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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.

To assess users’ usability, satisfaction, acceptance and effectiveness of the PRECIOUS system to promote behavior change toward healthier lifestyles. Design: Thirty-one adult patients with BMI>30 (...

COVID-19; Anxiety; Pregnancy COVID-19; Ansiedad; Embarazo COVID-19; Ansietat; Embaràs Background: To explore the depression and anxiety symptoms in the postpartum period during the SARS-CoV-2 pandemic and to identify potential risk factors. Methods: A multicentre observational cohort study including 536 women was performed at three hospitals in Spain. The Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Postpartum Bonding Questionnaire (PBQ) were assessed after birth. Depression (EPDS) and anxiety (STAI) symptoms were measured, and the cut-off scores were set at 10 and 13 for EPDS, and at 40 for STAI. Results: Regarding EPDS, 32.3% (95% CI, 28% to 36.5%) of women had a score ≥ 10, and 17.3% (95% CI, 13.9% to 20.7%) had a score ≥ 13. Women with an STAI score ≥ 40 accounted for 46.8% (95% CI, 42.3% to 51.2%). A lower level of social support (MOS-SSS), a fetal malformation diagnosis and a history of depression (p = 0.000, p = 0.019 and p = 0.043) were independent risk factors for postpartum depression. A lower level of social support and a history of mental health disorders (p = 0.000, p = 0.003) were independent risk factors for postpartum anxiety. Conclusion: During the SARS-CoV-2 pandemic, an increase in symptoms of anxiety and depression were observed during the postpartum period.

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.

Resumen Antecedentes y objetivo La calidad de vida relacionada con la salud (CVRS) se considera una medida de resultado del trasplante renal. En este estudio se evaluaron los cambios en la CVRS y los sintomas especificos de la enfermedad renal, ademas de los efectos de variables sociodemograficas y clinicas en la CVRS percibida por el paciente. Pacientes y metodo Se realizo un estudio longitudinal, con 5 momentos de evaluacion durante 2 anos despues del trasplante. Para evaluar la CVRS se administro el Kidney Disease Quality of Life Questionnaire Short Form , y el Hospital Anxiety and Depression Scale para evaluar el malestar emocional. Resultados A los 6 meses postrasplante, los pacientes tienen una CVRS similar a la poblacion general. La dimension de efectos de la enfermedad renal obtuvo un tamano de efecto grande (η 2 = 0,29), y un tamano medio la dimension de sobrecarga de la enfermedad renal (η 2 = 0,12), la dimension de actividad laboral (η 2 = 0,12) y la dimension de funcion sexual (η 2 = 0,13). El malestar emocional, la hemoglobina y la creatinina influyeron significativamente en la CVRS percibida por el paciente. Conclusiones Durante los 2 anos posteriores al trasplante renal se observo una mejora de la CVRS en cuanto a aspectos generales y sintomas especificos de la enfermedad.

Resumen Introduccion El trasplante es una modalidad de tratamiento optima para la enfermedad renal cronica avanzada, que requiere de por vida la adherencia al tratamiento inmunosupresor. El objetivo de este estudio fue evaluar la adherencia al tratamiento despues de un trasplante renal. Ademas de analizar el grado de informacion recibida al mes y 18 meses postrasplante y valorar su influencia en la adherencia al tratamiento. Material y metodos El Cuestionario simplicado de adherencia a la medicacion fue administrado al mes (T1), 6 meses (T2), 12 meses (T3), 18 meses (T4) y 24 meses (T5) postrasplante. La encuesta sobre aspectos del conocimiento y actitudes con respecto a la medicacion se utilizo al mes y 18 meses postrasplante. Los datos se presentaron con medidas de tendencia central, y fueron comparados con pruebas no parametricas. Resultados Participaron 73 pacientes, con una mediana de edad de 57 anos. El porcentaje de pacientes no-adherentes a la medicacion fueron el 9,6% (T1), 22,5% (T2), 29,2% (T3), 29,8% (T4) y 28,1% (T5). Al mes del trasplante «no consultar con el medico al olvidarse alguna toma» (p = 0,034) influyo significativamente en la no-adherencia farmacologica. A los 18 meses postrasplante ninguna de las cuestiones planteadas sobre el conocimiento de la medicacion influyo en la no-adherencia al tratamiento farmacologico. Conclusiones El mayor tiempo desde el trasplante incremento la no-adherencia al tratamiento. Algunas cuestiones referidas a la informacion dada sobre el tratamiento influyeron en la no-adherencia en el trasplante inmediato, pero no en el seguimiento.

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

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.

mHealth; Dieta; Activitat física mHealth; Dieta; Actividad física mHealth; Diet; Physical activity Background: mHealth has experienced a huge growth during the last decade. It has been presented as a new and promising pathway to increase self-management of health and chronic conditions in several populations. One of the most prolific areas of mHealth has been healthy lifestyles promotion. However, few mobile apps have succeeded in engaging people and ensuring sustained use. Objective: This paper describes the pilot test protocol of the PReventive Care Infrastructure based on Ubiquitous Sensing (PRECIOUS) project, aimed at validating the PRECIOUS system with end users. This system includes, within a motivational framework, the Bodyguard2 sensor (accelerometer with heart rate monitoring) and the PRECIOUS app. Methods: This is a pilot experimental study targeting morbidly obese prediabetic patients who will be randomized to three conditions: (1) Group 1 - Control group (Treatment as usual with the endocrinologist and the nurse + Bodyguard2), (2) Group 2 - PRECIOUS system (Bodyguard2 + PRECIOUS app), and (3) Group 3 - PRECIOUS system (Bodyguard2 + PRECIOUS app + Motivational Interviewing). The duration of the study will be 3 months with scheduled follow-up appointments within the scope of the project at Weeks 3, 5, 8, and 12. During the study, several measures related to healthy lifestyles, weight management, and health-related quality of life will be collected to explore the effectiveness of PRECIOUS to foster behavior change, as well as user acceptance, usability, and satisfaction with the solution. Results: Because of the encouraging results shown in similar scientific work analyzing health apps acceptance in clinical settings, we expect patients to widely accept and express satisfaction with PRECIOUS. We also expect to find acceptable usability of the preventive health solution. The recruitment of the pilot study has concluded with the inclusion of 31 morbidly obese prediabetic patients. Results are expected to be available in mid-2017. Conclusions: Adopting and maintaining healthy habits may be challenging in people with chronic conditions who usually need regular support to ensure mid/long-term adherence to recommendations and behavior change. Thus, mHealth could become a powerful and efficient tool since it allows continuous communication with users and immediate feedback. The PRECIOUS system is an innovative preventive health care solution aimed at enhancing inner motivation from users to change their lifestyles and adopt healthier habits. PRECIOUS includes ubiquitous sensors and a scientifically grounded app to address three main components of health: physical activity, diet, and stress levels. The PRECIOUS project Grant Agreement No. 611366 is a project supported by the European Commission through the 7th Framework Programme. PRECIOUS has eight beneficiaries from six countries (FI, UK, ES, AT, FR, BE) and is coordinated by AALTO-Korkeakoulusäätiö (FI).

Background and objective Health related quality of life (HRQoL) is recognised as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. Patients and method A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. Results At 6 months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large ( η 2 = 0.29), and medium on burden of kidney disease domain ( η 2 = 0.12), work status domain ( η 2 = 0.12), and sexual function domain ( η 2 = 0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. Conclusions An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation.

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 ¼ 0.013), • a –1.3 point for the mania subscale (p ¼ 0.016), • a –1.01 point for the YMRS (p ¼ 0.025). Improvement in depressive symptoms was not significant, neither in the CGI-BP (–1 point, p ¼ 0.074)nor in the HDRS (–5.2 points, p ¼ NS). The most common side-effect was sedation (n ¼ 6, 43%). Doses of quetiapine were significantly reduced by the end of the study (443 ± 235 mg/day versus 268 ± 190 mg/day, p ¼ 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 ¼ 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.

nbsp;Dispositional optimism is a personal resource that determines the coping style and adaptive response to chronic diseases. The aim of this study was to assess the correlations between dispositional optimism and coping strategies in patients with recent kidney transplantation and evaluate the differences in the use of coping strategies in accordance with the level of dispositional optimism.nbsp;Patients who were hospitalised in the nephrology department were selected consecutively after kidney transplantation was performed. The evaluation instruments were the Life Orientation Test-Revised, and the Coping Strategies Inventory. The data were analysed with central tendency measures, correlation analyses and means were compared using Studentrsquo;s t-test.nbsp;nbsp;66 patients with a kidney transplant participated in the study. The coping styles that characterised patients with a recent kidney transplantation were Social withdrawal and Problem avoidance. Correlations between dispositional optimism and coping strategies were significant in a positive direction in Problem-solving (plt;.05) and Cognitive restructuring (plt;.01), and inversely with Self-criticism (plt;.05). Differences in dispositional optimism created significant differences in the Self-Criticism dimension (t=2.58; plt;.01).nbsp;Dispositional optimism scores provide differences in coping responses after kidney transplantation. Moreover, coping strategies may influence the patientrsquo;s perception of emotional wellbeing after kidney transplantation.

Fundamento y objetivo Este trabajo pretende aportar datos sobre las caracteristicas de la demanda asistencial en urgencias de psiquiatria en un hospital general, especial-mente en relacion con la complejidad y adecuacion de las consultas. Pacientes y metodo Se aplico de manera prospectiva un registro estandarizado a todas las consultas consecutivas atendidas durante 40 dias en Urgencias de Psiquiatria del Hospital Clinico Universitario de Barcelona. Resultados La muestra estaba formada por 1.054 consultas (un 52,9% eran mujeres y el 47,1% varones). El motivo de consulta mas frecuente fue la ansiedad (33,4%), se administro medicacion en el 59,4% de las consultas y se hospitalizo al 20,5% de los pacientes. Se considero adecuada la consulta en el 60,1% de casos; se efectuaron exploraciones complementarias en el 28,9% y participo mas de un especialista en el estudio del caso en el 21,7%. Conclusiones Las consultas a una unidad de urgencias de psiquiatria constituyen una demanda asistencial de notable complejidad, por lo que parece aconsejable su ubicacion en un hospital general.

To compare psychophysiological responses among novice surgeons during performance of endoscopic sinus surgery (ESS).Randomized study.Academic institution.Fifteen novice surgeons.The psychophysiological effects of performing ESS were assessed among 15 novice surgeons at 30 minutes before (T - 30), at the beginning of (T0), at 15 minutes (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.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.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.

The purpose of this study was to investigate the relationship between functional polymorphisms in genes coding for dopamine metabolism and transport enzymes and the incidence of acute antipsychotic (AP)-induced extrapyramidal symptoms (EPS). We did not find evidence of the involvement of these polymorphisms in the predisposition towards or protection from EPS.

The aim of this study was to provide data about the characteristics of consultations in a Psychiatric Emergency Unit of a General Hospital.We evaluated prospectively all patients attended in the Psychiatric Emergency Unit of the Hospital Clínic of Barcelona over a period of 40 days. A standardized registry was applied.The sample consisted of 1,054 cases (52.9% women and 47.1% men). The most frequent reason for consultation was anxiety (33.4%). Some medication was administered in 59.4% cases and 20.5% of patients were hospitalized. The consultation was considered appropriate in 60.1% cases. Complementary exams were performed in 28.9% patients. In 21.7% cases, the patient had to be studied by more than one specialist.Consultations to a Psychiatric Emergency Unit may be complex, and therefore it seems reasonable that a general hospital has to be the ideal location for these units.

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.One hundred twenty bipolar I and II outpatients in remission (Young Mania Rating Scale score6, Hamilton Depression Rating Scale-17 score8) 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.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.Group psychoeducation is an efficacious intervention to prevent recurrence in pharmacologically treated patients with bipolar I and II disorder.

This prospective open-label study assessed the impact of add-on quetiapine in the treatment of rapid cycling bipolar patients.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).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).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.

A number of open studies and preliminary results of unpublished double-blind trials have suggested that the novel antipsychotic risperidone may be effective and well tolerated in the treatment of acute mania in bipolar disorder.A total of 174 patients entered this large, open, multicentre trial. Inclusion criteria were: current manic, hypomanic or mixed episode (DSM-IV), and a Young Mania Rating Scale (YMRS) score of7. Assessments included the YMRS, Positive and Negative Syndrome Scale (PANSS), Hamilton Rating Scale for Depression (HAM-D), Clinical Global Impression (CGI), and Udvalg for Kliniske Undersøgelser (UKU) subscale for neurological side effects.There were significant reductions (P0.0001) on the YMRS, PANSS and HAM-D scores and a significant improvement (P0.0001) in CGI ratings at the endpoint. There were no statistically significant increments in the severity of extrapyramidal symptoms according to the UKU. Risperidone was generally well tolerated. The mean dose of risperidone at the endpoint was 4.9+/-2.9 mg/day.This open study provides further evidence that risperidone is safe and effective in combination with mood stabilisers in the manic phase of bipolar disorder.The open design and the use of concomitant medications make unclear to what extent the positive results were entirely related to risperidone.

IntroductionAlexithymia is said to be an important feature of functional gastrointestinal disorders (FGD). Most studies focus on the presence of alexithymia in patients suffering non-motor FGD (NMFGD) but few studies have analyzed its occurrence in motor FGD (MFGD) patients.Objectives- To describe the presence of alexithymia, measured with the Toronto Alexithymia Scale (TAS-20), in a sample of FGD inpatients.- To analyze the differences in alexithymia, measured with the TAS-20, between MFGD and NMFGD inpatients.Material and method46 inpatients admitted to the Vall d’Hebron Digestive System Research Unit to study the existence of FGD were evaluated from January 2008 to July 2010. All patients completed the Toronto Alexithymia Scale (TAS-20).ResultsThe mean age of the sample was 41.02 ± 16.86 years, 89.1% were women and 10.9% were men. With regard to their diagnostic condition, 31 met criteria of NMFGD, 13 of MFGD, and 2 did not met criteria of both disorders. The mean TAS-20 total score was: 46.24 ± 13.60. MFGD patients obtained a mean score of 45.45 ± 12.53, and patients with NMFGD had a mean score of 45.75 ± 12.53. No statistically significant differences were found between both subtypes with regard to alexithymia.ConclusionsAlexithymia, measured with the TAS-20, may not be present in FGD. Discordances of our results with previous findings in FGD may be due to complex psychosocial factors and to psychometric difficulties in assessing alexithymia in this group of patients.

IntroductionPatients suffering from Functional Gastrointestinal Disorders (FGD) experience a high degree of psychological discomfort difficult to measure with current psychometric tools.Objectives- To describe the presence of affective symptoms measured with the Hospital Anxiety Depression (HAD) Scale in FGD inpatients.- To analyze the differences in HAD subscales scores between motor functional gastrointestinal disorders (MFGD) and non-motor functional gastrointestinal disorders (NMFGD).Material and method46 inpatients admitted to the Vall d’Hebron Digestive System Research Unit to study the existence of FGD were evaluated from January 2008 to July 2010. All patients completed the HAD scale and results from the two HAD subscales - Anxiety subscale (HAD-A) and Depression subscale (HAD-D)- were analyzed.ResultsThe mean age of the sample was 41.02 ± 16.86 years, 89.1% were women and 10.9% were men. Thirty-one patients met criteria of NMFGD, 13 of MFGD, and 2 did not met criteria of both diagnoses. The mean scores of the HAD were: HAD-A = 8.12 ± 5.23) and HAD-D = 5.20 ± 4.20. MFGD patients’ HAD results were: HAD-A = 7.00 ± 5.74 and HAD-D = 4.55 ± 4.52 while NMGFD HAD results were: HAD-A = 8.21 ± 4.98 and HAD-D = 4.96 ± 3.77. No statistically significant differences were found between both groups.ConclusionsAccording to our findings, MFGD patients do not meet HAD criteria of anxiety or depression while NMFGD patients only fulfill criteria for probable anxiety or depression. New psychometric tools should be developed in the future to study the psychological discomfort these patients usually complain of.

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.

OBJECTIVE: We analyzed clinical and psychosocial factors in patients with refractory psychogenic nonepileptic seizures, seeking characteristics that could hasten diagnosis. BACKGROUND: Psychogenic nonepileptic seizures remain a diagnostic challenge. Prognosis is best if patients are treated within 2 years of symptom onset. Psychosocial factors have been shown to provide important information for differential diagnosis. METHODS: Over a year and 1132 consecutive patients, our hospital's Epilepsy Unit suspected 93 patients of having psychogenic nonepileptic seizures and confirmed refractory psychogenic nonepileptic seizures in 67. We referred these patients to our psychiatric consultation unit for detailed diagnostic interviews, and 53 of the patients followed through. Two months after the psychiatric evaluation we gave them a psychiatric intervention, explaining the diagnosis and treating their comorbidities. We also tracked the patients' use of antiepileptic drugs for 3 months, from just before the psychiatric evaluation until a month after they started the intervention. RESULTS: Women, patients with an inadequate primary support group, and patients who had tried many antiepileptic drugs were most likely to have their diagnosis of psychogenic nonepileptic seizures delayed by >2 years after onset. A stepwise logistic regression showed that the 2 best predictors of late diagnosis were lack of availability of a primary support group and patients trying many antiepileptic drugs. CONCLUSIONS: Clinicians evaluating patients with questionable seizures should raise their suspicion of psychogenic nonepileptic seizures especially in female patients with an insufficient primary support group and a history of taking multiple antiepileptic drugs.