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Alonso-Solis A.,Biomedical Research Institute Sant Pau | Vives-Gilabert Y.,Autonomous University of Barcelona | Grasa E.,Biomedical Research Institute Sant Pau | Portella M.J.,Biomedical Research Institute Sant Pau | And 9 more authors.
Schizophrenia Research | Year: 2015

To understand the neural mechanism that underlies treatment resistant auditory verbal hallucinations (AVH), is still an important issue in psychiatric research. Alterations in functional connectivity during rest have been frequently reported in patients with schizophrenia. Though the default mode network (DN) appears to be abnormal in schizophrenia patients, little is known about its role in resistant AVH. We collected resting-state functional magnetic resonance imaging (R-fMRI) data with a 3. T scanner from 19 schizophrenia patients with chronic AVH resistant to pharmacological treatment, 14 schizophrenia patients without AVH and 20 healthy controls. Using seed-based correlation analysis, we created spherical seed regions of interest (ROI) to examine functional connectivity of the two DN hub regions (posterior cingulate cortex and anteromedial prefrontal cortex) and the two DN subsystems: dorsomedial prefrontal cortex subsystem and medial temporal lobe subsystem (p < 0.0045 corrected). Patients with hallucinations exhibited higher FC between dMPFC ROI and bilateral central opercular cortex, bilateral insular cortex and bilateral precentral gyrus compared to non hallucinating patients and healthy controls. Additionally, patients with hallucinations also exhibited lower FC between vMPFC ROI and bilateral paracingulate and dorsal anterior cingulate cortex. As the anterior cingulate cortex and the insula are two hubs of the salience network, our results suggest cross-network abnormalities between DN and salience system in patients with persistent hallucinations. © 2014 Elsevier B.V.


Cuenca-Royo A.M.,IMIM Hospital del Mar | Cuenca-Royo A.M.,CIBER ISCIII | Sanchez-Niubo A.,IMIM Hospital del Mar | Sanchez-Niubo A.,CIBER ISCIII | And 7 more authors.
Addictive Behaviors | Year: 2012

Aim: To assess the validity of two cannabis use severity scales among young cannabis users and to evaluate their ability to detect Substance Use Disorders (SUD). Participants: 241 volunteers (18-25. years), with a wide spectrum of cannabis use in the last 12. months. Measurements: The Cannabis Abuse Screening Test (CAST) and Severity of Dependence Scale (SDS) were self-administered. The Psychiatric Interview for Substance and Mental Disorders (PRISM) was used as gold standard for cannabis use disorders according to DSM-IV. Reliability and validity were assessed for two different CAST coding algorithms (b-binary and f-full) and for the SDS. In addition, the cannabis use diagnostic criteria contained in the PRISM were grouped to approximate forthcoming proposed DSM-V criteria to further evaluate these scales. Findings: 26.6% (95% CI: 21.0-32.2) of the subjects met criteria for cannabis dependence, and 49.0% (95% CI: 42.7-55.3) for cannabis use disorders. For both scales internal consistency (Cronbach's alpha > 0.71) and test-retest intraclass correlation coefficients (> 0.80) were good. The score 12 in the CAST-full discriminated better than others between presence and absence of dependence (27.0%; 95% CI: 21.4-32.6) while the score for discrimination of SUD was 9 (51.5%; 95% CI: 45.1-57.8). For the SDS the values were 7 (22.0%; 95% CI: 16.8-27.2) and 3 (64.7%; 95% CI: 58.7-70.8), respectively. According to proposed DSM-V criteria, for moderate and severe addiction the values for the CAST-f were 7 (68.5%; 95% CI: 62.5-74.3) and 12 (27%; 95% CI: 21.3-32.6) and for the SDS, 3 (65.0%; 95% CI: 58.7-70.8) and 7 (22%; 95% CI: 17.0-34.3), respectively. Conclusions: The CAST and SDS applied to young cannabis users are reliable and valid measures to detect cannabis use disorders when compared to both DSM-IV and proposed DSM-V criteria. © 2012 Elsevier Ltd.


PubMed | University Pompeu Fabra, Institute Of Neuropsiquiatria I Addiccions, University of Barcelona, Autonomous University of Barcelona and Rovira i Virgili University
Type: Review | Journal: Archives of psychiatric nursing | Year: 2016

To study the significance of therapeutic relationship between nurses and patients within the context of a psychiatric hospital.Narrative literature review. Content analysis.The significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting.Increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest.


PubMed | University Pompeu Fabra, University of Barcelona, Rovira i Virgili University, Autonomous University of Barcelona and Institute Of Neuropsiquiatria I Addiccions
Type: | Journal: BMC nursing | Year: 2017

Psychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method.The study will use a mixed method design. Qualitative methodology, through participative action research, will be employed to implement scientific evidence on the therapeutic relationship. A quasi-experimental, one-group, pre-test/post-test design will also be used to quantitatively measure the effectiveness of the implementation of the evidence. Participants will consist of nurses and patients from two psychiatric units in Barcelona. Nurses will be selected by theoretical sampling, and patients assigned to each nurses will be selected by consecutive sampling. Qualitative data will be gathered through discussion groups and field diaries. Quantitative data will be collected through the Working Alliance Inventory and the Interpersonal Reactivity Index. Qualitative data will be analysed through the technique of content analysis and quantitative data through descriptive and inferential statistics.This study will help to understand the process of change in a nursing team working in an inpatient psychiatric ward and will allow nurses to generate knowledge, identify difficulties, and establish strategies to implement change, as well as to assess whether the quality of the care they provide shows a qualitative improvement.


Buron E.,Institute Of Neuropsiquiatria I Addiccions
Actas españolas de psiquiatría | Year: 2013

The main objective of this study was to develop and validate a new olfactory measure that assesses the influence of olfaction on several emotional, behavioural, and cognitive issues: The Relational Scale of Olfaction (EROL). A secondary objective was to explore the relationship between the olfactory function and the anxiety and depression symptoms by means of EROL and the Hospital Anxiety and Depression Scale (HADS). A positive relationship between anxiety symptoms and the olfactory function was hypothesized. Regarding depressive symptoms, a significant relationship with the olfactory scores was not expected. Psychometric properties of EROL scale and correlations between HADS and EROL were tested in a sample from the general population. EROL showed an adequate level of test-retest reliability (ICC=.748) and good internal consistency (Cronbach's alpha=.761). Convergent validity with other olfactory measures was satisfactory. A one-factor solution was found for the scale. HADS showed a significant relationship with EROL (r=.280, p<.01), but the analysis through dimensions revealed that only the anxiety subscale correlated significantly and moderately with the olfactory measure (r=.325, p<.001), whereas the correlation with the depression subscale was non-significant (r=.146, p>.05). Given that EROL displayed good psychometrical properties, it appears as a suitable tool to assess the olfactory function in general population. The relationship between this olfactory scale and anxiety symptoms found in this study is an interesting issue that requires further research.


Pailhez G.,Institute Of Neuropsiquiatria I Addiccions | Bulbena A.,Institute Of Neuropsiquiatria I Addiccions
International Journal of Psychiatry in Clinical Practice | Year: 2010

Introduction. Body shape has been aim of study by Medicine throughout centuries to find connections between shapes and illnesses. Methods. The objective of this systematic review was to understand the origin, as well as update empirical research, of body constitution. Results. The study of body constitution and of some other groups of physical signs (such as minor physical anomalies or joint hypermobility) provides insights into the biology of mental disorders that may result in a greater understanding of its aetiology, treatment, and prevention. Discussion. We discuss the role of body constitution in order to support psychiatric nosology, especially in differential diagnosis, through an overall or holistic "body and mind" perception. © 2010 Informa Healthcare.


Buron E.,Institute Of Neuropsiquiatria I Addiccions | Bulbena A.,Institute Of Neuropsiquiatria I Addiccions
Psychopathology | Year: 2013

Background: Olfaction and its relation to mental health is an area of growing interest. Brain areas linked to olfaction partially overlap with brain areas involved in psychiatric disorders; consequently, the study of olfactory function allows us to explore the integrity of these brain areas with a non-invasive and effective method. Accordingly, the aim of this paper is to review olfactory function in affective and anxiety disorders. Methods: For this purpose, an extensive literature review of English-language studies on olfactory function in patients with the aforementioned pathologies was performed using several online databases. A manual search of relevant journals and books as well as reference lists from selected papers was also performed. Results: The available data show that depressed patients are usually characterised by preserved olfactory function, except for detection threshold, where contrasting reports have been found. Bipolar disorder has been studied to a lesser extent, but the findings have shown a lack of impairment in most cases. Research on seasonal affective disorders is scant, and future studies are needed to make conclusions. Anxiety disorders have been scarcely approached, but the results note identification deficits in obsessive-compulsive and posttraumatic stress disorders. Conclusions: Olfactory assessment appears to be a complementary, valuable research tool in the study of psychiatric disorders. However, further investigation is needed to improve our understanding of olfactory function in these disorders. Copyright © 2012 S. Karger AG, Basel.


Berge D.,Institute Of Neuropsiquiatria I Addiccions | Berge D.,Autonomous University of Barcelona | Carmona S.,Autonomous University of Barcelona | Rovira M.,Autonomous University of Barcelona | And 5 more authors.
Acta Psychiatrica Scandinavica | Year: 2011

Objective: To determine brain areas reduced in first episode of psychotic subjects and its association with lack of insight and negative symptoms. Method: Twenty-one drug naive first-episode subjects and 20 controls underwent a structural MRI scan and were clinically assessed. Optimized voxel-based-morphometry analysis (VBM) was implemented to find between-group differences and correlations between GM volume and: (i) lack of insight and (ii) negative symptoms. Results: Patients showed GM reduction in prefrontal and left temporal areas. A significant correlation was found between insight and GM volume in the cerebellum (corrected P=0.01), inferior temporal gyrus (corrected P=0.022), medial superior frontal gyrus (corrected P<0.001), and inferior frontal gyrus (corrected P=0.012), as the insight decreased, the volume decreased. Negative symptoms correlated with decreased GM volume at cerebellum (corrected P=0.037) and frontal inferior regions (corrected P<0.001), the more negative symptoms, the less volume. Conclusion: Our findings support an association between prefrontal, temporal, and cerebellar deficits and lack of insight in schizophrenia and confirm previous findings of GM deficits in patients since the first episode of psychosis. © 2010 John Wiley & Sons A/S.


PubMed | Institute Of Neuropsiquiatria I Addiccions and University of Barcelona
Type: Journal Article | Journal: Transplantation proceedings | Year: 2016

Failure of compliance with medical regimen is one of the major risk factors associated with morbidity and mortality in heart transplant (HT) recipients. Nevertheless, to date, there is no specific, gold-standard, comprehensive set of tools for assessing compliance in these patients.The objective of the present study was to develop a specific instrument for the assessment of noncompliance with medical recommendations in HT recipients.This prospective observational study used a nonprobability sampling method, which was performed from January 2006 to December 2012. All of the patients met clinical criteria for being included on the waiting list for a HT. We designed a scale for measuring the compliance degree at 12 months after heart transplantation. This scale included the most important aspects of the medical regimen, using nine discrete quantitative variables. The total score was described as the patients Noncompliance Factor (NCF). The results were analysed by mean, ranks, and percentages.The sample was constituted of 61 participants who underwent surgical HT intervention and completed the 12-month follow-up assessment. The overall incidence of noncompliance was around 30% and only 43.1% of the recipients had an acceptable degree of compliance.The overall incidence of noncompliance in HT recipients is high and this can generate worse clinical outcomes. Evaluation by specific screening instruments like the one proposed in the present study can be useful for a systematic detection of this phenomenon.


Murru A.,University of Barcelona | Popovic D.,University of Barcelona | Pacchiarotti I.,University of Barcelona | Hidalgo D.,University of Barcelona | And 2 more authors.
Current Psychiatry Reports | Year: 2015

Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management. © 2015, Springer Science+Business Media New York.

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