89 results on '"Torres-González, F."'
Search Results
2. Guiding light with singular beams in nanoplasmonic colloids
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Balbuena Ortega, A., primary, Torres-González, F. E., additional, López Gayou, V., additional, Delgado Macuil, R., additional, Cardoso Sakamoto, J. E. H., additional, Arzola, A. V., additional, Assanto, G., additional, and Volke-Sepulveda, K., additional
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- 2021
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3. The risk for depression conferred by stressful life events is modified by variation at the serotonin transporter 5HTTLPR genotype: evidence from the Spanish PREDICT-Gene cohort
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Cervilla, J A, Molina, E, Rivera, M, Torres-González, F, Bellón, J A, Moreno, B, Luna, J D, Lorente, J A, Mayoral, F, King, M, and Nazareth, I
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- 2007
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4. Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study
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Leurent, B., Nazareth, I., Bellón-Saameño, J., Geerlings, M.-I., Maaroos, H., Saldivia, S., Švab, I., Torres-González, F., Xavier, M., and King, M.
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- 2013
5. Predicting the onset of major depression in primary care: international validation of a risk prediction algorithm from Spain
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Bellón, J. Á., de Dios Luna, J., King, M., Moreno-Küstner, B., Nazareth, I., Montón-Franco, C., GildeGómez-Barragán, M. J., Sánchez-Celaya, M., Díaz-Barreiros, M. Á., Vicens, C., Cervilla, J. A., Švab, I., Maaroos, H.-I., Xavier, M., Geerlings, M. I., Saldivia, S., Gutiérrez, B., Motrico, E., Martínez-Cañavate, M. T., Oliván-Blázquez, B., Sánchez-Artiaga, M. S., March, S., del Mar Muñoz-García, M., Vázquez-Medrano, A., Moreno-Peral, P., and Torres-González, F.
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- 2011
6. WPA Thematic Conference: Mental Health and Family Medicine Professionals: Working Together, 9–11 February 2012, Granada
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Torres-González, F. and Ivbijaro, Gabriel
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- 2010
7. Unmet needs in the management of schizophrenia
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Torres-González F, Ibanez-Casas I, Saldivia S, Ballester D, Grandundefinedn P, Moreno-Kundefinedstner B, Xavier M, and Gundefinedmez-Beneyto M
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lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,lcsh:Neurology. Diseases of the nervous system ,lcsh:RC346-429 ,lcsh:RC321-571 - Abstract
Francisco Torres-González,1,8 Inmaculada Ibanez-Casas,1,8 Sandra Saldivia,2,8 Dinarte Ballester,3,8 Pamela Grandón,4,8 Berta Moreno-Küstner,5,8 Miguel Xavier,6,8 Manuel Gómez-Beneyto7,8 1Centro de Investigación Biomédica en Red de Salud Mental, University of Granada, Spain; 2Department of Psychiatry and Mental Health, Faculty of Medicine, University of Concepcion, Chile; 3Sistema de Saúde Mãe de Deus, Escola Superior de Saúde, Universidade do Vale do Rio dos Sinos, Brazil; 4Department of Psychology, Faculty of Social Sciences, University of Concepcion, Chile; 5Andalusian Psychosocial Research Group and Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Malaga, Spain; 6Department of Mental Health, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal; 7Centro de Investigación Biomédica en Red de Salud Mental, University of Valencia, Spain; 8Maristán Network, University of Granada, Granada, Spain Abstract: Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists. Keywords: schizophrenia, needs, unmet needs, severe mental disorders
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- 2014
8. Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers
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Runte-Geidel, A., Girela, E., López, Á., Ruiz, F., and Torres-González, F.
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Psychiatry ,Pharmacology ,Prisiones ,Análisis Cualitativo ,Farmacología ,España ,Protocolos ,Salud mental ,Spain ,Prisons ,Derechos del paciente ,Mental health ,Qualitative Analysis ,Protocols ,Psiquiatría ,Patient rights - Abstract
Aim: The aim of the study was to ascertain the opinions of both inmates and staff of prison establishments about the use of coercive measures justified for clinical reasons for people with mental health problems and about the need to create protocols to regulate the application of these measures. Method: These opinions were gathered in a Qualitative Study with Focus Groups (prison inmates and prison staff) from the Granada Penitentiary Centre and the Alicante Penitentiary Psychiatric Hospital, both in Spain. Results: The results showed that forced medication is the most commonly used coercive measure in these institutions. The inmates did not understand and rejected the use of this measure, above all because they were poorly informed about their illness and the medication required to treat it. The staff however defended the benefits of psychiatric medicine, even when administered without the patient's consent. Conclusions: Both inmates and staff agreed that it would be useful to have a protocol regulating the use of coercive measures. The study has also identified a number of important factors that could help to reduce the need for coercive measures or make their use unnecessary. Objetivos: El estudio ha pretendido conocer por un lado la opinión de personas internas en establecimientos penitenciarios, y por otro lado, la opinión de los funcionarios de estas instituciones sobre el uso de medidas coercitivas por indicación clínica en personas con problemas de salud mental y sobre la necesidad de creación de protocolos de actuación para la aplicación de estas medidas. Metodología: Estudio cualitativo que ha utilizado la técnica de Grupos Focales llevados a cabo con internos y funcionarios del Centro Penitenciario de Granada y del Hospital Psiquiátrico Penitenciario de Alicante, España. Resultados: Los resultados demuestran que la medida coercitiva más utilizada en estas instituciones es la medicación forzosa. Las personas internas no comprenden y rechazan la utilización de esta medida, sobre todo porque están mal informadas sobre su enfermedad y su tratamiento farmacológico, pero los profesionales abogan por los beneficios de la medicación psiquiátrica, aunque sea de forma involuntaria. Conclusiones: Tanto usuarios como profesionales están de acuerdo con la utilidad de la existencia de un protocolo de actuación para la aplicación de medidas coercitivas. Este estudio ha hallado importantes factores que podrían ayudar a disminuir la utilización de medidas coercitivas o incluso evitarlas.
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- 2014
9. Predicting the onset of anxiety syndromes at 12 months primary care attendees
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Moreno Peral, Patricia, Dios Luna, J., Marston, Louise, King, M., Nazareth, I., Mótrico Martínez, Emma, GildeGómez Barragán, M.J., Torres González, F., Monton Franco, C., Sánchez Celaya, Marta, Ortiz Boyer, D., Vicens, Catalina, Muñoz Bravo, Carlos, and Bellón Saameño, Juan Ángel
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- 2014
10. The risk for major depression conferred by childhood maltheatment is multiplied by BDNF and SERT genetic vulnerability: a replication study
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Gutiérrez Villar, Belén, Bellón Saameño, Juan Ángel, Rivera, M, Mótrico Martínez, Emma, King, M., Marston, Louise, Torres González, F., Molina Navarro, F., Moreno Kustner, Berta, Monton Franco, C., GildeGómez Barragán, M.J., Sánchez Celaya, Marta, Diaz Barreiros, M.A., and Vicens, Catalina
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- 2014
11. Psychometric properties of the Lost of Threatening Experiences LTE and ots association with psychosocial factors and mental disorders according to different scoring methods
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Mótrico Martínez, Emma, Moreno Kustner, Berta, Dios Luna, J., Torres González, F., King, M., Nazareth, I., and Monton Franco, C.
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- 2013
12. Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers
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Universidad de Alicante. Departamento de Estudios Jurídicos del Estado, Girela, E., López, A., Ortega, L., De-Juan, J., Ruiz, F., Bosch, J.I., Barrios Flores, Luis Fernando, Luna, J.D., Torres-González, F., Universidad de Alicante. Departamento de Estudios Jurídicos del Estado, Girela, E., López, A., Ortega, L., De-Juan, J., Ruiz, F., Bosch, J.I., Barrios Flores, Luis Fernando, Luna, J.D., and Torres-González, F.
- Abstract
We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.
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- 2014
13. Spatial analysis to identify hotspots of prevalence of schizophrenia
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Moreno B, García-Alonso CR, Negrín Hernández MA, Torres-González F, and Salvador-Carulla L
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The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning.
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- 2008
14. The EUNOMIA project on coercion in psychiatry: study design and preliminary data
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Tw, Kallert, Glöckner M, Onchev G, Raboch J, Karastergiou A, Solomon Z, Magliano L, Dembinskas A, Kiejna A, Nawka P, Torres-González F, Stefan Priebe, Kjellin L, Kallert, T. H., Glockner, M., Onchev, G., Raboch, J., Karastergiou, A., Solomon, Z., Magliano, Lorenza, Dembinskas, A., Kiejna, A., Nawka, P., TORRES GONZALEZ, F., Priebe, S., and Kjellin, L.
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coercion, psychiatric treatments ,Research Report - Abstract
Previous national research has shown significant variation in several aspects of coercive treatment measures in psychiatry. The EUNOMIA project, an international study funded by the European Commission, aims to assess the clinical practice of these measures and their outcomes. Its naturalistic and epidemiological design is being implemented at 13 centres in 12 European countries. This article describes the design of the study and provides preliminary data on the catchment areas, staff, available facilities and modalities of care at the participating centres.
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- 2006
15. Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers
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Runte-Geidel, A., primary, Girela, E., additional, López, Á., additional, Ruiz, F., additional, and Torres-González, F., additional
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- 2014
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16. Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers
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Girela, E., primary, López, A., additional, Ortega, L., additional, De-Juan, J., additional, Ruiz, F., additional, Bosch, J. I., additional, Barrios, L. F., additional, Luna, J. D., additional, and Torres-González, F., additional
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- 2014
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17. P-738 - Prevalence and correlates of psychotic symptoms in the spanish elderly community
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Valdearenas, L., primary, Torres-González, F., additional, de Dios Luna, J., additional, and Cervilla, J., additional
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- 2012
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18. Mental health of older people: the role of primary care
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Ivbijaro, G., primary, Torres-González, F., additional, Parmentier, H., additional, and Gómez-Beneyto, M., additional
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- 2011
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19. Successful GP intervention with frequent attenders in primary care: randomised controlled trial.
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Bellón JA, Rodríguez-Bayón A, de Dios Luna J, Torres-González F, Bellón, Juan Angel, Rodríguez-Bayón, Antonina, de Dios Luna, Juan, and Torres-González, Francisco
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Background: Frequent attenders to GP clinics can place an unnecessary burden on primary care. Interventions to reduce frequent attendance have had mixed results.Aim: To assess the effectiveness of a GP intervention to reduce frequent-attender consultations.Design Of Study: Randomised controlled trial with frequent attenders divided into an intervention group and two control groups (one control group was seen by GPs also providing care to patients undergoing the intervention).Setting: A health centre in southern Spain.Method: Six GPs and 209 randomly-selected frequent attenders participated. Three GPs were randomly allocated to perform the new intervention: of the 137 frequent attenders registered with these three GPs, 66 were randomly allocated to receive the intervention (IG) and 71 to a usual care control group (CG2). The other three GPs offered usual care to the other 72 frequent attenders (CG1). The main outcome measure was the total number of consultations 1 year post-intervention. Baseline measurements were recorded of sociodemographic characteristics, provider-user interface, chronic illnesses, and psychosocial variables. GPs allocated to the new intervention received 15 hours' training which incorporated biopsychosocial, organisational, and relational approaches. After 1 year of follow-up frequent attenders were contacted. An intention-to-treat analysis was used.Results: A multilevel model was built with three factors: time, patient, and doctor. After adjusting for covariates, the mean number of visits at 1 year in IG was 13.10 (95% confidence interval [CI]=11.39 to 14.94); in the CG1 group was 19.37 (95% CI=17.31 to 21.55); and in the CG2 group this was 16.72 (95% CI=4.84 to 18.72).Conclusion: The new intervention with GPs resulted in a significant and relevant reduction in frequent-attender consultations. Although further trials are needed, this intervention is recommended to GPs interested in reducing consultations by their frequent attenders. [ABSTRACT FROM AUTHOR]- Published
- 2008
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20. P02-242 - Mental health of older people: the role of primary care
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Ivbijaro, G., Torres-González, F., Parmentier, H., and Gómez-Beneyto, M.
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- 2011
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21. FC03-04 - The importance of measuring functional impairment with the composite international diagnostic interview in depression research. A PredictD-Spain study
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Moreno-Kustner, B., Motrico, E., Bellón, J., Gil-de-Gómez-Barragán, M.J., Díaz-Barreiros, M.A., Martínez-Cañavate, M.T., Vázquez-Medrano, A., March, S., and Torres-González, F.
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- 2010
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22. P02.325 Residential care in Andalusia and London: A comparison
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Trieman, N., Torres-Gonzalez, F., Rickard, C., Maestro, J.C., Laviana, M., and Moreno-Küstner, B.
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- 2000
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23. Guiding light with singular beams in nanoplasmonic colloids
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Karen Volke-Sepúlveda, Alejandro V. Arzola, A. Balbuena Ortega, F. E. Torres-González, Gaetano Assanto, R. Delgado Macuil, J. E. H. Cardoso Sakamoto, V. López Gayou, Balbuena Ortega, A., Torres-González, F. E., López Gayou, V., Delgado Macuil, R., Cardoso Sakamoto, J. E. H., Arzola, A. V., Assanto, G., and Volke-Sepulveda, K.
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010302 applied physics ,Diffraction ,Physics ,Physics and Astronomy (miscellaneous) ,business.industry ,Nonlinear optics ,Physics::Optics ,02 engineering and technology ,Nonlinear optics, solitons, vrtices, structured light, nanoparticles ,021001 nanoscience & nanotechnology ,Laser ,01 natural sciences ,law.invention ,Vortex ,Wavelength ,Optics ,law ,0103 physical sciences ,Light beam ,Coaxial ,0210 nano-technology ,business ,Structured light - Abstract
We investigate the nonlinear propagation of light beams with complex phase and intensity structures, including a Gaussian-embedded vortex, a Bessel vortex, and a Bessel-cosine necklace. We employ a colloidal suspension of bio-synthesized plasmonic gold nanoparticles, where a self-defocusing response is mediated by absorption at the laser wavelength (532 nm). We show that, by means of nonlocal nonlinearity, these structured two-dimensional beams with on-axis singularity can counteract the diffraction of the dark core and guide therein a coaxial Gaussian probe of different wavelengths (633 nm) and lower intensities. Angular steering of the confined probe is also demonstrated by tilting the propagation direction of the pump.
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- 2021
24. Differential impact of risk factors for women and men on the risk of major depressive disorder.
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Stegenga BT, King M, Grobbee DE, Torres-González F, Svab I, Maaroos HI, Xavier M, Saldivia S, Bottomley C, Nazareth I, Geerlings MI, Stegenga, Bauke T, King, Michael, Grobbee, Diederick E, Torres-González, Francisco, Švab, Igor, Maaroos, Heidi-Ingrid, Xavier, Miguel, Saldivia, Sandra, and Bottomley, Christian
- Abstract
Purpose: Our aim is to examine which risk factors have a greater impact in women than in men on the risk of major depressive disorder (MDD) and whether factors differ between a possible recurrent MDD and a first onset of MDD.Methods: Prospective cohort study of general practice attendees in seven countries, who were followed up at 6 and 12 months (predictD). Absolute risk differences (interaction contrast) across sex for onset of DSM-IV MDD after 6 or 12 months of follow-up were estimated for 35 risk factors from 7101 participants without MDD at baseline.Results: A total of 599 participants (80% female) had an onset of MDD at 6 or 12 months. Most risk factors had a greater impact in women than in men on the risk of MDD and were not restricted to a specific class of risk factors. After we stratified for a history of depressive symptoms, we found that the impact of risk factors across sex was generally stronger on possible recurrent MDD than on a first onset of MDD.Conclusions: Our findings may partly account for the observed difference in incidence of MDD between men and women. [ABSTRACT FROM AUTHOR]- Published
- 2012
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25. Patients' views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries
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Stefan Priebe, Jiri Raboch, Zahava Solomon, Anastasia Karastergiou, Andrzej Kiejna, Algirdas Dembinskas, Thomas W. Kallert, Francisco Torres-González, Pìtr Nawka, Duolao Wang, Matthias Glöckner, Christina Katsakou, Matthias Schuetzwohl, Andrea Fiorillo, George Onchev, Lars Kjellin, Priebe, S, Katsakou, C, Glöckner, M, Dembinskas, A, Fiorillo, Andrea, Karastergiou, A, Kiejna, A, Kjellin, L, Nawka, P, Onchev, G, Raboch, J, Schuetzwohl, M, Solomon, Z, TORRES GONZÁLEZ, F, Wang, D, and Kallert, T.
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Adult ,Cross-Cultural Comparison ,Hospitals, Psychiatric ,Male ,medicine.medical_specialty ,Adolescent ,Attitude of Health Personnel ,Declaration ,Legislation ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Psychiatric hospital ,Prospective Studies ,030212 general & internal medicine ,Psychiatry ,Prospective cohort study ,Aged ,business.industry ,Mental Disorders ,Public health ,Social environment ,Middle Aged ,Mental health ,030227 psychiatry ,Europe ,Psychiatry and Mental health ,Patient Satisfaction ,Multivariate Analysis ,Commitment of Mentally Ill ,Female ,business ,Diagnosis of schizophrenia - Abstract
BackgroundLegislation and practice of involuntary hospital admission vary substantially among European countries, but differences in outcomes have not been studied.AimsTo explore patients' views following involuntary hospitalisation in different European countries.MethodIn a prospective study in 11 countries, 2326 consecutive involuntary patients admitted to psychiatric hospital departments were interviewed within 1 week of admission; 1809 were followed up 1 month and 1613 3 months later. Patients' views as to whether the admission was right were the outcome criterion.ResultsIn the different countries, between 39 and 71% felt the admission was right after 1 month, and between 46 and 86% after 3 months. Females, those living alone and those with a diagnosis of schizophrenia had more negative views. Adjusting for confounding factors, differences between countries were significant.ConclusionsInternational differences in legislation and practice may be relevant to outcomes and inform improvements in policies, particularly in countries with poorer outcomes.
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- 2010
26. Coerced Hospital Admission and Symptom Change—A Prospective Observational Multi-Centre Study
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Thomas W. Kallert, Zahava Solomon, Anastasia Mastrogianni, Tomasz Adamowski, Georgi Onchev, Christina Katsakou, Andrea Fiorillo, Jiri Raboch, Algirdas Dembinskas, P. Nawka, Francisco Torres-González, Lars Kjellin, Stefan Priebe, Matthias Schützwohl, Stephen Bremner, Kallert, Tw, Katsakou, C, Adamowski, T, Dembinskas, A, Fiorillo, Andrea, Kjellin, L, Mastrogianni, A, Nawka, P, Onchev, G, Raboch, J, Schützwohl, M, Solomon, Z, TORRES GONZÁLEZ, F, Bremner, S, and Priebe, S.
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Male ,Multivariate analysis ,Non-Clinical Medicine ,Psychometrics ,Coercion ,Medical ethics ,Social and Behavioral Sciences ,Patient Admission ,Brief Psychiatric Rating Scale ,Law and legal sciences ,Psychology ,Prospective Studies ,Multi centre ,Prospective cohort study ,Psychiatry ,Multidisciplinary ,Anxiety Disorders ,Hospitals ,Hospitalization ,Mental Health ,Hospital admission ,Medicine ,Female ,Research Article ,Employment ,Adult ,medicine.medical_specialty ,Science ,Legislation ,MEDLINE ,Models, Biological ,medicine ,Humans ,Psychological and Psychosocial Issues ,Health Care Policy ,business.industry ,Patient Selection ,Diagnostic medicine ,Psychotherapy ,Therapies ,Multivariate Analysis ,Emergency medicine ,Schizophrenia ,Linear Models ,Observational study ,business ,Follow-Up Studies - Abstract
[Introduction] Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes. [Method] At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months. [Results] The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes. [Discussion] On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice., he multi-site research project (Acronym: EUNOMIA) “European Evaluation of Coercion in Psychiatry and Harmonisation of Best Clinical Practise” was funded by the European Commission (Quality of Life and Management of Living Resources Programme, contract no. QLG4-CT-2002-01036).
- Published
- 2011
27. Toxoplasma gondii Seropositivity Interacts with Catechol- O -methyltransferase Val105/158Met Variation Increasing the Risk of Schizophrenia.
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Rovira P, Gutiérrez B, Sorlózano-Puerto A, Gutiérrez-Fernández J, Molina E, Rivera M, Martínez-Leal R, Ibanez-Casas I, Martín-Laguna MV, Rosa A, Torres-González F, and Cervilla JA
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- Case-Control Studies, Humans, Immunoglobulin G, Toxoplasma, Catechol O-Methyltransferase genetics, Schizophrenia genetics, Toxoplasmosis genetics
- Abstract
Schizophrenia is a heterogeneous and severe psychotic disorder. Epidemiological findings have suggested that the exposure to infectious agents such as Toxoplasma gondii (T. gondii) is associated with an increased risk for schizophrenia. On the other hand, there is evidence involving the catechol-O-methyltransferase (COMT) Val105/158Met polymorphism in the aetiology of schizophrenia since it alters the dopamine metabolism. A case−control study of 141 patients and 142 controls was conducted to analyse the polymorphism, the prevalence of anti-T. gondii IgG, and their interaction on the risk for schizophrenia. IgG were detected by ELISA, and genotyping was performed with TaqMan Real-Time PCR. Although no association was found between any COMT genotype and schizophrenia, we found a significant association between T. gondii seropositivity and the disorder (χ2 = 11.71; p-value < 0.001). Furthermore, the risk for schizophrenia conferred by T. gondii was modified by the COMT genotype, with those who had been exposed to the infection showing a different risk compared to that of nonexposed ones depending on the COMT genotype (χ2 for the interaction = 7.28, p-value = 0.007). This study provides evidence that the COMT genotype modifies the risk for schizophrenia conferred by T. gondii infection, with it being higher in those individuals with the Met/Met phenotype, intermediate in heterozygous, and lower in those with the Val/Val phenotype.
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- 2022
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28. Severe Mental Illness in Community Mental Health Care in Spain: Prevalence and Related Factors.
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Martín-Pérez C, Herrero-Martin JJ, Pérez-López G, Pedrosa-García R, Ibañez-Casas I, Torres-González F, and Moreno-Küstner B
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- Adolescent, Adult, Affective Disorders, Psychotic therapy, Aged, Aged, 80 and over, Behavioral Symptoms therapy, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Personality Disorders therapy, Prevalence, Psychotic Disorders therapy, Schizophrenia therapy, Spain epidemiology, Substance-Related Disorders therapy, Young Adult, Affective Disorders, Psychotic epidemiology, Behavioral Symptoms epidemiology, Community Mental Health Services statistics & numerical data, Facilities and Services Utilization statistics & numerical data, Personality Disorders epidemiology, Psychotic Disorders epidemiology, Schizophrenia epidemiology, Substance-Related Disorders epidemiology
- Abstract
The aims of this study were to determine the prevalence of severe mental illness (SMI) in patients in contact with mental health services and to determine the factors associated with SMI. A total of 260 patients who met diagnostic criteria for SMI were assessed using the Global Assessment of Functioning (GAF) scale and Health of the Nation Outcome Scales. The overall prevalence of SMI was 6.08 per thousand. According to the three different cutoff points with GAF, the prevalence of SMI ranged from 5.38 per thousand under the weak criterion (GAF < 70) to 1.01 per thousand under the strict criterion (GAF < 50). In the regression model, the dependent variable (presence of SMI) was defined using a GAF < 60, and the variables independently associated with the dependent variable were years of disease duration since diagnose, mental health service use, alcohol or other substance abuse, and depressive anxiety and other psychological symptoms.
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- 2019
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29. Predicting the onset of hazardous alcohol drinking in primary care: development and validation of a simple risk algorithm.
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Bellón JÁ, de Dios Luna J, King M, Nazareth I, Motrico E, GildeGómez-Barragán MJ, Torres-González F, Montón-Franco C, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens C, and Moreno-Peral P
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- Alcohol Drinking prevention & control, Alcohol Drinking psychology, Alcoholism prevention & control, Alcoholism psychology, Dangerous Behavior, Humans, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Spain, Alcohol Drinking epidemiology, Alcoholism epidemiology, Algorithms, Primary Health Care methods
- Abstract
Background: Little is known about the risk of progressing to hazardous alcohol use in abstinent or low-risk drinkers., Aim: To develop and validate a simple brief risk algorithm for the onset of hazardous alcohol drinking (HAD) over 12 months for use in primary care., Design and Setting: Prospective cohort study in 32 health centres from six Spanish provinces, with evaluations at baseline, 6 months, and 12 months., Method: Forty-one risk factors were measured and multilevel logistic regression and inverse probability weighting were used to build the risk algorithm. The outcome was new occurrence of HAD during the study, as measured by the AUDIT., Results: From the lists of 174 GPs, 3954 adult abstinent or low-risk drinkers were recruited. The 'predictAL-10' risk algorithm included just nine variables (10 questions): province, sex, age, cigarette consumption, perception of financial strain, having ever received treatment for an alcohol problem, childhood sexual abuse, AUDIT-C, and interaction AUDIT-C*Age. The c-index was 0.886 (95% CI = 0.854 to 0.918). The optimal cutoff had a sensitivity of 0.83 and specificity of 0.80. Excluding childhood sexual abuse from the model (the 'predictAL-9'), the c-index was 0.880 (95% CI = 0.847 to 0.913), sensitivity 0.79, and specificity 0.81. There was no statistically significant difference between the c-indexes of predictAL-10 and predictAL-9., Conclusion: The predictAL-10/9 is a simple and internally valid risk algorithm to predict the onset of hazardous alcohol drinking over 12 months in primary care attendees; it is a brief tool that is potentially useful for primary prevention of hazardous alcohol drinking., (© British Journal of General Practice 2017.)
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- 2017
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30. Suicidality in primary care patients who present with sadness and anhedonia: a prospective European study.
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Moreno-Küstner B, Jones R, Švab I, Maaroos H, Xavier M, Geerlings M, Torres-González F, Nazareth I, Motrico-Martínez E, Montón-Franco C, Gil-de-Gómez MJ, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens-Caldentey C, and King M
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- Cohort Studies, Europe epidemiology, Female, Humans, Male, Middle Aged, Prospective Studies, Anhedonia, Depressive Disorder, Major epidemiology, Depressive Disorder, Major psychology, Primary Health Care, Suicide psychology, Suicide statistics & numerical data
- Abstract
Background: Sadness and anhedonia (loss of interest in activities) are central symptoms of major depression. However, not all people with these symptoms meet diagnostic criteria for major depression. We aimed to assess the importance of suicidality in the outcomes for primary care patients who present with sadness and anhedonia., Method: Cohort study of 2,599 unselected primary care attenders in six European countries followed up at 6 and 12 months., Results: 1) In patients with sadness and/or anhedonia who were not depressed at entry to the study, suicide plans (OR = 3.05; 95 % CI = 1.50-6.24; p = 0.0022) and suicide attempts (OR = 9.08; 95 % CI = 2.57-32.03; p = 0.0006) were significant predictors of developing new onset depression at 6 or 12 months. 2) In patients with sadness and/or anhedonia who met CIDI criteria for major depression at entry, suicidal ideation (OR = 2.93; 95 % CI = 1.70-5.07; p = 0.0001), suicide plans (OR = 3.70; 95 % CI = 2.08-6.57; p < 0.0001), and suicide attempts (OR = 3.33; 95 % CI = 1.47-7.54; p = 0.0040) were significant predictors of persistent depression at 6 or 12 months., Conclusions: Three questions on suicidality could help primary care professionals to assess such patients more closely without necessarily establishing whether they meet criteria for major depression.
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- 2016
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31. The risk for major depression conferred by childhood maltreatment is multiplied by BDNF and SERT genetic vulnerability: a replication study.
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Gutiérrez B, Bellón JÁ, Rivera M, Molina E, King M, Marston L, Torres-González F, Moreno-Küstner B, Moreno-Peral P, Motrico E, Montón-Franco C, GildeGómez-Barragán MJ, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens C, de Dios Luna J, Nazareth I, and Cervilla J
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- Child, Female, Follow-Up Studies, Humans, Male, Middle Aged, Polymorphism, Genetic, Risk, Spain, Brain-Derived Neurotrophic Factor genetics, Child Abuse, Depressive Disorder, Major genetics, Gene-Environment Interaction, Genetic Predisposition to Disease, Serotonin Plasma Membrane Transport Proteins genetics
- Abstract
Background: There is limited evidence for a moderating role of both serotonin transporter (SERT) and brain-derived neurotrophic factor (BDNF) genes on the risk for major depression (MD) developing after childhood maltreatment. However, research on this topic remains inconclusive, and there is a lack of data from longitudinal studies with large and representative population samples. Our study aimed to clarify whether, in the presence of previous childhood maltreatment, individuals carrying low functional alleles for both SERT 5-HTTLPR and BDNF Val66Met polymorphisms had a higher risk for MD., Methods: We explored 2- and 3-way gene (SERT and BDNF) × environment (childhood maltreatment) interactions in a large sample of Spanish adults who were followed up over a 3-year period and assessed in person for both DSM-IV MD and exposure to childhood maltreatment., Results: Our study included 2679 participants. Those with both the 5-HTTLPR s allele and the BDNF Met allele showed the highest risk of MD if they had previously experienced emotional (z = 2.08, p = 0.037), sexual (z = 2.19, p = 0.029) or any kind of childhood abuse (z = 2.37, p = 0.018). These 3-way interactions remained significant regardless of whether the 5-HTTLPR triallelic or the 5-HTTLPR biallelic polymorphisms were included in the analyses., Limitations: Retrospective assessment of childhood maltreatment may have resulted in a moderate degree of recall bias., Conclusion: Our results confirm that the risk of depression conferred by childhood maltreatment is modified by variation at both SERT and BDNF genes.
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- 2015
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32. Predicting the onset of anxiety syndromes at 12 months in primary care attendees. The predictA-Spain study.
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Moreno-Peral P, Luna Jde D, Marston L, King M, Nazareth I, Motrico E, GildeGómez-Barragán MJ, Torres-González F, Montón-Franco C, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens C, Muñoz-Bravo C, and Bellón JÁ
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- Adult, Aged, Anxiety Disorders epidemiology, Anxiety Disorders pathology, Cohort Studies, Depressive Disorder epidemiology, Depressive Disorder pathology, Female, Forecasting, Humans, Logistic Models, Male, Middle Aged, Primary Health Care, Quality of Life, Risk Factors, Spain, Anxiety Disorders diagnosis, Depressive Disorder diagnosis, Stress, Psychological
- Abstract
Background: There are no risk algorithms for the onset of anxiety syndromes at 12 months in primary care. We aimed to develop and validate internally a risk algorithm to predict the onset of anxiety syndromes at 12 months., Methods: A prospective cohort study with evaluations at baseline, 6 and 12 months. We measured 39 known risk factors and used multilevel logistic regression and inverse probability weighting to build the risk algorithm. Our main outcome was generalized anxiety, panic and other non-specific anxiety syndromes as measured by the Primary Care Evaluation of Mental Disorders, Patient Health Questionnaire (PRIME-MD-PHQ). We recruited 3,564 adult primary care attendees without anxiety syndromes from 174 family physicians and 32 health centers in 6 Spanish provinces., Results: The cumulative 12-month incidence of anxiety syndromes was 12.2%. The predictA-Spain risk algorithm included the following predictors of anxiety syndromes: province; sex (female); younger age; taking medicines for anxiety, depression or stress; worse physical and mental quality of life (SF-12); dissatisfaction with paid and unpaid work; perception of financial strain; and the interactions sex*age, sex*perception of financial strain, and age*dissatisfaction with paid work. The C-index was 0.80 (95% confidence interval=0.78-0.83) and the Hedges' g=1.17 (95% confidence interval=1.04-1.29). The Copas shrinkage factor was 0.98 and calibration plots showed an accurate goodness of fit., Conclusions: The predictA-Spain risk algorithm is valid to predict anxiety syndromes at 12 months. Although external validation is required, the predictA-Spain is available for use as a predictive tool in the prevention of anxiety syndromes in primary care.
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- 2014
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33. The Maristán stigma scale: a standardized international measure of the stigma of schizophrenia and other psychoses.
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Saldivia S, Runte-Geidel A, Grandón P, Torres-González F, Xavier M, Antonioli C, Ballester DA, Melipillán R, Galende E, Vicente B, Caldas JM, Killaspy H, Gibbons R, and King M
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- Adolescent, Adult, Female, Humans, Male, Middle Aged, Prejudice, Reproducibility of Results, Social Support, Young Adult, Psychiatric Status Rating Scales standards, Psychotic Disorders psychology, Schizophrenic Psychology, Social Perception, Social Stigma
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Background: People with schizophrenia face prejudice and discrimination from a number of sources including professionals and families. The degree of stigma perceived and experienced varies across cultures and communities. We aimed to develop a cross-cultural measure of the stigma perceived by people with schizophrenia., Method: Items for the scale were developed from qualitative group interviews with people with schizophrenia in six countries. The scale was then applied in face-to-face interviews with 164 participants, 103 of which were repeated after 30 days. Principal Axis Factoring and Promax rotation evaluated the structure of the scale; Horn's parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability., Results: The final scale has 31 items and four factors: informal social networks, socio-institutional, health professionals and self-stigma. Cronbach's alpha was 0.84 for the Factor 1; 0.81 for Factor 2; 0.74 for Factor 3, and 0.75 for Factor 4. Correlation matrix among factors revealed that most were in the moderate range [0.31-0.49], with the strongest occurring between perception of stigma in the informal network and self-stigma and there was also a weaker correlation between stigma from health professionals and self-stigma. Test-retest reliability was highest for informal networks [ICC 0.76 [0.67 -0.83]] and self-stigma [ICC 0.74 [0.64-0.81]]. There were no significant differences in the scoring due to sex or age. Service users in Argentina had the highest scores in almost all dimensions., Conclusions: The MARISTAN stigma scale is a reliable measure of the stigma of schizophrenia and related psychoses across several cultures. A confirmatory factor analysis is needed to assess the stability of its factor structure.
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- 2014
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34. Standardization of the MARISTÁN scale to measure needs in people with schizophrenia and related psychoses.
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Saldivia S, Torres-González F, Runte-Geidel A, Grandon P, Xavier M, Killaspy H, Ballester D, Antonioli C, Melipillan R, Galende E, Caldas JM, and King M
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- Adolescent, Adult, Analysis of Variance, Argentina, Brazil, Chile, Cross-Cultural Comparison, Employment statistics & numerical data, Female, Housing statistics & numerical data, Humans, Male, Middle Aged, Psychometrics, Reproducibility of Results, Spain, United Kingdom, Venezuela, Young Adult, Activities of Daily Living psychology, Health Services Needs and Demand statistics & numerical data, Quality of Life psychology, Schizophrenia, Surveys and Questionnaires standards
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Objective: Existing measures of needs in severe mental illness have been developed mainly from professionals' viewpoints and are Eurocentric. Our aim was to standardize a measure of the needs of people with schizophrenia across several cultures and based on users' own viewpoints., Method: An instrument to measure needs, based on qualitative data on users', carers' and professionals' views, was tested in 164 people with schizophrenia or related psychoses in six countries. Participants underwent face-to-face interviews, one third of which were repeated 30 days later. Principal axis factoring and Promax rotation evaluated scale structure; Horn's parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability., Results: The instrument contained four factors: (1) health needs; (2) work and leisure needs; (3) existential needs; and (4) needs for support in daily living. Cronbach's α for internal consistency was 0.81, 0.81, 0.77 and 0.76 for factors 1-4 and 0.81 for the scale as a whole. Correlation between factors was of moderate range for the first three factors (0.41-0.50) and low for the fourth factor (0.14-0.29). Intra-class correlation coefficient for test-retest reliability was 0.74 (0.64-0.82) for the whole scale. Mean item score on needs for support in daily living was lower than for the other factors., Conclusions: The MARISTÁN Scale of Needs evaluates needs from the patient perspective and it is a valid instrument to measure the needs of people with severe mental illness across cultures.
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- 2014
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35. Elder abuse and socioeconomic inequalities: a multilevel study in 7 European countries.
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Fraga S, Lindert J, Barros H, Torres-González F, Ioannidi-Kapolou E, Melchiorre MG, Stankunas M, and Soares JF
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- Aged, Aged, 80 and over, Analysis of Variance, Cross-Cultural Comparison, Cross-Sectional Studies, Educational Status, Europe epidemiology, Female, Humans, Logistic Models, Male, Middle Aged, Prevalence, Elder Abuse statistics & numerical data, Health Status Disparities, Residence Characteristics, Social Class
- Abstract
Objectives: To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level., Methods: In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60-84 years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models., Results: The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC=3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%)., Conclusion: There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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36. Psychometric properties of the List of Threatening Experiences--LTE and its association with psychosocial factors and mental disorders according to different scoring methods.
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Motrico E, Moreno-Küstner B, de Dios Luna J, Torres-González F, King M, Nazareth I, Montón-Franco C, Gilde Gómez-Barragán MJ, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens C, Moreno-Peral P, and Bellón JÁ
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- Adolescent, Adult, Aged, Anxiety epidemiology, Anxiety Disorders epidemiology, Cross-Sectional Studies, Depression epidemiology, Depressive Disorder epidemiology, Depressive Disorder, Major epidemiology, Female, Humans, Male, Mental Health, Middle Aged, Primary Health Care, Reproducibility of Results, Research Design, Social Support, Spain epidemiology, Young Adult, Life Change Events, Mental Disorders epidemiology, Psychometrics methods, Surveys and Questionnaires
- Abstract
Background: The List of Threatening Experiences (LTE) questionnaire is frequently used to assess stressful events; however, studies of its psychometric properties are scarce. We examined the LTE's reliability, factorial structure, construct validity and explored the association between LTE scores and psychosocial variables and mental disorders., Method: This study involved interviewing 5442 primary care attendees from Spain. Associations between four different methods of quantifying LTE scores, psychosocial factors, major depression (CIDI), anxiety disorders (PRIME-MD), alcohol misuse and dependence (AUDIT) were measured., Results: The LTE showed high test-retest reliability (Kappa range=0.61-0.87) and low internal consistency (α=0.44). Tetrachoric factorial analysis yielded four factors (spousal and relational problems; employment and financial problems; personal problems; illness and bereavement in close persons). Logistic multilevel regression found a strong association between greater social support and a lower occurrence of stressful events (OR range=0.36-0.79). The association between religious-spiritual beliefs and the LTE, was weaker. The association between mental disorders and LTE scores was greater for depression (OR range=1.64-2.57) than anxiety (OR range=1.35-1.97), though the highest ORs were obtained with alcohol dependence (OR range=2.86-4.80). The ordinal score (ordinal regression) was more sensitive to detect the strength of association with mental disorders., Limitations: We are unable to distinguish the direction of the association between stressful events, psychosocial factors and mental disorders, due to our cross-sectional design of the study., Conclusions: The LTE is a valid and reliable measure of stress in mental health, and the strength of association with mental disorders depends on the method of quantifying LTE scores., (© 2013 Elsevier B.V. All rights reserved.)
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- 2013
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37. Risk factors for onset of multiple or long major depressive episodes versus single and short episodes.
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Stegenga BT, Geerlings MI, Torres-González F, Xavier M, Svab I, Penninx BW, Nazareth I, and King M
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- Adolescent, Adult, Aged, Depressive Disorder, Major therapy, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Assessment, Risk Factors, Young Adult, Depressive Disorder, Major psychology
- Abstract
Purpose: Major depressive disorder may vary according to number and duration of episodes. It is unclear whether risk factors for onset of multiple or long episodes of depression (MDE) differ from risk factors for the onset of single and short ones., Methods: Data were used from a cohort study of 5,256 GP attendees without major depressive disorder at baseline, who were followed up three times (predictD). The numbers and duration of MDE were noted and categorized into no episodes, single and short (≤3 months), and multiple or long (>3 months) episodes at follow-up. Log-binomial regression models were used to calculate relative risks between the groups for 18 risk factors examined at baseline., Results: 165 persons (3 %) had a single and short MDE and 328 (6 %) had multiple or long MDE at follow-up. Lower education, anxiety, problems at work and financial strain significantly increased the risk of multiple or long MDE when compared to single and short MDE. Younger people were at reduced risk of multiple or long MDE., Conclusions: Our findings suggest that several risk factors can be identified that may help to predict onset of different types of MDE. These factors are easy to assess and may be used in the prevention of depression.
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- 2013
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38. Depression, anxiety and physical function: exploring the strength of causality.
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Stegenga BT, Nazareth I, Torres-González F, Xavier M, Svab I, Geerlings MI, Bottomley C, Marston L, and King M
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- Adult, Aged, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Activities of Daily Living psychology, Anxiety physiopathology, Causality, Depression physiopathology
- Abstract
Background: Depression, anxiety and physical function may be bi-directionally related. We aim to estimate the strength of the longitudinal associations between depression, anxiety and physical function., Methods: Prospective cohort study of general practice attendees across Europe (N=4757) assessed at baseline, 6, 12 and 24 months. Main outcome measures were Diagnostic and Statistical Manual of Mental Disorders-IV major depression, Patient Health Questionnaire anxiety and Short Form 12 physical function. Complete-case analyses using random coefficient models and logistic regression models were performed., Results: Those with depression (β=-1.90, 95% CI -3.42 to -0.39), anxiety (β=-4.12, 95% CI -5.39 to -2.86) or depression and anxiety (β=-5.74, 95% CI -7.38 to -4.10) had lower levels of physical function at baseline and over time compared with no diagnosis after adjustment for potential confounders. Physical function increased over time, but the rate of increase was not different between the groups. When compared with depression, those with anxiety (β=-2.22, 95% CI -4.08 to -0.36) or depression and anxiety (β=-3.83, 95% CI -5.95 to -1.71) had significantly lower levels of physical function at baseline. Lower levels of physical function at baseline were associated with onset of depression (OR 1.83, 95% CI 1.08 to 3.10) but even stronger with anxiety (OR 2.79, 95% CI 1.52 to 5.12) or depression and anxiety (OR 5.05, 95% CI 2.55 to 9.99) during 24 months compared with no dysfunction, after adjustment for potential confounders., Conclusion: It is essential to prevent lower levels of physical function as this is likely to lead to onset of depression and anxiety over time.
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- 2012
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39. Recent life events pose greatest risk for onset of major depressive disorder during mid-life.
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Stegenga BT, Nazareth I, Grobbee DE, Torres-González F, Svab I, Maaroos HI, Xavier M, Saldivia S, Bottomley C, King M, and Geerlings MI
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- Adolescent, Adult, Age of Onset, Aged, Cohort Studies, Europe epidemiology, Female, Humans, Male, Middle Aged, Netherlands epidemiology, Prospective Studies, Risk Factors, Surveys and Questionnaires, United Kingdom epidemiology, Young Adult, Depressive Disorder, Major epidemiology, Life Change Events
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Background: The authors examined an additive model for the association of life events and age with onset of major depressive disorder (MDD) and whether the combination of life events and age posed greater risk than the sum of their independent effects., Methods: Data were used from a prospective cohort study of 10,045 general practice attendees (PredictD). We included those without MDD at baseline (N=8293). We examined age divided into tertiles and into 10 year groups. Life events were assessed at baseline using the List of Threatening Life Experiences Questionnaire and categorized according to type. Main outcome measure was onset of DSM-IV MDD at 6 or 12 months of follow-up. The authors calculated Relative Excess Risks due to Interaction (RERI)., Results: 6910 persons (83.3%) had a complete follow-up, of whom 589 (8.5%) had an onset of MDD (166 younger, 254 middle aged and 169 older). The combined effect of personal problems (RERI=1.30; 95% CI 0.29 to 2.32), events in family or friends (RERI=1.23; 95% CI 0.28 to 2.19), or problems with law (RERI=1.57; 95% CI 0.33 to 2.82) and middle age was larger than the sum of individual effects., Limitations: Lower response to recruitment in the UK and the Netherlands., Conclusions: Recent life events carry the largest risk of onset of MDD in mid-life. Understanding the different vulnerability to life events according to age may help to indicate groups at a particular risk and assist in preventive strategies., (Copyright © 2011 Elsevier B.V. All rights reserved.)
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- 2012
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40. Acute psychopathology as a predictor of global functioning in patients with ICD-10 non-affective psychosis: a prospective study in 11 European countries.
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Petkari E, Salazar-Montes AM, Kallert TW, Priebe S, Fiorillo A, Raboch J, Onchev G, Karastergiou A, Nawka A, Dembinskas A, Kiejna A, Kjellin L, Torres-González F, and Cervilla JA
- Subjects
- Adult, Cross-Sectional Studies, Europe epidemiology, Female, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Patient Discharge statistics & numerical data, Predictive Value of Tests, Principal Component Analysis, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders diagnosis, Retrospective Studies, Young Adult, International Classification of Diseases statistics & numerical data, Psychopathology, Psychotic Disorders epidemiology, Psychotic Disorders physiopathology
- Abstract
This prospective analysis aimed to study the influence of psychopathological dimensions on the global functioning of persons suffering from psychotic disorders, taking into account the role of a broad range of potential confounders. A large international cohort (n=1888) with ICD-10 non-affective psychosis was evaluated both at baseline during a hospital admission and three months after discharge. Trained interviewers administered a global functioning scale (GAF) and a psychopathological scale (BPRS) at baseline and follow-up). Baseline BPRS psychopathological dimensions were extracted using Principal Component Analysis. Results of multiple linear regression analyses demonstrated that affective symptoms (depressive or manic) prospectively predict a better global functioning, whilst agitation/cognitive symptoms determined poorer global functioning. Other predictors showing an independent effect on better global functioning were medication compliance, country of residence, female gender, married or coupled status, younger age and having a diagnosis of schizoaffective disorder rather than schizophrenia or other ICD-10 psychosis. A predicting model for global functioning in patients with psychosis is provided, showing that assessment of affective and agitation/cognitive symptoms should be emphasised during admission as they can be more informative than positive/negative symptoms in prospectively planning follow-up care that is geared towards a better functional recovery., (Copyright © 2011 Elsevier B.V. All rights reserved.)
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- 2011
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41. Factorial validity and measurement equivalence of the Client Assessment of Treatment Scale for psychiatric inpatient care - a study in three European countries.
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Richardson M, Katsakou C, Torres-González F, Onchev G, Kallert T, and Priebe S
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- Bulgaria, England, Europe epidemiology, Factor Analysis, Statistical, Female, Hospitalization, Humans, Inpatients, Male, Mental Disorders diagnosis, Models, Statistical, Reproducibility of Results, Spain, Mental Disorders epidemiology, Mental Disorders therapy, Outcome Assessment, Health Care methods, Weights and Measures
- Abstract
Patients' views of inpatient care need to be assessed for research and routine evaluation. For this a valid instrument is required. The Client Assessment of Treatment Scale (CAT) has been used in large scale international studies, but its psychometric properties have not been well established. The structural validity of the CAT was tested among involuntary inpatients with psychosis. Data from locations in three separate European countries (England, Spain and Bulgaria) were collected. The factorial validity was initially tested using single sample confirmatory factor analyses in each country. Subsequent multi-sample analyses were used to test for invariance of the factor loadings, and factor variances across the countries. Results provide good initial support for the factorial validity and invariance of the CAT scores. Future research is needed to cross-validate these findings and to generalise them to other countries, treatment settings, and patient populations., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2011
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42. Existential questions in schizophrenia: perception of patients and caregivers.
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Wagner LC, Torres-González F, Geidel AR, and King MB
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- Adolescent, Adult, Female, Focus Groups, Humans, Male, Personal Autonomy, Qualitative Research, Social Stigma, Young Adult, Caregivers psychology, Existentialism psychology, Schizophrenia nursing, Schizophrenic Psychology, Self Concept
- Abstract
Objective: To examine existential questions in the daily life of people with schizophrenia and their caregivers., Methods: Qualitative study with focus groups. 146 people with schizophrenia (55% men) and 80 caregivers (75% women) participated. They came predominantly from primary and secondary health services of Argentina, Brazil, Chile, Spain, England and Venezuela. Each group had between six and ten participants. The data was explored through a content analysis process., Results: Four omnipresent existential themes were identified from the discussions: the need for personal development and to find meaning in life; the need to be respected and not suffer discrimination or stigma; the conflict resulting from the loss of autonomy; the importance of understanding the illness and recognizing it as an illness. The existential questions were closely associated with objective needs, such as the lack of occupational opportunities and employment, which generally result in a life without meaning., Conclusions: It is necessary to develop a new type of health care in which both the consideration for the person with schizophrenia and their subjectivity are as important as biological treatment. Health promotion strategies need to combat stigma and use mechanisms of occupational inclusion.
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- 2011
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43. [Mental health care: perceptions of people with schizophrenia and their carers].
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Wagner LC, Geidel AR, Torres-González F, and King MB
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- Adolescent, Female, Focus Groups, Humans, Male, Young Adult, Attitude of Health Personnel, Attitude to Health, Caregivers, Mental Health Services standards, Schizophrenia therapy
- Abstract
The current study aims to discover the opinions of patients and their (informal and formal) carers concerning the mental health care of individuals with long term schizophrenic disorders within different contexts and cultures. It's a qualitative study with focus groups,in which 6 research centers (from Argentina, Brazil, Chile, Spain, England and Venezuela) participated. Eight focus groups were conducted in each center, totaling 303 individuals in 46 groups. The data were analyzed with the aid of the Qualitative Solutions and Research/Non-numerical Unstructured Data Indexing program (QSR NUD*IST 4.0). The perception regarding the quality of care is influenced by the professional-patient relationship and the availability of resources. Poor quality of care is also perceived as discrimination. People with schizophrenia in general consider themselves to be ostracized by professionals and services and lacking in more humanized care. In the contexts in which community care is less advanced, the complaints center on resources and services that do not meet demands. On the other hand, in more developed contexts criticism centers more on the attitude of the professionals and the professional patient relationship. Over and above the need for resources and services, people with schizophrenia require more humanized health care.
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- 2011
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44. Coerced hospital admission and symptom change--a prospective observational multi-centre study.
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Kallert TW, Katsakou C, Adamowski T, Dembinskas A, Fiorillo A, Kjellin L, Mastrogianni A, Nawka P, Onchev G, Raboch J, Schützwohl M, Solomon Z, Torres-González F, Bremner S, and Priebe S
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Linear Models, Male, Models, Biological, Multivariate Analysis, Patient Admission statistics & numerical data, Patient Selection, Prospective Studies, Brief Psychiatric Rating Scale statistics & numerical data, Coercion, Hospitalization statistics & numerical data
- Abstract
Introduction: Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes., Method: At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months., Results: The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes., Discussion: On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice.
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- 2011
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45. Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study.
- Author
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Bellón JA, de Dios Luna J, Moreno B, Montón-Franco C, GildeGómez-Barragán MJ, Sánchez-Celaya M, Díaz-Barreiros MA, Vicens C, Motrico E, Martínez-Cañavate MT, Oliván-Blázquez B, Vázquez-Medrano A, Sánchez-Artiaga MS, March S, del Mar Muñoz-García M, Moreno-Peral P, Nazareth I, King M, and Torres-González F
- Subjects
- Adolescent, Adult, Aged, Depressive Disorder, Major diagnosis, Depressive Disorder, Major epidemiology, Female, Follow-Up Studies, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Outcome Assessment, Health Care, Psychometrics, Refusal to Participate statistics & numerical data, Risk Factors, Social Class, Spain epidemiology, Surveys and Questionnaires, Young Adult, Depressive Disorder, Major psychology, Health Behavior, Refusal to Participate psychology
- Abstract
Background: Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. This study was undertaken to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care., Methods: A systematic random sample of general practice attendees was recruited in seven Spanish provinces between October 2005 and February 2006. Major depression was diagnosed using the Composite International Diagnostic Interview and a set of 39 individual and environmental risk factors for depression were assessed at baseline and after 6 and 12 months of follow-up. Data were analysed using multilevel logistic regression., Results: 7777 primary care attendees aged 18-75 years were selected, of whom 1251 (16.1%) were excluded. Of the remaining 6526, 1084 (16.6%) refused to participate. Thus, 5442 patients (attending 231 family physicians in 41 health centres) were interviewed at baseline, of whom 3804 (70%) and 3567 (66%) remained at 6 and 12 months of follow-up, respectively. The province and sociodemographic factors were stronger predictors of attrition than psychosocial factors. Depression and anxiety had no effect but other psychosocial factors affected attrition. There were different profiles for the patients lost at 12 months when predictors measured at baseline versus 6 months were included., Conclusions: These findings suggest that several psychosocial factors might be considered factors of attrition in primary care cohorts and confirm that baseline characteristics are insufficient for analysing non-response in longitudinal studies, indicating that different retention strategies should be applied for patients interviewed at 6 and 12 months.
- Published
- 2010
- Full Text
- View/download PDF
46. Patients' views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries.
- Author
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Priebe S, Katsakou C, Glöckner M, Dembinskas A, Fiorillo A, Karastergiou A, Kiejna A, Kjellin L, Nawka P, Onchev G, Raboch J, Schuetzwohl M, Solomon Z, Torres-González F, Wang D, and Kallert T
- Subjects
- Adolescent, Adult, Aged, Attitude of Health Personnel, Commitment of Mentally Ill legislation & jurisprudence, Cross-Cultural Comparison, Europe epidemiology, Female, Humans, Male, Mental Disorders epidemiology, Mental Disorders psychology, Middle Aged, Multivariate Analysis, Prospective Studies, Young Adult, Commitment of Mentally Ill statistics & numerical data, Hospitals, Psychiatric statistics & numerical data, Mental Disorders therapy, Patient Satisfaction statistics & numerical data
- Abstract
Background: Legislation and practice of involuntary hospital admission vary substantially among European countries, but differences in outcomes have not been studied., Aims: To explore patients' views following involuntary hospitalisation in different European countries., Method: In a prospective study in 11 countries, 2326 consecutive involuntary patients admitted to psychiatric hospital departments were interviewed within 1 week of admission; 1809 were followed up 1 month and 1613 3 months later. Patients' views as to whether the admission was right were the outcome criterion., Results: In the different countries, between 39 and 71% felt the admission was right after 1 month, and between 46 and 86% after 3 months. Females, those living alone and those with a diagnosis of schizophrenia had more negative views. Adjusting for confounding factors, differences between countries were significant., Conclusions: International differences in legislation and practice may be relevant to outcomes and inform improvements in policies, particularly in countries with poorer outcomes.
- Published
- 2010
- Full Text
- View/download PDF
47. Comparison of risk factors for the onset and maintenance of depression.
- Author
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Bottomley C, Nazareth I, Torres-González F, Svab I, Maaroos HI, Geerlings MI, Xavier M, Saldivia S, and King M
- Subjects
- Age of Onset, Depressive Disorder epidemiology, Family Practice, Female, Humans, Male, Prevalence, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Time Factors, Depressive Disorder etiology
- Abstract
Background: Factors associated with depression are usually identified from cross-sectional studies., Aims: We explore the relative roles of onset and recovery in determining these associations., Method: Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months., Results: Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor's effect on onset is highly predictive of its impact on recovery., Conclusions: Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
- Published
- 2010
- Full Text
- View/download PDF
48. The gap in treatment of serious mental disorder in the community: a public health problem.
- Author
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Torres-González F
- Published
- 2009
49. High-activity variants of the uMAOA polymorphism increase the risk for depression in a large primary care sample.
- Author
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Rivera M, Gutiérrez B, Molina E, Torres-González F, Bellón JA, Moreno-Küstner B, King M, Nazareth I, Martínez-González LJ, Martínez-Espín E, Muñoz-García MM, Motrico E, Martínez-Cañavate T, Lorente JA, Luna JD, and Cervilla JA
- Subjects
- Adult, Alleles, Case-Control Studies, Confidence Intervals, DNA blood, DNA genetics, DNA isolation & purification, Depression diagnosis, Female, Gene Frequency, Genotype, Humans, Male, Middle Aged, Odds Ratio, Promoter Regions, Genetic, Prospective Studies, Risk Factors, Sex Factors, Spain, Depression genetics, Genetic Variation, Monoamine Oxidase genetics, Polymorphism, Genetic, Primary Health Care
- Abstract
Studies on the association between the functional uMAOA polymorphism and depression have yielded non-conclusive results up till now. One thousand two hundred twenty eight consecutive Spanish primary care attendees, participating in the PREDICT study, agreed to take part in this genetic PREDICT-Gene study. We explored the association between depression and either high-activity uMAOA alleles or genotypes. Depression was diagnosed using the Composite International Diagnostic Interview (CIDI) to establish three different depressive outcomes (ICD-10 Depressive Episode (DE), ICD-10 Severe Depressive Episode (SDE) and DSM-IV Major Depression (MD)). uMAOA genetic variation was determined by PCR amplification and subsequent electrophoresis. Crude and adjusted (gender and/or age) odds ratios, with 95% confidence intervals, were calculated for the associations between allele or genotype frequencies and all three depressive outcomes. We found associations between all three depressive phenotypes and either high-activity alleles or high-activity genotypes in both sexes. The associations were statistically significant for females but not for males. Testing the same associations on the entire sample (males and females) also yielded significant associations between depression and either high-activity alleles or high-activity genotype distribution that were independent of age and/or gender (ICD-10 DE: OR = 1.98; 95% CI: 1.42-1.77; P = 0.00002; ICD-10-SDE: OR = 2.05; 95% CI: 1.38-3.05; P = 0.0002; DSM-IV MD: OR = 1.91; 95% CI: (1.26-2.91); P = 0.0014). Our results provide fairly consistent evidence that high-activity variants of the MAOA promoter polymorphism confer a modestly higher risk for depression., ((c) 2008 Wiley-Liss, Inc.)
- Published
- 2009
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- View/download PDF
50. Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: methodology.
- Author
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Bellón JA, Moreno-Küstner B, Torres-González F, Montón-Franco C, GildeGómez-Barragán MJ, Sánchez-Celaya M, Díaz-Barreiros MA, Vicens C, de Dios Luna J, Cervilla JA, Gutierrez B, Martínez-Cañavate MT, Oliván-Blázquez B, Vázquez-Medrano A, Sánchez-Artiaga MS, March S, Motrico E, Ruiz-García VM, Brangier-Wainberg PR, Del Mar Muñoz-García M, Nazareth I, and King M
- Subjects
- Adolescent, Adult, Aged, Depressive Disorder epidemiology, Factor Analysis, Statistical, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prevalence, Primary Health Care, Prospective Studies, Recurrence, Reproducibility of Results, Risk Factors, Socioeconomic Factors, Spain epidemiology, Depressive Disorder diagnosis, Risk Assessment methods, Surveys and Questionnaires standards
- Abstract
Background: The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used., Methods: This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered) between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province., Results: All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work). There were 191 (0.16%) data entry errors., Conclusion: The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health care.
- Published
- 2008
- Full Text
- View/download PDF
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