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Miranda-Mendizabal A, Castellví P, Vilagut G, Alayo I, Almenara J, Ballester L, Echeburúa E, Gabilondo A, Gili M, Mortier P, Piqueras JA, Roca M, Auerbach RP, Bruffaerts R, Kessler RC, Alonso Caballero J. Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders. J Affect Disord 2024; 353:52-59. [PMID: 38417714 DOI: 10.1016/j.jad.2024.02.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Childhood/adolescence adversities and mental disorders are higher among LGB youths. AIMS To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. METHODS Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. RESULTS A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. LIMITATIONS Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. CONCLUSIONS Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.
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Affiliation(s)
- Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain; Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
| | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Carrer Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregar, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Laura Ballester
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso Caballero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
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Navarra-Ventura G, Riera-Serra P, Roca M, Gili M, García-Toro M, Vilagut G, Alayo I, Ballester L, Blasco MJ, Castellví P, Colom J, Casajuana C, Gabilondo A, Lagares C, Almenara J, Miranda-Mendizabal A, Mortier P, Piqueras JA, Soto-Sanz V, Alonso J. Factors associated with high and low mental well-being in Spanish university students. J Affect Disord 2024; 356:424-435. [PMID: 38631424 DOI: 10.1016/j.jad.2024.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/27/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.
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Affiliation(s)
- Guillem Navarra-Ventura
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Miquel Roca
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain.
| | - Mauro García-Toro
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Biosistemak Institute for Health Systems Research, Basque Country, Spain
| | - Laura Ballester
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Joan Colom
- Agència de Salut Pública de Catalunya (ASPCat), Barcelona, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Carolina Lagares
- Departamento de Estadística e Investigación Operativa, Universidad de Cádiz, Cádiz, Spain
| | - José Almenara
- Departamento de Biomedicina, Biotecnología y Salud Pública, Universidad de Cádiz, Cádiz, Spain
| | - Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Victoria Soto-Sanz
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine and Life Science, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Riera-Serra P, Navarra-Ventura G, Castro A, Gili M, Salazar-Cedillo A, Ricci-Cabello I, Roldán-Espínola L, Coronado-Simsic V, García-Toro M, Gómez-Juanes R, Roca M. Clinical predictors of suicidal ideation, suicide attempts and suicide death in depressive disorder: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01716-5. [PMID: 38015265 DOI: 10.1007/s00406-023-01716-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023]
Abstract
Patients with depressive disorders are especially prone to suicide risk. Among the clinical predictors of suicidality, those specifically related to depressive disorders have not been accurately detailed. Our aim was to conduct a systematic review and meta-analysis of studies reporting longitudinal predictors of suicidal ideation, suicide attempts and suicide death within depression, including diagnostic subtypes, symptoms, clinical course, and assessment scales. A systematic search of the literature between 2001 and 2022 identified 4422 references, among which 19 studies providing 45 different predictors of suicidality met the inclusion criteria. Random effects meta-analyses were performed for 22 predictors, three for suicidal ideation, eleven for suicide attempts and eight for suicide death. Heterogeneity and publication bias were inspected through I2 tests and Egger's tests respectively. Meta-analysis results showed that severity of hopelessness predicted suicidal ideation and suicide attempts. History of suicide attempts, suicidal ideation, severe depression, and psychotic symptoms predicted subsequent suicide attempts and suicide death. Time to full remission and sleep disturbances were also found as relevant predictors of future suicide behaviours. This review specifies which predictors of suicidality within the clinical features of depression will help clinicians and policy makers to better prevent suicide risk in patients with depressive disorders. Further longitudinal studies are needed to reliably assess the predictive ability of our results and to analyse other possible clinical predictors to prevent suicidality, especially with regard to suicidal ideation.
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Affiliation(s)
- Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain.
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Angie Salazar-Cedillo
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
- Balearic Islands Health Services (IB-SALUT), Primary Care Research Unit of Mallorca, Palma, Balearic Islands, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Lorenzo Roldán-Espínola
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Balearic Islands, Spain
| | - Rocío Gómez-Juanes
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Balearic Islands, Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, Palma, Balearic Islands, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Balearic Islands, Spain
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Navarra-Ventura G, Coronado-Simsic V, Riera-Serra P, Castro A, García-Toro M, Roca M, Gili M. Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey. Span J Psychiatry Ment Health 2023:S2950-2853(23)00035-2. [PMID: 38591831 DOI: 10.1016/j.sjpmh.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/02/2023] [Accepted: 08/25/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.
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Affiliation(s)
- Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain.
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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Castro A, Gili M, Visser M, Penninx BWJH, Brouwer IA, Montaño JJ, Pérez-Ara MÁ, García-Toro M, Watkins E, Owens M, Hegerl U, Kohls E, Bot M, Roca M. Soft Drinks and Symptoms of Depression and Anxiety in Overweight Subjects: A Longitudinal Analysis of an European Cohort. Nutrients 2023; 15:3865. [PMID: 37764652 PMCID: PMC10536294 DOI: 10.3390/nu15183865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/11/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Studies about the association of carbonated/soft drinks, coffee, and tea with depression and anxiety are scarce and inconclusive and little is known about this association in European adults. Our aim was to examine the association between the consumption of these beverages and depressive and anxiety symptom severity. METHODS A total of 941 European overweight adults (mean age, 46.8 years) with subsyndromal depression that participated in the MooDFOOD depression prevention randomized controlled trial (Clinical Trials.gov identifier: NCT2529423; date of the study: from 2014 to 2018) were analyzed. Depressive and anxiety symptom severity and beverage consumption were assessed using multilevel mixed-effects ordinal logistic regression models for each beverage consumption (carbonated/soft drink with sugar, carbonated/soft drink with non-nutritive sweeteners, coffee, and tea) with the three repeated measures of follow-up (baseline and 6 and 12 months). A case report form for participants' sociodemographic and clinical characteristics, the Food Frequency Questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-Item Scale, the MINI International Neuropsychiatric Interview 5.0, the Short Questionnaire to Assess Health-Enhancing Psychical Activity, and the Alcohol Use Disorders Identification Test were the research tools used. RESULTS Daily consumption of carbonated/soft drinks with sugar was associated with a higher level of anxiety. Trends towards significance were found for associations between both daily consumption of carbonated/soft drinks with sugar and non-nutritive sweeteners and a higher level of depression. No relationship was found between coffee and tea consumption and the level of depression and anxiety. CONCLUSIONS The high and regular consumption of carbonated/soft drink with sugar (amount of consumption: ≥1 unit (200 mL)/day) tended to be associated with higher level of anxiety in a multicountry sample of overweight subjects with subsyndromal depressive symptoms. It is important to point out that further research in this area is essential to provide valuable information about the intake patterns of non-alcoholic beverages and their relationship with affective disorders in the European adult population.
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Affiliation(s)
- Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.V.); (I.A.B.)
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (B.W.J.H.P.); (M.B.)
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.V.); (I.A.B.)
| | - Juan José Montaño
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - María Ángeles Pérez-Ara
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Medicine, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter EX4 4PY, UK; (E.W.); (M.O.)
| | - Matt Owens
- Department of Psychology, University of Exeter, Exeter EX4 4PY, UK; (E.W.); (M.O.)
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe Universität Frankfurt am Main, 60528 Frankfurt am Main, Germany;
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, 04109 Leipzig, Germany;
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (B.W.J.H.P.); (M.B.)
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.Á.P.-A.); (M.G.-T.); (M.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain;
- Department of Medicine, University of the Balearic Islands (UIB), 07122 Palma de Mallorca, Spain
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Roca M, Gili M. [Suicide prevention]. Med Clin (Barc) 2023; 161:158-159. [PMID: 37045670 DOI: 10.1016/j.medcli.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/14/2023]
Affiliation(s)
- Miquel Roca
- Departamento de Medicina, Instituto Universitario de Investigación en Ciencias de la Salud/Idisba, Universitat de les Illes Balears, Palma, España.
| | - Margalida Gili
- Departamento de Psicología, Instituto Universitario de Investigación en Ciencias de la Salud/Idisba, Universitat de les Illes Balears, Palma, España
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Portillo-Van Diest A, Ballester Coma L, Mortier P, Vilagut G, Amigo F, Puértolas Gracia B, García-Mieres H, Alayo I, Blasco MJ, Carrasco Espi P, Falcó R, Forteza-Rey I, Garcia-Pazo P, Gili M, Giménez-García C, Machancoses FH, Marzo Campos JC, Navarra-Ventura G, Piqueras JA, Rebagliato M, Roca M, Rodriguez Jiménez T, Roldan L, Ruiz-Palomino E, Soto-Sanz V, Alonso J. Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project. BMJ Open 2023; 13:e072641. [PMID: 37451741 PMCID: PMC10351263 DOI: 10.1136/bmjopen-2023-072641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION osf.io/p7csq.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Laura Ballester Coma
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Philippe Mortier
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Franco Amigo
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Beatriz Puértolas Gracia
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Helena García-Mieres
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- Kronikgune, Baracaldo, Euskadi, Spain
| | | | - Paula Carrasco Espi
- Department of Medicine, Universitat Jaume I, Castello de la Plana, Spain
- Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain
| | - Raquel Falcó
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Ines Forteza-Rey
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | - Patricia Garcia-Pazo
- Department of Nursing and Physiotherapy, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
- Development and Psychopathology, IdISBa, Palma de Mallorca, Illes Balears, Spain
| | - Margalida Gili
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | - Cristina Giménez-García
- Department of Basic and Clinical Psychology, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Castelló, Spain
| | - Francisco H Machancoses
- Predepartamental Unit of Medicine, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
| | | | | | - Jose A Piqueras
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Marisa Rebagliato
- CIBERESP, Madrid, Comunidad de Madrid, Spain
- Predepartamental Unit of Medicine, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- Environment and Health, CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Miquel Roca
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Medicine, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | | | | | - Estefanía Ruiz-Palomino
- Department of Basic and Clinical Psychology, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Castelló, Spain
| | - Victoria Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Jordi Alonso
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Riera-Serra P, Gili M, Navarra-Ventura G, Riera-López Del Amo A, Montaño JJ, Coronado-Simsic V, Castro A, Roca M. Longitudinal associations between executive function impairments and suicide risk in patients with major depressive disorder: A 1-year follow-up study. Psychiatry Res 2023; 325:115235. [PMID: 37178501 DOI: 10.1016/j.psychres.2023.115235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/16/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, 6 and 12 months. The Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess suicidality. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess EF. The association between EF impairments and suicidality was analyzed using mixed-effects models. Out of 167 eligible outpatients, 104 were included in the study. Of these, 72 were re-evaluated at 6 months and 60 at 12 months, obtaining 225 complete observations of the EF. Impaired decision-making and risk-taking behavior were associated with suicidal ideation. Difficulty in impulse control was related to suicidal ideation and to greater severity of suicidal ideation. Impaired spatial planning and working memory was linked to suicide attempts. Our results add to previous literature that the association between EF impairments and suicidality is maintained over the long term, supporting it as a longitudinal risk factor and a possible neurocognitive marker of suicide in patients with MDD.
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Affiliation(s)
- Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain.
| | - Antonio Riera-López Del Amo
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Juan José Montaño
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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9
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Barceló-Soler A, García-Campayo J, Araya R, Doukani A, Gili M, García-Palacios A, Mayoral F, Montero-Marin J. Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study. Front Psychol 2023; 14:1024966. [PMID: 37063543 PMCID: PMC10090318 DOI: 10.3389/fpsyg.2023.1024966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionPsychotherapies delivered via the Internet have been promoted as an alternative for improving access to psychological treatments. A conceptual working alliance model of blended (i.e., traditional face-to-face consultation combined with Internet-delivered psychotherapy) cognitive-behavioral therapy (b-CBT) for depression has been developed in the UK. However, little is known about how this important therapeutic process, namely the working alliance (WA), is developed and maintained in Internet-delivered cognitive-behavioral therapy without face-to-face consultation (i-CBT). The aim of this study was to evaluate the validity of the WA model of b-CBT in Spanish patients with depression receiving i-CBT.MethodsForty-one patients suffering from mild-moderate depression were interviewed to assess their experiences of an i-CBT program. Interviews were conducted with participants who received a self-guided application (n = 9), and low-intensity support (n = 10). Three group interviews were also conducted with patients who either did not start the program (n = 8) or did not complete it (n = 6), and with patients who did complete it (n = 8).ResultsQualitative thematic content analysis was performed using the constant comparative method, which revealed four main themes: “bond,” “goals,” “task,” and “usability heuristics,” all consistent with the existing literature. However, a new subcategory emerged, called “anonymity,” which may highlight the social stigma that mental illness still has in the Spanish context.ConclusionResults suggest that the development and maintenance of the WA through i-CBT could offer a better experience of the therapeutic process and improve the clinical impact.Clinical Trial RegistrationClinicaltrials.gov, identifier: NCT01611818.
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Affiliation(s)
- Alberto Barceló-Soler
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
- Department of Psychiatry, University of Zaragoza, Zaragoza, Spain
- *Correspondence: Javier García-Campayo,
| | | | - Asmae Doukani
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Margalida Gili
- Department of Psychology, University of the Balearic Islands, Palma, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health—CIBERESP), Madrid, Spain
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Garcia A, Yáñez AM, Bennasar-Veny M, Navarro C, Salva J, Ibarra O, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván B, Gili M, Roca M, Riera-Serra P, Aguilar-Latorre A, Montero-Marin J, Garcia-Toro M. Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial. Psychiatry Res 2023; 319:114975. [PMID: 36442318 DOI: 10.1016/j.psychres.2022.114975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.
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Affiliation(s)
- Aurora Garcia
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Aina M Yáñez
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB; CIBER de Epidemiologíública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Capilla Navarro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Joan Salva
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Olga Ibarra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Rocío Gomez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - María J Serrano-Ripoll
- Primary Care Research Unit of Majorca, Balearic Islands Health Services and Department of Psychology, UIB
| | - Bárbara Oliván
- Department of Psychology and Sociology, University of Zaragoza. Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Margalida Gili
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | | | - Jesús Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Mauro Garcia-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
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11
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Galmes-Panades AM, Angullo E, Mira-Martínez S, Bennasar-Veny M, Zamanillo-Campos R, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol-deRoque MA, Miralles J, Yañez AM, Romaguera D, Vidal-Thomas MC, Llobera-Canaves J, García-Toro M, Vicens C, Gervilla-García E, Oña JI, Malih N, Leiva A, Bulilete O, Montaño JJ, Gili M, Roca M, Ricci-Cabello I. Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial. Int J Environ Res Public Health 2022; 19:14706. [PMID: 36429423 PMCID: PMC9690330 DOI: 10.3390/ijerph192214706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.
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Affiliation(s)
- Aina M. Galmes-Panades
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Escarlata Angullo
- Escola Graduada Primary Health Care Center, Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07120 Palma de Mallorca, Spain
| | - Sofía Mira-Martínez
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Rocío Gómez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Rafael Jiménez
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Maria Antonia Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Jerónima Miralles
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Aina M. Yañez
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Maria Clara Vidal-Thomas
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Joan Llobera-Canaves
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Catalina Vicens
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Son Serra-La Vileta Primary Health Care Center, Balearic Health Service, 07013 Palma, Spain
| | - Elena Gervilla-García
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - José Iván Oña
- Dra. Teresa Piqué Primary Health Care Center, Balearic Health Service, 07003 Palma, Spain
| | - Narges Malih
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Oana Bulilete
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Juan José Montaño
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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12
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Gili M, Riera-Serra P, Roldán-Espínola L, Castro A, Coronado-Simsic V, García-Toro M, Roca M. Detection and treatment of depressive disorder in the spanish health system: a critical review. Actas Esp Psiquiatr 2022; 50:187-195. [PMID: 35867485 PMCID: PMC10803844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Health care for depression is a major challenge. The aim of this review is to capture the status of the detection, diagno- sis and treatment of depression in the Spanish public health system. The data from the latest National Health Survey (ENSE 2017) have been analyzed and a non-systematic search for publications has been carried out in the PubMed and Scopus databases. We highlight the high specificity and low sensitivity in the detection of cases of major depression by Primary Care (PC) physicians in Spain. The detection of depression is supe- rior in specialized care compared to PC. The new healthcare systems based on the shared approach and the hierarchical model of screening, diagnosis and referral are reviewed and we present improvement proposals based on various programs and models of healthcare for depression.
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Affiliation(s)
- Margalida Gili
- Health Research Institute of the Balearic Islands (IdlSBa)
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdlSBa)
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Lorenzo Roldán-Espínola
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Adoración Castro
- Health Research Institute of the Balearic Islands (IdlSBa)
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Victoria Coronado-Simsic
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdlSBa)
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdlSBa)
- University Institute of Health Science Research (IUNICS). University of the Balearic Islands (UIB)
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13
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Ballester L, Alayo I, Vilagut G, Mortier P, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Miranda-Mendizabal A, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Alonso J. Predictive models for first-onset and persistence of depression and anxiety among university students. J Affect Disord 2022; 308:432-441. [PMID: 35398107 DOI: 10.1016/j.jad.2021.10.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions. METHODS Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up. RESULTS A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline. LIMITATIONS Self-report data were used; external validation of the multivariable prediction models is needed. CONCLUSION MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; Girona University (UdG), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pere Castellví
- International University of Catalonia (UIC), Barcelona, Spain
| | | | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Medicine and Life Scienes, Universitat Pompeu Fabra, Barcelona, Spain.
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14
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Peter LJ, Gómez-Juanes R, Roca M, Gili M, Castro A, Pérez-Ara MÁ, Salvà J, Riera P, García-Toro M. Moderate alcohol consumption and depression prevention: A critical review. Actas Esp Psiquiatr 2022; 50:126-133. [PMID: 35643971 PMCID: PMC10828854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
There is a clear consensus that alcohol use disorders are associated with poorer outcomes concerning depression, and that drinking alcohol shouldn`t be recommended because of the risk of dependence. Until recently, literature focused almost exclusively on patients with alcohol use disorders and excludes patients with moderate alcohol use (MAU). It’s has been shown that MAU can prevent or improve the evolution of chronic diseases such as cardiovascular diseases, but several researchers have suggested that there is no safe level of alcohol drinking due to other effects on health. Nevertheless, there is some evidence regarding the antidepressant effect of moderate alcohol consumption. This critical review aims to sum up the direction and tendency of current research on the effect of MAU on depression and relate the causal or confounders factors that might explain the results.
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Affiliation(s)
- Lina-Jolien Peter
- Facultad de Medicina, Universidad de Leipzig, Semmelweisstraβe. 10, 04103 Leipzig, Alemania
| | - Rocío Gómez-Juanes
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Adoración Castro
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - María Ángeles Pérez-Ara
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
| | - Joan Salvà
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Pau Riera
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Mauro García-Toro
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitad de las Islas Baleares, Carretera de Valldemossa, km 7.5, 07122 Palma de Mallorca, España
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
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15
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Castro A, Roca M, Ricci-Cabello I, García-Toro M, Riera-Serra P, Coronado-Simsic V, Pérez-Ara MÁ, Gili M. Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph182413268. [PMID: 34948874 PMCID: PMC8702100 DOI: 10.3390/ijerph182413268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.
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Affiliation(s)
- Adoración Castro
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Correspondence: ; Tel.: +34-971259888
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), 28029 Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - María Ángeles Pérez-Ara
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Margalida Gili
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), 28029 Madrid, Spain
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16
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Avolio R, Andreoli T, Ercolini C, Mignone W, Beltrame R, Razzuoli E, Modesto P, Zoppi S, Crescio MI, Ostorero F, Gili M, Abete MC, Meloni D, Dellepiane M. Retrospective data analysis of animal poisoning events in Liguria. Vet Anim Sci 2021; 13:100178. [PMID: 34151043 PMCID: PMC8188559 DOI: 10.1016/j.vas.2021.100178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 11/15/2022] Open
Abstract
Confirmed animal poisoning cases were 215/497 (43.2%) from 2009 to 2018. Anticoagulant rodenticides (79.2%) were the main cause of animal poisoning. The most affected areas are located along the coast. Dogs and cats were 40.0% of confirmed animal poisoning.
Intentional poisoning represents a serious risk to domestic and wild animals, and it can be an environmental and human health issue as well . This paper is a retrospective study, which covers a decade, based on animal poisoning cases and poisoned baits that were submitted for diagnostic examinations to the Veterinary Medical Research Institute for Piedmont, Liguria and the Aosta Valley (IZS-PLVA) in Liguria region. All data were collected through a passive surveillance system introduced in Italy by a decree of the Ministry of Health in January 2009. 43.2% of the animal poisoning cases were confirmed by toxicological analysis, whereas toxic agents were detected in 31.1% of the baits. The most affected animal species were dogs and cats, followed by synanthropic birds,. Only 4% of the total poisoning events analysed involved wild animals and cases of livestock poisoning were minimal. An increased number of cases in January, March, April and August was noticed, but no seasonal trend was detected. The most affected areas were the ones with the highest level of urbanization and population density. The major cause of the poisonings and the most common substances detected in the examined baits were anticoagulants whereas cholinesterase inhibitors, organochlorine pesticides and carbamates were detected in a minor number of cases. This study raises concerns about deliberate animal poisoning in ligurian region and highlights the necessity to fight this phenomenon as it endangers animals, humans and environment.
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Affiliation(s)
- R Avolio
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - T Andreoli
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - C Ercolini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - W Mignone
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - R Beltrame
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - E Razzuoli
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - P Modesto
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - S Zoppi
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - M I Crescio
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - F Ostorero
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - M Gili
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - M C Abete
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - D Meloni
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
| | - M Dellepiane
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, Turin, 10154, Italy
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17
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Ballester L, Alayo I, Vilagut G, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, G. Forero C, Mortier P, Alonso J. Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students. Int J Environ Res Public Health 2021; 18:ijerph18105213. [PMID: 34068945 PMCID: PMC8156263 DOI: 10.3390/ijerph18105213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18-24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT's Cronbach's alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- Department of Psychology, Girona University (UdG), 17004 Girona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - José Almenara
- Department of Biomedicine, Biotechnology and Public Health, Faculty of Nursing and Physiotherapy, University of Cádiz (UCA), 11009 Cádiz, Spain;
| | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, 08208 Sabadell, Spain;
- CIBER Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Enrique Echeburúa
- Department of Clinical and Health Psychology, University of the Basque Country (UPV-EHU), 20018 San Sebastián, Spain;
- BioDonostia Health Research Institute, Osakidetza, 20014 San Sebastián, Spain;
| | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, 20014 San Sebastián, Spain;
| | - Margalida Gili
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.R.)
| | - Carolina Lagares
- Department of Statistic and Operational Research, Faculty of Medicine, University of Cádiz (UCA), 11009 Cádiz, Spain;
| | - José A. Piqueras
- Department of Health Psychology, Center for Applied Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University of Elche (UMH), 03202 Elche, Spain; (J.A.P.); (V.S.-S.)
| | - Miquel Roca
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.R.)
| | - Victoria Soto-Sanz
- Department of Health Psychology, Center for Applied Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University of Elche (UMH), 03202 Elche, Spain; (J.A.P.); (V.S.-S.)
| | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Pere Castellví
- School of Medicine, International University of Catalonia (UIC), 08195 Sant Cugat del Vallès, Spain; (P.C.); (C.G.F.)
| | - Carlos G. Forero
- School of Medicine, International University of Catalonia (UIC), 08195 Sant Cugat del Vallès, Spain; (P.C.); (C.G.F.)
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), 08003 Barcelona, Spain
- Correspondence: ; Tel.: +34-933160760
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Vreijling SR, Penninx BWJH, Bot M, Watkins E, Owens M, Kohls E, Hegerl U, Roca M, Gili M, Brouwer IA, Visser M, Beekman ATF, Jansen R, Lamers F. Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study. Psychol Med 2021; 52:1-10. [PMID: 33823960 PMCID: PMC9772915 DOI: 10.1017/s0033291721000337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Dietary interventions did not prevent depression onset nor reduced depressive symptoms in a large multi-center randomized controlled depression prevention study (MooDFOOD) involving overweight adults with subsyndromal depressive symptoms. We conducted follow-up analyses to investigate whether dietary interventions differ in their effects on depressive symptom profiles (mood/cognition; somatic; atypical, energy-related). METHODS Baseline, 3-, 6-, and 12-month follow-up data from MooDFOOD were used (n = 933). Participants received (1) placebo supplements, (2) food-related behavioral activation (F-BA) therapy with placebo supplements, (3) multi-nutrient supplements (omega-3 fatty acids and a multi-vitamin), or (4) F-BA therapy with multi-nutrient supplements. Depressive symptom profiles were based on the Inventory of Depressive Symptomatology. RESULTS F-BA therapy was significantly associated with decreased severity of the somatic (B = -0.03, p = 0.014, d = -0.10) and energy-related (B = -0.08, p = 0.001, d = -0.13), but not with the mood/cognition symptom profile, whereas multi-nutrient supplementation was significantly associated with increased severity of the mood/cognition (B = 0.05, p = 0.022, d = 0.09) and the energy-related (B = 0.07, p = 0.002, d = 0.12) but not with the somatic symptom profile. CONCLUSIONS Differentiating depressive symptom profiles indicated that food-related behavioral interventions are most beneficial to alleviate somatic symptoms and symptoms of the atypical, energy-related profile linked to an immuno-metabolic form of depression, although effect sizes were small. Multi-nutrient supplements are not indicated to reduce depressive symptom profiles. These findings show that attention to clinical heterogeneity in depression is of importance when studying dietary interventions.
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Affiliation(s)
- Sarah R. Vreijling
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Mariska Bot
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt am Main, Germany
| | - Miquel Roca
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISPA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Margalida Gili
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISPA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands
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Castro A, García-Palacios A, López-Del-Hoyo Y, Mayoral F, Pérez-Ara MÁ, Baños RM, García-Campayo J, Hurtado MM, Botella C, Barceló-Soler A, Villena A, Roca M, Gili M. Predictors of Adherence in Three Low-Intensity Intervention Programs Applied by ICTs for Depression in Primary Care. Int J Environ Res Public Health 2021; 18:ijerph18041774. [PMID: 33670353 PMCID: PMC7918657 DOI: 10.3390/ijerph18041774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/07/2021] [Indexed: 12/26/2022]
Abstract
Depression is one of the most common disorders in psychiatric and primary care settings, and is associated with disability, loss in quality of life, and economic costs. Internet-based psychological interventions have been shown to be effective in depression treatment but present problems with a low degree of adherence. The main aim of this study is to analyze the adherence predictors in three low-intensity interventions programs applied by Information and Communication Technologies (ICTs) for depression. A multi-center, randomized, controlled clinical trial was conducted with 164 participants with depression, who were allocated to: Healthy Lifestyle Program, Positive Affect Promotion Program or Mindfulness Program. Sociodemographic characteristics, Patient Health Questionnaire-9, Visual Analog Scale, Short Form Health Survey, Positive and Negative Affect Schedule, Five Facets Mindfulness Questionnaire, Pemberton Happiness Index and Treatment Expectancy Questionnaire were used to study adherence. Results showed that positive affect resulted in a predictor variable for Healthy Lifestyle Program and Positive Affect Promotion Program. Perceived health was also a negative adherence predictor for the Positive Affect Promotion Program. Our findings demonstrate that there are differences in clinical variables between treatment completers and non-completers and we provide adherence predictors in two intervention groups. Although new additional predictors have been examined, further research is essential in order to improve tailored interventions and increase adherence treatment.
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Affiliation(s)
- Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-971-259-888
| | - Azucena García-Palacios
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Fermín Mayoral
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - María Ángeles Pérez-Ara
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Rosa Mª Baños
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
- Department of Psychological, Personality, Evaluation and Treatment, University of Valencia, 46010 Valencia, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - María M. Hurtado
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - Cristina Botella
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
| | - Amelia Villena
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
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Navarro C, Yáñez AM, Garcia A, Seguí A, Gazquez F, Marino JA, Ibarra O, Serrano-Ripoll MJ, Gomez-Juanes R, Bennasar-Veny M, Salva J, Oliván B, Roca M, Gili M, Garcia-Toro M. Effectiveness of a healthy lifestyle promotion program as adjunctive teletherapy for treatment-resistant major depression during COVID 19 pandemic: A randomized clinical trial protocol. Medicine (Baltimore) 2020; 99:e22958. [PMID: 33157937 PMCID: PMC7647547 DOI: 10.1097/md.0000000000022958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Treatment-resistant depression (TRD) has a high prevalence and can be exacerbated by poor physical health and economic hardships, which have become common stressors during the current COVID-19 pandemic. The therapeutic approaches used to treat these patients are not always available, may be not be accepted by some patients, and often require face-to-face interactions. OBJECTIVE The main aim of this study will be to evaluate the effectiveness of an Internet-based adjuvant lifestyle-based intervention for patients with TRD. METHODS This will be a parallel, randomized, and controlled clinical trial. A total of 180 patients with TRD will be randomly allocated (1:1:1) to 1 of 3 groups: treatment prescribed by the mental health team and written suggestions for lifestyle changes (placebo control group); treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week mindfulness-based cognitive therapy program (active control group); or treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week lifestyle change promotion program (intervention group). We will perform this study during the COVID-19 pandemic, and will administer interventions by teletherapy, and contact participants by telephone calls, text messages, and/or teleconferences. We will collect patient data using questionnaires administered at baseline, immediately after the intervention, and after 6 and 12 months. The primary outcome will be score on the Beck Depression Inventory-II. The secondary outcomes will be score on the Clinical Global Impressions Scale (used to quantify and track patient progress and treatment response over time) and health-related quality of life measured using the European Quality of Life-5 Dimensions Questionnaire. DISCUSSION Patients with TRD are especially vulnerable when face-to-face psychotherapy is unavailable. The main strength of the proposed study is the novelty of the intervention to be used as an adjuvant therapy. Our results may provide guidance for treatment of patients with TRD in future situations that require lockdown measures. CLINICALTRIALS REGISTRATION NUMBER NCT04428099.
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Affiliation(s)
| | - Aina M. Yáñez
- Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development
| | - Aurora Garcia
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Andrea Seguí
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | | | | | - Olga Ibarra
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Maria J. Serrano-Ripoll
- Primary Care Research Unit of Majorca, Balearic Islands Health Services and Department of Psychology, University of the Balearic Islands, Palma
| | | | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development
| | - Joan Salva
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Bárbara Oliván
- Department of Psychology and Sociology, University of Zaragoza and Preventive Activities and Health Promotion Network, REDIAPP (G06/170), Zaragoza, Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS-IDISBA)
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21
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Thesing CS, Milaneschi Y, Bot M, Brouwer IA, Owens M, Hegerl U, Gili M, Roca M, Kohls E, Watkins E, Visser M, Penninx BWJH. Supplementation-induced increase in circulating omega-3 serum levels is not associated with a reduction in depressive symptoms: Results from the MooDFOOD depression prevention trial. Depress Anxiety 2020; 37:1079-1088. [PMID: 32845021 PMCID: PMC7693241 DOI: 10.1002/da.23092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is ambiguity on how omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are associated with depression, and what the temporality of the association might be. The present study aimed to examine whether (intervention-induced changes in) n-3 PUFA levels were associated with (changes in) depressive symptoms. METHODS Baseline, 6- and 12-month follow-up data on 682 overweight and subclinically depressed persons from four European countries that participated in the MooDFOOD depression prevention randomized controlled trial were used. Participants were allocated to four intervention groups: (a) placebos, (b) placebos and food-related behavioral activation therapy (F-BA), (c) multinutrient supplements (fish oil and multivitamin), and (d) multinutrient supplements and F-BA. Depressive symptoms were measured using the inventory of depressive symptomatology. PUFA levels (µmol/L) were measured using gas chromatography. Analyses were adjusted for sociodemographics, lifestyle, and somatic health. RESULTS Increases in n-3 PUFA, docosahexaenoic acid, and eicosapentaenoic acid levels over time were significantly larger in the supplement groups than in placebo groups. Change in PUFA levels was not significantly associated with the change in depressive symptoms (β = .002, SE = 0.003, p = .39; β = .003, SE = 0.005, p = .64; β = .005, SE = 0.005, p = .29; β = -.0002, SE = 0.0004, p = .69). Baseline PUFA levels did not modify the intervention effects on depressive symptoms. CONCLUSIONS In overweight and subclinical depressed persons, multinutrient supplements led to significant increases in n-3 PUFA levels over time, which were not associated with changes in depressive symptoms. Multinutrient supplements do not seem to be an effective preventive strategy in lowering depressive symptoms over time in these at-risk groups.
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Affiliation(s)
- Carisha S. Thesing
- Department of Psychiatry, Amsterdam Public Health Research Institute de Boelelaan, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health Research Institute de Boelelaan, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute de Boelelaan, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science and the Amsterdam Public Health research instituteVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Matt Owens
- Department of PsychologyUniversity of ExeterExeterUnited Kingdom
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics, and PsychotherapyGoethe‐Universität FrankfurtFrankfurt a.M.Germany
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut, Idisba, RediappUniversity of Balearic IslandsPalma de MallorcaSpain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut, Idisba, RediappUniversity of Balearic IslandsPalma de MallorcaSpain
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical FacultyUniversity of LeipzigLeipzigGermany
| | - Ed Watkins
- Department of PsychologyUniversity of ExeterExeterUnited Kingdom
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and the Amsterdam Public Health research instituteVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute de Boelelaan, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
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22
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Owens M, Watkins E, Bot M, Brouwer IA, Roca M, Kohls E, Penninx B, van Grootheest G, Cabout M, Hegerl U, Gili M, Visser M. Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression. BMJ Open 2020; 10:e034025. [PMID: 32933954 PMCID: PMC7493122 DOI: 10.1136/bmjopen-2019-034025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES We report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi-country cOllaborative project on the rOle of Diet, Food-related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms. DESIGN Randomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017. SETTING Germany, the Netherlands, UK and Spain. PARTICIPANTS Community sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18-75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up. INTERVENTIONS Daily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome: self-reported acceptability of the interventions. SECONDARY OUTCOMES adherence and self-reported depressive symptoms. RESULTS Most participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=-0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence. CONCLUSIONS F-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed. TRIAL REGISTRATION NUMBER NCT02529423.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Edward Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Mariska Bot
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Ingeborg Annemarie Brouwer
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Brenda Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Gerard van Grootheest
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ in Geest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Mieke Cabout
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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23
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Ballester L, Alayo I, Vilagut G, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Mortier P, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Jordi A. Mental disorders in Spanish university students: Prevalence, age-of-onset, severe role impairment and mental health treatment. J Affect Disord 2020; 273:604-613. [PMID: 32560960 DOI: 10.1016/j.jad.2020.04.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The university period carries risk for onset of common mental disorders. Epidemiological knowledge on mental disorders among Spanish university students is limited. AIMS To estimate lifetime and 12-month prevalence, persistence and age-of-onset of mental disorders among Spanish first-year university students, as well as associated role impairment and mental health treatment use. METHODS First-year university students (N=2,118; 55.4% female; mean age=18.8 years) from five Spanish universities completed a web-based survey, screening possible DSM-IV mental disorders (major depressive episode(MDE), mania/hypomania, generalized anxiety disorder(GAD), panic disorder(PD), alcohol abuse/dependence(AUD), drug abuse/dependence(DUD), and adult attention-deficit/hyperactivity disorder(ADHD)). Role impairment and treatment associated with mental disorders were assessed. RESULTS Lifetime and 12-month prevalence of any possible mental disorder was 41.3%(SE=1.08) and 35.7%(SE=1.05), respectively. Persistence (i.e., ratio of 12-month to lifetime prevalence) was 86.4%(SE=1.58). Median age-of-onset was 14 for adult ADHD, 15 for mood disorders and AUD, and 16 for anxiety disorders and DUD. One third (29.2%) of 12-month disorders were associated with role impairment. Twelve-month PD (OR=4.0;95%CI=1.9-8.5) had the highest odds for role impairment. Only 12.6% of students with 12-month disorder received any mental health treatment. Twelve-month treatment was the highest among those students with 12-month GAD (OR=7.4;95%CI=3.7-14.8). LIMITATIONS The assessment of mental disorders was based on self-reports. Cross-sectional nature of the data prevents causal associations. CONCLUSION One third of Spanish university students report a common mental disorder in the past year, and one third of those report severe role impairment. Only one out of eight students with 12-month mental disorders receives mental health treatment.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; Girona University (UdG), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria ParcTaulí, Sabadell, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- InstitutUniversitarid'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- InstitutUniversitarid'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pere Castellví
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KULeuven (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, Massachusetts, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Alonso Jordi
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain.
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Paans NPG, Bot M, Brouwer IA, Visser M, Gili M, Roca M, Hegerl U, Kohls E, Owens M, Watkins E, Penninx BWJH. Effects of food-related behavioral activation therapy on eating styles, diet quality and body weight change: Results from the MooDFOOD Randomized Clinical Trial. J Psychosom Res 2020; 137:110206. [PMID: 32798835 DOI: 10.1016/j.jpsychores.2020.110206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/14/2020] [Accepted: 07/26/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Depression and obesity are bi-directionally related, eating styles and diet quality are two important factors associated with both. It remains uncertain if and how these two factors can be modified. Therefore the current study aims to investigate whether food-related behavioral activation therapy (F-BA), targeting mood, dietary habits and food related behavior, can improve eating styles, and diet quality and reduce body weight in adults with overweight or obesity and subsyndromal depressive symptoms. METHODS Data were derived from the MooDFOOD prevention trial, a 2x2 factorial RCT investigating the effect of nutritional strategies on prevention of depression. Changes in emotional, uncontrolled, and cognitive restrained eating (Three Factor Eating Questionnaire Revised), Mediterranean Diet Score (MDS), and body weight were analyzed among 1025 adults who either received F-BA or no intervention for 12 months. Intervention effect was tested by longitudinal analysis of covariance using mixed model analysis. RESULTS The F-BA group showed a small decrease in emotional (β=-5.68, p<.001) and uncontrolled eating (β=-4.05, p=.03), and increase in cognitive restrained eating (β=5.53, p<.01), compared to no F-BA. The effect of the F-BA therapy on emotional and uncontrolled eating was stronger in those with higher baseline depressive symptoms (IDS-SR). The F-BA did also lead to small improvements in MDS (β=1.95, p<.001), but not to change in body weight. CONCLUSION Our trial showed no reduction in bodyweight, but provides support for the possibility to improve both unhealthy eating styles and diet quality using an intervention targeting these specifically, although effects were small [Trial registration: clinicaltrials.gov NCT02529423].
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Affiliation(s)
- Nadine P G Paans
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071 Palma de Mallorca, Spain
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatic and Psychotherapy, Senckenberg Distinguished Professorship, Goethe-University Frankfurt, Frankfurt A.M., Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Padron-Monedero A, Noguer-Zambano I, García TG, Suárez RS, Bobes J, Gili M, Pérez V, Roca M, Saiz-Ruiz J. Suicide. The post-COVID era: A time for action. Rev Psiquiatr Salud Ment (Engl Ed) 2020; 13:229-231. [PMID: 32703732 DOI: 10.1016/j.rpsm.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Alicia Padron-Monedero
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.
| | | | - Teresa Gómez García
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05), Instituto de Neurociencias del Principado de Asturias (ISPA), INEUROPA, Oviedo, Spain
| | - Margalida Gili
- InstitutoUniversitari de Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, Facultad de Medicina, Universitat de les Illes Balears, Spain
| | - Victor Pérez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), CIBERSAM, Department of Psychiatry, Universitat Autonoma de Barcelona, Spain
| | - Miquel Roca
- InstitutoUniversitari de Investigació en Ciències de la Salut (IUNICS/IDISBA), Rediapp, Facultad de Medicina, Universitat de les Illes Balears, Spain
| | - Jeronimo Saiz-Ruiz
- Department of Psychiatry, Universidad de Alcala/Hospital Ramon y Cajal, IRyCIS, CIBERSAM, Madrid, Spain
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Owens M, Watkins E, Bot M, Brouwer IA, Roca M, Kohls E, Penninx BWJH, Grootheest G, Hegerl U, Gili M, Visser M. Nutrition and depression: Summary of findings from the EU‐funded MooDFOOD depression prevention randomised controlled trial and a critical review of the literature. NUTR BULL 2020. [DOI: 10.1111/nbu.12447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M. Owens
- Department of Psychology University of Exeter Exeter UK
| | - E. Watkins
- Department of Psychology University of Exeter Exeter UK
| | - M. Bot
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - I. A. Brouwer
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - M. Roca
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - E. Kohls
- Department of Psychiatry and Psychotherapy Medical Faculty University Leipzig Leipzig Germany
| | - B. W. J. H. Penninx
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - G. Grootheest
- Amsterdam UMC Vrije Universiteit, Psychiatry Amsterdam Public Health Research Institute GGZ in Geest Specialized Mental Health Care Amsterdam The Netherlands
| | - U. Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy Goethe‐University Frankfurt Germany
| | - M. Gili
- Institut Universitari d’ Investigació en Ciències de la Salut (IUNICS/IDISBA) Rediapp University of Balearic Islands Palma de Mallorca Spain
| | - M. Visser
- Department of Health Sciences Faculty of Science Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
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Gili M, Castro A, García-Palacios A, Garcia-Campayo J, Mayoral-Cleries F, Botella C, Roca M, Barceló-Soler A, Hurtado MM, Navarro M, Villena A, Pérez-Ara MÁ, Riera-Serra P, Baños RM. Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial. J Med Internet Res 2020; 22:e15845. [PMID: 32501276 PMCID: PMC7305559 DOI: 10.2196/15845] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/03/2019] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
Background Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal. The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. Objective This study aimed to assess the effectiveness of 3 low-intensity, internet-based psychological interventions (healthy lifestyle psychoeducational program [HLP], focused program on positive affect promotion [PAPP], and brief intervention based on mindfulness [MP]) compared with a control condition (improved treatment as usual [iTAU]). Methods A multicenter, 4-arm, parallel randomized controlled trial was conducted between March 2015 and March 2016, with a follow-up of 12 months. In total, 221 adults with mild or moderate major depression were recruited in primary care settings from 3 Spanish regions. Patients were randomly distributed to iTAU (n=57), HLP (n=54), PAPP (n=56), and MP (n=54). All patients received iTAU from their general practitioners. The main outcome was the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) from pretreatment (time 1) to posttreatment (time 2) and up to 6 (time 3) and 12 (time 4) months’ follow-up. Secondary outcomes included the visual analog scale of the EuroQol, the Short-Form Health Survey (SF-12), the Positive and Negative Affect Schedule (PANAS), and the Pemberton Happiness Index (PHI). We conducted regression models to estimate outcome differences along study stages. Results A moderate decrease was detected in PHQ-9 scores from HLP (β=–3.05; P=.01) and MP (β=–3.00; P=.01) compared with iTAU at posttreatment. There were significant differences between all intervention groups and iTAU in physical SF-12 scores at 6 months after treatment. Regarding well-being, MP and PAPP reported better PHI results than iTAU at 6 months post treatment. PAPP intervention significantly decreased PANAS negative affect scores compared with iTAU 12 months after treatment. Conclusions The low-intensity, internet-based psychological interventions (HLP and MP) for the treatment of depression in primary care are more effective than iTAU at posttreatment. Moreover, all low-intensity psychological interventions are also effective in improving medium- and long-term quality of life. PAPP is effective for improving health-related quality of life, negative affect, and well-being in patients with depression. Nevertheless, it is important to examine possible reasons that could be implicated for PAPP not being effective in reducing depressive symptomatology; in addition, more research is still needed to assess the cost-effectiveness analysis of these interventions. Trial Registration ISRCTN Registry ISRCTN82388279; http://www.isrctn.com/ISRCTN82388279 International Registered Report Identifier (IRRID) RR2-10.1186/s12888-015-0475-0
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Affiliation(s)
- Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Adoración Castro
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Azucena García-Palacios
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, Univeristy Jaume I, Castellón, Spain.,Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
| | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain.,Departament of Psychiatry, Hospital Miguel Servet, University of Zaragoza, Zaragoza, Spain
| | - Fermin Mayoral-Cleries
- Mental Heath Unit, Hospital Regional of Malaga, Biomedicine Research Institute (IBIMA), Málaga, Spain
| | - Cristina Botella
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, Univeristy Jaume I, Castellón, Spain.,Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | | | - María M Hurtado
- Mental Heath Unit, Hospital Regional of Malaga, Biomedicine Research Institute (IBIMA), Málaga, Spain
| | - MªTeresa Navarro
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Amelia Villena
- Mental Health Unit of Pozoblaco, Hospital Los Pedroches, Córdoba, Spain
| | - M Ángeles Pérez-Ara
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Pau Riera-Serra
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Rosa Mª Baños
- Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain.,Department of Psychological, Personality, Evaluation and Treatment, University of Valencia, Valencia, Spain
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Roca M, Martin-Santos R, Saiz J, Obiols J, Serrano MJ, Torrens M, Subirà S, Gili M, Navinés R, Ibañez A, Nadal M, Barrantes N, Cañellas F. Diagnostic Interview for Genetic Studies (DIGS): Inter-rater and test-retest reliability and validity in a Spanish population. Eur Psychiatry 2020; 22:44-8. [PMID: 17188842 DOI: 10.1016/j.eurpsy.2006.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Revised: 10/13/2006] [Accepted: 10/19/2006] [Indexed: 11/18/2022] Open
Abstract
AbstractObjectiveTo test the reliability and validity of the DIGS in Spanish population.MethodsInter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as “gold standard”. The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS.ResultsOverall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression = 0.877 to schizophrenia = 1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder).ConclusionMost of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.
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Affiliation(s)
- Miguel Roca
- Hospital Joan March, University of Balearic Islands, Institut Universitari d'Investigació en Ciències de la Salut, Edifici Guillem Cifre, Carretera de Valldemossa km 7,5, 07122 Palma de Mallorca, Baleares, Spain.
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Barceló-Soler A, Baños RM, López-Del-Hoyo Y, Mayoral F, Gili M, García-Palacios A, García-Campayo J, Botella C. Interventions of computerized psychotherapies for depression in Primary Care in Spain. Actas Esp Psiquiatr 2019; 47:236-246. [PMID: 31869424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice.
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Affiliation(s)
| | - Rosa M Baños
- Universidad de Valencia, Valencia, España CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España
| | | | - Fermín Mayoral
- Hospital Regional Universitario de Málaga, Málaga, España Instituto de Investigación Médica de Málaga (IBIMA), Málaga, España
| | - Margalida Gili
- IUNICS-IDISBA, Universitat de les Illes Balears, Palma, España
| | - Azucena García-Palacios
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España Universitat Jaume I, Castellón, España
| | - Javier García-Campayo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, España Universidad de Zaragoza, Zaragoza, España Hospital Universitario Miguel Servet, Zaragoza, España
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España Universitat Jaume I, Castellón, España
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Ballester L, Alayo I, Vilagut G, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Forero CG, Bruffaerts R, Mortier P, Auerbach RP, Nock MK, Sampson N, Kessler RC, Alonso J. Accuracy of online survey assessment of mental disorders and suicidal thoughts and behaviors in Spanish university students. Results of the WHO World Mental Health- International College Student initiative. PLoS One 2019; 14:e0221529. [PMID: 31487306 PMCID: PMC6728025 DOI: 10.1371/journal.pone.0221529] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/08/2019] [Indexed: 12/31/2022] Open
Abstract
Objective To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive Episode[MDE], Mania/Hypomania[M/H], Panic Disorder[PD], Generalized Anxiety Disorder[GAD]) and suicidal thoughts and behaviors[STB] used in the UNIVERSAL project. Methods Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18–24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12-month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales [CIDI-SC], the Self-Injurious Thoughts and Behaviors Interview [SITBI] and the Columbia-Suicide Severity Rating Scale [C-SSRS]. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview [MINI]. Measures of diagnostic accuracy and McNemar χ2 test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity. Results A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1–55.1% and negative predictive values 90.2–99.0%; likelihood ratios positive were in the range of 2.1–14.6 and likelihood ratios negative 0.1–0.6. All outcomes showed adequate areas under the curve [AUCs] (AUC>0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs>0.8). Conclusion The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- Girona University (UdG), Girona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- InstitutUniversitarid’Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- InstitutUniversitarid’Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Ronny Bruffaerts
- UniversitairPsychiatrisch Centrum, KULeuven (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- UniversitairPsychiatrisch Centrum, KULeuven (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Boston, Massachusetts, United States of America
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- PompeuFabraUniversity (UPF), Barcelona, Spain
- * E-mail:
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31
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Roca M, del Amo ARL, Riera-Serra P, Pérez-Ara MA, Castro A, Roman Juan J, García-Toro M, García-Pazo P, Gili M. Suicidal risk and executive functions in major depressive disorder: a study protocol. BMC Psychiatry 2019; 19:253. [PMID: 31420027 PMCID: PMC6697936 DOI: 10.1186/s12888-019-2233-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/07/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. METHODS Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). DISCUSSION First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or "marker" in clinical and neurobiological studies about suicidal behavior in depressive patients.
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Affiliation(s)
- Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122, Palma, Spain.
| | | | - Pau Riera-Serra
- 0000000118418788grid.9563.9University of the Balearic Islands, Palma, Spain
| | - Mª. Angeles Pérez-Ara
- 0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | - Adoración Castro
- 0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | - J. Roman Juan
- 0000000118418788grid.9563.9University of the Balearic Islands, Palma, Spain
| | - Mauro García-Toro
- 0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | - Patricia García-Pazo
- 0000000118418788grid.9563.9Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Margalida Gili
- 0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
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32
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Soto-Sanz V, Castellví P, Piqueras JA, Rodríguez-Marín J, Rodríguez-Jiménez T, Miranda-Mendizábal A, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, Cebrià A, Gabilondo A, Gili M, Lagares C, Roca M, Alonso J. Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta-analysis of longitudinal studies. Acta Psychiatr Scand 2019; 140:5-19. [PMID: 30980525 DOI: 10.1111/acps.13036] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess internalizing and externalizing symptoms as risk factors for suicidal behaviour and suicide among adolescents and young adults. METHOD We conducted a systematic review of articles published until January 2017. We identified 26 883 potential papers; 1701 full-text articles were assessed for eligibility, of which 1479 were excluded because of methodological reasons. Diverse meta-analyses were performed for each group of symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CI) or beta coefficients for categorical variables, and effect size (ES) were calculated for continuous variables. RESULTS Finally, 41 studies were included, involving participants aged 12-26 years for a systematic review, and 24 articles were included for meta-analysis. The meta-analysis showed that youths with any internalizing (ES = 0.93) or externalizing symptoms (ES = 0.76 and OR = 2.59) were more likely to attempt suicide in future. This effect was also seen in depression symptoms (OR = 6.58 and ES = 1.00), legal problems (OR = 3.36), and anxiety (ES = 0.65). CONCLUSION Reported internalizing and externalizing symptoms are predictors of suicide behaviour in young people; therefore, the detection and management of these symptoms in young populations could be a crucial strategy for preventing suicidality in this group.
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Affiliation(s)
- V Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Alicante, Spain
| | | | - J A Piqueras
- Department of Health Psychology, Miguel Hernandez University of Elche, Alicante, Spain
| | - J Rodríguez-Marín
- Department of Health Psychology, Miguel Hernandez University of Elche, Alicante, Spain
| | - T Rodríguez-Jiménez
- Department of Health Psychology, Miguel Hernandez University of Elche, Alicante, Spain.,Department of Psychology, Catholic University of Murcia, Murcia, Spain
| | - A Miranda-Mendizábal
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - O Parés-Badell
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J Almenara
- Area of Preventive Medicine and Public Health, University of Cadiz, Cadiz, Spain
| | - I Alonso
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - M J Blasco
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología, y Salud Pública (CIBERESP), Madrid, Spain
| | - A Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - A Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, País Vasco, Spain.,Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute, San Sebastián, Spain
| | - M Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain.,Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - C Lagares
- Department of Statistics and Operative Research, University of Cádiz, Cádiz, Spain
| | - M Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain.,Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - J Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología, y Salud Pública (CIBERESP), Madrid, Spain
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33
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Blasco MJ, Vilagut G, Almenara J, Roca M, Piqueras JA, Gabilondo A, Lagares C, Soto-Sanz V, Alayo I, Forero CG, Echeburúa E, Gili M, Cebrià AI, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Alonso J. Suicidal Thoughts and Behaviors: Prevalence and Association with Distal and Proximal Factors in Spanish University Students. Suicide Life Threat Behav 2019; 49:881-898. [PMID: 30039575 DOI: 10.1111/sltb.12491] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental). METHODS First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared. RESULTS A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2-2.5); sexual assault (OR = 5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015). CONCLUSION Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.
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Affiliation(s)
- Maria Jesús Blasco
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Basque Country, San Sebastián, Spain
| | | | | | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos G Forero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Center for Depression, Anxiety and Stress Research, McLean Hospital, Boston, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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34
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Parmentier FBR, García-Toro M, García-Campayo J, Yañez AM, Andrés P, Gili M. Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Front Psychol 2019; 10:506. [PMID: 30906276 PMCID: PMC6418017 DOI: 10.3389/fpsyg.2019.00506] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/20/2019] [Indexed: 12/21/2022] Open
Abstract
The present study examined the effects of mindfulness on depression and anxiety, both direct and indirect through the mediation of four mechanisms of emotional regulation: worry, rumination, reappraisal and suppression. Path analysis was applied to data collected from an international and non-clinical sample of 1151 adults, including both meditators and non-meditators, who completed an online questionnaire battery. Our results show that mindfulness are related to lower levels of depression and anxiety both directly and indirectly. Suppression, reappraisal, worry and rumination all acted as significant mediators of the relationship between mindfulness and depression. A similar picture emerged for the relationship between mindfulness and anxiety, with the difference that suppression was not a mediator. Our data also revealed that the estimated number of hours of mindfulness meditation practice did not affect depression or anxiety directly but did reduce these indirectly by increasing mindfulness. Worry and rumination proved to be the most potent mediating variables. Altogether, our results confirm that emotional regulation plays a significant mediating role between mindfulness and symptoms of depression and anxiety in the general population and suggest that meditation focusing on reducing worry and rumination may be especially useful in reducing the risk of developing clinical depression.
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Affiliation(s)
- Fabrice B R Parmentier
- Department of Psychology and Institute of Health Sciences (iUNICS), University of the Balearic Islands, Palma, Spain.,Balearic Islands Health Research Institute (IdISBa), Palma, Spain.,School of Psychology, The University of Western Australia, Perth, WA, Australia
| | - Mauro García-Toro
- Department of Psychology and Institute of Health Sciences (iUNICS), University of the Balearic Islands, Palma, Spain.,Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | | | - Aina M Yañez
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Pilar Andrés
- Department of Psychology and Institute of Health Sciences (iUNICS), University of the Balearic Islands, Palma, Spain.,Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Margalida Gili
- Department of Psychology and Institute of Health Sciences (iUNICS), University of the Balearic Islands, Palma, Spain.,Balearic Islands Health Research Institute (IdISBa), Palma, Spain
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35
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Bot M, Brouwer IA, Roca M, Kohls E, Penninx BWJH, Watkins E, van Grootheest G, Cabout M, Hegerl U, Gili M, Owens M, Visser M. Effect of Multinutrient Supplementation and Food-Related Behavioral Activation Therapy on Prevention of Major Depressive Disorder Among Overweight or Obese Adults With Subsyndromal Depressive Symptoms: The MooDFOOD Randomized Clinical Trial. JAMA 2019; 321:858-868. [PMID: 30835307 PMCID: PMC6439597 DOI: 10.1001/jama.2019.0556] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/28/2019] [Indexed: 12/15/2022]
Abstract
Importance Effects of nutritional interventions on the prevention of major depressive disorder (MDD) in overweight adults are unknown. Objective To examine the effect of 2 nutritional strategies (multinutrient supplementation, food-related behavioral activation therapy) and their combination for prevention of a new MDD episode in overweight adults with subsyndromal depressive symptoms. Design, Setting, and Participants This multicenter 2 × 2 factorial randomized clinical trial included overweight adults (body mass index, 25-40) with elevated depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] scores ≥5) and no MDD episode in the past 6 months from 4 European countries. A total of 1025 adults were randomized (July 30, 2015-October 12, 2016) and followed up for 1 year (October 13, 2017). Interventions Daily multinutrient supplements (1412-mg omega-3 fatty acids, 30-μg selenium, 400-μg folic acid, and 20-μg vitamin D3 plus 100-mg calcium) vs placebo and 21 individual or group therapy sessions vs none (blinded to researchers) for 1 year. Participants were allocated to placebo without therapy (n = 257), placebo with therapy (n = 256), supplements without therapy (n = 256), and supplements with therapy (n = 256). Main Outcome and Measures Cumulative 1-year onset of MDD via the Mini International Neuropsychiatric Interview at 3, 6, and 12 months. Logistic regression using effect-coded variables (-1 indicating control, 1 indicating intervention) evaluated intervention effects both individually and in combination (interaction) on MDD onset. Results Among 1025 participants (mean age, 46.5 years; 772 women [75%]; mean BMI, 31.4), 779 (76%) completed the trial. During the 12-month follow-up, 105 (10%) developed MDD: 25 (9.7%) patients in the placebo without therapy, 26 (10.2%) in the placebo with therapy, 32 (12.5%) in the supplement without therapy, and 22 (8.6%) in the supplement with therapy group. None of the treatment strategies affected MDD onset. The odds ratio (OR) for supplements was 1.06 (95% CI, 0.87-1.29); for therapy, 0.93 (95% CI, 0.76-1.13); and for their combination, 0.93 (95% CI, 0.76-1.14; P for interaction, .48). One person in the supplementation with therapy group, died. Twenty-four patients in each of the placebo groups and 24 patients in the supplementation with therapy group were hospitalized, and 26 patients in the supplementation-only group were hospitalized. Conclusions and Relevance Among overweight or obese adults with subsyndromal depressive symptoms, multinutrient supplementation compared with placebo and food-related behavioral activation therapy compared with no therapy did not reduce episodes of major depressive disorder during 1 year. These findings do not support the use of these interventions for prevention of major depressive disorder. Trial registration ClinicalTrials.gov Identifier: NCT02529423.
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Affiliation(s)
- Mariska Bot
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miquel Roca
- Institut Universitari d’ Investigació en Ciències de la Salut, Idisba, Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Brenda W. J. H. Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter, United Kingdom
| | - Gerard van Grootheest
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Mieke Cabout
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Margalida Gili
- Institut Universitari d’ Investigació en Ciències de la Salut, Idisba, Rediapp, University of Balearic Islands, Palma de Mallorca, Spain
| | - Matthew Owens
- Department of Psychology, University of Exeter, Exeter, United Kingdom
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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36
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Miranda-Mendizabal A, Castellví P, Parés-Badell O, Alayo I, Almenara J, Alonso I, Blasco MJ, Cebrià A, Gabilondo A, Gili M, Lagares C, Piqueras JA, Rodríguez-Jiménez T, Rodríguez-Marín J, Roca M, Soto-Sanz V, Vilagut G, Alonso J. Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health 2019; 64:265-283. [PMID: 30635683 PMCID: PMC6439147 DOI: 10.1007/s00038-018-1196-1] [Citation(s) in RCA: 317] [Impact Index Per Article: 63.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 12/12/2018] [Accepted: 12/19/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults. METHODS Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12-26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed. RESULTS Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54-2.50), and males for suicide death (HR 2.50, 95% CI 1.8-3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend's suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied. CONCLUSIONS More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.
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Affiliation(s)
- Andrea Miranda-Mendizabal
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
- Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Pere Castellví
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
- Department of Psychology, Jaen University, Jaén, Spain
| | - Oleguer Parés-Badell
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José Almenara
- Preventive Medicine Area and Public Health, University of Cádiz, Cádiz, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
- Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Annabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, San Sebastian, Spain
- Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute, San Sebastian, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain
- Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - Carolina Lagares
- Department of Statistics and Operative Research, University of Cádiz, Cádiz, Spain
| | | | | | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain
- Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - Victoria Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM-Institut Hospital del Mar d´Investigacions Mèdiques, PRBB Building. Doctor Aiguader 88, 08003, Barcelona, Spain.
- Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Monreal-Bartolomé A, Barceló-Soler A, Castro A, Pérez-Ara MÁ, Gili M, Mayoral F, Hurtado MM, Moreno EV, Botella C, García-Palacios A, Baños RM, López-Del-Hoyo Y, García-Campayo J. Efficacy of a blended low-intensity internet-delivered psychological programme in patients with multimorbidity in primary care: study protocol for a randomized controlled trial. BMC Psychiatry 2019; 19:66. [PMID: 30744610 PMCID: PMC6371446 DOI: 10.1186/s12888-019-2037-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/25/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) has included comorbidity between depression and a chronic disease among the 10 leading global health priorities. Although there is a high prevalence of multimorbidity, health care systems are mainly designed for the management of individual diseases. Given the difficulty in delivering face-to-face psychological treatments, alternative models of treatment delivery have been proposed, emphasizing the role of technologies such as the Internet. The aim of this study is to assess the efficacy in Primary Care (PC) of a blended low-intensity psychological intervention applied using information and communication technologies (ICTs) for the treatment of multimorbidity in PC (depression and type 2 diabetes/low back pain) by means of a randomized controlled trial (RCT). Our main hypothesis is that improved usual care combined with psychological therapy applied using ICTs will be more efficacious for improvement in the symptomatology of multimorbidity, compared to a group with only improved treatment as usual six months after the end of treatment. METHODS A protocol has been designed combining a face-to-face intervention with a supporting online programme that will be tested by an RCT conducted in three different regions (Andalusia, Aragon and the Balearic Islands). The RCT will evaluate three hundred participants diagnosed with depression and type 2 diabetes/low back pain. Four highly experienced research groups specializing in clinical psychology are involved in this trial, and there will be ample possibilities for translation and transfer to usual clinical practice. DISCUSSION This clinical trial will lead to improvement in financial sustainability, maximizing the use of resources and responding to principles of efficiency and effectiveness. Furthermore, based on the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. In conclusion, positive results of this study could have a significant impact on one of the most important health-related problems, multimorbidity. TRIAL REGISTRATION ClinicalTrials.gov, NCT03426709 . Registered retrospectively on 08 February 2018.
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Affiliation(s)
- Alicia Monreal-Bartolomé
- 0000 0000 9314 1427grid.413448.ePrimary Care Prevention and Health Promotion Research Network, RedIAPP, Carlos III Health Institute, Madrid, Spain ,0000000463436020grid.488737.7Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Alberto Barceló-Soler
- 0000000463436020grid.488737.7Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain ,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Adoración Castro
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain ,0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut, IUNICS-IDISPA, University of the Balearic Islands, Palma, Spain
| | - Mª. Ángeles Pérez-Ara
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain ,0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut, IUNICS-IDISPA, University of the Balearic Islands, Palma, Spain
| | - Margalida Gili
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain ,0000000118418788grid.9563.9Institut Universitari d’Investigació en Ciències de la Salut, IUNICS-IDISPA, University of the Balearic Islands, Palma, Spain
| | - Fermín Mayoral
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, Malaga, Spain
| | - Maria Magdalena Hurtado
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, Malaga, Spain
| | - Esperanza Varela Moreno
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, Malaga, Spain
| | - Cristina Botella
- 0000 0001 1957 9153grid.9612.cJaume I University, Castellon de la Plana, Spain ,0000 0000 9314 1427grid.413448.eCIBER Physiopathology Obesity and Nutrition (CIBERobn) Carlos III Health Institute, Madrid, Spain
| | - Azucena García-Palacios
- 0000 0000 9314 1427grid.413448.eCIBER Physiopathology Obesity and Nutrition (CIBERobn) Carlos III Health Institute, Madrid, Spain ,0000 0001 1957 9153grid.9612.cDepartment of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, Castellon, Spain
| | - Rosa M. Baños
- 0000 0000 9314 1427grid.413448.eCIBER Physiopathology Obesity and Nutrition (CIBERobn) Carlos III Health Institute, Madrid, Spain ,0000 0001 2173 938Xgrid.5338.dDepartment of Psychological, Personality, Evaluation and Treatment, University of Valencia, Valencia, Spain
| | - Yolanda López-Del-Hoyo
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain. .,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain. .,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain ,0000 0000 9854 2756grid.411106.3Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Mira A, Soler C, Alda M, Baños R, Castilla D, Castro A, García-Campayo J, García-Palacios A, Gili M, Hurtado M, Mayoral F, Montero-Marín J, Botella C. Exploring the Relationship Between the Acceptability of an Internet-Based Intervention for Depression in Primary Care and Clinical Outcomes: Secondary Analysis of a Randomized Controlled Trial. Front Psychiatry 2019; 10:325. [PMID: 31133899 PMCID: PMC6523778 DOI: 10.3389/fpsyt.2019.00325] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/26/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Depression is one of the most prevalent psychological disorders worldwide. Although psychotherapy for depression is effective, there are barriers to its implementation in primary care in Spain. The use of the Internet has been shown to be a feasible solution. However, the acceptability of Internet-based interventions has not been studied sufficiently. Objective: To assess the acceptability of an Internet-based intervention (IBI) for depression in primary care, and explore the relationship between expectations and satisfaction and the improvement in the clinical variables in primary care patients receiving this intervention. Furthermore, it offers data about the effects of some sociodemographic characteristics on these acceptability variables and analyzes whether the expectations are related to finalizing the intervention. Methods: Data were based on depressive patients who were participants in a randomized controlled trial. In the present study, we present the data from all the participants in the Internet intervention groups (N = 198). All the participants filled out the expectation and satisfaction scales (six-item scales regarding treatment logic, satisfaction, recommending, usefulness for other disorders, usefulness for the patient, and unpleasantness), the Beck Depression Inventory-II, and the secondary outcome measures: depression and anxiety impairment, and positive and negative affect. Results: Results showed that participants' expectations and satisfaction with the program were both high and differences in expectations and satisfaction depended on some sociodemographic variables (age: older people have higher expectations; sex: women have greater satisfaction). A positive relationship between these variables and intervention efficacy was found: expectations related to "usefulness for the patient" were a statistically related predictor to the results on the BDI-II (Beta = 0.364), and the perception of how logical the treatment is (Beta = 0.528) was associated with change in the clinical variable. Furthermore, the higher the expectations, the higher the improvements exhibited by the patients in all measures evaluated during the ten intervention modules. High expectations were also directly related to finalizing the intervention. Conclusions: This is the first study in Spain to address this issue in the field of IBIs for depression in primary care. The IBI showed high acceptance related to the intervention's efficacy and completion. Research on IBI acceptability could help to implement the treatment offered. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01611818.
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Affiliation(s)
- Adriana Mira
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Carla Soler
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Marta Alda
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain.,Aragon Institute for Health Research (IIS Aragon), Zaragoza, Spain.,University Hospital Miguel Servet, Zaragoza, Spain
| | - Rosa Baños
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain
| | - Diana Castilla
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Adoración Castro
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Javier García-Campayo
- Aragon Institute for Health Research (IIS Aragon), Zaragoza, Spain.,University Hospital Miguel Servet, Zaragoza, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Margalida Gili
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Mariena Hurtado
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital Carlos Haya, University of Malaga, Málaga, Spain
| | - Fermín Mayoral
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain.,Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital Carlos Haya, University of Malaga, Málaga, Spain
| | - Jesús Montero-Marín
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain.,Aragon Institute for Health Research (IIS Aragon), Zaragoza, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, ISCIII, Madrid, Spain
| | - Crisitina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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Gili M, López-Navarro E, Castro A, Homar C, Navarro C, García-Toro M, García-Campayo J, Roca M. Gender differences in mental health during the economic crisis. Psicothema 2017; 28:407-413. [PMID: 27776609 DOI: 10.7334/psicothema2015.288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. METHOD A total of 7,914 patients in 2006 and 5,876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders. RESULTS Between 2006 and 2010 the prevalence of Major Depressive Disorder increased 155.7% in men and 104.9% in women; Generalized Anxiety Disorder increased 98.3% in men and 71.3% in women; and Multisomatoform Disorder increased 100.05% in men and 37% in women. The effect of the Employment confounder was significant across all comparisons: Major Depressive Disorder Generalized Odds Ratio=2.557 for Men (p<.001), 2.046 for Women (p=.002); Generalized Anxiety Disorder Generalized Odds Ratio= 2.153 (p<.001) for Men, 1.546 for Women (p<.001); and for Non-specific Multisomatoform Disorder Generalized Odds Ratio=1.680 for Men (p<.001) and 1.301 for women (p=.014). CONCLUSION Overall prevalence of mental disorders increased significantly between 2006 and 2010, especially in males, who are more sensitive to the effect of the current economic recession than women.
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Castro A, López-Del-Hoyo Y, Peake C, Mayoral F, Botella C, García-Campayo J, Baños RM, Nogueira-Arjona R, Roca M, Gili M. Adherence predictors in an Internet-based Intervention program for depression. Cogn Behav Ther 2017; 47:246-261. [PMID: 28871896 DOI: 10.1080/16506073.2017.1366546] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Internet-delivered psychotherapy has been demonstrated to be effective in the treatment of depression. Nevertheless, the study of the adherence in this type of the treatment reported divergent results. The main objective of this study is to analyze predictors of adherence in a primary care Internet-based intervention for depression in Spain. A multi-center, three arm, parallel, randomized controlled trial was conducted with 194 depressive patients, who were allocated in self-guided or supported-guided intervention. Sociodemographic and clinical characteristics were gathered using a case report form. The Mini international neuropsychiatric interview diagnoses major depression. Beck Depression Inventory was used to assess depression severity. The visual analogic scale assesses the respondent's self-rated health and Short Form Health Survey was used to measure the health-related quality of life. Age results a predictor variable for both intervention groups (with and without therapist support). Perceived health is a negative predictor of adherence for the self-guided intervention when change in depression severity was included in the model. Change in depression severity results a predictor of adherence in the support-guided intervention. Our findings demonstrate that in our sample, there are differences in sociodemographic and clinical variables between active and dropout participants and we provide adherence predictors in each intervention condition of this Internet-based program for depression (self-guided and support-guided). It is important to point that further research in this area is essential to improve tailored interventions and to know specific patients groups can benefit from these interventions.
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Affiliation(s)
- Adoración Castro
- a IUNICS-IDISBA , University of Balearic Islands , Palma de Mallorca , Spain.,b Primary Care Prevention and Health Promotion Research Network , RedIAPP , Madrid , Spain
| | - Yolanda López-Del-Hoyo
- b Primary Care Prevention and Health Promotion Research Network , RedIAPP , Madrid , Spain.,c Department of Psychiatry, Hospital Miguel Servet , University of Zaragoza , Zaragoza , Spain
| | - Christian Peake
- d Facultad de Educación, Departamento de Fundamentos de la Pedagogía , Universidad Católica de la Santísima Concepción , Concepción , Chile
| | - Fermín Mayoral
- e Mental Health Department, Institute of Biomedicine of Málaga , University Regional Hospital of Málaga , Málaga , Spain
| | - Cristina Botella
- f Faculty of Health Sciences, Department of Clinical and Basic Psychology and Biopsychology , University Jaume I , Castellon , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III , Madrid , Spain
| | - Javier García-Campayo
- b Primary Care Prevention and Health Promotion Research Network , RedIAPP , Madrid , Spain.,c Department of Psychiatry, Hospital Miguel Servet , University of Zaragoza , Zaragoza , Spain
| | - Rosa María Baños
- g CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III , Madrid , Spain.,h Department of Psychological, Personality, Evaluation and Treatment , University of Valencia , Valencia , Spain
| | - Raquel Nogueira-Arjona
- i Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments , University of Malaga, Malaga, Spain of Malaga , Malaga , Spain
| | - Miquel Roca
- a IUNICS-IDISBA , University of Balearic Islands , Palma de Mallorca , Spain.,b Primary Care Prevention and Health Promotion Research Network , RedIAPP , Madrid , Spain
| | - Margalida Gili
- a IUNICS-IDISBA , University of Balearic Islands , Palma de Mallorca , Spain.,b Primary Care Prevention and Health Promotion Research Network , RedIAPP , Madrid , Spain
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Miranda-Mendizábal A, Castellví P, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, Cebrià A, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Rodríguez-Marín J, Rodríguez-Jiménez T, Soto-Sanz V, Vilagut G, Alonso J. Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis. Br J Psychiatry 2017; 211:77-87. [PMID: 28254960 DOI: 10.1192/bjp.bp.116.196345] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 11/23/2022]
Abstract
BackgroundResearch suggests that lesbian, gay and bisexual (LGB) adolescents have a higher risk of suicidal behaviours than their heterosexual peers, but little is known about specific risk factors.AimsTo assess sexual orientation as a risk factor for suicidal behaviours, and to identify other risk factors among LGB adolescents and young adults.MethodA systematic search was made of six databases up to June 2015, including a grey literature search. Population-based longitudinal studies considering non-clinical populations aged 12-26 years and assessing being LGB as a risk factor for suicidal behaviour compared with being heterosexual, or evaluating risk factors for suicidal behaviour within LGB populations, were included. Random effect models were used in meta-analysis.ResultsSexual orientation was significantly associated with suicide attempts in adolescents and youths (OR = 2.26, 95% CI 1.60-3.20). Gay or bisexual men were more likely to report suicide attempts compared with heterosexual men (OR = 2.21, 95% CI 1.21-4.04). Based on two studies, a non-significant positive association was found between depression and suicide attempts in LGB groups.ConclusionsSexual orientation is associated with a higher risk of suicide attempt in young people. Further research is needed to assess completed suicide, and specific risk factors affecting the LGB population.
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Affiliation(s)
- A Miranda-Mendizábal
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - P Castellví
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - O Parés-Badell
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - J Almenara
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - I Alonso
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - M J Blasco
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - A Cebrià
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - A Gabilondo
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - M Gili
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - C Lagares
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - J A Piqueras
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - M Roca
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - J Rodríguez-Marín
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - T Rodríguez-Jiménez
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - V Soto-Sanz
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - G Vilagut
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
| | - J Alonso
- A. Miranda-Mendizábal, MD, MPH, Health Services Research Group, Institut Hospital del Mar d'Investigacións Mèdiques (IMIM) and Department of Health and Experimental Sciences, Pompeu Fabra University (UPF), Barcelona; P. Castellví, PhD, Health Services Research Group, IMIM and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona; O. Parés-Badell, MD, MPH, Health Services Research Group, IMIM, Barcelona; J. Almenara, MD, PhD, Faculty of Nursing and Physiotherapy, University of Cádiz; I. Alonso, PhD, Morales Meseguer Hospital, Murcia; M. J. Blasco, MSc, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona; A. Cebrià, PhD, Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell; A. Gabilondo, MD, PhD, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, and Mental Health and Psychiatric Care Research Unit, BioDonosti Health Research Institute; M. Gili, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca; C. Lagares, PhD, Department of Statistics and Operative Research, University of Cádiz; J. A. Piqueras, PhD, Department of Health Psychology, Miguel Hernandez University of Elche; M. Roca, MD, PhD, IUNICS-IDISPA and Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca; J. Rodríguez-Marín, PhD, T. Rodríguez-Jiménez, PhD, v. Soto-Sanz, BSc, Department of Health Psychology, Miguel Hernandez University of Elche; G. Vilagut, Health Services Research Group, IMIM, and CIBERESP, Barcelona; Jordi Alonso, MD, PhD, Health Services Research Group, IMIM, Department of Health and Experimental Sciences, UPF, and CIBERESP, Barcelona, Spain
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Castellví P, Lucas-Romero E, Miranda-Mendizábal A, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, Cebrià A, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Rodríguez-Marín J, Rodríguez-Jimenez T, Soto-Sanz V, Alonso J. Longitudinal association between self-injurious thoughts and behaviors and suicidal behavior in adolescents and young adults: A systematic review with meta-analysis. J Affect Disord 2017; 215:37-48. [PMID: 28315579 DOI: 10.1016/j.jad.2017.03.035] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/09/2017] [Accepted: 03/10/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Adolescents with previous self-injurious thoughts and behaviors (SITB) have over 2-fold risk of dying by suicide, higher than older ages. This meta-analysis aims to disentangle the association of each SITB with subsequent suicidal behavior in adolescence/young adulthood, the contribution of each SITB, and the proportion of suicide deaths with no previous suicide attempt. METHODS We searched 6 databases until June 2015. INCLUSION CRITERIA 1. Assessment of any previous SITB [a) suicidal thoughts and behaviors (ideation; threat/gesture; plan; attempt); b) non-suicidal thoughts and behaviors (thoughts; threat/gesture; self-injury); c) self-harm] as a risk factor of suicide attempt or suicide death; 2. Case-control or cohort studies; 3. Subjects aged 12-26y. Random effect models, metaregression analyses including mental health and environmental variables, and population attributable risks (PAR)s were estimated. RESULTS From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). While 68% of all youth suicide deaths had no previous suicide attempt, suicide death was very strongly associated with any previous SITB (OR=22.53, 95%CI: 18.40-27.58). Suicide attempts were also associated with a history of previous SITB (OR=3.48, 95%CI: 2.71-4.43). There were no moderating effects for mental health and environmental features. The PAR of previous SITB to suicide attempts is 26%. LIMITATIONS There is considerable heterogeneity between the available studies. Due to limitations in the original studies, an over-estimation of the proportion dying at their first attempt cannot be ruled out, since they might have missed unrecognized previous suicide attempts. CONCLUSIONS Although more than two thirds of suicide deaths in adolescence/young adulthood have occurred with no previous suicidal behavior, previous SITBs have a much higher risk of dying by suicide than previously reported in this age group.
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Affiliation(s)
- P Castellví
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - E Lucas-Romero
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - A Miranda-Mendizábal
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - O Parés-Badell
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J Almenara
- Area of Preventive Medicine and Public Health. University of Cadiz, Spain
| | - I Alonso
- Morales Meseguer Hospital, Murcia, Spain
| | - M J Blasco
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - A Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - A Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Spain; Mental Health and Psychiatric Care Research Unit. BioDonosti Health Research Institute, Spain
| | - M Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain; Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - C Lagares
- Department of Statistics and Operative Research. University of Cádiz. Spain
| | - J A Piqueras
- Department of Health Psychology, Miguel Hernandez University of Elche, Spain
| | - M Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain; Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - J Rodríguez-Marín
- Department of Health Psychology, Miguel Hernandez University of Elche, Spain
| | - T Rodríguez-Jimenez
- Department of Health Psychology, Miguel Hernandez University of Elche, Spain
| | - V Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Spain
| | - J Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
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Castellví P, Miranda-Mendizábal A, Parés-Badell O, Almenara J, Alonso I, Blasco MJ, Cebrià A, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Rodríguez-Marín J, Rodríguez-Jimenez T, Soto-Sanz V, Alonso J. Exposure to violence, a risk for suicide in youths and young adults. A meta-analysis of longitudinal studies. Acta Psychiatr Scand 2017; 135:195-211. [PMID: 27995627 DOI: 10.1111/acps.12679] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the association and magnitude of the effect of early exposure to different types of interpersonal violence (IPV) with suicide attempt and suicide death in youths and young adults. METHOD We searched six databases until June 2015. Inclusion criteria were as follows: (1) assessment of any type of IPV as risk factor of suicide attempt or suicide: (i) child maltreatment [childhood physical, sexual, emotional abuse, neglect], (ii) bullying, (iii) dating violence, and (iv) community violence; (2) population-based case-control or cohort studies; and (3) subjects aged 12-26 years. Random models were used for meta-analyses (Reg: CRD42013005775). RESULTS From 23 682 articles, 29 articles with 143 730 subjects for meta-analyses were included. For victims of any IPV, OR of subsequent suicide attempt was 1.99 (95% CI: 1.73-2.28); for child maltreatment, 2.25 (95% CI: 1.85-2.73); for bullying, 2.39 (95% CI: 1.89-3.01); for dating violence, 1.65 (95% CI: 1.40-1.94); and for community violence, 1.48 (95% CI: 1.16-1.87). Young victims of IPV had an OR of suicide death of 10.57 (95% CI: 4.46-25.07). CONCLUSION Early exposure to IPV confers a risk of suicide attempts and particularly suicide death in youths and young adults. Future research should address the effectiveness of preventing and detecting early any type of IPV exposure in early ages.
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Affiliation(s)
- P Castellví
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - A Miranda-Mendizábal
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - O Parés-Badell
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - J Almenara
- Area of Preventive Medicine and Public Health, University of Cadiz, Cadiz, Spain
| | - I Alonso
- Morales Meseguer Hospital, Murcia, Spain
| | - M J Blasco
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - A Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - A Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Donostia-San Sebastián, Spain.,Mental Health and Psychiatric Care Research Unit, BioDonostia Health Research Institute, Donostia-San Sebastián, Spain
| | - M Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain.,Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - C Lagares
- Department of Statistics and Operative Research, University of Cádiz, Cádiz, Spain
| | - J A Piqueras
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - M Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain.,Network of Preventive Activities and Health Promotion, University of Balearic Islands, Palma de Mallorca, Spain
| | - J Rodríguez-Marín
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - T Rodríguez-Jimenez
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - V Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - J Alonso
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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Montero-Marín J, Araya R, Pérez-Yus MC, Mayoral F, Gili M, Botella C, Baños R, Castro A, Romero-Sanchiz P, López-Del-Hoyo Y, Nogueira-Arjona R, Vives M, Riera A, García-Campayo J. An Internet-Based Intervention for Depression in Primary Care in Spain: A Randomized Controlled Trial. J Med Internet Res 2016; 18:e231. [PMID: 27565118 PMCID: PMC5018101 DOI: 10.2196/jmir.5695] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/26/2016] [Accepted: 06/23/2016] [Indexed: 12/31/2022] Open
Abstract
Background Depression is the most prevalent cause of illness-induced disability worldwide. Face-to-face psychotherapeutic interventions for depression can be challenging, so there is a need for other alternatives that allow these interventions to be offered. One feasible alternative is Internet-based psychological interventions. This is the first randomized controlled trial (RCT) on the effectiveness of an Internet-based intervention on depression in primary health care in Spain. Objective Our aim was to compare the effectiveness of a low-intensity therapist-guided (LITG) Internet-based program and a completely self-guided (CSG) Internet-based program with improved treatment as usual (iTAU) care for depression. Methods Multicenter, three-arm, parallel, RCT design, carried out between November 2012 and January 2014, with a follow-up of 15 months. In total, 296 adults from primary care settings in four Spanish regions, with mild or moderate major depression, were randomized to LITG (n=96), CSG (n=98), or iTAU (n=102). Research completers at follow-up were 63.5%. The intervention was Smiling is Fun, an Internet program based on cognitive behavioral therapy. All patients received iTAU by their general practitioners. Moreover, LITG received Smiling is Fun and the possibility of psychotherapeutic support on request by email, whereas CSG received only Smiling is Fun. The main outcome was the Beck Depression Inventory-II at 3 months from baseline. Mixed-effects multilevel analysis for repeated measures were undertaken. Results There was no benefit for either CSG [(B coefficient=-1.15; P=.444)] or LITG [(B=-0.71; P=.634)] compared to iTAU, at 3 months. There were differences at 6 months [iTAU vs CSG (B=-4.22; P=.007); iTAU vs LITG (B=-4.34; P=.005)] and 15 months [iTAU vs CSG (B=-5.10; P=.001); iTAU vs LITG (B=-4.62; P=.002)]. There were no differences between CSG and LITG at any time. Adjusted and intention-to-treat models confirmed these findings. Conclusions An Internet-based intervention for depression combined with iTAU conferred a benefit over iTAU alone in the Spanish primary health care system. Trial Registration Clinicaltrials.gov NCT01611818; https://register.clinicaltrials.gov/prs/app/action/SelectProtocol? selectaction=Edit&uid=U0001NPQ&ts=2&cx=gctdh2&sid=S0003KJ6 (Archived by WebCite at http://www.webcitation.org/6jbsUvUDz)
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Affiliation(s)
- Jesús Montero-Marín
- Faculty of Health Sciences and Sports, University of Zaragoza, Zaragoza, Spain
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Román YE, Garcia-Toro M, Gili M, Roca M. Key clinical data in the differential diagnosis between onset of Bipolar Disorder and Borderline Personality Disorder. Actas Esp Psiquiatr 2016; 44:153-156. [PMID: 27388107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | - Mauro Garcia-Toro
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISPA), RedIAPP, UIB, Mallorca, Spain
| | - Margalida Gili
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISPA), RedIAPP, UIB, Mallorca, Spain
| | - Miquel Roca
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISPA), RedIAPP, UIB, Mallorca, Spain
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46
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Roca M, Kohls E, Gili M, Watkins E, Owens M, Hegerl U, van Grootheest G, Bot M, Cabout M, Brouwer IA, Visser M, Penninx BW. Prevention of depression through nutritional strategies in high-risk persons: rationale and design of the MooDFOOD prevention trial. BMC Psychiatry 2016; 16:192. [PMID: 27277946 PMCID: PMC4898322 DOI: 10.1186/s12888-016-0900-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/02/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Obesity and depression are two prevalent conditions that are costly to individuals and society. The bidirectional association of obesity with depression, in which unhealthy dietary patterns may play an important role, has been well established. Few experimental studies have been conducted to investigate whether supplementing specific nutrients or improving diet and food-related behaviors can prevent depression in overweight persons. METHOD/DESIGN The MooDFOOD prevention trial examines the feasibility and effectiveness of two different nutritional strategies [multi-nutrient supplementation and food-related behavioral change therapy (FBC)] to prevent depression in individuals who are overweight and have elevated depressive symptoms but who are not currently or in the last 6 months meeting criteria for an episode of major depressive disorder (MDD). The randomized controlled prevention trial has a two-by-two factorial design: participants are randomized to daily multi-nutrient supplement (omega-3 fatty acids, calcium, selenium, B-11 vitamin and D-3 vitamin) versus placebo, and/or FBC therapy sessions versus usual care. Interventions last 12 months. In total 1000 participants aged 18-75 years with body mass index between 25-40 kg/m(2) and with a Patient Health Questionnaire-9 score ≥ 5 will be recruited at four study sites in four European countries. Baseline and follow-up assessments take place at 0, 3, 6, and 12 months. Primary endpoint is the onset of an episode of MDD, assessed according to DSM-IV based criteria using the MINI 5.0 interview. Depressive symptoms, anxiety, food and eating behavior, physical activity and health related quality of life are secondary outcomes. During the intervention, compliance, adverse events and potentially mediating variables are carefully monitored. DISCUSSION The trial aims to provide a better understanding of the causal role of specific nutrients, overall diet, and food-related behavior change with respect to the incidence of MDD episodes. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective nutritional public health strategies for the prevention of clinical depression. TRIAL REGISTRATION ClinicalTrials.gov. Number of identification: NCT02529423 . August 2015.
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Affiliation(s)
- Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISPA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071, Palma de Mallorca, Spain.
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS/IDISPA), Rediapp, University of Balearic Islands, Carretera de Valldemosssa km 7,5, 07071, Palma de Mallorca, Spain
| | - Ed Watkins
- Department of Psychology, University of Exeter, Exeter, UK
| | - Matthew Owens
- Department of Psychology, University of Exeter, Exeter, UK
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Leipzig, Medical Faculty, Leipzig, Germany
| | - Gerard van Grootheest
- GGZ inGeest and Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Mariska Bot
- GGZ inGeest and Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Mieke Cabout
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W Penninx
- GGZ inGeest and Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Soria V, Vives M, Martínez-Amorós È, Gálvez V, Monzón S, Crespo JM, Gili M, Menchón JM, Roca M, Parker G, Urretavizcaya M. The CORE system for sub-typing melancholic depression: Adaptation and psychometric properties of the Spanish version. Psychiatry Res 2016; 239:179-83. [PMID: 27010187 DOI: 10.1016/j.psychres.2016.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 11/18/2022]
Abstract
We report the development procedure for a Spanish version of the CORE measure for subtyping melancholic depression and its psychometric properties. The sample comprised two subsets of depressive patients: 117 in-patients clinically assessed after admission and before discharge; and 34 in- and out-patients who were video-recorded, with each recording being rated by independent raters and re-rated six months later. The internal consistency of the Spanish version of the CORE was high, with Cronbach's alpha coefficient of 0.93 for the total CORE score. High intra-class correlation coefficient for the total score (0.96) and the three subscales (around 0.8) indicate high inter-rater reliability. Baseline and six-month ratings of video-recordings showed high test-retest reliability. Regarding construct validity, the correlation between the CORE and the Newcastle endogeneity scale scores was 0.64. A ROC curve generated an optimal cut-off of 10 to predict the definition of endogeneity/melancholia based on the Newcastle score >=6 and the DSM-IV-TR definition of melancholia. The comparison between the CORE scores at admission and at discharge revealed large differences, indicating demonstrable sensitivity to change. The Spanish version of the CORE system is a reliable and valid instrument for sub-typing depression in terms of melancholic versus non-melancholic sub-types.
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Affiliation(s)
- Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
| | - Margalida Vives
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Èrika Martínez-Amorós
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Verònica Gálvez
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia
| | - Saray Monzón
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - José M Crespo
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia
| | - Mikel Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
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García-Toro M, Vicens-Pons E, Gili M, Roca M, Serrano-Ripoll MJ, Vives M, Leiva A, Yáñez AM, Bennasar-Veny M, Oliván-Blázquez B. Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome. J Affect Disord 2016; 194:105-8. [PMID: 26807670 DOI: 10.1016/j.jad.2015.12.064] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/10/2015] [Accepted: 12/26/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Obesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months. METHODS 273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF). RESULTS At the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS. CONCLUSIONS Obesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough.
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Affiliation(s)
- M García-Toro
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - E Vicens-Pons
- Primary Care Prevention and Health Promotion Research Network, Spain; Psychiatric Service, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - M Gili
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - M Roca
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | | | - M Vives
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - A Leiva
- Primary Care Research Unit of Mallorca, Health Services-IbSalut, Instituto de Investigación Sanitaria, Spain
| | - A M Yáñez
- Instituto de Investigación Sanitaria de Palma, IdISPa, Spain
| | - M Bennasar-Veny
- University of Balearic Islands, Spain; Department of Nursing, School of Nursing and Physiotherapy, University of Balearic Islands, Spain
| | - B Oliván-Blázquez
- Primary Care Prevention and Health Promotion Research Network, Spain; Department of Psychology and Sociology, University of Zaragoza, Spain
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García-Toro M, Vicens C, García-Campayo J, Gili M. Feasibility of an integrated mindfulness and Mediterranean lifestyle program. Actas Esp Psiquiatr 2016; 44:46. [PMID: 26905890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 01/01/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Mauro García-Toro
- Institut Universitari d’Investigació en Ciències de la Salut. Universitat de les Illes Balears. Palma de Mallorca. Illes Balears Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Spain
| | - Caterine Vicens
- Institut Universitari d’Investigació en Ciències de la Salut. Universitat de les Illes Balears. Palma de Mallorca. Illes Balears Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Spain
| | - Javier García-Campayo
- Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Spain Departamento de Psiquiatría, Hospital Miguel Servet, Zaragoza
| | - Margalida Gili
- Institut Universitari d’Investigació en Ciències de la Salut. Universitat de les Illes Balears. Palma de Mallorca. Illes Balears Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Spain
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Roca M, López-Navarro E, Monzón S, Vives M, García-Toro M, García-Campayo J, Harrison J, Gili M. Cognitive impairment in remitted and non-remitted depressive patients: A follow-up comparison between first and recurrent episodes. Eur Neuropsychopharmacol 2015; 25:1991-8. [PMID: 26293584 DOI: 10.1016/j.euroneuro.2015.07.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/08/2015] [Accepted: 07/24/2015] [Indexed: 01/07/2023]
Abstract
Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.
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Affiliation(s)
- Miquel Roca
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain.
| | - Emilio López-Navarro
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Saray Monzón
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Margalida Vives
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Mauro García-Toro
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Javier García-Campayo
- Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain; Department of Psychiatry, Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain
| | - John Harrison
- Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Margalida Gili
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
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