Severe Mental Illness in Community Mental Health Care in Spain: Prevalence and Related Factors.

The term severe mental illness (SMI) has been used in psychiatry to refer to long-term mental health conditions that involve severe behavioural problems, disability, and social dysfunction. To date, definitive and consensual criteria for SMI are lacking, although these criteria are essential to determine the prevalence of SMI.The aim of this study was to determine the prevalence of severe mental illness (SMI) in patients in contact with mental health services and to determine the factors associated with SMI. A total of 260 patients who met diagnostic criteria for SMI were assessed using GAF and HoNOS scales. The overall prevalence of SMI was 6.08 per thousand. According to the three different cutoff points with GAF, the prevalence of SMI ranged from 5.38 per thousand under the weak criterion (GAF < 70) to 1.01 per thousand under the strict criterion (GAF < 50). In the regression model, the dependent variable (presence of SMI) was defined using a GAF < 60, and the variables independently associated with the dependent variable were years of disease duration since diagnoses, mental health service use, alcohol or other substance abuse, and depressive anxiety and other psychological symptoms.Universidad de Malaga. Campus de Excelencia Internacional Andalucía Tech. This work was supported by the Andalusian Government (grant number 167/04; PI-0332/08)

Patient-reported impact of symptoms in schizophrenia scale (PRISS): Development and validation

Background We report the psychometric properties of the Patient-Reported Impact of Symptoms in Schizophrenia Scale (PRISS), which assesses the impact of subjective experiences or qualia in outpatients with this condition. Methods A cross-sectional study was carried out in 162 patients diagnosed with schizophrenia in Spain. The PRISS measures the presence, frequency, concern and interference with daily life of self-reported experiences related to the main symptoms observed in these patients. The psychometric analysis included test-retest reliability, internal consistency and structural and convergent validity. Results The 28-item PRISS showed good test-retest reliability as 64.3% of the intraclass correlation coefficient values were between 0.40 and 0.79, which were statistically significant (p < 0.01). Analysis of the structural validity revealed a three-factor structure, (1) productive subjective experiences, (2) affective-negative subjective experiences and (3) excitation, which accounted for 56.11% of the variance. Of the Pearson's correlation coefficients analysed between the PRISS and the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS) and World Health Organization Disability Assessment Schedule (WHO-DAS), 72.2% were statistically significant (p < 0.05) and ranged from 0.38–0.42, 0.32–0.42 and 0.40–0.42, respectively. Conclusion Our results indicate that the PRISS appears to be a brief, reliable and valid scale to measure subjective experiences in schizophrenia and provides valuable information complementary to clinical evaluation.This study has been funded by the ‘Instituto de Salud Carlos III’ through the project PI16/00647 and co- funded by the European Regional Development Fund (FEDER) ‘A way to make Europe’. Funding for open access charge: Universidad de Málaga / CBU

Los sistemas de información al servicio de la sanidad

Las TIC han permitido en la última década dar un paso de gigante en el registro y la gestión de información sanitaria. El proyecto Diraya, la base informática del Sistema Andaluz de Salud, integra los datos de cada usuario en un historial único y facilita su consulta dentro de la red

Reviewing the Social GRACES: What Do They Add and Limit in Systemic Thinking and Practice?

The Social Graces framework is increasingly used within training institutions, as a means of encouraging learners to critically explore issues of social difference. Attending to issues of power and diversity is believed to help trainee family therapists become more alert to any biases that may impact on therapy. This review paper draws on the developing literature to examine what the social graces add and limit in systemic thinking and practice. It also considers an alternative approach for exploring power and difference in family therapy practice

Changes in total death rate and in ischaemic heart disease death rate in interethnic South African populations, 1978 - 1989

Ischaemic heart disease (IHD) in prosperous Western populations rose markedly in the 1940s, peaked between 1970 and 1975 and then fell variably - by about 50% in the USA and Australia. Undoubtedly, decreases in serum cholesterol levels, in the incidence of hypertension and in smoking frequencies are largely responsible. In South Africa, in all population groups other than blacks, IHD rates rose analogously, with Asians and whites attaining very high rates. However, from 1978 to 1989, the total death rate among white males (per 100 000 world population) fell from 1 002 to 631 (37%), and the IHD mortality rate from 312 to 139 (56%). Rates for Asians were 1 306 - 1 130 (14%) and 355 - 226 (36%), respectively, and for coloureds 1 691 to 1 392 (18%) and 171 to 110 (36%). For blacks, the total mortality rate remained unchanged; IHD rates were low, but these data are unreliable. Percentage falls in the IHD rate exceed those in the total death rate, especially among whites, indicating true decreases in IHD rate. Understandably, the accuracy of the data, as with such data overseas, is questionable. Local falls are none the less in line with those noted in Western countries. Rates for whites remain very high, and are even higher for Asians. While knowledge of the reasons for the rises and falls in IHD rates reInains incomplete, whites have none the less taken some preventive action, although Asians and coloureds apparently little

Factores asociados al riesgo suicida en Andalucía. Estudio PISMA-ep suicidio

El suicidio es un importante problema de salud mental a nivel internacional. Más de 800.000 personas se suicidan cada año. La conducta suicida es más frecuente que el suicidio consumado y por cada suicidio consumado, se dan entre 10 y 20 casos de intento suicida (1).Los estudios epidemiológicos que toman en consideración la prevalencia y los factores asociados al riesgo suicida en diferentes poblaciones son escasos, no existiendo estudios previos sobre esta realidad en Andalucía. El objetivo de este estudio es conocer laprevalencia del riesgo suicida y analizar su asociación con variables demográficas, psicosociales y clínicas. Estudio transversal mediante una encuesta domiciliaria sobre una muestra representativa de adultos no institucionalizados de ambos sexos con edades comprendidas entre 18 y 75 años. 4507 sujetos fueron entrevistados utilizando la Entrevista Neuropsiquiátrica Internacional (MINI) (3) para evaluar el riesgo suicida actual. Se utilizaron instrumentos estandarizados para la evaluación de las siguientes variables independientes: demográficas (edad, género, estado civil, situación laboral, nivel educativo, nivel de urbanicidad del lugar de residencia y provincia de residencia), psicosociales (eventos vitales estresantes, experiencias de maltrato físico, psicológico y sexual en la infancia, funcionamiento personal y social, apoyo social y rasgos de personalidad: neuroticismo e impulsividad) y clínicas (historia familiar de problemas psiquiátricos, antecedentes de suicidio en la familia, dependencia a la nicotina y otras drogas y consumo de alcohol). Se realizó un análisis exploratorio de la distribución de los datos, incluyendo frecuencias y medias de todas las variables independientes. Se calculó la prevalencia del riesgo suicida actual (IC; 95%). Para el análisis univariante se utilizó el test chi-cuadrado y la prueba t-student y finalmente se realizó un análisis multivariante de regresión logística de efectos fijos, contralado por provincia. El 6,4% de la muestra de sujetos presentan riesgo de suicidio actual. Los resultados del modelo multivariante indican que las asociaciones estadísticamente significativas con el riesgo suicida actual fueron ser mujer, mayor edad, estar divorciado/separado/viudo/soltero, historia familiar de enfermedad mental, mayor número deeventos vitales estresantes, menos apoyo social, niveles mayores de neuroticismo, consumo elevado de alcohol, y dependencia a nicotina y otras drogas. Nuestros resultados son similares a los encontrados en otros estudios previos (4). Conclusiones Se trata del primer estudio epidemiológico realizado en Andalucía sobre el riesgo de suicidio, ofreciéndonos importantes resultados de interés clínico para la prevención del suicidio. Bibliografía 1. World Health Organisation. Prevention suicide: A global Imperative. 2014. Disponible en: ihttp://www.who.int/mental_health/suicide-prevention/world_report_2014/es/ 2. Hardt J., Bernert S., Matschinger H., Angermeier M.G., VilagutG., Bruffaerts R., et al. Systematic review of risk factors for suicide and suicide attempt among psychiatric J Affective Disorders 2015; 175: 168–174. 3. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Herqueta T, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl.20):22-33. 4. Nock M.K., Borges G, Bromet E.J., Cha C.B., Kessler R.C., Lee S.Suicide and suicidal behavior.Epidemiol Rev. 2008;30:133-54Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

The cholera epidemic in South Africa, 1980 - 1987 Epidemiological features

During the cholera epidemic in South Africa, 1980-1987, 25251 cases of cholera were bacteriologically proven. The case-fatality rate was 1,4%. Outbreaks occurred in the summer rainfall season. Age-specific aUack rates followed the pattern typically found during the 'epidemic phase' of the disease in most years. The vast majority of patients were black South Africans living in rural areas with an average annual rainfall in excess of 600 mm. The containment strategy employed is summarised. Despite the apparent eradication of the disease, it is strongly recommended that vigilance should be maintained and investigations of all possible sources of infection and all human contacts of any new proven case should be carried out speedily and thoroughly

A Gestão do Medo através da Arte

O presente ensaio fotográfico apresenta uma reflexão sobre a gestão do medo a partir da reportagem fotográfica da exposição “Nossos medos” exibida em dezembro de 2017 no Centro de Cultura Mirante do Solar de Itaparica (Bahia). A exposição recolhe as pinturas de 16 crianças, resultado de um trabalho artístico-educativo coordenado por Fanny Glemarec, educadora da ONG alemã Ilha das Crianças, também de Itaparica. Inspirado na pintura do artista norueguês Edvard Munch ‘O Grito’, o trabalho convida-nos a fazer uma reflexão sobre a importância da gestão do medo como forte emoção que nos movimenta e/ou nos paralisa, nos determina e/ou nos indetermina e, de qualquer forma, sempre nos condiciona, para tomar consciência de até que ponto nos acostumamos a viver com medo