Abnormal motor asymmetry only during bimanual movement in schizophrenic patients compared with healthy subjects.

In schizophrenia, research on motor asymmetry has focused on the direction and the degree of handedness using unimanual motor tests and tasks. However, typically both hands collaborate in the production of most manual movements. This study explored motor asymmetry exhibited during unimanual and bimanual tasks in schizophrenic and healthy subjects using a new experimental motor battery. Specifically, the authors investigated the motor indices of laterality during finger-tapping and hand-turning tasks in four unimanual and four bimanual conditions in 84 schizophrenic and 31 healthy subjects, all right-handed. The schizophrenic patients showed reduced motor asymmetries only during bimanual tap…

A short message service (SMS)-based strategy for enhancing adherence to antipsychotic medication in schizophrenia

Abstract Background The aim of this study was to assess the impact of a short message service (SMS)-based strategy on adherence to antipsychotic treatment. Methods A multicentre, randomised, open-label, controlled, 6-month study with clinically stabilised outpatients with schizophrenia was conducted. The patients assigned to the intervention received daily SMS reminders to take their medication for 3 months. Self-reported medication adherence was determined using the Morisky Green Adherence Questionnaire (MAQ). Secondary outcomes were severity of illness, attitude towards medication, insight into illness and health-related quality of life. Results A total of 254 patients were analysed. A si…

Is recession bad for your mental health? The answer could be complex: evidence from the 2008 crisis in Spain

Abstract Background We explored the impact of 2008 recession on the prevalence of mental health problems in Spain. Methods Repeated cross-sectional survey design. Datasets from 2006 and 2011 were used, and temporal change was examined. The study was conducted on the economically active population (16–64 years old). The two surveys included 29,478 and 21,007 people, obtaining a 96 and 89.6% response rate, respectively. Multiple logistic regression models were adjusted to identify poor mental health risk factors. A standardisation analysis was performed to estimate the prevalence of people at risk of poor mental health (GHQ+). Results The prevalence of GHQ+ following the crisis increased in m…

Early age of onset, brain morphological changes and non-consistent motor asymmetry in schizophrenic patients.

Previous data suggest abnormalities in the consistence of motor dominance in schizophrenia (e.g. mixed-handedness, poor correlation between hand, eye and foot preferences and an increase of hand-eye crossed dominance). The aim of this work is to examine the clinical significance of hand-eye and hand-foot crossed dominance in a sample of 61 right-handed schizophrenic patients. The application of multivariate analysis revealed that 23 right-handed and non-right-eyed patients (crossed hand-eye dominant group) had a significant earlier clinical onset and smaller brain size, global and frontal area, than 38 right-handed and right-eyed schizophrenics (consistent hand-eye dominance group). These f…

Mental health of older people: the role of primary care

There are currently over 600 million people aged over 60 and it is predicted that, by 2025, the number will double and, by 2050 there will be over 2 billion people aged 60 and above and the number of over 60's will be greater than the number of children under the age of 15. Co-morbid physical and mental health conditions are associated with an aging population and many of this population will suffer from stroke, hypertension, loneliness, depression, dementia, mobility and sight problems. The traditional approach of caring for people in hospitals is increasingly inappropriate for many of the elderly population and primary care is often the first point of contact for many people seeking acces…

Unmet needs in the management of schizophrenia

Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Wi…

Similar effect of family history of psychosis on Sylvian fissure size and auditory P200 amplitude in schizophrenic and bipolar subjects.

Several cerebral studies point to the non-specificity of structural and functional changes described in schizophrenia and bipolar disorders. Furthermore, the origin of these changes is still unclear. The present study investigated the effect of a family history (FH) of psychotic disorders in first-degree relatives on computed tomographic (CT) measures (ventricular, cerebral and Sylvian fissure size) and auditory event-related potentials (amplitudes and latencies of peak components in oddball paradigms) in 30 schizophrenic patients and 24 bipolar type I patients. We found a significant correlation between FH and the size of the right Sylvian fissure, and between FH and auditory P200 amplitud…

Specific executive/attentional deficits in patients with schizophrenia or bipolar disorder who have a positive family history of psychosis

Neurocognitive impairments are well documented in patients with schizophrenia and their healthy first-degree biological relatives. Less is known about neuropsychological performance in bipolar disorders, but some studies indicate that, compared to schizophrenia, bipolar disorder displays a similar profile pattern with less severe deficits. The genetic and environmental contributions to the development of neurocognitive deficits are also unclear. This study explored the effect of a family history (FH) of psychotic disorders in first-degree relatives on a variety of cognitive domains (abstraction and flexibility, verbal fluency, verbal memory, motor activity and visual-motor processing/attent…

FC10.06 What is a Psychiatrist? What are They Really Doing? A Qualitative Study Combining Focus Groups and Work Sampling

The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

Abstract Background Little is published about the impact of the 2008 economic crisis on mental health services in Spain. Method An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Results Age-adjusted psychiatric (ICD9 290–319) hospital discharge rates significantly increased from Apr…

Discordancia entre fuentes estadísticas sanitarias de ámbito nacional (EMH y EESCRI, 1990-2009). Análisis de la morbilidad psiquiátrica

Resumen Introduccion Dos fuentes estadisticas sanitarias proporcionan datos sobre altas y estancias en todos los hospitales espanoles: la Encuesta de Morbilidad Hospitalaria (EMH) y la Estadistica de Establecimientos Sanitarios con Regimen de Internado (EESCRI). Nuestro objetivo es contrastar ambas fuentes para definir su precision y pertinencia en estudios de epidemiologia psiquiatrica. Material y metodos Se focaliza el analisis en 2 aspectos: 1.- comparar el numero de altas y estancias psiquiatricas recogidas entre 1990-2009; 2.- analizar y comparar el modo en que se proporciona la estancia media. Resultados Las diferencias entre ambas fuentes son profundas y aumentan con el tiempo. En 20…

Psychometric behaviour of the strengths and difficulties questionnaire (SDQ) in the Spanish national health survey 2006

Abstract Background The Strengths and Difficulties Questionnaire (SDQ) is a tool to measure the risk for mental disorders in children. The aim of this study is to describe the diagnostic efficiency and internal structure of the SDQ in the sample of children studied in the Spanish National Health Survey 2006. Methods A representative sample of 6,773 children aged 4 to 15 years was studied. The data were obtained using the Minors Questionnaire in the Spanish National Health Survey 2006. The ROC curve was constructed and calculations made of the area under the curve, sensitivity, specificity and the Youden J indices. The factorial structure was studied using models of exploratory factorial ana…

Correlates of Symptom Dimensions in Schizophrenia Obtained with the Spanish Version of the Manchester Scale

In the last decade, a significant number of studies have been published which suggest a multifactorial psychopathological structure in schizophrenia. Seventy-eight acute and chronic schizophrenic patients diagnosed in accordance with DSM-III-R criteria were studied with the Manchester Scale, Premorbid Adjustment Scale, Family History-RDC Interview, Digit Span, Mini-Mental State and computerized tomography (CT). A factorial analysis of the symptoms as recorded with the Spanish version of the Manchester Scale was carried out. Three factors (‘positive’, ‘negative’ and ‘disorganization’) accounted for 79% of the total variance. Poor premorbid adjustment was associated with high scores for the ‘…

Psychometric properties of the parental bonding instrument in a Spanish sample.

The Parental Bonding Instrument was translated into Spanish and administered to a sample of 205 Spanish primiparae 3 days after childbirth. Reliability, factorial structure and predictive validity for affective disorders were evaluated. The Spanish version of the PBI has psychometric features similar to those described in other cultures. However, the results suggest that in future research the predictive power of the “Control” factor in affective disorders might be improved by splitting it into two subfactors: “Overprotection” and “Restraint”.

Bridging from research evidence to health policy and from health policy to clinical practice: the case of the Spanish strategy for mental health

Introduction: In the last 30 years the Spanish NHS has evolved from a tightly centralized structure to seventeen autonomous regional health systems. As a result a number of benefits have been obtained but also important side-effects such as unjustified variation in clinical practice and a substantial loss of equity. Description: To deal with these unwanted developments the Spanish Inter-territorial Board of the NHS has recently approved and launched several health strategies on priority areas: diabetes, coronary ischemia, palliative care, cancer and mental health. The strategies are based on scientific evidence or consensus and they have been agreed on by all the regions. However, the degre…

Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up

Abstract Objective Many studies have reported that cognitive ability may be predictive of the functional outcome for patients with schizophrenia. However, no study has prospectively examined these aspects in schizophrenia and bipolar disorders simultaneously. The present study attempted to analyze if neurocognition and clinical status predicts the real-life functioning for patients with schizophrenia or bipolar I disorder, using a longitudinal design. Method Forty-seven schizophrenic and 43 bipolar I outpatients were assessed twice with a neurocognitive battery (Executive Functions, Working Memory, Verbal Memory, Visual Memory, Visual-Motor Processing, Vigilance, Vocabulary and Motor Speed …

Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain

Previous research suggests that the economic crisis can affect mental health. The purpose of this study was to analyse the association of risk of poor mental health with various socioeconomic, demographic, health, quality of life, and social support variables

Self-reported chronic mental health problems and mental health service use in Spain.

Objectives: To determine the prevalence of self-reported chronic mental health problems (MHPs) and mental health service use and their determinants, among the Spanish population over 14 years of age. Methods: Data from the 1999 Spanish Survey on Disabilities, Deficiencies, and State of Health were used. The survey is a cross-sectional study based on a multi-stage stratified sample of all the non-institutionalized Spanish population aged over 14 years (n=59,101, 11% non-responders). Multivariate logistic regression analysis were used. Results: 10.7% of the Spanish population suffer from an MHP. The highest prevalences were found in women, divorced/separated persons, those with a lower level…

Motor speed predicts stability of cognitive deficits in both schizophrenic and bipolar I patients at one-year follow-up

Background We examined whether motor speed assessed by the finger tapping test predicts generalized and specific stable deficits because of a common patho-genic process in bipolar and schizophrenic patients. Methods: One hundred and two patients underwent a battery of neuropsychological tests. Patients with a score of less than one standard deviation from their siblings' sample in two assessments with an interval of one year were defined as suffering from stable deficits because of a common pathogenic process. In addition to univariate analyses, factor analyses, ordinal logistic regression, and multiple linear regressions were used. A general score was also calculated. Results: No differenc…

No paradox, no progress: inverse cancer comorbidity in people with other complex diseases.

Salvador Martínez [et al.]. 5 p., 2 tables and references.

Discordance between two national health statistics sources (EMH and EESCRI, 1990–2009). Analysis of psychiatric morbidity

Abstract Introduction Two statistical sources provide data on hospital stays and discharges for all Spanish hospitals: Hospital Morbidity Survey (acronym in Spanish: EMH) and Statistics of Health Establishments providing Inpatient Care (acronym in Spanish: EESCRI). Our aim is to contrast these two statistical sources to define their accuracy and relevance in psychiatric epidemiology studies. Material and methodology The analysis is based on two aspects: (1) Compare the number of psychiatric stays and hospital discharges from 1990 to 2009. (2) Analyse and compare how the average stay is provided. Results The differences between the two statistical sources are significant and increase over ti…

FC01.06 Prognostic significance of childhood externalising symptoms

Five Interpersonal Factors Are Predictive of the Response to Treatment of Major Depression With Antidepressants in Primary Care

Introduction: Factors relating to the interpersonal relationship between the patient and their physician and social environment are important components, which contribute to their response to treatment for major depressive disorder. This study aimed to assess the influence of optimism, perfectionism, therapeutic alliance, empathy, social support, and adherence to medication regimen in the response to antidepressant treatments in the context of normal primary care clinical practice.Method: We conducted a prospective study in which 24 primary care physicians administered sertraline or escitalopram to 89 patients diagnosed with major depressive disorder. The response to treatment and remission…

Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study

BackgroundEmpirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors.MethodA 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling …