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Pérez-Balaguer A, Sanz-Aranguez-Ávila B, Gil-Benito E, Solari-Heresmann LM, Del Sol-Calderón P, Gayubo-Moreo L, de Arce-Cordón R. Does the COVID-19 pandemic condition the delusional content of patients with psychosis? An observational study. Rev Colomb Psiquiatr (Engl Ed) 2023; 52:297-304. [PMID: 38036382 DOI: 10.1016/j.rcpeng.2021.07.007] [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] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/05/2021] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The primary objective is to analyse the impact of the COVID-19 pandemic on the triggers of psychopathology and on the delusional content of patients with psychotic symptoms treated during the first three months of the pandemic in a tertiary hospital in Madrid. METHODS We conducted a cross-sectional, observational and retrospective study of all patients attending the psychiatric emergency room (ER) between 11th March and 11th June 2020. Sociodemographic and clinical variables were included. The chi-squared test or Fisher's exact test were performed to compare categorical variables. The level of statistical significance was set at P<.05. RESULTS In the first month of the pandemic, COVID-19 conditioned the delirious content of 38.5% of the admitted patients and acted as a direct trigger for 46.2% of consultations. In the second week it affected 100.0% of the patients in both cases. Subsequently, a progressive and significant decrease was observed, with COVID-19 being the triggering factor for 17.6% and 11.5% of consultations in the second and third months of the pandemic respectively. Similarly, it was the main determinant of the delusional content in 13.7% and 3.8% of cases respectively. CONCLUSIONS The current pandemic affects delirium's pathoplasty. The delusional content of patients admitted with psychotic symptoms is quickly conditioned, which may be related to the radical change in their life, without transition or prior preparation. The patient's environmental context and events have a huge impact on the dynamics and characteristics of mental disorders.
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Affiliation(s)
- Ana Pérez-Balaguer
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain.
| | | | - Elena Gil-Benito
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | | | - Pablo Del Sol-Calderón
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | - Lydia Gayubo-Moreo
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | - Rosario de Arce-Cordón
- Departamento de Psiquiatría, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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Alarcón Ariza DF, Zambrano Jerez LC, Ramírez Rivero CE, Niño García JA, Ruiz Quecan AC, Domínguez Alvarado GA. Burns in the context of a shared psychotic disorder in a Colombian referral centre: A case report. Revista Colombiana de Psiquiatría (English ed ) 2023; 52:156-160. [PMID: 37460342 DOI: 10.1016/j.rcpeng.2021.04.004] [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] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/05/2021] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder. CASE We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia. CONCLUSIONS The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
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Affiliation(s)
- Diego Fernando Alarcón Ariza
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia.
| | - Laura Cristina Zambrano Jerez
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Carlos Enrique Ramírez Rivero
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Jorge Andrés Niño García
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | - Adriana Catalina Ruiz Quecan
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
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Lorente-Rovira E, Grasa E, Ochoa S, Corripio I, Peláez T, López-Carrilero R, Gutiérrez-Gea Á, Morano-Guillén M, Villagrán JM, Bartels-Velthuis AA, Jenner JA, Sanjuán J. Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI). Revista de Psiquiatría y Salud Mental (English Edition) 2022; 15:259-271. [PMID: 36513402 DOI: 10.1016/j.rpsmen.2020.03.002] [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: 03/06/2019] [Accepted: 03/11/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI). MATERIALS AND METHODS A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire. RESULTS The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test-retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test-retest reliability. CONCLUSIONS The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.
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Affiliation(s)
- Esther Lorente-Rovira
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Eva Grasa
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Trinidad Peláez
- CIBERSAM, Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | | | | | - José M Villagrán
- Hospital Jerez de la Frontera, Servicio Andaluz de Salud, Cádiz, Spain
| | - Agna A Bartels-Velthuis
- University of Groningen, the Netherlands; University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Jack A Jenner
- Jenner Consult, Haren, the Netherlands Groningen, the Netherlands
| | - Julio Sanjuán
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain; Faculty of Medicine, Valencia, Spain
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Brañas A, Lahera G, Barrigón ML, Canal-Rivero M, Ruiz-Veguilla M. Effects of childhood trauma on facial recognition of fear in psychosis. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:29-37. [PMID: 35144915 DOI: 10.1016/j.rpsmen.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/09/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Childhood trauma has been reported as a risk factor for psychosis. Different types of traumatic experiences in childhood could lead to different clinical manifestations in psychotic disorders. METHODS We studied differences in social cognition (emotion recognition and theory of mind) and clinical symptoms in a sample of 62 patients with psychosis (less than five years of illness) and childhood trauma, analysing performance by trauma type. RESULTS Psychotic patients with a history of childhood trauma other than sexual abuse were more capable of recognizing fear as a facial emotion (especially when facial stimuli were non-degraded) than participants with a history of sexual abuse or with no history of childhood trauma (P = .008). We also found that the group that had suffered sexual abuse did not show improvement in fear recognition when exposed to clearer stimuli, although this intergroup difference did not reach statistical significance (P = .064). We have not found other differences between abuse groups, neither in clinical symptoms (PANSS factors) nor in Hinting Task scores. CONCLUSION We have found differences in fear recognition among patients with psychotic disorders who have experienced different types of childhood trauma.
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Alarcón Ariza DF, Zambrano Jerez LC, Ramírez Rivero CE, Niño García JA, Ruiz Quecan AC, Domínguez Alvarado GA. Burns in the Context of a Shared Psychotic Disorder in a Colombian Referral Centre: a Case Report. Rev Colomb Psiquiatr (Engl Ed) 2021; 52:S0034-7450(21)00076-7. [PMID: 34083077 DOI: 10.1016/j.rcp.2021.04.003] [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: 08/27/2020] [Revised: 12/22/2020] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder. CASE We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia. CONCLUSIONS The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
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Affiliation(s)
- Diego Fernando Alarcón Ariza
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia.
| | - Laura Cristina Zambrano Jerez
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Carlos Enrique Ramírez Rivero
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Jorge Andrés Niño García
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | - Adriana Catalina Ruiz Quecan
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
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Valle R. Review of Early Intervention Programmes in Psychosis: Implementation Proposal for Peru. Rev Colomb Psiquiatr (Engl Ed) 2020; 49:178-186. [PMID: 32888661 DOI: 10.1016/j.rcp.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/14/2018] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
Abstract
A delay in receiving an antipsychotic treatment is associated with unfavourable clinical and functional outcomes in patients with a first episode of psychosis. In recent years, early psychosis intervention programmes have been implemented that seek the early detection and treatment of patients who begin to describe psychotic symptoms. These programmes have shown to be more effective than standard care in improving the symptoms of the disorder and recovering the patient's functionality, in turn proving to be more cost-effective. The benefits of these programmes have led to their implementation in high-income countries. However, implementation in medium- and low-income countries has been slower. Peru, a Latin American country with an upper middle income, is undergoing a mental health reform that prioritises health care based on the prevention, treatment and psychosocial recovery of patients from a comprehensive and community approach. The present manuscript describes the characteristics and structure of the pioneering and more developed programmes for early psychosis intervention, and discusses the benefits and challenges of implementing an early psychosis intervention programme in Peru in the current context of mental health reform.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú; Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Perú.
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Lorente-Rovira E, Grasa E, Ochoa S, Corripio I, Peláez T, López-Carrilero R, Gutiérrez-Gea Á, Morano-Guillén M, Villagrán JM, Bartels-Velthuis AA, Jenner JA, Sanjuán J. Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI). Rev Psiquiatr Salud Ment (Engl Ed) 2020; 15:S1888-9891(20)30027-6. [PMID: 32493672 DOI: 10.1016/j.rpsm.2020.03.002] [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: 03/06/2019] [Revised: 11/08/2019] [Accepted: 03/11/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI). MATERIALS AND METHODS A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire. RESULTS The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test-retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test-retest reliability. CONCLUSIONS The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.
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Affiliation(s)
- Esther Lorente-Rovira
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Eva Grasa
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Trinidad Peláez
- CIBERSAM, Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | | | | | - José M Villagrán
- Hospital Jerez de la Frontera, Servicio Andaluz de Salud, Cádiz, Spain
| | - Agna A Bartels-Velthuis
- University of Groningen, the Netherlands; University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Jack A Jenner
- Jenner Consult, Haren, the Netherlands Groningen, the Netherlands
| | - Julio Sanjuán
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain; Faculty of Medicine, Valencia, Spain
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Brañas A, Lahera G, Barrigón ML, Canal-Rivero M, Ruiz-Veguilla M. Effects of childhood trauma on facial recognition of fear in psychosis. Rev Psiquiatr Salud Ment (Engl Ed) 2019; 15:S1888-9891(19)30022-9. [PMID: 30872020 DOI: 10.1016/j.rpsm.2019.01.005] [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] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/14/2018] [Accepted: 01/09/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Childhood trauma has been reported as a risk factor for psychosis. Different types of traumatic experiences in childhood could lead to different clinical manifestations in psychotic disorders. MATERIAL AND METHODS We studied differences in social cognition (emotion recognition and theory of mind) and clinical symptoms in a sample of 62 patients with psychosis (less than 5 years of illness) and childhood trauma, analysing performance by trauma type. RESULTS Psychotic patients with a history of childhood trauma other than sexual abuse were more capable of recognizing fear as a facial emotion (especially when facial stimuli were non-degraded) than participants with a history of sexual abuse or with no history of childhood trauma (P=.008). We also found that the group that had suffered sexual abuse did not show improvement in fear recognition when exposed to clearer stimuli, although this intergroup difference did not reach statistical significance (P=.064). We have not found other differences between abuse groups, neither in clinical symptoms (PANSS factors) nor in Hinting Task scores. CONCLUSION We have found differences in fear recognition among patients with psychotic disorders who have experienced different types of childhood trauma.
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Affiliation(s)
- Antía Brañas
- Departamento de Psiquiatría, Complexo Hospitalario Universitario de Ourense, Ourense, España; Facultad de Medicina, Universidad de Alcalá, Madrid, España
| | - Guillermo Lahera
- Facultad de Medicina, Universidad de Alcalá, Madrid, España; CIBERSAM, Madrid, España
| | - María Luisa Barrigón
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, Madrid, España; Universidad Autónoma, Madrid, España
| | - Manuel Canal-Rivero
- Departamento de Psiquiatría, Hospital Universitario Germans Trías i Pujol, Badalona, Barcelona, España
| | - Miguel Ruiz-Veguilla
- Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Unidad de Hospitalización de Salud Mental, Sevilla, España.
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Tamayo-Agudelo W, Jaén-Moreno MJ, Luque-Luque R. [Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample]. ACTA ACUST UNITED AC 2015; 44:213-9. [PMID: 26578472 DOI: 10.1016/j.rcp.2015.05.015] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/30/2015] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. OBJECTIVES To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). METHODS This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. RESULTS A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analysis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, suggesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ(2)). However, some incremental goodness-of-fit indexes (normalized χ(2) [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. CONCLUSIONS The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.
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Affiliation(s)
| | - María José Jaén-Moreno
- Cátedra de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad de Córdoba, España
| | - Rogelio Luque-Luque
- Cátedra de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad de Córdoba, España
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Zuñiga Zambrano YC, Vásquez R. [Psychiatric Disorders in Pediatric Patients With Systemic Lupus Erythematosus in a Reference Hospital]. ACTA ACUST UNITED AC 2014; 43:73-9. [PMID: 26574961 DOI: 10.1016/j.rcp.2014.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/04/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To describe the psychiatric manifestations in pediatric patients with systemic erythematous lupus seen in the Fundación Hospital de la Misericordia. METHODS Observational descriptive study. Medical charts and test results of inpatients and outpatients between 2007 and2013 were reviewed; 39 patients were selected. SPSS 19 was used for statistical analysis. Statistical significance was considered with P=.05. RESULTS Mean age was 13.7 (2.33), with 78.9% female. The most frequent psychiatric manifestation was anxiety (52.6%), followed by adjustment disorder and depression (36.8% each one), psychosis (10%), conversion disorder (7.9%), and obsessive compulsive disorder (5.3%). The mean SLICC score was 2.76 (2.8), and the mean SLEDAI score was 20.81 (20.82). Antinuclear antibodies were positive in 81.25%. Neuropsychiatric lupus was diagnosed in 65.8% of patients; seizures were observed in 23.7%, headache in 36.8%, stroke in 13.2%, vasculitis, chorea 5.3%, and meningitis 5.3% of patients. The mean time from lupus diagnosis was 20.47 (22.2) months, with the shortest period for adjustment disorder and the longest period in patients with conversion disorder (pseudo-seizures) being 15 months and 31 months, respectively. The highest SLEDAI score was in patients with psychosis (35.5 [16.21] vs 19.08 [13.72]; P=.032), and also the highest disease damage (SLICC, 4.25 [4.03] vs 2.58 [2.67]; P=.27) in comparison with the other manifestations. CONCLUSIONS The most frequent psychiatric manifestations were anxiety, depression, and adjustment disorder, with a higher frequency than other studies, and with lupus activity principally in patients with psychosis.
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Affiliation(s)
| | - Rafael Vásquez
- Psiquiatra infantil y de adolescentes, docente, Universidad Nacional de Colombia, Bogotá, Colombia
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11
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Gerardo TR, Ricardo SP, Luis EJ. [Analysis of the Structure of Acute Psychotic Disorder]. Rev Colomb Psiquiatr 2012; 41:48-60. [PMID: 26573469 DOI: 10.1016/s0034-7450(14)60068-8] [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: 03/20/2011] [Accepted: 12/12/2011] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Schizophrenia is a clinically heterogeneous disorder. A multifactorial structure of this syndrome has been described in previous reports. The aim of this study was to evaluate what are the possible diagnostic categories in patients having acute psychotic symptoms, studying their clinical characteristics in a cross-sectional study. METHODS An instrument for measuring psychotic symptoms was created using previous scales (SANS, SAPS, BPRS, EMUN, Zung depression scale). Using as criteria statistical indexes and redundance of items, the initial instrument having 101 items has been reduced to 57 items. 232 patients with acute psychotic symptoms, in most cases schizophrenia, attending Clínica Nuestra Señora de la Paz in Bogotá and Hospital San Juan de Dios in Chía have been evaluated from April, 2008 to December, 2009. Multivariate statistical methods have been used for analyzing data. RESULTS A six-factor structure has been found (Deficit, paranoid-aggressive, disorganized, depressive, bizarre delusions, hallucinations). Cluster analysis showed eight subtypes that can be described as: 1) bizarre delusions-hallucinations; 2) deterioration and disorganized behavior; 3) deterioration; 4) deterioration and paranoid-aggressive behavior; 5) bizarre delusions; 6) paranoia-anxiety- aggressiveness; 7) depressive symptoms and bizarre delusions; 8) paranoia and aggressiveness with depressive symptoms CONCLUSION These subtypes allow a more exhaustive characterization that those included in standard classification schemes and should be validated in longitudinal studies.
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Affiliation(s)
- Téllez R Gerardo
- Psiquiatra. Clínica Nuestra Señora de la Paz. Docente adjunto del Departamento de Psiquiatría, de la Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Sánchez P Ricardo
- Psiquiatra. MSc en Epidemiología Clínica. Especialista en Estadística. Profesor titular del Departamento de Psiquiatría de la Universidad Nacional de Colombia, Bogotá, Colombia
| | - Eduardo Jaramillo Luis
- Psiquiatra. MSc en Farmacología, profesor asociado del Departamento de Psiquiatría, de la Universidad Nacional de Colombia, Bogotá, Colombia
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