Severe mental disorders

严重精神障碍
  • 文章类型: Journal Article
    功能行为评估(FBA)方法涉及使用单案例设计(SCD)来研究问题行为-环境突发事件,并进行考虑这种功能关系的干预措施。尽管这种方法被认为是治疗几种心理问题的循证实践(EBP),没有基于FBA的妄想干预措施的荟萃分析研究,幻觉和杂乱无章的言语-通常被操作为“非典型发声”-已经进行了。因此,本研究的目的是回顾和综合基于FBA的成人非典型发声干预措施的结果.我们对这些干预措施进行了系统评价和多层次荟萃分析,使用最近开发的效应大小估计器进行SCD研究(即,对数响应比)。所有符合我们资格标准的研究都提供了证据,支持基于FBA的非典型发声干预措施的有效性,总体平均效果大小减少了72%。发现出版年份和方法学质量都是重要的主持人。尽管有一些方法上的限制,我们可以得出结论,基于FBA的干预措施可有效减少非典型发声.这些结果的含义可能会引起精神卫生界的兴趣。
    The Functional Behavioral Assessment (FBA) approach involves the use of single-case designs (SCD) to study the problem behavior-environment contingencies and conduct interventions that consider this functional relationship. Although this approach has been considered an evidence-based practice (EBP) for the treatment of several psychological problems, no meta-analytic studies of FBA-based interventions on delusions, hallucinations and disorganized speech -commonly operationalized as \"atypical vocalizations\"- have been carried out. Therefore, the purpose of this study was to review and synthesize the results of FBA-based interventions on adults\' atypical vocalizations. We conducted a systematic review and a multi-level meta-analysis of these interventions, using a recently developed effect size estimator for SCD studies (i.e., log response ratio). All the studies that met our eligibility criteria provided evidence supporting the effectiveness of FBA-based interventions on atypical vocalizations, with an overall average effect size of a 72% reduction. Both the publication year and the methodological quality were found to be significant moderators. Despite some methodological limitations, we can conclude that FBA-based interventions are effective to reduce atypical vocalizations. The implications of these results could be of interest for the mental health community.
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  • 文章类型: Journal Article
    BACKGROUND: The hypotheses of autoimmune, allergic or infectious etiology of severe mental illness have been reported in the scientific literature repeatedly. The main objective of this work is to study the relationship of inflammatory, autoimmunity or recent infection markers with the fact of suffering Severe Mental Disorders (SMD).
    METHODS: In the present case-control study, adult patients with a diagnosis of SMD were compared with controls who underwent routine health checks that included analytical control. Cases with psychosis substance-induced and controls with diagnosis of any psychiatric illness were excluded. In both groups, patients with chronic inflammatory diseases or intercurrent infectious disease were also excluded. A set of common analytical parameters, markers of infectious diseases and inflammatory markers were retrieved for both groups, as well as demographic and clinical data.
    RESULTS: A total of 212 subjects (81 cases and 131 controls) were recruited. From cases, 70 (86.4%) have a diagnosis of Schizophrenia Disease (SD) and 11 (13.6%) of Schizoaffective Disorder (SAD). In the multivariate model the female sex (OR 0.24, 95% CI 0.12-0.46) and the neutrophil-lymphocyte ratio (OR 3.00, 95% CI 1.91-4.70) were associated with the fact of being case.
    CONCLUSIONS: Patients with SMD seem to have higher inflammatory markers compared to the general population, being the neutrophil-lymphocyte ratio, the marker associated with more strength. The role of inflammatory processes in the etiology of this type of disorders, if confirmed, opens interesting and innovative therapeutic possibilities.
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  • 文章类型: Journal Article
    Severe mental disorders have been reported to be associated with an increased cardiovascular risk. To measure the potential risk excess as compared, not with the baseline cardiovascular risk for the general population, but with the cardiovascular risk associated with drug iatrogenia. 197 reported cases of cardiovascular adverse reaction to antipsychotic drugs as compared to the reported cases of this type of adverse reactions to drugs other than antipsychotics entered in the Spanish Pharmacovigilance System database (FEDRA) (1995-2018) in an observational case/non-case study. Risk estimates of association were reporting odds ratio (ROR), and, chi-square test (χ2). Overall disproportionality for the whole drug class was found [ROR 2.3 (95% CI 2.0-2.7)], χ2 = 127.07]. When the two types of antipsychotics (typical and atypical) were analysed separately, we also found statistically significant disproportionality, and this disproportionality is similar between both groups, with disproportionality measures around 2.30, with the confidence intervals not including the 1. The disproportionality observed suggests a risk excess that might be greater than expected, which holds particularly true for torsade de pointes, sudden death and cardiac arrhythmias in patients treated with any of the two types of antipsychotics. There was no significant risk for ischaemic heart disease.
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