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Sobregrau P, Baillès E, Carreño M, Donaire A, Boget T, Setoain X, Bargalló N, Rumià J, V Sánchez Vives M, Pintor L. Psychiatric and psychological assessment of patients with drug-resistant epilepsy and psychogenic nonepileptic seizures (PNES) with no response to previous treatments. Epilepsy Behav 2023; 145:109329. [PMID: 37453292 DOI: 10.1016/j.yebeh.2023.109329] [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: 04/03/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Psychogenic nonepileptic seizures (PNES) are common imitators of epileptic seizures. Refractoriness to antiseizure medication hinders the differential diagnosis between ES and PNES, carrying deleterious consequences in patients with PNES. Psychiatric and psychological characteristics may assist in the differential diagnosis between drug-resistant epilepsy (DRE) and PNES. Nevertheless, current comprehensive psychiatric and psychological descriptive studies on both patient groups are scarce and with several study limitations. This study provides a comprehensive psychiatric and psychological characterization of Spanish patients with DRE and PNES. METHOD A cross-sectional and comparative study was completed with 104 patients with DRE and 21 with PNES. Psychiatric and psychological characteristics were assessed with the HADS, SCL-90-R, NEO-FFI-R, PDQ-4+, COPE, and QOLIE-31 tests. Parametric and non-parametric tests were used, and regression models were fit to further explore factors affecting patients' life quality. RESULTS Patients with PNES had greater levels of somatization and extraversion and were associated with benzodiazepine intake. Patients with DRE showed greater narcissistic personality disorder symptoms than those with PNES. In patients with DRE, difficulty in performing basic needs-related tasks and greater psychological distress severity and seizure frequency were associated with poorer life quality. In contrast, being a woman, having a psychiatric disorder history, and greater psychiatric symptoms' intensity were associated with poorer life quality in patients with PNES. CONCLUSION Patients with DRE and PNES share similar psychiatric and psychological characteristics, with only very few being significantly different.
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Affiliation(s)
- Pau Sobregrau
- Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain; Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain.
| | - Eva Baillès
- Health Psychology Unit, Psychiatry Department, Vall d'Hebron, Barcelona 08035, Spain
| | - Mar Carreño
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Antonio Donaire
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Teresa Boget
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - Xavier Setoain
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Núria Bargalló
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Jordi Rumià
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - María V Sánchez Vives
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain; Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain
| | - Luís Pintor
- Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
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Mayor-Silva LI, Romero-Saldaña M, Moreno-Pimentel AG, Álvarez-Melcón ÁC, Molina-Luque R, Meneses-Monroy A. Psychological Impact during Confinement by COVID-19 on Health Sciences University Students-A Prospective, Longitudinal, and Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9925. [PMID: 36011554 PMCID: PMC9408345 DOI: 10.3390/ijerph19169925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The objective was to analyze the factors that influence reactions to confinement situations, such as personality, humor, coping with stressors, and resilience, and to compare this population with a normal situation of exposure to an intense academic stressor such as a partial test, and with the confinement situation caused by the COVID-19 pandemic. METHODS A longitudinal study was performed involving 116 health sciences students from Spain. Three situations were evaluated: a basal situation of normality at the beginning of the course, situation facing an academic stressor (partial test), and confinement situation due to COVID-19. The Positive and Negative Affect Schedule (PANAS), Coping Orientation to Problems Experienced (COPE), Connor-Davidson Resilience Scale, and NEO-FFI scale were used. RESULTS Significant differences were observed in the increase in negative humor and decrease in positive one, as well as decrease in "Focus on and Venting of Emotions". Personality factors that better predict humor at confinement were "conscientiousness" for having positive humor and low "extraversion" for negative humor. CONCLUSIONS The confinement situation due to COVID-19 has caused changes in predominant humor, as well as in coping strategies. Personality factors positively or negatively influence the situation.
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Affiliation(s)
- Luis Iván Mayor-Silva
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Manuel Romero-Saldaña
- Grupo Asociado de Investigación GA-16, Estilos de Vida, Innovación y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Faculty of Medicine and Nursing, University of Cordoba, 14071 Córdoba, Spain
| | | | | | - Rafael Molina-Luque
- Grupo Asociado de Investigación GA-16, Estilos de Vida, Innovación y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Faculty of Medicine and Nursing, University of Cordoba, 14071 Córdoba, Spain
| | - Alfonso Meneses-Monroy
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
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Sobregrau P, Peri JM, Sánchez del Valle R, Molinuevo JL, Barra B, Pintor L. Psychiatric and Psychosocial Characteristics of a Cohort of Spanish Individuals Attending Genetic Counseling Due to Risk for Genetically Conditioned Dementia. J Alzheimers Dis Rep 2022; 6:461-478. [PMID: 36186729 PMCID: PMC9484134 DOI: 10.3233/adr-210067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Predictive genetic tests are presently effective over several medical conditions, increasing the demand among patients and healthy individuals. Considering the psychological burden suspected familial dementia may carry on individuals, assessing personality, coping strategies, and mental health could aid clinicians in findings the appropriate time for delivering genetic test results and predict compliance regarding genetic counseling and expectations towards the genetic condition depending on the outcome. Objective: To describe the psychiatric, psychological, and coping characteristics of a sample of Spanish individuals at risk of familial dementia before genetic test results were given. Methods: We included 54 first degree relatives of patients diagnosed with Alzheimer’s disease, lobar frontotemporal degeneration, or prion diseases. The NEO-FFI-R, COPE, and HADS tests evaluated personality, coping strategies, and psychological distress, respectively. Results: Anxiety and depression were below the cut-off point for mild severity. Conscientiousness and Agreeableness were the most preponderant personality factors, while Neuroticism was the least. Positive reinterpretation and Acceptance were the most frequent coping strategies, and Denial and Alcohol and drug use were the least used. Ongoing medical pathologies increased depression, while psychiatric disorders worsened psychological distress. Conclusion: Contrary to our expectations, PICOGEN candidates showed psychological distress and personality traits within normative ranges, and the use of problem-focused coping strategies prevailed over avoidance coping strategies. Nevertheless, clinicians should pay particular attention to individuals attending genetic counseling who are women, aged, and present an ongoing psychiatric disorder and psychiatric history at inclusion to ensure their mental health and adherence throughout the process.
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Affiliation(s)
- Pau Sobregrau
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Psychology Faculty, University of Barcelona (UB), Barcelona, Spain
| | - Josep M. Peri
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Raquel Sánchez del Valle
- Neurology Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona, Spain
| | | | - Bernardo Barra
- Clínica Universidad de Los Andes, Servicio de Salud Mental, Santiago, Chile
- Psychiatric Department, School of Medicine, Andrés Bello University, Santiago, Chile
| | - Luís Pintor
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Psychology Faculty, University of Barcelona (UB), Barcelona, Spain
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona, Spain
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Tait J, Edmeade L, Delgadillo J. Are depressed patients' coping strategies associated with psychotherapy treatment outcomes? Psychol Psychother 2022; 95:98-112. [PMID: 34617396 DOI: 10.1111/papt.12368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In theory, depression is thought to be associated with deficits in adaptive and excesses in maladaptive coping strategies. This study aimed to investigate associations between coping strategies and depression treatment outcomes. METHOD Participants (N = 126) completed measures of adaptive and maladaptive coping strategies before and after accessing evidence-based psychotherapies for depression. The primary outcome was self-reported depression severity measured with the Patient Health Questionnaire (PHQ-9). Hierarchical regression was used to investigate associations between coping strategies and post-treatment depression symptoms, controlling for therapeutic alliance and relevant demographics. RESULTS Lower pre-treatment engagement coping and higher rumination predicted higher post-treatment depression, but both of these effects became non-significant after controlling for baseline depression severity. Similarly, correlations between change in rumination and change in depression were no longer significant after controlling for baseline severity. CONCLUSIONS Deficits in adaptive (engagement) and excesses in maladaptive (rumination) coping strategies may simply be proxy indicators (epiphenomena) of depression severity. PRACTITIONER POINTS Lower pre-treatment engagement coping predicted higher post-treatment depression Higher pre-treatment rumination predicted higher post-treatment depression Change in rumination during treatment correlated with change in depression symptoms However, none of the above associations remained statistically significant after controlling for baseline depression severity.
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Affiliation(s)
- James Tait
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, UK
| | | | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, UK
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Mayor-Silva LI, Romero-Saldaña M, Moreno-Pimentel AG, Álvarez-Melcón Á, Molina-Luque R, Meneses-Monroy A. The role of psychological variables in improving resilience: Comparison of an online intervention with a face-to-face intervention. A randomised controlled clinical trial in students of health sciences. NURSE EDUCATION TODAY 2021; 99:104778. [PMID: 33540351 DOI: 10.1016/j.nedt.2021.104778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/21/2020] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Most studies on improving resilience lack representative samples and pre- and post-intervention assessments. Results regarding the effectiveness of online interventions versus face-to-face interventions are mixed. OBJECTIVES To evaluate the effectiveness of online and face-to-face programmes for the improvement of coping strategies to develop resilience to stressful situations, and to assess their relationship with personality traits, mood, and academic stressors. DESIGN Randomised controlled clinical trial. Three-armed parallel design. PARTICIPANTS 245 students of the Nursing and Physical Therapy Degree. METHODS Students were randomly assigned to the control group (CG), intervention group 1 (IG-1, face-to-face) or intervention group 2 (IG-2, online). They were assessed after the intervention with the following instruments: the Positive and Negative Affect Schedule (PANAS), the Academic Stressors Scale, the Coping Orientation to Problems Experienced (COPE), the Connor-Davidson Resilience Scale, and the NEO-FFI scale. RESULTS Negative affect was higher in IG-1 (p = 0.12). The greatest stressors were methodological deficiencies of the teaching staff, academic overload, and beliefs about academic performance. The most widely used coping strategies were "Active Problem-Focused Coping" and "Seeking Social Support". There were differences between IG-1 and IG-2 only regarding "Focus on and Venting of Emotions" (p = 0.086). On the Resilience scale, "Persistence, Tenacity, and Self-Efficacy" was higher in the CG, and there were differences with IG-1 (p = 0.06). With respect to the traits measured by the NEO-FFI questionnaire, higher levels of emotional instability (neuroticism) were observed in IG-1 than in the CG (p = 0.06). CONCLUSIONS The results of both interventions are similar, with increased self-awareness of negative personality traits, which is useful for those ignoring their areas for improvement. In addition, these factors are further increased in individuals with high levels of neuroticism and low levels of extraversion. The online intervention was as effective as the face-to-face intervention.
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Affiliation(s)
- Luis Iván Mayor-Silva
- Faculty of Nursing, Physical Therapy, and Podiatry, Complutense University of Madrid, Faculty of Medicine Building, 3.ª Planta, Plaza de Ramón y Cajal, 3, CP: 28040 Madrid, Spain.
| | - Manuel Romero-Saldaña
- Grupo Asociado de Investigación Estilos de vida, innovación y salud. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC). Faculty of Nursing, University of Cordoba. Avda. Menéndez Pidal, s/n 14071, Córdoba, Spain.
| | - Antonio Gabriel Moreno-Pimentel
- Faculty of Nursing, Physical Therapy, and Podiatry, Complutense University of Madrid, Faculty of Medicine Building, 3.ª Planta, Plaza de Ramón y Cajal, 3, CP: 28040 Madrid, Spain.
| | - Ángela Álvarez-Melcón
- Faculty of Nursing, Physical Therapy, and Podiatry, Complutense University of Madrid, Faculty of Medicine Building, 3.ª Planta, Plaza de Ramón y Cajal, 3, CP: 28040 Madrid, Spain.
| | - Rafael Molina-Luque
- Grupo Asociado de Investigación Estilos de vida, innovación y salud. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC). Faculty of Nursing, University of Cordoba. Avda. Menéndez Pidal, s/n 14071, Córdoba, Spain
| | - Alfonso Meneses-Monroy
- Faculty of Nursing, Physical Therapy, and Podiatry, Complutense University of Madrid, Faculty of Medicine Building, 3.ª Planta, Plaza de Ramón y Cajal, 3, CP: 28040 Madrid, Spain.
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The location of coping strategies within the Alternative Five Factor Model of personality. NEW IDEAS IN PSYCHOLOGY 2021. [DOI: 10.1016/j.newideapsych.2020.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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