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Abstract Background Suicide has become a first-order public health concern, especially following the negative impact of COVID-19 on the mental health of the general population. Few studies have analysed the effects of early psychotherapeutic interventions on subjects who have attempted suicide, and even fewer have focused on those hospitalized in non-psychiatric units after a Medically Serious Suicide Attempt (MSSA). The main aim of this study is to describe the protocol designed to evaluate the effectiveness of individual psychological treatment for patients hospitalized after an MSSA. The secondary objectives of the study are: (1) to evaluate the impact on quality of life and other psychosocial variables of patients with a recent MSSA who receive early psychological intervention; (2) to analyse the biological, psychological, and clinical impact of early psychotherapeutic treatment on subjects hospitalized after an MSSA. Methods A longitudinal randomised controlled trial will be conducted with patients over 16 years of age admitted to two general hospitals. The case intervention group will enrol for 8-sessions of individual psychotherapy, Suicide Attempts Multi-component Intervention Treatment (SAMIT), combining Dialectical Behaviour Therapy (DBT), Mentalization-Based Therapy (MBT), and Narrative approaches, while the control group will receive a treatment-as-usual intervention (TAU). Longitudinal assessment will be conducted at baseline (before treatment), post-treatment, and 3, 6, and 12 months after. The main outcome variable will be re-attempting suicide during follow-up. Discussion Some psychotherapeutic interventions, usually implemented in outpatient, have proven to be effective in preventing suicidal behaviours. The combination of some of these may be a powerful treatment for preventing future SA in patients hospitalised after an MSSA, which is the most severely suicidal subgroup. Moreover, assessment of the biological, clinical and psychometric impact of this new intervention on patients during the first year after the attempt may help understand some of the multi-level factors associated with the effectiveness of psychotherapeutic interventions in MSSAs. The prevalence of high suicide rates requires the design of effective psychological interventions for their prevention, and also in order to design new pharmacological and psychological treatments. Trial registration ClinicalTrials.gov ID: NCT06238414. Date of registration: 1st February 2024, final update is protocol version 3.0, 19th March 2024.

Introduction Previous research has shown that it is feasible to integrate motivational interviewing techniques with behavioural and psychological interventions for the treatment of obesity. Moreover, these combined interventions have the potential to improve health-related outcomes of people living with obesity (PLWO) and to afford maintenance of behavioural changes over time. In addition, the use of virtual reality (VR) embodiment techniques in the treatment of eating disorders and obesity has promising preliminary effectiveness. The objective of this study is to assess the clinical efficacy of a VR intervention that uses embodiment and body-swapping techniques and has been specifically developed to cover the needs of PLWO.Methods and analysis A randomised control trial will be carried out with an estimated sample of 96 participants with body mass index (BMI)>30. The whole duration of the trial will be 12 months. Participants will be recruited from the external consultations of the Vall d'Hebron University Hospital and be randomly assigned to three groups. The experimental group 1 will engage in a virtual self-conversation using the ConVRself platform, the experimental group 2 will participate in a ‘pre-established discourse’ provided by the virtual counsellor, who will give psychoeducation advice, and the control group will continue with treatment as usual. Readiness to change, BMI, eating habits and physical activity, psychological well-being, body image satisfaction, quality of life in relation to body image, and weight bias internalisation will be assessed at baseline, post intervention, 1-week and 4-week follow-up. Finally, variables related to adherence and satisfaction with the VR tool will be evaluated for the experimental groups.Ethics and dissemination This study was approved by the Research Projects Committee of the Vall d’Hebron University Hospital. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences and other events for the scientific and clinical community, and the general public.Trial registration number NCT05094557.

Introducción: la investigación sobre rasgos de personalidad en pacientes con trasplante renal es limitada. El objetivo de este estudio fue describir el perfil de personalidad de pacientes con trasplante renal, utilizando el modelo alternativo de cinco factores (AFFM), y compararlo con población estándar española. Material y métodos: la personalidad fue evaluada mediante el Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Una muestra de 207 pacientes con trasplante renal se emparejó por edad y género con 207controles de la población estándar. El análisis de regresión logística permitió estudiar la aportación de cada dimensión del ZKPQ al perfil distintivo de los pacientes trasplantados. Resultados: aparecieron diferencias significativas en las dimensiones de Neuroticismo-Ansiedad (p=.001), Agresión-Hostilidad (p=.009) y Actividad (p=.001), con puntuaciones bajas en pacientes trasplantados en comparación con la población estándar. La sociabilidad (p=.024) fue significativamente mayor en pacientes trasplantados. En el análisis de regresión, las bajas puntuaciones en Neuroticismo-Ansiedad (p=.005) y Actividad (p=.001) fueron predictores significativos para caracterizar los rasgos de personalidad de pacientes trasplantados. Conclusiones: desde el AFFM, los pacientes con trasplante renal muestran un perfil diferente de personalidad comparado con la población estándar, con bajas puntuaciones en las dimensiones de Neuroticismo-Ansiedad y Actividad.

Background: Suicide has become a first-order public health concern, especially following the negative impact of COVID-19 on the mental health of the general population. Few studies have analysed the effects of early psychotherapeutic interventions on subjects who have attempted suicide, and even fewer have focused on those hospitalized in non-psychiatric units after a Medically Serious Suicide Attempt (MSSA). The main aim of this study is to describe the protocol designed to evaluate the effectiveness of individual psychological treatment for patients hospitalized after an MSSA. The secondary objectives of the study are: (1) to evaluate the impact on quality of life and other psychosocial variables of patients with a recent MSSA who receive early psychological intervention; (2) to analyse the biological, psychological, and clinical impact of early psychotherapeutic treatment on subjects hospitalized after an MSSA. Methods: A longitudinal randomised controlled trial will be conducted with patients over 16 years of age admitted to two general hospitals. The case intervention group will enrol for 8-sessions of individual psychotherapy, Suicide Attempts Multi-component Intervention Treatment (SAMIT), combining Dialectical Behaviour Therapy (DBT), Mentalization-Based Therapy (MBT), and Narrative approaches, while the control group will receive a treatment-as-usual intervention (TAU). Longitudinal assessment will be conducted at baseline (before treatment), post-treatment, and 3, 6, and 12 months after. The main outcome variable will be re-attempting suicide during follow-up. Discussion: Some psychotherapeutic interventions, usually implemented in outpatient, have proven to be effective in preventing suicidal behaviours. The combination of some of these may be a powerful treatment for preventing future SA in patients hospitalised after an MSSA, which is the most severely suicidal subgroup. Moreover, assessment of the biological, clinical and psychometric impact of this new intervention on patients during the first year after the attempt may help understand some of the multi-level factors associated with the effectiveness of psychotherapeutic interventions in MSSAs. The prevalence of high suicide rates requires the design of effective psychological interventions for their prevention, and also in order to design new pharmacological and psychological treatments. Trial registration: ClinicalTrials.gov ID: NCT06238414. Date of registration: 1st February 2024, final update is protocol version 3.0, 19th March 2024. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic and lockdown measures have had a clear psychological impact on families, and specifically those with children with chronic illnesses have reported greater overloads and exhaustion. The objective of this study was to evaluate the exposure, impact and experience of the pandemic on families of pediatric solid organ transplant (SOT) recipients compared to families of healthy children and adolescents.Methods: We recruited 96 families, 48 with a pediatric SOT recipient and 48 healthy controls, matched by child age and gender. A primary caregiver from each family responded to an online sociodemographic questionnaire and the COVID-19 Exposure and Family Impact Survey (CEFIS), which explores the exposure, impact and experience of the pandemic and lockdown on families.Results: Exposure to the pandemic was greater in families of healthy children and adolescents. The impact was mostly negative in both groups: caregivers reported increased anxiety (76%) and mood disturbances (71.9%) and hindered quality of sleep (64.6%) and health habits (58.3%). On the positive side, family relationships improved. Qualitatively, the SOT group positively perceived isolation and established hygienic measures as protective and destigmatizing, although they reported fear of virus transmission to their child.Conclusions: The psychological impact of the pandemic has been similar in both groups, although families of transplant recipients have protected themselves more, probably because they are used to prevention measures and they see contagion as a graver risk. Additionally, SOT recipients' families presented some idiosyncratic elements, especially a decrease in their perception of stigma associated with the medical condition. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and depression during pregnancy can lead to adverse maternal and neonatal outcomes. The SARS CoV‐2 pandemic, and the complete lockdown required during the first wave in most countries are stressors for pregnant women and can lead to anxiety and depression during pregnancy. The aim of this study was to explore depression and anxiety symptoms, and social support in pregnant women during the SARS CoV‐2 lockdown, as well as to explore demographic risk factors. Material and methods: A prospective cohort study was performed at Hospital Universitari Vall d'Hebron, Barcelona, including pregnant women attending the antenatal clinic during the SARS‐CoV2 lockdown period. Three questionnaires were administered to study depression (EPDS), anxiety (STAI) and Social Support (MOS‐SSS). STAI state (STAIs) described the actual state of anxiety and the STAI trait (STAIt) described the trait of anxiety. A cut‐off of 10 for EPDS and 40 for STAI was considered to be clinically relevant. The main outcome measures were depression and anxiety symptoms. Results: A total of 217 women were invited to participate, and 204 accepted (94%). From these, 164 filled in the EPDS, 109 STAI and 159 MOS‐SSS questionnaires: 37.8% (95% confidence interval [CI] 30.5%‐45.7%) (62/164) of women showed an EPDS result ≥10, 59.6% (95% CI 49.8%‐68.8%) (65/109) a STAI state (STAIs) ≥40, and 58.7% (95% CI 48.9%‐67.9%) (64/109) a STAI trait (STAIt) ≥40. Regression analysis showed that mental health disorder, Latin American origin and lack of social support were independent risk factors for anxiety symptoms in the STAIs (P =.032, P =.040 and P =.029, respectively). Regarding depressive symptoms, maternal body mass index, mental health disorders and social support were independent factors (P =.013, P =.015 and P =.000, respectively). Conclusions: A lockdown scenario during the first wave of the SARS‐CoV 2 pandemic increased the symptoms of anxiety and depression among pregnant women, particularly affecting those with less social support. [ABSTRACT FROM AUTHOR]

Health-related behaviours and psychological distress were examined after kidney transplantation. Patients were evaluated at 1 month, 6 months and 1 year after transplantation. Participants completed the Healthy Behaviours Questionnaire and the Hospital Anxiety and Depression Scale. No significant differences in Healthy Behaviours Questionnaire’s total score and psychological comorbidity were observed at three time points. However, there was an increase in drug-consumer habits (p < 0.05) and a reduction in sedentary lifestyle (p < 0.05) at 6 months and 1 year. Moreover, at 1 year, post-transplant had increased the harmful health habits (p < 0.05). In regression analysis, anxiety symptoms were significant predictors of Healthy Behaviours Questionnaire change at a year post-transplantation. [ABSTRACT FROM AUTHOR]

Functional gastrointestinal disorders have been related with different psychological conditions. On the contrary, the role of psychological factors within gastrointestinal motor disorders remains unclear. The objective of this study was to explore the differences and congruence with clinical performance of the psychological profile and subjective functionality among patients diagnosed with functional gastrointestinal disorders and gastrointestinal motor disorders. Using a double-blind design, 56 inpatients from a Gastroenterology Department were included in the study. No major differences were detected between the two groups. However, clinical performance was coherent with subjective physical functioning only among patients diagnosed with gastrointestinal motor disorders. These results may provide useful information for gastroenterologists dealing with patients’ complaints not consistent with their clinical profile. [ABSTRACT FROM AUTHOR]

Acute spinal cord injury leaves patients severely impaired and generates high levels of psychological distress among them and their families, which can cause a less active role in rehabilitation, worse functional recovery, and less perceived satisfaction with the results. Additionally, rehabilitation professionals who deal with this psychological distress could ultimately experience higher stress and more risk of burnout. This article presents the study protocol of the ESPELMA project, aimed to train rehabilitation professionals in the clinical management of acute spinal cord injury-associated psychological distress, and to measure the impact of this training on the patients' perceived satisfaction with treatment. [ABSTRACT FROM AUTHOR]

Objective: To compare psychophysiological responses among novice surgeons during performance of endoscopic sinus surgery (ESS). Design: Randomized study. Setting: Academic institution. Participants: Fifteen novice surgeons. Main Outcome Measures: The psychophysiological effects of performing ESS were assessed among 15 novice surgeons at 30 minutes before (T-30), at the beginning of (T0), at 15minutes (T15), and 45 minutes (T45) during, and at 30 minutes after (T+30) surgery. Participants were randomized to perform ESS with a computer- assisted surgery system, to perform ESS without a computer-assisted surgery system, or to be evaluated on a nonsurgical day (control day). Measured were the State- Trait Anxiety Inventory score, Visual Analog Anxiety Scale score, heart rate, blood pressure, and plasma cortisol and prolactin levels. Results: Anxiety as measured by the State-Trait Anxiety Inventory score was not modified by the experimental conditions. The mean (SEM) Visual Analog Anxiety Scale score increased (P<.05) during ESS at T0 (2.45 [0.32]), T15 (3.46 [0.50]), and T45 (3.17 [0.46]) compared with the control day (1.19 [0.19], 1.32 [0.26], and 1.20 [0.19], respectively). The mean (SEM) systolic blood pressure (in millimeters of mercury) increased (P<.05) during ESS at T0 (127 [2]), T15 (126 [3]), and T45 (125 [2]) compared with the control day (120 [3], 119 [4], and 116 [3], respectively). The mean (SEM) heart rate (in beats per minute) increased during ESS but was significant only at T15 (73 [4]) compared with the control day (64 [3]). The mean (SEM) plasma cortisol level (in micrograms per deciliter) increased 29% above baseline during performance of ESS and reached a maximum peak at T45 (12.6 [1.2]) compared with the control day (9.7 [1.1]), while prolactin levels did not change. The Visual Analog Anxiety Scale score, heart rate, blood pressure, and endocrine biomarkers of stress were not significantly modified during performance of ESS with a computer- assisted surgery system. Conclusion: This study demonstrates for the first time that cardiovascular and anxiety changes during performance of ESS are not associated with increased levels of prototypical endocrine stress hormones. [ABSTRACT FROM AUTHOR]

Background: Studies on individual psychotherapy indicate that some interventions may reduce the number of recurrences in bipolar patients. However, there has been a lack of structured, well-designed, blinded, controlled studies demonstrating the efficacy of group psychoeducation to prevent recurrences in patients with bipolar I and II disorder. Methods: One hundred twenty bipolar I and II outpatients in remission (Young Mania Rating Scale score <6, Hamilton Depression Rating Scale–17 score <8) for at least 6 months prior to inclusion in the study, who were receiving standard pharmacologic treatment, were included in a controlled trial. Subjects were matched for age and sex and randomized to receive, in addition to standard psychiatric care, 21 sessions of group psychoeducation or 21 sessions of nonstructured group meetings. Subjects were assessed monthly during the 21-week treatment period and throughout the 2-year follow-up. Results: Group psychoeducation significantly reduced the number of relapsed patients and the number of recurrences per patient, and increased the time to depressive, manic, hypomanic, and mixed recurrences. The number and length of hospitalizations per patient were also lower in patients who received psychoeducation. Conclusion: Group psychoeducation is an efficacious intervention to prevent recurrence in pharmacologically treated patients with bipolar I and II disorder. [ABSTRACT FROM AUTHOR]

Vieta E, Parramon G, Padrell E, Nieto E, Martinez-Arán A, Corbella B, Colom F, Reinares M, Goikolea JM, Torrent C. Quetiapine in the treatment of rapid cycling bipolar disorder. Bipolar Disord 2002: 4: 335–340. © Blackwell Munksgaard, 2002 Introduction: This prospective open-label study assessed the impact of add-on quetiapine in the treatment of rapid cycling bipolar patients. Methods: Fourteen rapid cycling bipolar patients were treated with quetiapine, which was added to their ongoing medication regimen for 112 ± 33 days. At the beginning of the study, five were manic, three were in a mixed state, three were depressed, two hypomanic and one was euthymic. Patients were assessed prospectively with a modified version of the Clinical Global Impression Scale for Bipolars (CGI-BP), the Young Scale for mania (YMRS) and the Hamilton Scale for Depression (HDRS). Results: A significant reduction of the following scale scores was observed: • a 1.8 point reduction for the general CGI-BP (p=0.013), • a –1.3 point for the mania subscale (p=0.016), • a –1.01 point for the YMRS (p=0.025). Improvement in depressive symptoms was not significant, neither in the CGI-BP (–1 point, p=0.074) nor in the HDRS (–5.2 points, p=NS). The most common side-effect was sedation (n=6, 43%). Doses of quetiapine were significantly reduced by the end of the study (443 ± 235 mg/day versus 268 ± 190 mg/day, p=0.008) and they also differed according to the initial episode to be treated (720 ± 84 mg/day for mania, and 183 ± 29 mg/day for depression, p=0.023). Conclusions: Quetiapine could possibly be an effective treatment for rapid cycling bipolar patients. Adequate doses for acute episodes could significantly differ according to the episode polarity and the length of treatment. [ABSTRACT FROM AUTHOR]