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Robles E, Angelone C, Ondé D, Vázquez C. Somatic symptoms in the general population of Spain: Validation and normative data of the Patient Health Questionnaire-15 (PHQ-15). J Affect Disord 2024; 362:762-771. [PMID: 39029703 DOI: 10.1016/j.jad.2024.07.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/01/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE The Patient Health Questionnaire (PHQ-15) has been widely used to assess somatic symptoms. This study aimed to analyze the psychometric properties of the Spanish version of the PHQ-15, its structure and score distribution across demographic variables in a Spanish sample. In addition, we examined variations in somatic symptoms among different demographic subgroups. METHOD 1495 individuals from the Spanish population answered a series of self-reported measures, including PHQ-15. To examine the factorial structure of the PHQ-15, Confirmatory Factor Analysis (CFA) was performed. Additionally, a bifactor CFA model was examined using the Exploratory Structural Equation Modeling (ESEM) framework. RESULTS Women showed more somatic symptoms than men, and younger individuals showed more somatic symptoms than the older ones. It was also revealed positive associations between somatic symptoms and levels of depression, anxiety, and suspiciousness, while negative associations were found between somatic symptoms and perceived resilience and happiness. Regarding the factorial structure of the PHQ-15, although the one-factor and bifactor models were suitable, the bifactor model underscores the presence of a robust general factor. LIMITATIONS It is a cross-sectional study, not including non-institutionalized individuals. CONCLUSION Somatic symptoms are more frequent in women and younger individuals. Furthermore, the presence of physical symptoms is associated to other psychological aspects, such as depression or anxiety. Finally, bifactor model was the most appropriate to explain the factorial structure of the PHQ-15.
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Affiliation(s)
- Elena Robles
- School of Psychology, Complutense University, Madrid, Spain
| | - Chiara Angelone
- School of Psychology and Education, University of Bologna, Bologna, Italy
| | - Daniel Ondé
- School of Psychology, Complutense University, Madrid, Spain
| | - Carmelo Vázquez
- School of Psychology, Complutense University, Madrid, Spain.
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Tabares Tabares M, Vélez Álvarez C, Bernal Salcedo J, Murillo Rendón S. Anxiety in young people: Analysis from a machine learning model. Acta Psychol (Amst) 2024; 248:104410. [PMID: 39032273 DOI: 10.1016/j.actpsy.2024.104410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
The study addresses the detection of anxiety symptoms in young people using artificial intelligence models. Questionnaires such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) are used to collect data, with a focus on early detection of anxiety. Three machine learning models are employed: Support Vector Machine (SVM), K Nearest Neighbors (KNN), and Random Forest (RF), with cross-validation to assess their effectiveness. Results show that the RF model is the most efficient, with an accuracy of 91 %, surpassing previous studies. Significant predictors of anxiety are identified, such as parental education level, alcohol consumption, and social security affiliation. A relationship is observed between anxiety and personal and family history of mental illness, as well as with characteristics external to the model, such as family and personal history of depression. The analysis of the results highlights the importance of considering not only clinical but also social and family aspects in mental health interventions. It is suggested that the sample size be expanded in future studies to improve the robustness of the model. In summary, the study demonstrates the usefulness of artificial intelligence in the early detection of anxiety in young people and highlights the relevance of addressing multidimensional factors in the assessment and treatment of this condition.
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Affiliation(s)
| | - Consuelo Vélez Álvarez
- Grupo Promoción de la Salud y Prevención de la Enfermedad, Universidad de Caldas, Colombia.
| | | | - Santiago Murillo Rendón
- Grupo Inteligencia Artificial, Universidad de Caldas, Colombia; Grupo Ingeniería de Software, Universidad Autónoma de Manizales, Colombia.
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Anmella G, Primé-Tous M, Segú X, Solanes A, Ruíz V, Martín-Villalba I, Morilla I, Also-Fontanet A, Sant E, Murgui S, Sans-Corrales M, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Martínez-Cerdá JF, Blanch J, Radua J, Fullana MÀ, Cavero M, Vieta E, Hidalgo-Mazzei D. PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:114-125. [PMID: 33933665 DOI: 10.1016/j.rpsm.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND About 30-50% of Primary Care (PC) users in Spain suffer mental health problems, mostly mild to moderate anxious and depressive symptoms, which account for 2% of Spain's total Gross domestic product and 50% of the costs associated to all mental disorders. Mobile health tools have demonstrated to cost-effectively reduce anxious and depressive symptoms while machine learning (ML) techniques have shown to accurately detect severe cases. The main aim of this project is to develop a comprehensive ML digital support platform (PRESTO) to cost-effectively screen, assess, triage, and provide personalized treatments for anxious and depressive symptoms in PC. METHODS The project will be carried out in 3 complementary phases: First, a ML predictive severity model will be built based on all the cases referred to the PC mental health support programme during the last 5 years in Catalonia. Simultaneously, a smartphone app to monitor and deliver psychological interventions for anxiety and depressive symptoms will be developed and tested in a clinical trial. Finally, the ML models and the app will be integrated in a comprehensive decision-support platform (PRESTO) which will triage and assign to each patient a specific intervention based on individual personal and clinical characteristics. The effectiveness of PRESTO to reduce waiting times in receiving mental healthcare will be tested in a stepped-wedge cluster randomized controlled trial in 5 PC centres. DISCUSSION PRESTO will offer timely and personalized cost-effective mental health treatment to people with mild to moderate anxious and depressive symptoms. This will result in a reduction of the burden of mental health problems in PC and on society as a whole. TRIAL REGISTRATION The project and their clinical trials were registered in Clinical Trials.gov: NCT04559360 (September 2020).
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Affiliation(s)
- Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Aleix Solanes
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Inés Martín-Villalba
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Ivette Morilla
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonieta Also-Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Sandra Murgui
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Mireia Sans-Corrales
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Victor Vicens
- Chief Medical Officer and co-founder of Abi Global Health, Spain
| | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Jordi Blanch
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Chief Medical Officer and co-founder of Abi Global Health, Spain; Director of the Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Spain; President of the European Association of Psychosomatic Medicine, Spain
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miquel-Àngel Fullana
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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Diego S, Morales A, Orgilés M. Treating Emotional Disorders in Spanish Children: A Controlled Randomized Trial in a Clinical Setting. Behav Ther 2024; 55:292-305. [PMID: 38418041 DOI: 10.1016/j.beth.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 05/31/2023] [Accepted: 07/03/2023] [Indexed: 03/01/2024]
Abstract
Super Skills for Life (SSL) is a CBT-transdiagnostic group intervention currently being translated and validated in multiple countries. In Spanish children, it has shown a positive impact on anxious and depressive symptoms, as well as other variables such as self-concept, prosocial behaviors, or behavioral problems. However, the effectiveness of the program to treat internalizing symptoms in children with a mental disorder in a clinical setting has not been examined so far. The aim of this study was to evaluate the effectiveness of SSL in a Spanish sample of children with a major internalizing disorder. Participants aged 8-12 years (71.6% boys) were randomly allocated to the SSL group (n = 43) or the waiting list control (WLC) group (n = 43). All children and their parents completed a series of measures before the first session and after the last session or at about the same time in the WLC group. The effectiveness of the intervention was assessed using generalized estimating equations. Significant reductions from pretest to posttest across multiple outcomes were found in children who participated in SSL group compared to those in the WLC group, including anxiety symptoms (SCAS, p = .02), anxiety interference (CALIS, p = .002), depressive symptoms (CDI, p = .033) and remission from diagnosis (K-SADS, p < .001). This study provides initial support for SSL as an effective treatment for children with emotional disorders in clinical settings. Future studies are needed to analyze long-term effects and broader benefits of the program in clinical contexts.
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Affiliation(s)
- Sara Diego
- Miguel Hernández University; Hospital Clínico Universitario de Valencia.
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5
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Fort-Rocamora C, Casañas R, Torres-Torres A, Mas-Expósito L, González M, Carbonero-Judez MT. Evaluation of a group intervention based on Mindfulness in patients with anxiety and depression cared for in mental health community center: a quasy-experimental study. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:14-22. [PMID: 38220142 DOI: 10.1016/j.enfcle.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE To evaluate the effectiveness a group intervention based on Mindfulness in patients with anxiety and depression treated in a community mental health center. Secondarily, evaluate quality of life and adherence to the intervention. METHODS Quasi-experimental study with evaluations pre-post intervention in people over 18 years of age treated at the Les Corts Adult Mental Health Center (AMHC), Barcelona, between March 2015 and December 2019. INCLUSION CRITERIA (1) anxiety symptoms (Hamilton Anxiety Rating Scale >10 points); (2) sign informed consent. Variables collected: (1) anxiety; (2) depression (Beck Depression Inventory); (3) quality of life (EuroQoL) and (4) adherence to the intervention. The intervention (9 weekly sessions; 75min) was carried out by two nurses. Each group consisted of 10-15 patients. RESULTS 128 patients were included, of which 103 were women with a mean age of 52.23 years (SD 12.78). Comparisons pre and post measures, its showed improvements in relation to anxiety, depressive symptoms and general quality of life (p<0.001) and in its dimensions of anxiety-depression (p=0.003). The mean number of sessions attended was 6.17 (SD 2.31), and they were statistically significant and positively correlated with an improvement in anxiety (p<0.001) and depressive symptoms (EQ-5D) (p=0.021). There were no differences between age groups. CONCLUSION The group intervention based on Mindfulness improves anxiety and depressive symptoms, as well as the quality of life. This improvement in the symptomatology is associated to greater adherence to the intervention.
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Affiliation(s)
- Clara Fort-Rocamora
- Centro de Salud Mental de Adultos de Les Corts, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain
| | - Rocío Casañas
- Departamento de Investigación, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain.
| | - Ana Torres-Torres
- Centro de Salud Mental de Adultos de Les Corts, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain
| | - Laia Mas-Expósito
- Departamento de Investigación, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain
| | - Maria González
- Centro de Salud Mental de Adultos de Les Corts, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain
| | - M Teresa Carbonero-Judez
- Centro de Salud Mental de Adultos de Les Corts, Associació Centre d'Higiene Mental Les Corts (CHMLC), Grup CHM Salut Mental, Barcelona, Spain
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Rojas RL, Cremades CF, Celleri M, Garay CJ. Overall Anxiety Severity and Impairment Scale (OASIS) and Overall Depression Severity and Impairment Scale (ODSIS): Adaptation and Validation in Buenos Aires, Argentina. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e10451. [PMID: 37732148 PMCID: PMC10508253 DOI: 10.32872/cpe.10451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/15/2023] [Indexed: 09/22/2023] Open
Abstract
Background The OASIS and ODSIS scales are two transdiagnostic brief 5-item instruments designed to assess the severity and functional impairment associated with symptoms of anxiety and depression, respectively. The present study aimed to adapt and validate the online versions of both scales in Buenos Aires, Argentina. Method A sample of 344 women and men from the general population of Buenos Aires completed a test battery consisting of the OASIS, the ODSIS, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Positive and Negative Affect Scale (PANAS) and the Multicultural Quality of Life Index (MQLI). Descriptive statistics and item discrimination of both scales were analyzed, as well as their factorial structure, internal consistency, and convergent and discriminant validity, using the R programming language. Results The results showed a unidimensional factorial structure, excellent internal consistency, and adequate construct validity for both the OASIS and the ODSIS. Conclusion These results supports the use of both scales as valid and reliable instruments to assess severity and interference due to anxiety and depression in the general population of Buenos Aires, Argentina.
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Affiliation(s)
| | | | - Milagros Celleri
- Faculty of Psychology, Universidad de Buenos Aires, Buenos Aires, Argentina
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7
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Puerto-Casasasnovas E, Galiana-Richart J, Mastrantonio-Ramos MP, López-Muñoz F, Rocafort-Nicolau A. Direct and Indirect Management Models in Public Health in the Framework of Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2279. [PMID: 36767645 PMCID: PMC9916335 DOI: 10.3390/ijerph20032279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
This article analyzes the relationship between per capita expenditure and financial and macroeconomic variables in the framework of mental health, in regions where the prevailing system is public healthcare governed by the state and in regions where the prevailing system is that of public ownership. The period 2006-2017 was analyzed. A simple linear regression analysis was carried out to determine the relationship between the expenditure per inhabitant and a series of relevant variables such as asset turnover, cash flow, and expenditure as a percentage of gross domestic product (GDP), applying statistical tests to validate the study. In regions where public-private co-financing prevails in the health system, two crucial variables to measure per capita expenditure on mental health were GDP per capita and cash flow of mental health providers. In the regions where management is direct, the crucial variables were asset turnover of mental health providers and expenditure on mental health as a percentage of GDP per capita. These elements are key to determining how to develop public investment policies in hospital systems in the different regions of Europe and the world.
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Affiliation(s)
- Elena Puerto-Casasasnovas
- Departamento de Empresa, Facultad de Economía y Empresa, Universitat de Barcelona, 08034 Barcelona, Spain
- Departamento de Contabilidad y Finanzas, EAE Business School, 08015 Barcelona, Spain
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, 28692 Madrid, Spain
- Departamento de Contabilidad y Finanzas, La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain
| | - Jorge Galiana-Richart
- Departamento de Empresa, Facultad de Economía y Empresa, Universitat de Barcelona, 08034 Barcelona, Spain
- Departamento de Contabilidad y Finanzas, EAE Business School, 08015 Barcelona, Spain
- Departamento de Contabilidad y Finanzas, La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain
| | | | - Francisco López-Muñoz
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, 28692 Madrid, Spain
- Unidad de Neuropsicofarmacología, Instituto de Investigación Hospital 12 de Octubre (i + 12), 28041 Madrid, Spain
- Portucalense Institute of Neuropsychology and Cognitive and Behavioural Neurosciences (INPP), Universidade Portucalense, 4200-072 Porto, Portugal
| | - Alfredo Rocafort-Nicolau
- Departamento de Economía Financiera y Contabilidad, Universitat de Barcelona, 08034 Barcelona, Spain
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Casimiro-Andújar AJ, Martín-Moya R, Maravé-Vivas M, Ruiz-Montero PJ. Effects of a Personalised Physical Exercise Program on University Workers Overall Well-Being: "UAL-Activa" Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11331. [PMID: 36141603 PMCID: PMC9516988 DOI: 10.3390/ijerph191811331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Background and objectives: Regular individualised physical exercise (PE) is a habit that not only has consequences for overall health (physical, emotional, social and mental) but can also have positive effects on organisations and institutions, as it helps workers to improve their personal balance and recover from the effort of their working day, showing higher levels of energy, commitment and productivity. The aim of this study was to understand the relationship between the practice of PE and well-being in personal life and at work, as well as job satisfaction, overall health and the assessment of the personal training service provided by final-year students studying for a degree in Physical Activity and Sport Sciences. Methods: This study used a qualitative research methodology. There were 25 employees of the University of Almeria (UAL) (M = 52.16 ± 9.55 years), divided into two focus groups and participating in the physical exercise program "UAL Activa". Results: The following three main themes, based on the results, emerged: (a) social well-being during PE practice, (b) assessment of the personal training service and (c) physical exercise as an emotional benefit at work. Conclusion. The workers' interventions have shown that participating in a personalised PE program led by a personal trainer can improve overall health and mood, with a very positive influence on the working environment.
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Affiliation(s)
- Antonio Jesús Casimiro-Andújar
- SPORT Research Group (CTS-1024), CERNEP Research Center, Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain
| | - Ricardo Martín-Moya
- Physical Education and Sport Department, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain
| | - María Maravé-Vivas
- Department of Pedagogy and Didactics of Social Sciences, Language and Literature, Universitat Jaume I, 12006 Castellón, Spain
| | - Pedro Jesús Ruiz-Montero
- Physical Education and Sport Department, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain
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González-Sanguino C, Ausín B, Castellanos MÁ, Muñoz M. Mental health in a heterogeneous clinical sample. A cross-sectional study of predictors and gender differences. Heliyon 2022; 8:e09823. [PMID: 35815124 PMCID: PMC9260627 DOI: 10.1016/j.heliyon.2022.e09823] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/27/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Women have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender. Methods A cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables. Results Women in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma. Conclusion Being female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested.
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Affiliation(s)
- Clara González-Sanguino
- Clinical Psychology Department, School of Education and Social Work, University of Valladolid, Extraordinary Chair Against Stigma UCM-Group 5, Spain
- Corresponding author.
| | - Berta Ausín
- Clinical Psychology Department, School of Psychology, University Complutense of Madrid, Extraordinary Chair Against Stigma UCM-group 5, Spain
| | - Miguel Ángel Castellanos
- Department of Psychobiology and Methodology in Behavioral Science, School of Psychology, University Complutense of Madrid, Spain
| | - Manuel Muñoz
- Clinical Psychology Department, School of Psychology, University Complutense of Madrid, Extraordinary Chair Against Stigma UCM-group 5, Spain
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10
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Aguilera-Martín Á, Gálvez-Lara M, Cuadrado F, Moreno E, García-Torres F, Venceslá JF, Corpas J, Jurado-González FJ, Muñoz-Navarro R, González-Blanch C, Ruiz-Rodríguez P, Barrio-Martínez S, Prieto-Vila M, Carpallo-González M, Cano-Vindel A, Moriana JA. Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol. BMC Psychiatry 2022; 22:99. [PMID: 35139809 PMCID: PMC8826705 DOI: 10.1186/s12888-022-03726-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).
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Affiliation(s)
- Ángel Aguilera-Martín
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain.
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain.
| | - Fátima Cuadrado
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Eliana Moreno
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Francisco García-Torres
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - José F Venceslá
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Jorge Corpas
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Francisco J Jurado-González
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Roger Muñoz-Navarro
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - César González-Blanch
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Spain
| | - Paloma Ruiz-Rodríguez
- Castilla La Nueva Primary Care Centre, Health Service of Madrid, C/ Teruel, 4, 28941, Fuenlabrada, Spain
| | - Sara Barrio-Martínez
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Spain
| | - Maider Prieto-Vila
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - María Carpallo-González
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - Antonio Cano-Vindel
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - Juan A Moriana
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
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Osma J, Martínez-García L, Peris-Baquero Ó, Navarro-Haro MV, González-Pérez A, Suso-Ribera C. Implementation, efficacy and cost effectiveness of the unified protocol in a blended format for the transdiagnostic treatment of emotional disorders: a study protocol for a multicentre, randomised, superiority controlled trial in the Spanish National Health System. BMJ Open 2021; 11:e054286. [PMID: 34972770 PMCID: PMC8720993 DOI: 10.1136/bmjopen-2021-054286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Emotional disorders (EDs) have become the most prevalent psychological disorders in the general population, which has boosted the economic burden associated with their management. Approximately half of the individuals do not receive adequate treatment. Consequently, finding solutions to deliver cost-effective treatments for EDs has become a key goal of today's clinical psychology. Blended treatments, a combination of face-to-face and online interventions, have emerged as a potential solution to the previous. The Unified Protocol for the Transdiagnostic Treatment of EDs (UP) might serve this purpose, as it can be applied to a variety of disorders simultaneously and its manualised format makes it suitable for blended interventions. METHODS AND ANALYSIS The study is a multicentre, randomised, superiority, clinical trial. Participants will be 310 individuals with a diagnosis of an ED. They will be randomised to a treatment as usual (individual cognitive behavioural therapy) or a UP condition in a blended format (face-to-face individual UP +online, app-based UP). Primary outcomes will be ED diagnostic criteria and depression and anxiety symptoms. Cost efficiency of the intervention, app usability, as well as opinion and confidence in the treatment will also be evaluated. Assessment points will include baseline and 3 months, 6 months and 12 months after UP treatment. ETHICS AND DISSEMINATION The study has received approvals by the Ethics Research Committee of Navarra, Castellón, Euskadi, Castilla y León, Extremadura, Lleida and Aragón. The study is currently under an approval process by the Ethics Research Committees of all the remaining collaborating centres. Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings. TRIAL REGISTRATION NUMBER NCT04304911.
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Affiliation(s)
- J Osma
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Laura Martínez-García
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Óscar Peris-Baquero
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - María Vicenta Navarro-Haro
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
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12
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Peris-Baquero Ó, Osma J, Gil-LaCruz M, Martínez-García L. Acceptability of and intention to use the Unified Protocol delivered in group format in the Spanish Public Health System. J Eval Clin Pract 2021; 27:1299-1309. [PMID: 33565231 DOI: 10.1111/jep.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The high prevalence of emotional disorders leads to a high demand for mental care which results in high costs and long waiting lists in public mental health settings. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a recent emotion-regulation-based intervention that can be a cost-effective solution in public mental health settings due its transdiagnostic approach and the possibility to apply it in group format. However, the acceptability by mental healthcare professionals (MHCPs) delivering the UP in group format has not been explored. METHODS Thirty-three MHCPs, grouped into MHCPs without previous experience and MHCPs with experience in delivering the UP, were asked about aspects of acceptability and intention to use. Quantitative analysis was carried out to explore MHCPs acceptability. Furthermore, qualitative opinion about UP were collected through a SWOT (strengths, weaknesses, opportunities, threats) analysis to explore MHCPs opinion of delivering the UP intervention in a group format, within the Spanish Public Mental Health System. RESULTS The results showed high scores in all acceptability dimensions and intention to use in the future. SWOT analysis showed strengths and opportunities focusing on its transdiagnostic nature and the cost-effective benefits of group treatment, and weaknesses and threats related to the limited material and human resources. CONCLUSIONS Findings indicate high acceptability of the UP by MHCPs working within the Spanish Public Mental Health System and also identified areas for improvements. In order to enhance the dissemination and implementation of the UP, it is essential to consider MHCPs' perceptions and to be open to their suggestions.
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Affiliation(s)
- Óscar Peris-Baquero
- Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain.,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Jorge Osma
- Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain.,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Marta Gil-LaCruz
- Departamento de Psicología y Sociología, Facultad de Ciencias de la Salud, Zaragoza, Spain
| | - Laura Martínez-García
- Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain.,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
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Torres DP, Gutiérrez EFA, Maresca IP. Psicoterapias intensivas prolongadas ambulatorias para niños y adolescentes con trastorno mental grave. CLÍNICA CONTEMPORÁNEA 2021. [DOI: 10.5093/cc2021a11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Osma J, Peris-Baquero O, Suso-Ribera C, Farchione TJ, Barlow DH. Effectiveness of the Unified Protocol for transdiagnostic treatment of emotional disorders in group format in Spain: Results from a randomized controlled trial with 6-months follow-up. Psychother Res 2021; 32:329-342. [PMID: 34132170 DOI: 10.1080/10503307.2021.1939190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The present study aims to investigate the effectiveness of the Unified Protocol (UP), a transdiagnostic treatment of emotional disorders (EDs), when applied in a group format in the public mental health system in Spain. METHODS 488 participants with a primary diagnosis of ED were randomized to the UP group or to the treatment as usual (TAU; individual, disorder-specific cognitive behavioral therapy). Personality, depression and anxiety symptoms, affect, and quality of life were assessed at pre-treatment, 3 months after treatment onset (coinciding with the end of the UP treatment), and 6 and 9 months after treatment onset (follow-ups). The moderating effect of the treatment condition and the number of sessions received in the evolution of study outcomes was investigated with a linear mixed model analysis. RESULTS A significant improvement in outcomes occurred in both conditions, except for extraversion in the TAU. Improvements in depression, anxiety and quality of life were larger in the UP condition. After the treatment, improvements were maintained at follow-ups in all study outcomes. An interaction between Time*Condition*Sessions was found for depression. CONCLUSION The results add to the existing evidence on the effectiveness of the UP and may be important for implementation purposes in the Spanish or other similar public mental health systems. Trial registration number NCT03064477 (March 10, 2017).
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Affiliation(s)
- J Osma
- Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - O Peris-Baquero
- Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | | | - T J Farchione
- Center for Anxiety and Related Disorders, Boston University (EEUU), Boston, MA, USA
| | - D H Barlow
- Center for Anxiety and Related Disorders, Boston University (EEUU), Boston, MA, USA
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15
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Adaptation of the Beck Anxiety Inventory in population of Buenos Aires. INTERACCIONES: REVISTA DE AVANCES EN PSICOLOGÍA 2020. [DOI: 10.24016/2020.v6n3.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Currently, anxiety disorders are the most prevalent worldwide, reaching a rate of 5% in Argentina in 2017. The Beck Anxiety Inventory (BAI) is one of the instruments most used in research and clinic today. In its construction, one of the objectives was to evaluate anxiety symptoms that are not usually evident in depressive disorders, which is why it is a relevant test to make a differential diagnosis. The objective of this study was to adapt the BAI to adult population of Buenos Aires. Methods: A direct translation of the inventory and then an expert judgment to assess the content validity were carried out. The discrimination capacity of the items was analyzed, and the structural validity of the test were evaluated according to different models found in the literature. Also, the internal consistency of the instrument was analyzed. Results: The adaptation presents adequate content validity and the items have been shown to discriminate adequately. As for the confirmatory factor analyzes, the most parsimonious solution, which indicates the one-dimensionality of the construct, was chosen, providing evidence of construct validity. The adaptation presents adequate internal consistency. Tentative normative values are offered. Conclusion: Evidence of validity and reliability has been found for the Argentine adaptation of the BAI. It is considered an instrument of great clinical utility.
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Carbonell Á, Navarro-Pérez JJ, Mestre MV. Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1366-1379. [PMID: 32115797 DOI: 10.1111/hsc.12968] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
The aim of this systematic integrative review is to analyse the challenges and barriers found in mental healthcare systems and the impact they have on the family. Searches were made of the Web of Science, Scopus, Medline and Cochrane databases using terms relating to mental health, family care and healthcare systems. We included and critically evaluated studies published in English between 2015 and 2019 that directly or indirectly analysed public mental health policies and the consequences they have for the family. We analysed our findings following the inductive content analysis approach. A total of 32 articles that met quality indicators were identified. Very closely related structural, cultural, economic and healthcare barriers were found that contribute to the treatment gap in mental health. The family covers the care systems' deficiencies and weaknesses, and this leads to overload and a diminishing quality of life for caregivers. It is acknowledged that people with mental illness and their families should be able to participate in the development of policies and thus contribute to strengthening mental healthcare systems worldwide.
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Affiliation(s)
- Ángela Carbonell
- Inter-University Research of Local Development (IidL) and Social Work and Social Services Department, University of Valencia, Valencia, Spain
| | - José-Javier Navarro-Pérez
- Inter-University Research of Local Development (IidL) and Social Work and Social Services Department, University of Valencia, Valencia, Spain
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Pérez-Belmonte S, Galiana L, Sancho P, Oliver A, Tomás JM. Subtypes of Depression: Latent Class Analysis in Spanish Old People with Depressive Symptoms. Life (Basel) 2020; 10:life10050070. [PMID: 32443474 PMCID: PMC7281018 DOI: 10.3390/life10050070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is one of the most disabling disorders and the one that most contributes to disability. When it occurs in older people, it is an additional burden to their potential physical and cognitive deficiencies, making MDD an important public health problem that supposes a large investment in health. There is a clear lack of consistency between the subtypes of depression found in the literature, ranging from two to seven classes, with three being the most commonly found non-melancholic, melancholic and psychotic, or putative psychotics. The aim of this research is to add knowledge to the profiles of depressive symptoms in a representative sample of older Spanish people, and to study the possible relationship of these symptom profiles with variables that have traditionally been related to depression. Spanish data from the sixth wave of SHARE were used, with 612 Spanish older adults living in Spain. A routine of several LCAs with a different number of classes was performed to answer this first aim to classify Spanish adults with depression symptoms. The results pointed out the presence of three different classes among the participants in the study: psychosomatic (11.12%), melancholic (14.21%), and anhedonic (74.67%). This work represents a step forward to understand the heterogeneity of major depressive disorder, facilitating the diagnosis, and subsequent treatment of older adults.
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Affiliation(s)
- Sergio Pérez-Belmonte
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain; (S.P.-B.); (A.O.); (J.M.T.)
| | - Laura Galiana
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain; (S.P.-B.); (A.O.); (J.M.T.)
- Correspondence: ; Tel.: +34-9638-64505
| | - Patricia Sancho
- Department of Educational and Developmental Psychology, University of Valencia, 46010 Valencia, Spain;
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain; (S.P.-B.); (A.O.); (J.M.T.)
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain; (S.P.-B.); (A.O.); (J.M.T.)
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Osma J, Suso-Ribera C, Peris-Baquero Ó, Gil-Lacruz M, Pérez-Ayerra L, Ferreres-Galan V, Torres-Alfosea MÁ, López-Escriche M, Domínguez O. What format of treatment do patients with emotional disorders prefer and why? Implications for public mental health settings and policies. PLoS One 2019; 14:e0218117. [PMID: 31181100 PMCID: PMC6557569 DOI: 10.1371/journal.pone.0218117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/25/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We analyzed the preference of three psychological intervention formats-individual, group, and online-in a sample of 267 patients with a primary diagnosis of emotional disorder in Spanish public mental health settings. METHOD We studied patients' preferences considering sociodemographic characteristics, diagnoses, history of psychological treatments, number of sessions, and satisfaction with past interventions. RESULTS Most participants (85.4%) preferred psychological treatment in an individual format, 14.2% in group, and 0.4% online. When comparing the people who chose individual and group treatment, no demographic or clinical differences were found. The arguments against group format were the lack of privacy and expression difficulties. Regarding online format, these included being considered impersonal and ineffective. CONCLUSION The rejection of group and online psychotherapy formats allows us to define the actions we should carry out in public mental health settings to improve the acceptance of more cost-effective therapy formats.
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Affiliation(s)
- Jorge Osma
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
| | - Carlos Suso-Ribera
- Departamento de psicología básica, clínica y psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - Marta Gil-Lacruz
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
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Psychometric properties and validation of the Spanish versions of the overall anxiety and depression severity and impairment scales. J Affect Disord 2019; 252:9-18. [PMID: 30953927 DOI: 10.1016/j.jad.2019.03.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Anxiety and depressive disorders are the most frequent disorders for which patients seek care in public health settings in Spain. This study aimed at validating the Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS), which are brief screening scales for anxiety and depression consisting of only five items each. METHODS The study was conducted in a Spanish clinical sample receiving outpatient mental health treatment (N = 339). A subsample of participants (n = 219) was assessed before and after receiving a course of cognitive-behavioral treatment. RESULTS The results revealed excellent internal consistency estimates (Cronbach's alpha for the OASIS and the ODSIS was 0.87 and 0.94, respectively), along with promising convergent and discriminant validity and test-criterion relationships (i.e., moderate correlation with other measures of depression and anxiety, as well as with neuroticism, quality of life, adjustment, and negative affect). A one-dimensional structure was obtained for the OASIS and the ODSIS. The ROC analyses indicated an area under the curve of 0.83 for the OASIS and the ODSIS when predicting moderate-to-severe anxiety and depression, respectively. Good sensitivity to therapeutic change was also evidence and the analysis of the sensitivity as a function of 1-specificity area suggested a cutoff value of 10 for both scales. LIMITATIONS Inter-rater reliability of diagnoses with the ADIS-IV interview could not be investigated and the results obtained may not be generalizable to other samples and health settings. CONCLUSIONS The availability of these two short and psychometrically sound measures should make screening of anxiety and depressive symptoms in routine care more feasible.
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Moreno E, Muñoz-Navarro R, Medrano LA, González-Blanch C, Ruiz-Rodríguez P, Limonero JT, Moretti LS, Cano-Vindel A, Moriana JA. Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients. J Affect Disord 2019; 252:114-121. [PMID: 30981054 DOI: 10.1016/j.jad.2019.04.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 03/07/2019] [Accepted: 04/07/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. METHODS A total of 1255 patients completed the computerized version of GAD-7 and a subsample of 238 cases was assessed at the 3-month follow-up. A confirmatory factor analysis (CFA) was performed and analyses of multiple-group invariance were also conducted to determine the extent to which the factor structure was comparable across various sociodemographic groups and over time. RESULTS The results showed that both a one- and two-factor structure (representing somatic and cognitive-affective components) were invariant across sociodemographic groups and over time. The two-factor structure provided the best model fit. LIMITATIONS Results cannot be generalized to all primary care patients, as only patients whose general practitioners consider them to suffer emotional disorders were included. CONCLUSIONS Our study supports the reliability and validity of the one- and two-factor model of the GAD-7, both for screening purposes and for monitoring response to treatment.
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Affiliation(s)
- Eliana Moreno
- Department of Psychology, Maimónides Institute for Research in Biomedicine of Cordoba-IMIBIC, Reina Sofía University Hospital, University of Córdoba, Av. Menéndez Pidal, s/n, 14004 Córdoba, Spain.
| | - Roger Muñoz-Navarro
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Avd. Blasco Ibañez, 21, 46010, Valencia, Spain.
| | | | - César González-Blanch
- Mental Health Centre, University Hospital "Marqués de Valdecilla"- IDIVAL, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain.
| | - Paloma Ruiz-Rodríguez
- Castilla La Nueva Primary Care Centre, Health Service of Madrid, Calle Teruel, 4, 28941 Fuenlabrada, Madrid, Spain.
| | - Joaquín T Limonero
- Department of Basic Psychology, Autonomous University of Barcelona, Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain.
| | - Luciana Sofía Moretti
- Faculty of Psychology, University Siglo 21, De los Latinos 8555, 5008 Córdoba, Argentina.
| | - Antonio Cano-Vindel
- Department of Basic Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223 Madrid, Spain.
| | - Juan A Moriana
- Department of Psychology, Maimónides Institute for Research in Biomedicine of Cordoba-IMIBIC, Reina Sofía University Hospital, University of Córdoba, Av. Menéndez Pidal, s/n, 14004 Córdoba, Spain.
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González-Blanch C, Fernando Hernández-de-Hita, Muñoz-Navarro R, Ruíz-Rodríguez P, Medrano LA, Moriana JA, Cano-Vindel A. Domain-specific associations between disability and depression, anxiety, and somatization in primary care patients. Psychiatry Res 2018; 269:596-601. [PMID: 30205353 DOI: 10.1016/j.psychres.2018.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/26/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
This study explores the associations between different disability domains and the most prevalent symptoms of mental disorders in primary care patients (i.e. depression, anxiety, and somatization). A total of 1241 participants from 28 primary care centres completed self-report measures of depression, anxiety, and somatization. This same sample also completed the Sheehan Disability Scale (SDS) to assess functional impairment in work, social life, and family life domains. Associations between the symptoms and each disability domain were examined using hierarchical regression analyses. Depression emerged as the strongest predictor of all three disability domains. Somatization was associated only with the work domain, and anxiety was associated only with the family life domain. Clinical symptoms explained a greater proportion of the variance than sociodemographic variables. In primary care patients, depression, anxiety and somatizations were associated with distinct domains of disability. Early provision of effective treatments in the primary care setting may be crucial to reduce the societal burden of common mental disorders.
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Affiliation(s)
- César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla- IDIVAL. Santander, Spain.; Faculty of Health Sciences, Universidad Europea del Atlántico, Santander, Spain.
| | | | - Roger Muñoz-Navarro
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | | | - Juan Antonio Moriana
- Department of Psychology, University of Córdoba/Maimónides Institute for Research in Biomedicine of Córdoba-IMIBIC/Reina Sofía University Hospital, Spain
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Ruiz-Rodríguez P, Cano-Vindel A, Muñoz-Navarro R, Wood CM, Medrano LA, Moretti LS. Cost-Effectiveness and Cost-Utility Analysis of the Treatment of Emotional Disorders in Primary Care: PsicAP Clinical Trial. Description of the Sub-study Design. Front Psychol 2018; 9:281. [PMID: 29559944 PMCID: PMC5845711 DOI: 10.3389/fpsyg.2018.00281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 02/19/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction: In the primary care (PC) setting in Spain, the prevalence of emotional disorders (EDs) such as anxiety, depression and somatoform disorder is high. In PC patients, these disorders are not always managed in accordance with the recommendations provided by clinical practice guidelines, resulting in major direct and indirect economic costs and suboptimal treatment outcomes. The aim is to analyze and compare the cost-effectiveness and cost-utility of group-based psychological therapy versus treatment as usual (TAU). Methods: Multicenter, randomized controlled trial involving 300 patients recruited from PC centers in Madrid, Spain, with symptoms or possible diagnosis of anxiety, mood (mild or moderate), or somatoform disorders. Patients will be randomized to one of two groups: an experimental group, which will receive group-based transdiagnostic cognitive-behavioral therapy (TD-CBT); and a control group, which will receive TAU (mainly pharmacological interventions) prescribed by their general practitioner (GP). Clinical assessment will be performed with the Patient Health Questionnaire (PHQ). Direct and indirect costs will be calculated and relevant socio-demographic variables will be registered. The Spanish version of the EuroQol 5D-5L will be administered. Patients will be assessed at baseline, immediately after treatment finalization, and at 6 and 12 months post-treatment. Discussion: To our knowledge, this is the first study to compare TD-CBT to TAU in the PC setting in Spain. This is the first comparative economic evaluation of these two treatment approaches in PC. The strength of the study is that it is a multicenter, randomized, controlled trial of psychotherapy and TAU for EDs in PC. Trial registration: Protocol code: ISCRCTN58437086; 20/05/2013. EUDRACT: 2013-001955-11. Protocol Version: 6, 11/01/2014.
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Affiliation(s)
| | - Antonio Cano-Vindel
- Department of Basic Psychology II (Cognitive Processes), Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Roger Muñoz-Navarro
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Cristina M Wood
- Department of Basic Psychology II (Cognitive Processes), Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Leonardo A Medrano
- Department of Psychological Assessment, Universidad Siglo 21, Córdoba, Argentina
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