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This study was designed to investigate the global utilization of occupational therapy (OT) services by patients with hereditary transthyretin amyloidosis (ATTRv) in Spain. The main objective was to find out whether these patients have access to OT services and the types of interventions being offered to them, together with their satisfaction and real benefits as users. We developed an online questionnaire which was distributed to patients with ATTRv in Spain through patient associations. Seventy-four patients with a diagnosis of ATTRv residing in Spain participated in the study. Thirteen had already used OT services at least once, felt that OT interventions improved their quality of life, would recommend OT services to others, and would return to see an occupational therapist. However, 61 had never used this type of service before. Of these, 35 knew what OT is and 13 declared that they considered that OT interventions in ATTRv could be positive for them. The results suggest that the use of OT services by ATTRv patients is low, mainly because of the lack of information about the occupational profile of individuals with this disease. The low response rate obtained for the survey limits generalization, and thus further research to confirm these preliminary findings is needed.

Background: Major depression disorder (MDD)11 Abbreviations: BMI: Body mass index; MDD: Major depressive disorder; WHR: wait-to-hip-ratio and obesity are among the most common public health problems. The majority of epidemiological studies demonstrated a strong relationship between sociodemographic factors like age and socioeconomic status and depression. Also, a bidirectional link between depression and obesity is discussed. However, differences regarding sociodemographic factors and obesity between participants with and without lifetime MDD might occur, but potentially not in all individuals. This study intends to contribute to this discussion by investigating whether or not sociodemographic factors, chronic illness status, and overweight differ between individuals with and without lifetime MDD. Methods: In the MooDFOOD depression prevention trial, 1025 overweight or obese participants with subsyndromal symptoms of depression were recruited. Lifetime history of MDD, number of lifetime MDD episodes, sociodemographic data, and chronic illness were assessed via clinical interview, also standardized anthropometric measures (body mass index [BMI], waist-to-hip ratio [WHR]). Results: A lifetime MDD diagnosis was present in 33.5% of the sample. Individuals with lifetime MDD and individuals who never suffered from MDD did not differ regarding sex, age, marital status, educational level, employment status, and income. Further, there were no significant differences in BMI, WHR, and number of chronic illnesses between participants with and without lifetime MDD. Limitations: The cross-sectional nature of the data prohibited causal inferences. Conclusion: Sociodemographic variables, chronic illness status and anthropometric measures seem not to be related to the status of having suffered from MDD in the past vs. not having suffered from MDD in people who are currently overweight or obese.

The spread of covid-19 has had a profound effect on the global economy, and the likelihood that the pandemic will lead to a huge recession and outstrip the financial crisis of 2008 is high. Kisely and colleagues1 and Gold,2 along with Greenberg and colleagues,3 have pointed out the urgent need for strategies to minimise the psychological distress of healthcare workers. Current evidence indicates that after the pandemic …

espanolIntroduccion: los trastornos del sueno y los trastornos afectivos (trastorno depresivo mayor y trastorno de ansiedad generalizada) son dos de las condiciones comorbidas mas frecuentes en los pacientes con dolor cronico. Objetivo: el objetivo principal de este estudio es evaluar la calidad del sueno y la prevalencia del trastorno depresivo mayor y trastorno de ansiedad generalizada en pacientes con dolor cronico osteomuscular. Como objetivos secundarios se senalan: comparar la calidad del sueno y la evaluacion del dolor en distintas variables y conocer los predictores de la calidad del sueno. Material y metodos: se diseno un estudio descriptivo transversal realizado en la Unidad del Dolor del Servicio de Anestesiologia y Reanimacion del Hospital Son Llatzer (Palma de Mallorca). Un total de 39 pacientes participaron en el estudio, todos ellos mayores de edad y con diagnostico de dolor cronico tipo osteomuscular. La inclusion se realizo durante los meses de marzo, abril y mayo de 2013. Se excluyeron aquellos pacientes menores de 18 anos, rechazaban participar en el estudio y/o presentaban un trastorno psiquiatrico grave (demencia, psicosis, abuso de alcohol/drogas). Se utilizo un cuestionario de elaboracion propia para recoger variables sociodemograficas, de estilo de vida y clinicas, una escala visual analogica para evaluar la intensidad del dolor, la entrevista Neuropsiquiatrica Internacional para determinar diagnostico de trastorno depresivo mayor y trastorno de ansiedad generalizada, el Cuestionario de Pittsburgh para evaluar la calidad del sueno y la Escala de Depresion Montgomery-Asberg para evaluar la gravedad de la sintomatologia depresiva. Resultados: la muestra refirio una mala calidad del sueno. El 69,2 % de la muestra presentaba un trastorno depresivo mayor y/o un 65,5 % un trastorno de ansiedad generalizada. No se encontraron diferencias estadisticamente significativas en la calidad del sueno entre los grupos tratados con opioides potentes y tratados con opioides menores/antiinflamatorios. Existen diferencias estadisticamente significativas en determinados items del Cuestionario de Pittsburgh: calidad subjetiva del sueno, eficiencia habitual, perturbaciones del sueno, disfuncion durante el dia y en la puntuacion total del cuestionario, asi como en la evaluacion del dolor en el que los pacientes con depresion presentaban puntuaciones mas elevadas respecto a los que no tenian depresion. Los predictores significantes de la calidad del sueno fueron la edad y la gravedad de la depresion. Conclusiones: estos resultados van en la linea de aquellas investigaciones que muestran que los pacientes con dolor cronico presentan pobre calidad de sueno, depresion y ansiedad. Se necesitan futuras investigaciones para evaluar estas variables, conocer la importancia de los factores implicados en esta condicion medica y mejorar el manejo clinico y la calidad de vida de estos pacientes. EnglishIntroduction: Sleep disturbances and affective disorders (major depressive disorder and generalized anxiety disorder) are two comorbidities very frequents in patients with chronic pain. Objective: The main objective is to evaluate sleep quality and the prevalence of major depressive disorder and generalized anxiety disorder in patients with musculoskeletal chronic pain. As secondary objectives: To compare sleep quality and pain severity with different variables and to know the sleep quality predictors. Material and methods: Transversal descriptive study was made in the Pain Unit from Son Llatzer Hospital (Palma de Mallorca, Spain). A total of 39 patients were included, all of them older than 18 years old and with musculoskeletal chronic pain. Inclusion was during March, April and May 2013. Excluded were patients younger than 18 years old, those who refuse to participate in the study or/and those who diagnosed with severe psychiatric disorder (dementia, psychosis, alcohol/drug abuse). Pain severity was assessed by a visual analogue scale, major depressive disorder and generalized anxiety disorder was assessed by the International Neuropsychiatric Interview, sleep quality was assessed by the Pittsburgh Questionnaire and depressive symptomatology was assessed by the Montgomery-Asberg Questionnaire. Results: Chronic pain patients related poor sleep quality. 69.2 % of patients had major depressive disorder and/or 65.5% had a generalized anxiety disorder. There are not statistical differences in quality of sleep between pharmacological groups (potens opioids vs. minor/antiinflamatories). There are statistical differences in some Pittsburgh Questionnaire items: subjective sleep quality, regular efficiency, dreams perturbances, daily dysfunction and total score, as well as, in pain severity: patients with depression had higher scores than patients without depression. The significant predictors of sleep quality were age and depression severity. Conclusions: These results are in accordance with other studies that show that chronic pain patients suffer poor sleep quality, depression and anxiety. Future researchers are necessary to evaluate these variables, to know the importance of these factors that play a role in this medical condition and to improve clinical management and quality of life of these patients.

The present article reviews recent studies analyzing the association between health-related quality of life (HRQoL) and personality in inflammatory bowel disease (IBD). HRQoL is especially important in chronic diseases, since the strategic goals of treatment are to relieve symptoms, delay progression and improve functional quality. Some studies show that HRQoL in patients with IBD is significantly lower than that in the general population. Few studies have analyzed the association between personality and IBD and the results are contradictory. The most prevalent personality disorders in IBD are avoidant personality disorder and obsessive-compulsive personality disorder. Some results of a longitudinal study corroborating impaired HRQoL in these patients and the presence of one or more personality disorders in 57% of the sample are discussed.

Objectives: This study focuses on the comorbidity between medical and psychiatric illnesses in a sample taken from the general population. Methods: We design a two-stage epidemiological community study in the island of Formentera (Spain), using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). In the first stage, the sample (N=697) was screened using the General Health Questionnaire (GHQ-28). In the second stage, the SCAN, subjects' clinical histories and General Practitioners' diagnosis were used to evaluate psychiatric disorders and medical illnesses. The final sample comprised 242 subjects. Results: Subjects with diagnosed ICD-10 mental disorders presented higher comorbidity with medical pathologies than the group of respondents without psychiatric diagnosis, although the differences were not statistically significant. Of the psychiatric conditions, mood disorders (in which differences were significant) and neurotic disorders were the ones that most frequently presented comorbidity, followed by sleep disorders. Mean scores on the GHQ-28 used at the screening stage, and mean scores on neurotic, depressive and somatic symptoms on the SCAN, were significantly higher in the comorbid group. Comorbidity was more frequent in females. Conclusion: More studies on comorbidity in general population are required, with diagnostic instruments that cover the whole of the psychiatric spectrum and correct assessment systems for medical diagnosis.

Background Depression is one of the most common disorders in primary care and the fourth most disabling medical condition worldwide. Although gender differences in the prevalence of depression are well established, the little available data on gender-related differences in disabilities among depression patients gives controversial results. This study aims to analyse whether there are gender differences in the disabilities experienced by patients with depression. Methods A cross-sectional, multicentre, nationwide epidemiological study was conducted, with 1226 patients. A Case Report Form was used to collect sociodemographic data and the 12-item version of the World Health Organization Disability Assessment Schedule II (WHO-DAS-II) was used to assess functioning. Depression severity was assessed using the Quick Inventory of Depressive Symptomatology (QIDS). Results Non-statistically significant differences in functioning were found between males and females. An item-by-item analysis of the WHO-DAS-II shows significant differences between both sexes in specific areas. Women obtained higher scores than men for standing for long periods and walking a long distance. Males scored higher than women in dealing with people you did not know well and maintaining a friendship. Limitations Given the descriptive and cross-sectional nature of the study, the results are limited, highlighting the need for further research. Also, other variables that might influence disability, such as medical illnesses, were not considered. Conclusions The effect of depression on disability is similar for both sexes but not uniform in terms of the impact on different aspects of the quality of life. These findings could be an important factor in the assessment of functioning and management of depression.

Background Burnout has traditionally been described by means of the dimensions of exhaustion, cynicism and lack of eficacy from the "Maslach Burnout Inventory-General Survey" (MBI-GS). The "Burnout Clinical Subtype Questionnaire" (BCSQ-12), comprising the dimensions of overload, lack of development and neglect, is proposed as a brief means of identifying the different ways this disorder is manifested. The aim of the study is to test the construct and criterial validity of the BCSQ-12. Method A cross-sectional design was used on a multi-occupational sample of randomly selected university employees (n = 826). An exploratory factor analysis (EFA) was performed on half of the sample using the maximum likelihood (ML) method with varimax orthogonal rotation, while confirmatory factor analysis (CFA) was performed on the other half by means of the ML method. ROC curve analysis was preformed in order to assess the discriminatory capacity of BCSQ-12 when compared to MBI-GS. Cut-off points were proposed for the BCSQ-12 that optimized sensitivity and specificity. Multivariate binary logistic regression models were used to estimate effect size as an odds ratio (OR) adjusted for sociodemographic and occupational variables. Contrasts for sex and occupation were made using Mann-Whitney U and Kruskall-Wallis tests on the dimensions of both models. Results EFA offered a solution containing 3 factors with eigenvalues > 1, explaining 73.22% of variance. CFA presented the following indices: χ2 = 112.04 (p < 0.001), χ2/gl = 2.44, GFI = 0.958, AGFI = 0.929, RMSEA = 0.059, SRMR = 0.057, NFI = 0.958, NNFI = 0.963, IFI = 0.975, CFI = 0.974. The area under the ROC curve for 'overload' with respect to the 'exhaustion' was = 0.75 (95% CI = 0.71-0.79); it was = 0.80 (95% CI = 0.76-0.86) for 'lack of development' with respect to 'cynicism' and = 0.74 (95% CI = 0.70-0.78) for 'neglect' with respect to 'inefficacy'. The presence of 'overload' increased the likelihood of suffering from 'exhaustion' (OR = 5.25; 95% IC = 3.62-7.60); 'lack of development' increased the likelihood from 'cynicism' (OR = 6.77; 95% CI = 4.79-9.57); 'neglect' increased the likelihood from 'inefficacy' (OR = 5.21; 95% CI = 3.57-7.60). No differences were found with regard to sex, but there were differences depending on occupation. Conclusions Our results support the validity of the definition of burnout proposed in the BSCQ-12 through the brief differentiation of clinical subtypes.

Building upon Deci’s and Ryan (1985) Self-determination theory as well as the sportive behavioral correlates of the model of Commitment (Scanlan et al., 1976), this study tries to establish the relationship between motivation and commitment in youth sport. For this purpose 454 young competitive soccer players answered the Sport Motivation Scale (SMS) and the Sport Commitment Questionnaire (SCQ) during the regular season. The SMS measures the three dimensions of the Motivational continuum (the Amotivation, the Extrinsic Motivation and the Intrinsic Motivation). The SCQ measures the Sportive Commitment and its composing factors such as the Enjoyment, the Alternatives to the sport, and the Social Pressure. Our findings provided a clear pattern of the influence of motivation in sport enjoyment and commitment, outlining the positive contribution of intrinsic and extrinsic motivation to enjoyment and commitment. Amotivation, contributes positively to alternatives to sport and negatively to enjoyment and commitment. It should be noted that extrinsic motivation has a higher contribution to enjoyment whereas intrinsic motivation has a higher contribution to commitment. RESUMEN: Fundamentándose en la teoría de la Autodeterminación (Deci y Ryan, 1985) así como en los correlatos conductuales del modelo de Compromiso (Scanlan et al. 1976), este estudio trata de establecer las relaciones entre motivación y compromiso en jóvenes jugadores de fútbol. Con este propósito 454 jóvenes jugadores de fútbol contestaron la Escala de Motivación Deportiva (SMS) y el Cuestionario de Compromiso Deportivo (SCQ). El SMS mide las tres dimensiones del continuum motivacional (Amotivación, Motivación extrínseca y motivación intrínseca). El SCQ mide el compromiso deportivo y los factores que lo componen, tales como el disfrute, las alternativas al deporte y la presión social. Nuestros resultados proporcionan un patrón claro acerca de la influencia de la motivación en el compromiso y la diversión en el deporte, subrayando la contribución positiva de la motivación intrínseca y extrínseca en la diversión y el compromiso. La amotivación contribuye positivamente a las alternativas al deporte y negativamente a la diversión y el compromiso. Es de destacar que la motivación extrínseca tiene una contribución mayor a la diversión, mientras que la motivación intrínseca tiene una contribución mayor al compromiso. This work was partly funded by the grant SEJ2007-64528/PSIC (Ministerio de Educación y Ciencia, Dirección General de Investigación, Spain). We would like to thank Adela Bujosa for her assistance in the data collection.

The present article reviews recent studies analyzing the association between health-related quality of life (HRQoL) and personality in inflammatory bowel disease (IBD). HRQoL is especially important in chronic diseases, since the strategic goals of treatment are to relieve symptoms, delay progression and improve functional quality. Some studies show that HRQoL in patients with IBD is significantly lower than that in the general population. Few studies have analyzed the association between personality and IBD and the results are contradictory. The most prevalent personality disorders in IBD are avoidant personality disorder and obsessive-compulsive personality disorder. Some results of a longitudinal study corroborating impaired HRQoL in these patients and the presence of one or more personality disorders in 57% of the sample are discussed.

Background Three different burnout types have been described: The "frenetic" type describes involved and ambitious subjects who sacrifice their health and personal lives for their jobs; the "underchallenged" type describes indifferent and bored workers who fail to find personal development in their jobs and the "worn-out" in type describes neglectful subjects who feel they have little control over results and whose efforts go unacknowledged. The study aimed to describe the possible associations between burnout types and general sociodemographic and occupational characteristics. Methods A cross-sectional study was carried out on a multi-occupational sample of randomly selected university employees (n = 409). The presence of burnout types was assessed by means of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)", and the degree of association between variables was assessed using an adjusted odds ratio (OR) obtained from multivariate logistic regression models. Results Individuals working more than 40 hours per week presented with the greatest risk for "frenetic" burnout compared to those working fewer than 35 hours (adjusted OR = 5.69; 95% CI = 2.52-12.82; p < 0.001). Administration and service personnel presented the greatest risk of "underchallenged" burnout compared to teaching and research staff (adjusted OR = 2.85; 95% CI = 1.16-7.01; p = 0.023). Employees with more than sixteen years of service in the organisation presented the greatest risk of "worn-out" burnout compared to those with less than four years of service (adjusted OR = 4.56; 95% CI = 1.47-14.16; p = 0.009). Conclusions This study is the first to our knowledge that suggests the existence of associations between the different burnout subtypes (classified according to the degree of dedication to work) and the different sociodemographic and occupational characteristics that are congruent with the definition of each of the subtypes. These results are consistent with the clinical profile definitions of burnout syndrome. In addition, they assist the recognition of distinct profiles and reinforce the idea of differential characterisation of the syndrome for more effective treatment.

Background Burnout has been traditionally defined in relation to the dimensions of "exhaustion", "cynicism", and "inefficiency". More recently, the Burnout Clinical Subtype Questionnaire (BCSQ-12) further established three different subtypes of burnout: the "frenetic" subtype (related to "overload"), the "under-challenged" subtype (related to "lack of development"), and the "worn-out" subtype (related to "neglect"). However, to date, these definitions have not been applied to students. The aims of this research were (1) to adapt a Spanish version of the BCSQ-12 for use with students, (2) to test its factorial validity, internal consistency, convergent and discriminant validity, and (3) to assess potential socio-demographic and occupational risk factors associated with the development of the subtypes. Method We used a cross-sectional design on a sample of dental students (n = 314) from Santiago and Huesca universities (Spain). Participants completed the Burnout Clinical Subtype Questionnaire Student Survey (BCSQ-12-SS), the Maslach Burnout Inventory Student Survey (MBI-SS), and a series of socio-demographic and occupational questions formulated for the specific purpose of this study. Data were subjected to exploratory factor analysis (EFA) using the principal component method with varimax orthogonal rotation. To assess the relations with the criterion, we calculated the Pearson correlation coefficient (r), multiple correlation coefficient (Ry.123), and the coefficient of determination (R2y.123). To assess the association between the subtypes and the socio-demographic variables, we examined the adjusted odds ratio (OR) obtained from multivariate logistic regression models. Results Factorial analyses supported the theoretical proposition of the BCSQ-12-SS, with α-values exceeding 0.80 for all dimensions. The "overload-exhaustion" relation was r = 0.59 (p < 0.001), "lack of development"-"cynicism", r = 0.49 (p < 0.001), "neglect"-"inefficiency", r = 0.47 (p < 0.001). The "overload"-"lack of development" relation was r = 0.21 (p < 0.001), "overload"-"neglect", r = 0.20 (p < 0.001), and "lack of development"-"neglect", r = 0.38 (p < 0.001). The BCSQ-12-SS explained 38.44% of the variability in "exhaustion", (Ry.123 = 0.62), 30.25% in "cynicism" (Ry.123 = 0.55), and 26.01% in "inefficiency" (Ry.123 = 0.51). "Hours spent on studying" was found to be associated with "overload" (p = 0.001), "campus" with "lack of development" (p = 0.013), and ""failed subjects" with "neglect" (p = 0.011). Conclusions The results support the definition of burnout as established by the BCSQ-12-SS. As such, the BCSQ-12-SS can be used for the recognition of clinical profiles and for the suggestion of potential intervention strategies specific to the characteristics of each particular case.