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Mindfulness-based narrative therapy (MBNT) is a therapeutic intervention for the treatment of depression in cancer patients. In a previous randomized controlled trial, MBNT was found to ameliorate anxiety and depression, improve functional dimensions of quality of life, and enhance treatment adherence. In this review, we describe MBNT and its technical characteristics in the context of other psychotherapeutic interventions for depression in cancer patients. We highlight needed adjustments to other narrative approaches and recommend clinical modifications tailored to the needs of cancer patients that are intended to encompass the client's initial depressive narrative. The narrative construction is supported by emotional regulation and attachment relationships on the one hand and by individual and social linguistic capabilities on the other. Through destabilization of the depressive narrative, MBNT facilitates the emergence of new meanings using both verbal and non-verbal techniques based on mindfulness. The attitude and practice of mindfulness are integrated throughout the therapeutic process. In summary, MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message In this review, we describe mindfulness-based narrative therapy (MBNT) for the treatment of depression in cancer patients., In a previous controlled trial, we found significant benefits of MBNT in terms of reducing depressive symptoms and improving treatment adherence and quality of life in depressed, non-metastatic cancer patients., Narrative construction is socially and neurobiologically derived., MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients., MBNT is proposed as an interesting and promising intervention, particularly for patients with somatic pathologies. [ABSTRACT FROM AUTHOR]

Objective: To compare narrative therapy (NT) plus escitalopram versus escitalopram plus usual care on quality of life and depressive symptomatology of depressed patients with oncologic disease. Methods: A total of 72 subjects (mean age 54.6 years), predominantly female with non-metastatic breast, lung and colon cancer and depressive disorder (DSM-IV-TR) were randomized to receive treatment with NT plus escitalopram ( n=39) or escitalopram (10-20 mg QD) plus usual care ( n=33). Main endpoints were improvement in dimensions of quality of life measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and reduction of depressive symptoms using the Hospital Anxiety and Depression Scale at weeks 12 and 24. Results: The combined therapy group showed significantly greater improvement in all the functioning dimensions ( p<0.01), pain scale ( p=0.02), global health ( p=0.02), and global quality of life ( p=0.007) at weeks 12 and 24. There were no statistically significant differences in depressive symptomatology between the groups. From week 12 to week 24 study retention was higher in the combined treatment group ( p=0.01). Conclusions: Brief NT in combination with escitalopram was superior to usual care and escitalopram in improving functioning dimensions of quality life. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: The action mechanisms that explain how Mindfulness Based Interventions (MBIs) improve the well-being of people with mental disorders remain unclear (Alsubaie et al., 2017). This question leads us to ask how we measure mindfulness as a construct. Only two questionnaires are available nowadays in Spanish: the Five Facets Mindfulness Questionnaire (FFMQ) (Cebolla et al., 2012) and the Mindfulness Attention and Awareness Scale (MAAS) (Brown and Ryan, 2003). In the Spanish validation of the MAAS (Soler et al., 2012) the authors report a lack of sensibility to change that may render it inadequate to be used for the purpose of measuring the influence over mindfulness of a given intervention. Objectives: To test if a MBI (SocialMIND®) increases mindfulness, as measured by MAAS. Methods: A prospective single group clinical trial including participants with psychotic disorders was carried out. Mindfulness disposition was measured with the MAAS after 8 weeks of treatment. Results: 33 participants were included. MAAS scores did not increase after SocialMIND® (t=0.005, p=1). Conclusions: These results seem to support previous evidence which points towards the lack of sensibility to change of the MAAS (MacKillop et al., 2007; Soler et al., 2012). MAAS does not discriminate between non meditators and novice meditators. This is highly important in psychotic population because they have troubles acquiring habits, such as meditation. MAAS might be a valid instrument for studies where intense meditation practice is made, so a pre-post intervention change may be detected. More sensible instruments or new specific ones must be validated in Spanish. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive impairment is usually found in people with Schizophrenia SpectrumDisorder (SDD) (Schaefer et al., 2013). Sustained attention is one of the most characteristic cognitive areas affected and has been largely studied for decades (Hoonakker et al., 2017). Sustained attention is defined as the ability to maintain attention on a given stimulus or task for a span of time (Parasuraman, 1984). Mindfulness is theorized to improve the attentional process. However, the effects of Mindfulness Based Interventions (MBIs) on cognition are still unclear (Lao & Meadows, 2017). Objectives: To test if a MBI (SocialMIND®) improves attentional performance in SDD patients Methods: A parallel-group, single-blind, randomized, controlled (SocialMIND® versus Psychoeducational Multicomponent Intervention [PMI]), clinical trial has been implemented. The participants received 16 weeks group therapy of SocialMIND® or PMI. Sustained attention was measured with the Continuous Performance Test (CPT-IP). Results: 23 participants were included. A better performance on CPT-IP was found in patients allocated to SocialMIND® (M=3.46, SD=0.73) compared to PMI (M=2.79, SD=1.18) after sixteen weeks of treatment (T=2.89, p=0.009, d=1.19). However, this improvement was only found in the 2-digit task. Conclusions: 3-digit and 4-digit tasks increase the difficulty of the test involving greater implication of other cognitive processes such as working memory. Taking this into account, it's possible that MBIs improves sustained attention but has no effects on working memory. [ABSTRACT FROM AUTHOR]

Introduction: Studies have associated students from Medicine and other healthcare degrees with high levels of stress and depression. This puts at risk both their mental health and the quality of physician-patient relationship. Mindfulness-Based Stress Reduction (MBSR) program has been shown to improve psychological wellbeing and to reduce rumination; however, it seems unclear if digital programs have the same effect. Objectives: To compare the effectiveness of a mindfulness smartphone app versus an adapted version of the MBSR program among healthcare students. Methods: A parallel-group, single-blind, randomised (1:1:1), controlled trial was designed. 140 students of Medicine, Nursing, Psychology and Nutrition were allocated to either the app program, the in-person program, or a waitlist. The assessment of depressive symptoms was included though the Beck Depression Inventory at baseline and post-intervention (8 weeks). Results: 86 participants completed BDI at both times and an intention-to-treat analysis was performed. Depressive levels changed from 7.21 (SD 6.08) to 4.07 (SD 4.44) in the app group, and from 7.11 (SD 6.62) to 5.26 (SD 5.21) in the in-person group. ANOVA test did not find a significant difference for depression among the three arms. Conclusions: Only a tendency to significance was found for both the app and the in-person program for the reduction of depressive symptoms. Most participants presented minimum levels of depression at baseline, so a floor effect might be considered as an explanation. Future studies are needed to determine the effect of mindfulnessbased programs on the depression levels of healthcare students. [ABSTRACT FROM AUTHOR]

Introduction: Mindfulness-based interventions are showing promising results for people with Schizophrenia Spectrum Disorders (SSD) (Goldberg et al., 2018), though their action mechanisms are yet to be clarified. Social cognition has drawn a great deal of attention in recent decades as people with psychosis tend to perform worse than healthy controls in socio-cognitive tasks (Green et al., 2015). A core component of social cognition is attributional style and people with psychosis tend to perceive more intentionality and hostility in other people's behaviors in negative and ambiguous situations than controls (Savla et al., 2012). Objectives: To explore the changes in hostility bias after Social-MIND® in a sample of people with SSD. Methods: SocialMIND® is a mindfulness-based social cognition training delivered over 9 months, the first two including 8 weekly sessions. 46 patients were included: 25 subjects completed a feasibility trial (Mediavilla et al., 2019a) while 21 subjects are currently enrolled in a Randomized Controlled Trial (Mediavilla et al., 2019b). Assessment included the Ambiguous Intentions Hostility Questionnaire (AIHQ). Results: 46 participants completed weekly sessions and assessment. Participants showed a significant improvement in hostility bias as measured by the AIHQ (p=0,018, d=0,38). Conclusions: SocialMIND® is among the few social cognition trainings to achieve an improvement in hostility bias in people with psychosis (Roberts et al., 2014). Given the role of social cognition in SSD as predictor and mediator of social functioning (Galderisi et al., 2018), future research lines should delve deeper into the action mechanisms and key active ingredients of social cognition trainings for people with psychosis. [ABSTRACT FROM AUTHOR]

Introduction: Insight disruption is a core characteristic of Schizophrenia Spectrum Disorder (SSD) (Moritz et al., 2017). Beck introduced the concept of "cognitive insight" as the capacity of the patient to distance oneself from and to reevaluate misguided beliefs and interpretations (Beck et al., 2004). This insight can bemeasured by the Beck Cognitive Insight Scale (BCIS). Mindfulness is defined as paying attention to the present moment, on purpose and non-judgmentally (Kabat-Zinn, 1994). Mindfulness meditation promotes an open orientation to one's mental events so Mindfulness Based Interventions (MBIs) might improve psychotic patients' cognitive insight. Objectives: To test if a mindfulness-based intervention (SocialMIND®) for patients with first-episode psychosis increases cognitive insight. Methods: A parallel-group, randomized, controlled (SocialMIND® versus psychoeducational multicomponent intervention [PMI]), clinical trial has been implemented. 23 participants received 16 weeks of group therapy. Cognitive insight was measured with the BCIS. Results: There were significant differences in BCIS scores in the Self-certainty subscale between PMI (M1=9,09, SD=3,83, M2=9.55, S.D2=3.24,) and SocialMIND® (M1=6,46, SD1=2,44, M2=5.38, SD2=2.66) after 16 weeks of treatment (t(22)=-2.2, p=0.04, d=0.88). Conclusions: This result is congruent with the theorical background of each intervention. PMI focuses on providing educational information about psychosis. This expert information might lead to the sensation of a better understanding of the pathology and may increase the sensation of certainty. Meanwhile, SocialMIND® approaches the psychotic experience and the way the patient's mind is working from an experiential and individual point of view. This might lead to a greater awareness of mental processes, reducing the certainty about mind contents. [ABSTRACT FROM AUTHOR]

Introduction: Impairment in different social cognition domains has been found across different phases of schizophrenia spectrum disorders. There is growing evidence showing that they are linked with worse functional outcomes, which raises the question whether they remain stable over time. To date, few studies have tried to establish a comparison between social cognition performance in early and chronic psychosis and mixed findings have arised Objectives: The aim of the current study is to compare social cognition performance between samples of early and chronic psychosis. Methods: Data from 81 patients: 53 chronic (>5y) psychotic patients and 28 early psychosis (<5y) was collected. Patients were assessed on different Social Cognition tasks: Reading the mind in the eyes test (RMET), Ambiguous Intentions Hostility Questionnaire (AIHQ) and Hinting Task Test (HT). Results: Compared with chronic SSD patients, Early Psychosis group had better performance on some social cognition tasks: HT, Mean Difference (MD): -1,593 CI 95% -2,551 to -0,634 p:0.02; and RMET MD: -3,142 CI95% -5.490 to -0,794 p:0.01. Although no differences were found on global AIHQ performance, Early Psychosis patients tended to display more aggression attributions (AIHQ-AB MD: -,24080 CI95% -,474 to -,007 p: 0,044), and Chronic SSD patients more hostility attributions (AIHQ-HB MD: 0,303 CI95% 0,002 to 0,603) Conclusions: Social Cognition decline in psychotic population is a largely unexplored field, although it can be an important factor explaining functional decline in patients not attending psychosocial treatments focusing on this field. Clinical significance of the results and limitations of the study are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Oncohematological diseases were the fifth cancerrelated cause of mortality in 2017. Given the development of new therapeutics options, life expectancy and cronicity rates have increased. Quality of life in these patients has become a very important issue. QoL in this group is quite lower than in general population. Among this group, those who go throught HSCT have more complicated situations; HSCT may have a deep emotional impact. 25-36% of HSCT patients have psychopathological disturbances, anxiety and depression symptoms are the most common. Anxiety and depression prior transplantation are associated with slower recovery from transplantation. It is important to give an integrative support to patients and families, including psychological interventions. Mindfulness-Based Intervention is a good option, given the nature of the process which sorrounds HSCT. Potential stressors and uncontrollable and unpredictable characteristics of the procedure require stress management, acceptance, compassion, self-care and emotion regulation habilities; all of them are trained in MBI. Objectives: To describe group differences between those who get emotional support and emotion regulation-MBI prior HSCT, and those who do not, in terms of sociodemographic and clinical data. Methods: Retrospective, quasi-experimental study. We will study differences between both groups: age, gender, diagnosis, disease stage, type of transplantation (autologous or allogeneic), marital and employment status. Results: We will expect to find some predictors variables of who engages in psychological intervention and who does not, in order to find new approaches to attend needs of every singular patient. Conclusions: Caring emotional aspects of these patients could positively influence the course of disease, and help to increase QoL. [ABSTRACT FROM AUTHOR]

Introduction: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, formally recognized in 2007, is more frequent than any other known paraneoplastic encephalitis. A 77.8% of patients are young female adults. In approximately 40% of the subjects, the disease is associated with an ovarian teratoma. The teratomaassociated cases are significantly more likely to present psychiatric symptoms than those without teratomas. Objectives: We report the case of a 37-year old female patient who was admitted in the Neurology ward after presenting neurological features in combination with symptoms of mood disorder, insomnia and aggressive behavior. We aim to review the clinical features that should lead us to suspect an anti-NMDAR encephalitis in a patient with psychiatric symptoms. Methods: A case reported is presented. A narrative review via scientific database (PubMed) was conducted. Results: Our patient had previously suffered a virus encephalitis. At the beginning, she presented a non-specific prodromal phase with headache and fever, as well as abnormal behavior. She was admitted at the Neurology ward for follow-up. Later on, appeared insomnia, agitation, disorganized thinking, manic symptoms and autonomic instability. Anti-NMDAR encephalitis was confirmed with the detection of antibodies against the GluN1 subunit of the NMDAR in the CSF of the patient and an ovarian teratoma was found and removed. Conclusions: When a patient without any psychiatric history presents a new-onset psychosis, especially in combination with dyskinesias, seizures, memory problems, decreased level of consciousness and/or catatonia, anti-NMDAR encephalitis should always be considered as a differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Serotonin síndrome (SS) is a potentially lifethreatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. In patients taking linezolid, an oxazolidinone antibiotic widely used for resistant nosocomial infections, along with seretoninergic antidepressants there is a documented risk for SS. Objectives: We report the case of a difficult-to-control asthma patient, diagnosed with MRSA pneumonia during a prolonged hospitalization for asthma exacerbation, concurrently taking an SNRI (venlafaxine). We aim to review the evidence about the mechanisms of seretonin toxicity when drugs in the MAOinhibitor class (like linezolid) are combined with proseretoninergic agents as well as the current clinical guidelines for the management of patients with concurrent antidepressant treatment requiring linezolid for a new resistant nosocomial infection. Methods: A case report is presented. A narrative review via scientific database (PubMed, Google scholar) was conducted. Results: While SS has not been described in clinical trials of linezolid, several cases have been reported after commercialization of this antibiotic, especially when used concurrently or within close temporal relation to a seretoninergic agent like SSRI/SNRI antidepressants. The mechanism of action is not fully understood. Conclusions: To our knowledge, there are not any guidelines for the adequate management of these cases, with current recommendations for use of linezolid and seretoninergic antidepressants based on risk-benefit personalized analyses. [ABSTRACT FROM AUTHOR]

Background: Suicide is an international health concern with immeasurable impact from the perspective of human and social suffering. Prior suicide attempts, anxious and depressive symptoms, and relatively lower health-related quality of life (HRQoL) are among the most replicated risk factors for suicide. Our goal was to visualize the distribution of these features and their interconnections with use of a network analysis approach in individuals who recently attempted suicide., Methods: Individuals with a recent suicide attempt were recruited from nine University Hospitals across Spain as part of the SURVIVE cohort study. Anxious and depressive symptoms, and perceived HRQoL were included in the network analysis. Network structures were estimated with the EBICglasso model. Centrality measures and bridge symptoms connecting communities were explored. Subnetworks comparing younger and older individuals, and women and men were analyzed., Results: A total of 1106 individuals with a recent suicide attempt were included. Depressed mood was the symptom with the greatest influence in the overall network, followed by anxiety symptoms such as feeling nervous, worrying, restless, and having difficulties to relax. Perceived general health was associated with increased suicidal ideation in the whole sample. Older people showed a specific connection between perceived general health and depressed mood., Limitations: The cross-sectional design does not allow determination of established causality., Conclusions: Depressed mood was the core network's symptom and, therefore, an important target in the management and prevention of suicide. HRQoL had more influence on the network of older populations, in which it should be a primary focus., Competing Interests: Declaration of competing interest IG has received grants and served as consultant, advisor or CME speaker for the following identities: ADAMED, Angelini, Casen Recordati, Esteve, Ferrer, Gedeon Richter, Janssen Cilag, Lundbeck, Lundbeck-Otsuka, Luye, SEI Healthcare, Viatris outside the submitted work. She also receives royalties from Oxford University Press, Elsevier, Editorial Médica Panamericana. EV has received grants and served as consultant, advisor, or CME speaker for the following entities: AB-Biotics, AbbVie, Angelini, Biogen, Biohaven, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Idorsia, Janssen, Lundbeck, Medincell, Novartis, Orion Corporation, Organon, Otsuka, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris, outside the submitted work. Dr. Roger S. McIntyre has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Neurawell, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, Abbvie, Atai Life Sciences. Dr. Roger McIntyre is a CEO of Braxia Scientific Corp. The rest of authors have no conflict of interest to declare., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Few controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment., Material and Methods: Randomized, prospective, multicenter, single-blinded trial that included BP-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation., Results: Eighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either., Conclusions: In our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning., (Copyright © 2021 SEP y SEPB. Published by Elsevier España S.L.U. All rights reserved.)

Introduction: Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children's attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders., Methods: 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants., Results: Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group., Discussion: This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders., Competing Interests: The authors have declared that no competing interest exist., (Copyright: © 2023 Ruiz-Parra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Suicide is one of the leading causes of avoidable death. Gathering national data on suicidal behaviour incidence is crucial to develop evidence-based public policies. The study has two primary objectives: (1) to determine the incidence of suicide attempts in Spain and related risk factors, and (2) to analyze the efficacy of secondary prevention programmes to prevent suicide re-attempting in comparison to treatment as usual (TAU)., Materials and Methods: Multisite, coordinated, cohort study with three nested randomized controlled trials. A cohort of 2000 individuals (age >=12) with suicidal behaviour will be recruited at ten sites distributed across Spain. Assessments will be conducted within 10 days of the suicide attempt (V0-baseline visit) and after 12 months (V4-last visit) and will include clinician reported and participant reported outcomes (PROs). Between V0 and V4, PROs will be collected remotely every three months (V1, V2 and V3). Optatively, cohort participants will participate in three nested randomized-controlled-trials (RCTs) evaluating different secondary prevention interventions: Participants aged 18 years and older will be randomly allocated to: Telephone-based Management+TAU vs. TAU or iFightDepression-Survive+TAU vs. TAU. Participants aged between 12 and 18 years will be allocated to a specific intervention for youths: Self Awareness of Mental Health+TAU vs. TAU., Results: This study will provide interesting data to estimate suicide attempt incidence in Spain. and will provide evidence on three., Conclusions: Evidence on three potentially efficacious interventions for individuals at high risk of suicide will be obtained, and this could improve the treatment given to these individuals., Trial Registration: NCT04343703., (Copyright © 2020 Sociedad Española de Psiquiatría y Salud Mental (SEPSM). Published by Elsevier España S.L.U. All rights reserved.)

Background: The efficacy of mindfulness-based interventions to reduce anxiety or improve quality of life (QoL) in patients with cardiac pathologies is well established. However, there is scarce information on the efficacy, applicability, and safety of these interventions in adult patients with an implantable cardioverter-defibrillator (ICD). In this study, we examined their efficacy on QoL, psychological and biomedical variables, as well as the applicability and safety of a mindfulness-based intervention in patients with an ICD., Methods: Ninety-six patients with an ICD were randomized into two intervention groups and a control group. The interventions involved training in mindfulness-based emotional regulation, either face-to- -face or using the "REM Volver a casa" mobile phone application (app)., Results: The sample presented medium-high QoL baseline scores (mean: 68), low anxiety (6.84) and depression (3.89), average mindfulness disposition (128), and cardiological parameters similar to other ICD populations. After the intervention, no significant differences were found in the variables studied between the intervention and control groups. Retention was average (59%), and there were no adverse effects due to the intervention., Conclusions: After training in mindfulness-based emotional regulation (face-to-face or via app), no significant differences were found in the QoL or psychological or biomedical variables in patients with an ICD. The intervention proved to be safe, with 59% retention.

Introduction: Colorectal cancer is the third most common cancer worldwide both in men and women. Around one-third of patients with cancer will suffer from anxiety or depression symptoms. The aim of this study was to evaluate the effectiveness of a Mindfulness-based stress reduction intervention through a mobile application ("En Calma en el Quirófano")., Method: This study is a multicenter, single-blind (evaluator), controlled, randomised trial that compares the effectiveness of a mindfulness training through a mobile application (intervention group) and treatment as usual (control group) in three different moments (T0 or baseline, T1 or hospital discharge and T2 or one month after surgery). Anxiety and depression symptoms (HADS), quality of life (WHOQOL), pain, (VAS) and satisfaction (CSQ) were assessed., Results: In all, there were 270 referred patients. Among them, 39 and 43 were assigned to the intervention and control groups respectively. 82 patients were analyzed: 39 patients used the app, and 43 patients continued with the treatment as usual. There were no significant changes between groups and time. We observed a slight trend in which intervention group had less depression and anxiety symptoms since T0 and T2 (B = -0.2; 95% CI between 8.8 and 9.2)., Conclusions: The sample of this study had a high mean age (65 years old), and low levels of anxiety and depression and medium levels of pre-surgery quality of life in baseline. These factors could have influenced limiting the effectiveness of the app. Prospective research lines should focus on evaluating the effectiveness of mobile applications for younger patients with surgical pathologies., (Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Background and Aims: The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers' mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms., Methods: We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire - Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness., Conclusions: This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies., Registration Details: ClinicalTrials.gov Identifier: NCT04980326., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Healthcare workers (HCWs) from COVID-19 hotspots worldwide have reported poor mental health outcomes since the pandemic's beginning. The virulence of the initial COVID-19 surge in Spain and the urgency for rapid evidence constrained early studies in their capacity to inform mental health programs accurately. Here, we used a qualitative research design to describe relevant mental health problems among frontline HCWs and explore their association with determinants and consequences and their implications for the design and implementation of mental health programs., Materials and Methods: Following the Programme Design, Implementation, Monitoring, and Evaluation (DIME) protocol, we used a two-step qualitative research design to interview frontline HCWs, mental health experts, administrators, and service planners in Spain. We used Free List (FL) interviews to identify problems experienced by frontline HCWs and Key informant (KI) interviews to describe them and explore their determinants and consequences, as well as the strategies considered useful to overcome these problems. We used a thematic analysis approach to analyze the interview outputs and framed our results into a five-level social-ecological model (intrapersonal, interpersonal, organizational, community, and public health)., Results: We recruited 75 FL and 22 KI interviewees, roughly balanced in age and gender. We detected 56 themes during the FL interviews and explored the following themes in the KI interviews: fear of infection, psychological distress, stress, moral distress, and interpersonal conflicts among coworkers. We found that interviewees reported perceived causes and consequences across problems at all levels (intrapersonal to public health). Although several mental health strategies were implemented (especially at an intrapersonal and interpersonal level), most mental health needs remained unmet, especially at the organizational, community, and public policy levels., Conclusions: In keeping with available quantitative evidence, our findings show that mental health problems are still relevant for frontline HCWs 1 year after the COVID-19 pandemic and that many reported causes of these problems are modifiable. Based on this, we offer specific recommendations to design and implement mental health strategies and recommend using transdiagnostic, low-intensity, scalable psychological interventions contextually adapted and tailored for HCWs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mediavilla, Monistrol-Mula, McGreevy, Felez-Nobrega, Delaire, Nicaise, Palomo-Conti, Bayón, Bravo-Ortiz, Rodríguez-Vega, Witteveen, Sijbrandij, Turrini, Purgato, Vuillermoz, Melchior, Petri-Romão, Stoffers-Winterling, Bryant, McDaid, Park, Ayuso-Mateos and RESPOND Consortium.)

Objective: To determine the cost-effectiveness of 2 strategies for post-discharge suicide prevention, an Enhanced Contact intervention based on repeated in-person and telephone contacts, and an individual 2-month long problem-solving Psychotherapy program, in comparison to facilitated access to outpatient care following a suicide attempt., Methods: We conducted a cost-effectiveness analysis based on a decision tree between January and December 2019. Comparative effectiveness estimates were obtained from an observational study conducted between 2013 and 2017 in Madrid, Spain. Electronic health care records documented resource use (including extra-hospital emergency care, mortality, inpatient admission, and disability leave). Direct cost data were derived from Madrid's official list of public health care prices. Indirect cost data were derived from Spain's National Institute of Statistics., Results: Both augmentation strategies were more cost-effective than a single priority outpatient appointment considering reasonable thresholds of willingness to pay. Under the base-case scenario, Enhanced Contact and Psychotherapy incurred, respectively, €2,340 and 6,260 per averted attempt, compared to a single priority appointment. Deterministic and probabilistic sensitivity analyses showed both augmentation strategies to remain cost-effective under several scenarios. Enhanced Contact was slightly cost minimizing in comparison to Psychotherapy (base-case scenario: €-196 per averted attempt)., Conclusions: Two post-discharge suicide prevention strategies based on Enhanced Contact and Psychotherapy were cost-effective in comparison to a single priority appointment. Increasing contacts between suicide attempters and mental health-care providers was slightly cost minimizing compared to psychotherapy.

Objective: To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students., Methods: The authors conducted a single-blind, randomised controlled trial with three parallel groups. Participants were allocated to the mobile app, the in-person mindfulness-based program (IMBP), or a control group. Assessments at baseline and postintervention (8 weeks) included measures of anxiety, empathy, self-compassion, and mindfulness., Results: Of 168 students randomised, 84 were analysed on an intention-to-treat basis (app: n  = 31; IMBP: n  = 23; control: n  = 30). The mobile app group showed a large effect size for reductions in trait anxiety compared with controls ( g  = 0.85, p  = 0.003), and a medium, nonsignificant effect compared with the IMBP group ( g  = 0.52, p  = 0.152). Participants from both interventions experienced a significant increase in self-compassion and mindfulness compared with controls. Levels of empathy remained unchanged for the 3 arms., Conclusions: A mobile app can be as effective as an IMBP in reducing anxiety and increasing self-compassion and mindfulness among healthcare students.

Background: Although evidence-based psychological treatments for chronic pain (CP) have been demonstrated to be effective for a variety of outcomes, modest effects observed in recent reviews indicate scope for improvement. Self-compassion promotes a proactive attitude towards self-care and actively seeking relief from suffering. Consequently, more compassionate people experience better physical, psychological and interpersonal well-being., Methods: We conducted a single-blind, randomized, controlled trial to examine the effects of a Mindful Self-Compassion program (MSC) on relevant clinical outcomes in patients with CP. Patients were randomly assigned to one of the two intervention arms: MSC or cognitive-behavioural therapy (CBT). The protocols of both intervention arms were standardized and consisted of a 150-min session once a week during 8 weeks formatted to groups of no more than 20 participants. The primary outcome was self-compassion, measured with the Self-Compassion Scale (SCS). The secondary outcomes were other pain-related scores, quality-of-life measures, and anxiety and depression scores., Results: In all, 62 and 61 patients were assigned to the MSC and CBT groups, respectively. The MSC intervention was more effective than CBT for self-compassion (average treatment effect [ATE] = 0.126, p < 0.05). The secondary outcomes, pain acceptance (ATE = 5.214, p < 0.01), pain interference (ATE = -0.393, p < 0.05), catastrophizing (ATE = -2.139, p < 0.10) and anxiety (ATE = -0.902, p < 0.05), were also favoured in the experimental arm (MSC). No serious adverse events were observed., Conclusions: Mindful Self-Compassion is an appropriate therapeutic approach for CP patients and may result in greater benefits on self-compassion and emotional well-being than CBT., Significance: This randomized controlled trial compares the novel intervention (MSC program) with the gold standard psychological intervention for CP (CBT). MSC improves the levels of self-compassion, a therapeutic target that is receiving attention since the last two decades, and it also improves anxiety symptoms, pain interference and pain acceptance more than what CBT does. These results provide empirical support to guide clinical work towards the promotion of self-compassion in psychotherapeutic interventions for people with CP., (© 2021 European Pain Federation - EFIC®.)

The measures to contain the spread of the COVID-19 outbreak have no precedent in the recent history of many countries. Around 2,000 million people in the world are in isolation or quarantine, and gatherings of people have been expressly banned in many countries. In Spain, this prohibition affects workplaces, schools, and the national health system, where most of the healthcare is being provided either on the phone or online.

Competing Interests: None.

Objective: According to randomized trials, contact after a suicide attempt lowers relapse risk. However, effectiveness studies based on real clinical data can provide additional external validity., Method: We conducted an observational study to determine if an emergency department (ED)-initiated intervention for suicide attempt risk reduction, consisting on scheduling a single added appointment within 7 days after discharge following a suicide attempt, can reduce the risk of relapse. The study included 1,775 patients who had been treated at a general hospital ED due to a suicide attempt. The principal outcome measure was ED return after a new attempt. We obtained Kaplan-Meier survival functions and used Cox proportional hazard regression models to estimate unadjusted and adjusted risks of relapse by treatment phase. Covariates included: age, gender, history of suicide attempts, history of psychiatric disorders, concurrent alcohol/drug abuse, number of attempts during follow-up, admission as an inpatient and family support., Results: A total of 497 (22.5%) attempts were followed by a relapse. Subjects exposed to the studied intervention had a lower risk of relapse after a suicide attempt, with a 24% adjusted risk reduction estimate., Conclusion: Our real-world results suggest that an additional early appointment, scheduled before discharging suicide attempters, reduces suicide reattempt risk., (© 2019 The American Association of Suicidology.)