se consideró pertinente agregar patrones conductuales, así como reacomodar y redefinir las categorías propuestas. Los tres observadores realizaron el mismo procedimiento que en el estudio 1 con una segunda videograbación. Además de las frecuencias de las conductas observadas, se midió la duración de la conducta. Se obtuvo una validez interobservadores de r=0.993, p<0.001. Resultados y discusión Se probó que el ECSI es una herramienta confiable y válida para examinar la conducta no-verbal de pacientes durante entrevistas. Se espera que el ECSI se pueda incluir al proceso diagnóstico durante las sesiones psicoterapéuticas.

Background Psychotherapeutic diagnosis is largely based on verbal explorations and/or psychological tests. In contrast, the relevance of non-verbal communication is often disregarded. Here, we aim to provide a tool to measure and assess non-verbal behavior in clinical interviews, based on the Ethological Coding System for Interviews (ECSI), developed by Troisi (1999), which was translated and validated in Spanish. An ethogram is a catalogue of behaviours or patterns of behaviour, which are operationalized and grouped in categories such as affiliation, flight, assertiveness, relaxation and so forth. Method Study 1. The ECSI was translated into Spanish. Three "blind" observers registered the frequencies of the behavioral patterns of the patient. The recordings were made in 15 seconds intervals during the first and the last 10 minutes of a clinical interview. An inter-observer reliability of r=0.989, p<0.001 was obtained. Study 2. Based on the first study, it was considered pertinent to add behavioral patterns, as well as rearranging and redefining the proposed categories. The three "blind" observers performed the same task as in study 1 with a second video-recording. Aside from the frequency of the observed behaviours, the duration of the behavior was measured. An inter-observer reliability of r=0.993, p<0.001 was obtained. Results and discussion The ECSI has proven a reliable and valid tool for the examination of patients' nonverbal behaviour during interviews. It is hoped that the ECSI can be added to the diagnostic process during psychotherapeutic sessions.