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Picornell-Gallar D, González-Fraile E. Burnout Syndrome Among Catholic Clergy: A Systematic Review. J Relig Health 2024; 63:1830-1848. [PMID: 37682353 DOI: 10.1007/s10943-023-01883-8] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes evidence related to burnout in Catholic clergy and potential modulating variables. Following the PRISMA methodology, systematic searches in different scientific databases identified 17 studies, revealing that burnout is related to age, personality traits, and type of priesthood. No relation between burnout and social support, self-care, spiritual practice, or workload was detected. It is necessary to adapt conceptual models to the peculiarities of burnout among clergy, extending assessment strategies and introducing working and organizational perspectives in the analysis of modulating variables, and in the development of prevention and intervention programs.
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Affiliation(s)
- Damián Picornell-Gallar
- Department of Health, Faculty of Health Sciences, International University of La Rioja, UNIR, C/ Gran Vía Rey Juan Carlos I, 41., 26002, Logroño, La Rioja, Spain.
| | - Eduardo González-Fraile
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, Logroño, Spain
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Morales-Pillado C, Fernández-Castilla B, Sánchez-Gutiérrez T, González-Fraile E, Barbeito S, Calvo A. Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis. Psychol Med 2023; 53:6304-6315. [PMID: 36472150 PMCID: PMC10520607 DOI: 10.1017/s0033291722003610] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/26/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Technology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis. METHODS Randomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis. RESULTS Fifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09-0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46-2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology. CONCLUSIONS TBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.
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Affiliation(s)
- Carla Morales-Pillado
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
- Faculty of Health Science, Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Belén Fernández-Castilla
- Department of Methodology of Behavioral and Health Sciences, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | | | | | - Sara Barbeito
- Faculty of Health Science, Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Ana Calvo
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
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Ballesteros J, Moreno-Calvete MC, Santos-Zorrozúa B, González-Fraile E. Cognitive behavioural therapy plus standard care versus standard care for persistent aggressive behaviour or agitation in people with schizophrenia. Cochrane Database Syst Rev 2023; 7:CD013511. [PMID: 37490701 PMCID: PMC10368081 DOI: 10.1002/14651858.cd013511.pub2] [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] [Indexed: 07/27/2023]
Abstract
BACKGROUND Schizophrenia and other psychoses are thought to be associated with a substantial increase in aggressive behaviour, violence and violent offending. However, acts of aggression or violence committed by people with severe mental illness are rare and circumscribed to a small minority of individuals. We know little about the frequency and variability of violent episodes for people with schizophrenia who present chronic or recurrent aggressive episodes, and of available interventions to reduce such problems. A psychological intervention, cognitive behavioural therapy (CBT), aims to challenge dysfunctional thoughts and has been used since the mid-1970s to improve mental health and emotional disorders. CBT includes different interventional procedures, such as cognitive therapy, elements of behavioural therapy, problem-solving interventions, and coping skills training, among others. Although CBT presents much diversity, interventions are characteristically problem-focused, goal-directed, future-oriented, time-limited (about 12 to 20 sessions over four to six months), and empirically based. CBT has shown clinically beneficial effects in persistent positive and negative symptoms of schizophrenia and its use as an add-on therapy to medication in the treatment of schizophrenia is supported by treatment guidelines. However, several Cochrane Reviews recently concluded that, due to the low quality of evidence available, no firm conclusions can currently be made regarding the effectiveness of adding CBT to standard care for people with schizophrenia, or about CBT compared to other psychosocial treatments for people with schizophrenia. Whereas CBT is not an emergency or crisis intervention that acts immediately on the known or unknown triggers underlying aggressive behaviour, might be a timely treatment used to manage persistent aggression or repeated aggressive episodes in people with schizophrenia. OBJECTIVES To assess the efficacy and safety of cognitive behavioural therapy (CBT) plus standard care versus standard care alone for people with schizophrenia and persistent aggression. SEARCH METHODS On 18 January 2023, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials which is based on CENTRAL, CINAHL, ClinicalTrials.Gov, Embase, ISRCTN, MEDLINE, PsycINFO, PubMed, and WHO ICTRP. We also inspected references of all identified studies for more studies. SELECTION CRITERIA All randomised controlled trials comparing CBT plus standard care with standard care alone for people with schizophrenia and persistent aggression. DATA COLLECTION AND ANALYSIS We independently inspected citations, selected studies, extracted data and appraised study quality. For binary outcomes, we calculated risk ratios (RR) and their 95% confidence intervals (CIs). For continuous outcomes we calculated mean differences (MD) and their 95%CIs for outcomes reported with the same measurement scale. Post hoc, for counts over person-time outcomes, we calculated incidence rate ratios (IRRs) and their 95%CIs. If feasible, we combined study outcomes with the random-effects model. We assessed the risk of bias for included studies and created a summary of findings table using the GRADE approach. MAIN RESULTS We included two studies with 184 participants with psychotic disorder (mainly schizophrenia) and violence. The studies were run in forensic units and prison. Both studies were at high risk of bias on blinding (performance and detection bias). CBT plus standard care as compared with standard care may result in little to no difference in the frequency of physical violence at end of trial (IRR 0.52; 95% CI 0.23 to 1.18) and follow-up (IRR 0.86; 95% CI 0.44 to 1.68). The confidence interval did not exclude the null effect, and the certainty of the evidence is very low due to lack of blinding and to the small sample size. One study reported no deaths in both arms and zero serious and other adverse events. The other study did not report any figure for deaths or adverse events. CBT plus standard care as compared with standard care may result in little to no difference in leaving the study early for any reason (RR 1.04; 95% CI 0.53 to 2.00). Confidence interval did not exclude the null effect and the certainty of the evidence is low due to lack of blinding and the small sample size. AUTHORS' CONCLUSIONS Whereas the evidence from only two studies with 184 participants suggests the use of CBT plus standard care may reduce some aggressive behaviours in patients with schizophrenia, the grading of the certainty of the evidence is very low. It implies that there is not yet reliable evidence to guide clinical decisions and therefore more evidence is needed to get a more precise estimate of the effect of the intervention. Currently, we have very little confidence in the effect estimate, and the true effect could be substantially different from its estimate.
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Affiliation(s)
- Javier Ballesteros
- Department of Neuroscience, University of the Basque Country, CIBER Salud Mental (CIBERSAM), Leioa, Spain
| | - Maria Concepcion Moreno-Calvete
- Department of Mental Health, Biocruces Bizkaia Health Research Institute, Bizkaia Mental Health Network, Basque Health Service, Bilbao, Spain
| | - Borja Santos-Zorrozúa
- Scientific coordination Unit, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Eduardo González-Fraile
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de la Rioja, Logroño, Spain
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Fernández-Modamio M, Gil-Sanz D, Arrieta-Rodríguez M, Santacoloma-Cabero I, Bengochea-Seco R, González-Fraile E, Muñiz J. A randomized study on the efficacy of the Social Cognition Training Program-brief version in a sample of patients with schizophrenia. Psychiatr Rehabil J 2021; 44:1-10. [PMID: 32250132 DOI: 10.1037/prj0000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In recent years, various interventions have been developed to train social cognition in schizophrenia, which have been shown to be effective in improving emotional processing, theory of mind and social perception, as well as community functioning. One of these interventions is the Social Cognition Training Program (SCTP), a program consisting of 24 sessions. For the present study we developed a brief version of 12 sessions with the aim to improve its applicability. To evaluate the effectiveness of this version, a randomized controlled trial was conducted comparing the SCTP to a neurocognitive training. METHOD The trial was conducted with a sample of 299 patients with schizophrenia, with assessments conducted at baseline, posttreatment, and 6- and 12-month follow up. The assessment protocol included tests of emotion recognition, theory of mind, attributional style, symptomatology, community functioning, and neurocognitive functioning. RESULTS The results obtained showed that the patients of the experimental group improved in the recognition of the emotions of sadness, anger, and fear, and in the first- and second-order theory of mind. However, no significant improvement was observed in the measures of community functioning. Improvements in first- and second-order theory of mind but not emotion recognition persisted at follow ups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Results obtained showed that deficits in social cognition can be ameliorated, although it could be necessary to have booster sessions to maintain the benefits of the training and to complement the SCPT with another type of interventions aimed specifically at transferring the benefits of social cognition training to "real" life. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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González-Fraile E, Ballesteros J, Rueda JR, Santos-Zorrozúa B, Solà I, McCleery J. Remotely delivered information, training and support for informal caregivers of people with dementia. Cochrane Database Syst Rev 2021; 1:CD006440. [PMID: 33417236 PMCID: PMC8094510 DOI: 10.1002/14651858.cd006440.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Indexed: 12/26/2022]
Abstract
BACKGROUND Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions. OBJECTIVES To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia. SEARCH METHODS We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials. SELECTION CRITERIA We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia. DATA COLLECTION AND ANALYSIS Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates. MAIN RESULTS We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20). AUTHORS' CONCLUSIONS Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.
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Affiliation(s)
| | - Javier Ballesteros
- Department of Neuroscience, University of the Basque Country, CIBER Salud Mental (CIBERSAM), Leioa, Spain
| | - José-Ramón Rueda
- Department of Preventive Medicine and Public Health, University of the Basque Country, Leioa, Spain
| | - Borja Santos-Zorrozúa
- Scientific coordination Unit, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Recio-Barbero M, Segarra R, Zabala A, González-Fraile E, González-Pinto A, Ballesteros J. Cognitive Enhancers in Schizophrenia: A Systematic Review and Meta-Analysis of Alpha-7 Nicotinic Acetylcholine Receptor Agonists for Cognitive Deficits and Negative Symptoms. Front Psychiatry 2021; 12:631589. [PMID: 33889097 PMCID: PMC8055861 DOI: 10.3389/fpsyt.2021.631589] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Schizophrenia is a severe and enduring disease and is one of the leading causes of disability worldwide. Cognitive impairment is a core clinical symptom that plays a crucial role in functional outcomes and prognosis, thus making it a relevant treatment target. The aim of this study was to assess the efficacy of alpha-7 nicotinic acetylcholine receptor agonists (α7 nAChR) as adjunctive treatment to enhance cognition and ameliorate negative symptoms in patients with schizophrenia. Methods: A search strategy was developed for MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials up to May 2019. We included randomized controlled trials (RCTs) that compared antipsychotic treatment plus α7 nAChR agonists with antipsychotic treatment plus placebo and determined their effects on the main cognitive domains proposed by the MATRICS initiative and on negative symptoms. Two authors independently reviewed study eligibility and data extraction and assessed the risk of bias of the studies included. According to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, we used a random-effects model and assessed the quality of the evidence. Results: Thirteen studies were included in the quantitative analysis. No differences were found in any of the cognitive domains assessed in four RCTs (n = 414). In contrast, nine RCTs (n = 978) presented a small effect in support of α7 nAChR agonists for negative symptoms [standardized mean difference -0.28, 95% CI (-0.56 to -0.00); P = 0.05], even though the confidence to support this evidence is low according to the GRADE system. Conclusions: Current evidence is too weak to consider α7 nAChR agonists as an effective add-on treatment to antipsychotics to enhance cognition and negative symptoms.
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Affiliation(s)
| | - Rafael Segarra
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Psychiatry, Cruces University Hospital, Barakaldo, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Arantzazu Zabala
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | | | - Ana González-Pinto
- Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Araba University Hospital, Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
| | - Javier Ballesteros
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Fernández-Modamio M, Gil-Sanz D, Arrieta-Rodríguez M, Gómez de Tojeiro-Roce J, Bengochea-Seco R, González-Fraile E. Emotion recognition in patients with schizophrenia: The role of sex. Psicothema 2020; 32:197-203. [PMID: 32249745 DOI: 10.7334/psicothema2019.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Despite the abundant research on emotion recognition in schizophrenia, there are still some issues about which there is no conclusive data. The present study examined one these issues: the role that sex plays in emotion recognition. METHOD The sample consisted of 440 participants, 220 patients with schizophrenia and 220 controls. Measures of the six basic emotions, psychopathology, and cognitive functioning were taken. The data were analyzed by repeated measures analysis of variance. RESULTS Controls perceived all emotions, except happiness, better than patients. In the patient group three main results were obtained: 1) men recognized disgust and neutral expressions better than women; 2) happiness and sadness were better recognized on female faces, while disgust and neutral expressions were better recognized on male faces; and 3) a significant interaction was seen between the stimulus sex and the participant sex only for the fear emotion. CONCLUSIONS The results obtained support the hypothesis that deficits in the recognition of emotions is a core feature of schizophrenia that affects both men and women to the same extent. There is no clear pattern of interaction between the sex of the perceiver and the sex of the photograph used as a stimulus.
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Fernández-Modamio M, Gil-Sanz D, Arrieta-Rodríguez M, Santacoloma-Cabero I, Bengochea-Seco R, González-Fraile E, Muñiz J. Neurocognition functioning as a prerequisite to intact social cognition in schizophrenia. Cogn Neuropsychiatry 2020; 25:14-27. [PMID: 31621495 DOI: 10.1080/13546805.2019.1680355] [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] [Indexed: 12/19/2022]
Abstract
Introduction: There are mixed findings regarding the relationships between neurocognition and social cognition in schizophrenia. This study aims to provide new empirical evidence to help determine the relationships between these constructs in schizophrenia.Methods: 299 stabilised patients with schizophrenia aged 18-65 years old were recruited. After having into account exclusion criteria, final sample was contained 284 patients. The Emotion Recognition Assessment Test (ERAT) was used to assess six basic emotions. To assess the theory of mind (ToM), the Hinting Task and the Faux-Pas Test were used, and the Screen for Cognitive Impairment in Psychiatry (SCIP) was administered to assess cognitive functioning. Bivariate and multivariate analyses (partial correlations, canonical correlation, regression analysis, and confirmatory and exploratory factor analysis) were conducted.Results: Statistically significant relationships were found between the subtests of the SCIP and social cognitive measures. The redundancy coefficient in the canonical analysis was 0.13. The CFA analysis showed that the best model has a two-factor structure, in which neurocognition and social cognition are correlated factors. Less than 10% of patients with impaired cognitive functioning have a performance within normal range on social cognition tests.Conclusions: The findings show that neurocognition and social cognition are independent but related constructs.
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Affiliation(s)
| | - David Gil-Sanz
- Centro Hospitalario Padre Menni, Santander, Spain.,Universidad Europea del Atlántico, Santander, Spain
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- Centro Hospitalario Padre Menni, Santander, Spain
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González-Fraile E, Domínguez-Panchón AI, Berzosa P, Costas-González AB, Garrido-Jimenez I, Rufino-Ventura D, López-Aparicio JI, Martín-Carrasco M. Efficacy of a psychoeducational intervention in caregivers of people with intellectual disabilities: A randomized controlled trial (EDUCA-IV trial). Res Dev Disabil 2019; 94:103458. [PMID: 31525613 DOI: 10.1016/j.ridd.2019.103458] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) are usually cared for by their own parents, families or informal caregivers. Caring for a person with ID can have a negative impact on caregivers' mental health (burden, depression, anxiety). The main aim of the EDUCA-IV trial was testing the efficacy of a psychoeducational intervention program (PIP) versus standard practice and to see whether the PIP intervention would reduce the caregiver's burden at post-intervention (4 months) and at follow-up (8 months). METHOD This was a multi-centre randomised controlled trial including 194 caregivers (96 randomised to PIP, 98 to control condition). PIP intervention consists of 12 weekly group sessions. The control group received treatment as usual. Primary outcomes measured included the Zarit Burden Interview (ZBI). Secondary outcomes were caregivers' mental health (GHQ-28), anxiety (STAI) and depression (CES-D). RESULTS The decrease of ZBI scores was not significant at 4 months. There was significant decrease in the GHQ scores at 4 and 8 months. CES-D showed relevant results at follow-up. Intention to treat analyses showed similar results. CONCLUSIONS The PIP intervention seems not to be effective reducing burden, but appears to have a positive result on general mental health. The program was well received and valued by caregivers.
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Affiliation(s)
| | - Ana I Domínguez-Panchón
- Aita-Menni Hospital, Arrasate-Mondragón, Spain; Fundación de Investigación Mª Angustias Giménez (FIDMAG), Barcelona, Spain
| | - Pilar Berzosa
- International University of La Rioja, Logroño, Spain
| | | | | | | | | | - Manuel Martín-Carrasco
- Fundación de Investigación Mª Angustias Giménez (FIDMAG), Barcelona, Spain; Padre Menni Psychiatric Centre (Sisters Hospitallers), Pamplona, Spain; CIBERSAM G10, Vitoria-Gazteiz, Spain
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Mimentza N, González-Fraile E, Arango-Lasprilla JC, Ortiz-Marqués N, Berrios GE, González-Pinto A, Quemada JI. Assessing irritability in patients with stroke: psychometric properties of the Irritability Questionnaire. Brain Inj 2019; 34:115-121. [PMID: 31645136 DOI: 10.1080/02699052.2019.1681513] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Irritability is a very common symptom after stroke and a source of a great deal of distress to patients and caretakers. We evaluated the psychometric properties of the Irritability Questionnaire (IQ) in a sample of patients with stroke.Methods: we recruited 94 participants (47 stroke patients and 47 healthy controls) that participated in a 6-month longitudinal observational study. The IQ includes three dimensions in the assessment: emotion, cognition, and behavior. IQ has two subscales: The Irritability Questionnaire (IRQ) and the Carer's Irritability Questionnaire (CIRQ). Internal consistency, convergent validity, and sensitivity to change were evaluated for both IRQ and CIRQ.Results: Cronbach's alpha for the IRQ was 0.91 (95% CI: 0.76 to 0.87), whereas for the CIRQ was 0.92 (95% CI: 0.89 to 0.94). Convergent validity was good for both subscales. IRQ did not show sensitivity to change at 6 months (p-value = 0.99), while CIRQ showed moderate changes (-0.29, p-value = 0.124).Conclusions: IQ presented good psychometric properties to assess irritability in stroke. The tool detected significant differences between groups (stroke and healthy controls) and can be considered a valid instrument for clinical and research purposes.
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Affiliation(s)
- Naiara Mimentza
- Aita Menni Hospital, Unit of Acquired Brain Injury, Mondragón-Arrasate, Spain
| | | | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, Leioa, Spain
| | | | - German E Berrios
- Department of Psychiatry, Department of Psychiatry, University of Cambridge, UK
| | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Vitoria Spain.,University of the Basque Country (EHU/UPV), Leioa, Spain
| | - Jose I Quemada
- Aita Menni Hospital, Unit of Acquired Brain Injury, Mondragón-Arrasate, Spain
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Alberich S, Fernández-Sevillano J, González-Ortega I, Usall J, Sáenz M, González-Fraile E, González-Pinto A. A systematic review of sex-based differences in effectiveness and adverse effects of clozapine. Psychiatry Res 2019; 280:112506. [PMID: 31401291 DOI: 10.1016/j.psychres.2019.112506] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 08/08/2018] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022]
Abstract
Clozapine is one of the most widely used antipsychotics for treating psychiatric illnesses such as schizophrenia and bipolar disorder. This drug, however, is associated with adverse effects such as weight gain, metabolic syndrome, and blood dyscrasias. The manifestations of mental illness may differ between men and women. Yet, there is little evidence on the influence of sex on treatment response or the occurrence of AEs. To fill this gap of knowledge, we carried out a systematic review of the literature on sex differences in the effectiveness and adverse effects of clozapine. Scant evidence has been published on differences in effectiveness of clozapine between men and women. Indeed, to the best of our knowledge, this issue has only been addressed in a published study. Regarding adverse effects, males have been reported to be more likely to develop metabolic abnormalities such as cholesterol or triglycerides, hypertension, and cardiovascular risk, while females are at a higher risk for gaining weight, developing diabetes, and needing laxatives. Nevertheless, given the scarcity of sex-based studies on this drug, further studies are needed to explore sex-based differences, as the results obtained may be crucial to clinical practice and help improve the quality of life of patients.
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Affiliation(s)
- Susana Alberich
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; National Distance Education University Spain (UNED), Vitoria, Spain.
| | - Jessica Fernández-Sevillano
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; University of the Basque Country (EHU/UPV), Spain
| | - Itxaso González-Ortega
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; National Distance Education University Spain (UNED), Vitoria, Spain
| | - Judith Usall
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), University of Barcelona, Research Unit Parc Sanitari Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Marga Sáenz
- University of the Basque Country (EHU/UPV), Spain; Hospital Universitario Cruces, Biocruces, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bilbao, España
| | | | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; University of the Basque Country (EHU/UPV), Spain
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Escobedo AA, Almirall P, González-Fraile E, Ballesteros J. Efficacy of 5-nitroimidazole compounds for giardiasis in Cuban children: systematic review and meta-analysis. Infez Med 2019; 27:58-67. [PMID: 30882380] [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] [Indexed: 06/09/2023]
Abstract
Five-nitroimidazole (5-NI) compounds are among the most commonly used medications in the treatment of giardiasis. However, after more than five decades of their initial indication for such treatment, there are some concerns about the efficacy of 5-NIs in giardiasis. This study sought to compare the efficacy of any 5-NI with any other antigiardial drug for the treatment of Cuban children with giardiasis. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched CUMED, EBSCOhost and PubMed databases. Two reviewers independently assessed trial eligibility, trial quality and extracted appropriate data. The primary outcome was the parasitological cure. The effect estimate was the pooled relative risk (RR) with 95% confidence intervals (CI). We included seven RCTs in the systematic review, involving a total of 1046 children. When the effect of 5-NIs was compared with that of benzimidazole compounds, the pooled effect was significant and favored 5-NIs [the relative risk (RR) is 1.35, 95% CI =1.05 to 1.75], with high heterogeneity (4 studies, I2 =79%). Compared with chloroquine, the pooled effects of the 5-NIs were not significant [RR is 0.96, 95% CI=0.79 to 1.18, (2 studies, I2=68%)]. Our results support the use of 5-NIs (mainly tinidazole) as first-line therapy for Cuban pediatric patients infected with Giardia and may continue being used as reference drugs in future RCTs of giardiasis. These data could help inform policy decisions in Cuba. Caution is needed in extrapolating such data in other settings.
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Affiliation(s)
- Angel A Escobedo
- Academic Paediatric Hospital "Pedro Borrás", La Habana, Cuba; Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, United Kingdom
| | - Pedro Almirall
- Municipal Centre of Hygiene, Epidemiology and Microbiology "Plaza", La Habana, Cuba
| | | | - Javier Ballesteros
- University of the Basque Country UPV/EHU and CIBERSAM. Medical School, Department of Neuroscience, Leioa, Spain
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13
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Escobedo AA, Almirall P, González-Fraile E, Ballesteros J. Efficacy of mebendazole in paediatric patients with giardiasis: A systematic review and meta-analysis. Acta Trop 2018; 188:50-57. [PMID: 30092225 DOI: 10.1016/j.actatropica.2018.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/30/2018] [Accepted: 08/03/2018] [Indexed: 12/21/2022]
Abstract
Mebendazole (MBZ), a benzimidazole compound, has received attention in treating patients with giardiasis because it has shown beneficial effects both in vitro and in vivo. The aim of this study was to assess with a systematic review and meta-analysis of randomized controlled trials (RCTs) the efficacy of MBZ compared to other antigiardial agents in children. We searched RCTs of MBZ for the treatment of Giardia infections published in PubMed and EBSCOhost. Application of inclusion and exclusion criteria, data extraction, and assessment of methodological quality were independently performed in duplicate. The primary outcome was the parasitological cure. We included 7 RCTs in the systematic review (639 patients). There was no clinical difference in the parasitological cure between MBZ and metronidazole (MTZ). The relative risk (RR) was 0.81 [95% Confidence Interval 0.61-1.09], with high heterogeneity (4 trials, I2 = 81%). The prediction interval expected to cover the results of a new trial was wide enough (0.22-2.96) to support both a clinically relevant difference favouring either MBZ or MTZ. The decision to support any treatment should be based not only on efficacy but also safety and cost. Although our results suggest that MBZ may be an effective treatment option for children with Giardia infection, they should also be interpreted and translated into clinical practice with caution, as the evidence is based on a limited number of RCTs presenting high heterogeneity.
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Abstract
BACKGROUND Schizophrenia is a severe, persistent mental disorder, and a leading cause of disability worldwide. Cognitive impairments presented in schizophrenia lead to a worse prognostic, thus treatments targeted to enhance cognition in schizophrenia may be clinically relevant. AIMS The purpose of this study was to assess the efficacy of acetylcholinesterase inhibitors as add-on medication to antipsychotics on cognition in patients with schizophrenia. METHODS Search strategies were developed for Medline, Embase and Cochrane Central Register of Controlled Trials, and are current to March 2018. We included randomised controlled trials that compared antipsychotics plus acetylcholinesterase inhibitors versus antipsychotics plus placebo on prespecified cognitive domains (speed of processing, attention and working memory). Two review authors independently evaluated study eligibility, extracted data and assessed the risk of bias of included studies. We used random-effects model for meta-analyses and assessed the quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS We included nine randomised controlled trials. Six randomised controlled trials ( n=219) presented evidence that acetylcholinesterase inhibitors improve speed of processing (standardised mean difference -0.52, 95% confidence interval (-0.79 to -0.25); p value=0.0002). However, eight randomised controlled trials ( n=252) did find placebo was better than acetylcholinesterase inhibitors in the attention domain (-0.43, (-0.72 to -0.13); p value=0.005) and eight randomised controlled trials ( n=273) did not find differences in the working memory (-0.14, (-0.51 to 0.24), p value=0.47). CONCLUSIONS The current evidence is too weak to base recommendations on the use of acetylcholinesterase inhibitors as adjunctive treatments to antipsychotics to improve basic cognitive functions. We have limited confidence in the effect estimates.
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Affiliation(s)
- Borja Santos
- 1 Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country, Leioa, Spain
| | | | - Arantzazu Zabala
- 3 Department of Neuroscience, Psychiatry, University of the Basque Country, Leioa, Spain.,5 CIBERSAM, Madrid, Spain
| | - Virginia Guillén
- 3 Department of Neuroscience, Psychiatry, University of the Basque Country, Leioa, Spain
| | - José R Rueda
- 6 Department of Public Health, University of the Basque Country, Leioa, Spain
| | - Javier Ballesteros
- 3 Department of Neuroscience, Psychiatry, University of the Basque Country, Leioa, Spain.,5 CIBERSAM, Madrid, Spain
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Fernández-Modamio M, Arrieta-Rodríguez M, Bengochea-Seco R, Santacoloma-Cabero I, Gómez de Tojeiro-Roce J, García-Polavieja B, González-Fraile E, Martín-Carrasco M, Griffin K, Gil-Sanz D. Faux-Pas Test: A Proposal of a Standardized Short Version. Clin Schizophr Relat Psychoses 2018:CSRP.FEAR.061518. [PMID: 29944413 DOI: 10.3371/csrp.fear.061518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Previous research on theory of mind suggests that people with schizophrenia have difficulties with complex mentalization tasks that involve the integration of cognition and affective mental states. One of the tools most commonly used to assess theory of mind is the Faux-Pas Test. However, it presents two main methodological problems: 1) the lack of a standard scoring system; 2) the different versions are not comparable due to a lack of information on the stories used. These methodological problems make it difficult to draw conclusions about performance on this test by people with schizophrenia. The aim of this study was to develop a reduced version of the Faux-Pas test with adequate psychometric properties. The test was administered to control and clinical groups. Interrater and test-retest reliability were analyzed for each story in order to select the set of 10 stories included in the final reduced version. The shortened version showed good psychometric properties for controls and patients: test-retest reliability of 0.97 and 0.78, inter-rater reliability of 0.95 and 0.87 and Cronbach's alpha of 0.82 and 0.72.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kim Griffin
- PRESHCO (a consortium of Wellesley and Smith Colleges), Córdoba, Andalucía, Spain
| | - David Gil-Sanz
- Centro Hospitalario Padre Menni - Psychology, Spain, Cantabria
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Gonçalves-Pereira M, González-Fraile E, Santos-Zorrozúa B, Martín-Carrasco M, Fernández-Catalina P, Domínguez-Panchón AI, Muñoz-Hermoso P, Ballesteros J. Assessment of the consequences of caregiving in psychosis: a psychometric comparison of the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). Health Qual Life Outcomes 2017; 15:63. [PMID: 28381222 PMCID: PMC5382493 DOI: 10.1186/s12955-017-0626-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 12/09/2016] [Accepted: 03/13/2017] [Indexed: 01/27/2023] Open
Abstract
Background The Zarit Burden Interview (ZBI) was originally developed to assess the level of subjective burden in caregivers of people with dementia. The Involvement Evaluation Questionnaire (IEQ) is amongst the leading scales to assess caregiving consequences in severe mental illness. We aimed to compare the psychometric properties of the ZBI, a generic tool, and of the IEQ, a more specific tool to assess the consequences of caregiving in schizophrenia and related disorders. Methods Secondary analyses of a 16-week, randomized controlled trial of a psychoeducational intervention in 223 primary caregivers of patients with schizophrenia or schizoaffective disorder. Psychometric properties (internal consistency, convergent and discriminative validity, and sensitivity to change) were evaluated for both ZBI and IEQ. Results Internal consistency was good and similar for both scales (ZBI: 0.91, 95% CI: 0.89, 0.94; IEQ: 0.86, 95% CI: 0.83, 0.89). Convergent validity was relevant for similar domains (e.g. ZBI total score vs IEQ-tension r = 0.69, 95% CI: 0.61, 0.75) and at least moderate for the rest of domains (ZBI total score, personal strain and role strain vs IEQ-urging and supervision). Discriminative validity against psychological distress and depressive symptoms was good (Area Under the Curve [AUC]: 0.77, 95% CI: 0.71, 0.83; and 0.69, 95% CI: 0.63, 0.78 – for ZBI against GHQ-28 and CES-D respectively; and AUC: 0.72, 95% CI: 0.65, 0.78; and 0.69, 95% CI: 0.62, 0.77 – for IEQ against GHQ-28 and CES-D respectively). AUCs against the reference criteria did not differ significantly between the two scales. After the intervention, both scales showed a significant decrease at endpoint (p-values < 0.001) with similar standardised effect sizes for change (-0.36, 95% CI: -0.58, -0.15 – for ZBI; -0.39, 95% CI: -0.60, -0.18 – for IEQ). Conclusions Both ZBI and IEQ have shown satisfactory psychometric properties to assess caregiver burden in this sample. We provided further evidence on the performance of the ZBI as a general measure of subjective burden. Trial registration (ISRCTN32545295).
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Affiliation(s)
- Manuel Gonçalves-Pereira
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.,Clínica Psiquiátrica de S. José (Sisters Hospitallers), Lisboa, Portugal
| | - Eduardo González-Fraile
- Institute of Psychiatric Research (Sisters Hospitallers), Bilbao, Spain. .,Universidad Internacional de La Rioja, Logroño, Spain.
| | | | - Manuel Martín-Carrasco
- Institute of Psychiatric Research (Sisters Hospitallers), Bilbao, Spain.,Padre Menni Psychiatric Clinic (Sisters Hospitallers), Pamplona, Spain.,CIBER Mental Health, Vitoria, Spain
| | | | | | | | - Javier Ballesteros
- University of the Basque Country, UPV/EHU, Leioa, Spain.,CIBER Mental Health, Leioa, Spain
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Martin-Carrasco M, Evans-Lacko S, Dom G, Christodoulou NG, Samochowiec J, González-Fraile E, Bienkowski P, Gómez-Beneyto M, Dos Santos MJH, Wasserman D. EPA guidance on mental health and economic crises in Europe. Eur Arch Psychiatry Clin Neurosci 2016; 266:89-124. [PMID: 26874960 DOI: 10.1007/s00406-016-0681-x] [Citation(s) in RCA: 69] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 01/28/2016] [Indexed: 12/16/2022]
Abstract
This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.
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Affiliation(s)
- M Martin-Carrasco
- Institute of Psychiatric Research, Mª Josefa Recio Foundation (Hospitaller Sisters), Bilbao, Spain. .,Centro de Investigación en Red Salud Mental (CIBERSAM), Madrid, Spain. .,Clinica Padre Menni, Department of Psychiatry, Joaquin Beunza, 45, 31014, Pamplona, Spain.
| | - S Evans-Lacko
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.,PSSRU, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - G Dom
- Collaborative Antwerp Psychiatric Research Institute, Antwerp University, 2610, Wilrijk, Belgium
| | | | - J Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - E González-Fraile
- Institute of Psychiatric Research, Mª Josefa Recio Foundation (Hospitaller Sisters), Bilbao, Spain
| | - P Bienkowski
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - M Gómez-Beneyto
- Centro de Investigación en Red Salud Mental (CIBERSAM), Madrid, Spain.,University of Valencia, Valencia, Spain
| | - M J H Dos Santos
- Portuguese Society of Psychiatry and Mental Health, Beatriz Ângelo Hospital, Lisbon, Portugal
| | - D Wasserman
- National Centre for Suicide Research and Prevention of Mental Health, Karolinska Institute, Stockholm, Sweden
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González-Fraile E, Martín-Carrasco M, Ballesteros J. Efficacy of MLC601 on functional recovery after stroke: A systematic review and meta-analysis of randomized controlled trials. Brain Inj 2016; 30:267-70. [DOI: 10.3109/02699052.2015.1118764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Martín-Carrasco M, Fernández-Catalina P, Domínguez-Panchón AI, Gonçalves-Pereira M, González-Fraile E, Muñoz-Hermoso P, Ballesteros J. A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia. Eur Psychiatry 2016; 33:9-17. [PMID: 26852375 DOI: 10.1016/j.eurpsy.2016.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 08/27/2015] [Revised: 12/23/2015] [Accepted: 01/03/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Patient's relatives usually care for patients with schizophrenia, and as informal caregivers they experience negative consequences. The aim of the EDUCA-III trial is to test the efficacy of a psychoeducational intervention program (PIP) versus standard care to reduce the caregiver burden at post-intervention (4 months), and at follow-up (8 months). METHOD A two-arm, evaluator blind, multicentre, randomized controlled trial. The PIP group had 12 weekly group sessions. The control intervention group had the usual support and standard care. Primary outcomes were change scores since baseline on the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). RESULTS One hundred and nine caregivers were randomized to PIP and 114 to control condition from 23 research sites. The decrease of ZBI scores was significantly higher on the PIP arm at 4 months (mean difference [MD]=-4.33; 95% CI -7.96, -0.71), and at 8 months (MD=-4.46; 95% CI -7.79, -1.13). There were no significant decreases in the IEQ scores (MD at 4 months=-2.80; 95% CI -6.27, 0.67; MD at 8 months=-2.85; 95% CI -6.51, 0.81). CONCLUSIONS The PIP condition seems to reduce caregiver burden. TRIAL REGISTRATION ISRCTN32545295.
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Affiliation(s)
- M Martín-Carrasco
- Institute of Psychiatric Research, Bilbao, Spain; Padre Menni Psychiatric Centre, Pamplona, Spain; CIBER Mental Health, Spain
| | | | | | - M Gonçalves-Pereira
- Clínica Psiquiátrica de S. José (Sisters Hospitallers), Lisboa, Portugal; CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | | | | | - J Ballesteros
- University of the Basque Country, UPV/EHU, Leioa, Spain; CIBER Mental Health, Spain
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González-Fraile E, Solà I, Ballesteros J, Rueda JR, Martinez G, Santos B. Information, support and training for informal caregivers of people with dementia. Cochrane Database of Systematic Reviews 2015. [DOI: 10.1002/14651858.cd006440.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Eduardo González-Fraile
- Hermanas Hospitalarias (Fundación Mª Josefa Recio - Instituto de Investigaciones Psiquiátricas); Department of Mental Health; C/ Egaña 10 Bilbao Spain 48010
| | - Ivan Solà
- CIBER Epidemiología y Salud Pública (CIBERESP) - Universitat Autònoma de Barcelona; Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau); Sant Antoni Maria Claret 171 - Edifici Casa de Convalescència Barcelona Catalunya Spain 08041
| | - Javier Ballesteros
- University of the Basque Country; Department of Neuroscience; Barrio Sarriena S/N PO Box 699 Leioa Spain E-48080
| | - José-Ramón Rueda
- University of the Basque Country; Department of Preventive Medicine and Public Health; Barrio Sarriena S.N. Leioa Bizkaia Spain E-48080
| | - Gabriel Martinez
- Faculty of Medicine and Dentistry, Universidad de Antofagasta, Servicio de Salud Antofagasta, Hospital Regional de Antofagasta; Iberoamerican Cochrane Centre, Barcelona, Spain; Avenida Argentina Nº 2000 Antofagasta Antofagasta Chile 127001
| | - Borja Santos
- University of the Basque Country; Department of Neuroscience; Barrio Sarriena S/N PO Box 699 Leioa Spain E-48080
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Martín-Carrasco M, Ballesteros-Rodríguez J, Domínguez-Panchón AI, Muñoz-Hermoso P, González-Fraile E. Interventions for caregivers of patients with dementia. Actas Esp Psiquiatr 2014; 42:300-314. [PMID: 25388772] [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: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION With the aging of the population, an increasing number of people have dementia, most of whom are receiving home care. Caregivers are exposed to a variety of stressors, which may lead to feeling burdened, or to depression and anxiety. Various programs or structured interventions have been developed to prevent or lessen these negative consequences. The efficacy of these interventions is debated, mainly due to methodological differences between studies. Review studies so far have presented important discrepancies, thus perpetuating a lack of clarity regarding this important geriatric care problem. The effectiveness of interventions designed to prevent or reduce the burden and/or symptoms of anxiety and depression in informal caregivers are reviewed precisely and rigorously. METHODS A systematic review of randomized controlled studies assessing the efficacy of structured interventions on the variables of burden, depression and anxiety in informal caregivers of patients with dementia. RESULTS The literature search yielded 997 references, of which 35 met the screening criteria. Of these studies, 51.4% had results that were statistically favorable to intervention. The methodology used varied widely between studies. CONCLUSIONS Overall, the available evidence favors the implementation of structured intervention programs, although the results are heterogeneous. Psychoeducational interventions yield better results and can be better adapted to the needs of caregivers.
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Affiliation(s)
- Manuel Martín-Carrasco
- Instituto de Investigaciones Psiquiátricas Fundación Mª Josefa Recio, Bilbao. España Clínica Psiquiátrica Padre Menni. Pamplona. España Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), G10
| | - Javier Ballesteros-Rodríguez
- Instituto de Investigaciones Psiquiátricas Fundación Mª Josefa Recio, Bilbao. España Universidad del País Vasco Departamento de Neurociencias de Medicina. Lejona. España Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), G16
| | - Ana I Domínguez-Panchón
- Instituto de Investigaciones Psiquiátricas Fundación Mª Josefa Recio, Bilbao. España Hospital Aita Menni. Arrasate-Mondragón. España
| | - Paula Muñoz-Hermoso
- Instituto de Investigaciones Psiquiátricas Fundación Mª Josefa Recio, Bilbao. España Clínica Psiquiátrica Padre Menni. Pamplona. España
| | - Eduardo González-Fraile
- Instituto de Investigaciones Psiquiátricas Fundación Mª Josefa Recio, Bilbao. España Universidad del País Vasco Departamento de Neurociencias de Medicina. Lejona. España
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González-Fraile E, Domínguez-Panchón AI, Fernández-Catalina P, Gonçalves-Pereira M. [The different versions of the State-Trait Anxiety Inventory]. Rev Psiquiatr Salud Ment 2014; 7:151-2. [PMID: 24704395 DOI: 10.1016/j.rpsm.2014.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/03/2014] [Accepted: 01/09/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Eduardo González-Fraile
- Instituto de Investigaciones Psiquiátricas, Fundación M. Josefa Recio, Bilbao, Vizcaya, España.
| | | | - Paola Fernández-Catalina
- Línea de Rehabilitación Psicosocial, Centro de Día y Equipo de Apoyo Social Comunitario de Puente de Vallecas, Madrid, España
| | - Manuel Gonçalves-Pereira
- Clínica Psiquiátrica de S. José, Irmãs Hospitaleiras, Lisboa, Portugal; Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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Martín-Carrasco M, Domínguez-Panchón AI, Muñoz-Hermoso P, González-Fraile E, Ballesteros-Rodríguez J. [Assessment tools to measure burden in the informal caregiver of patients with dementia]. Rev Esp Geriatr Gerontol 2013; 48:276-84. [PMID: 24161356 DOI: 10.1016/j.regg.2013.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 10/10/2012] [Revised: 06/14/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED The complexity of dementia caregiver burden concept has led to a significant number of assessment tests using various approaches. For this reason, a review of these measurementss could be useful for clinical or research purposes. OBJECTIVE The objective of the study is to perform an updated review on the tools available, classifying them according to the burden criterion by studying their characteristics and psychometric properties, and providing those most relevant for application. METHOD The method applied consisted of a database search -Pubmed, PsycINFO, Embase and Psicodoc (1980-2012). RESULTS A total of 31 assessment tools were selected, grouped on the basis of the burden concept evaluated: objective/subjective burden, burden from a multidimensional approach, and as distress associated with patient impairment. CONCLUSIONS This study provides a suitable tool for using caregiver burden assessment tools accurately. A marked conclusion is the need to establish agreements in the assessment methods, in order to develop standard knowledge and application to healthcare practice.
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Affiliation(s)
- Manuel Martín-Carrasco
- Instituto de Investigaciones Psiquiátricas (IIP), Fundación M. Josefa Recio, CIBERSAM, G10, Bilbao, España.
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Ballesteros J, Santos B, González-Fraile E, Muñoz-Hermoso P, Domínguez-Panchón AI, Martín-Carrasco M. Unidimensional 12-item Zarit Caregiver Burden Interview for the assessment of dementia caregivers' burden obtained by item response theory. Value Health 2012; 15:1141-1147. [PMID: 23244818 DOI: 10.1016/j.jval.2012.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 07/09/2012] [Accepted: 07/12/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To develop a one-dimensional version of the 22-item Zarit Caregiver Burden Interview (ZBI) by applying item response theory approaches. METHODS The answers to the 22-item ZBI of 241 caregivers participating in a clinical trial were analyzed 1) with a Mokken nonparametric item response theory analysis to ascertain the dimensional structure underlying the scale and obtain a one-dimensional reduced version, 2) with the Samejima's graded response model to assess the item characteristics of the reduced version, and 3) with confirmatory factor analysis to confirm the unidimensionality of the reduced ZBI version and assess the item loadings to the burden latent variable. RESULTS Mokken analysis resulted in a major one-dimensional scale comprising 12 items directly related with burden. All items showed scalability indices over 0.30. The scalability for the overall scale was 0.44 defining a medium scale according to Mokken's criteria. An unconstrained Samejima's graded response model showed appropriate fit, and most items of the reduced 12-item ZBI presented pertinent difficulty and discrimination parameters. The results of the 12-item ZBI confirmatory factor analysis fitted to a one-dimensional latent structure for burden (comparative fit index=0.975; root-mean-square error of approximation=0.067; weighted root mean square residual=0.677). All factor lodgings were above 0.40 with items 9 (strained by the relative) and 22 (overall feeling of burden) presenting the highest loadings. CONCLUSIONS The reduced 12-item ZBI fits a one-dimensional latent variable of burden. Further psychometric studies, focusing on its equivalence for different populations, sensitivity to change, and minimal important difference are warranted.
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Affiliation(s)
- Javier Ballesteros
- Department of Neuroscience - Psychiatry, Medical School, University of the Basque Country, UPV/EHU, Leioa, Spain.
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