Preparando el escenario para dejar de fumar en el paciente con Trastorno Bipolar: intervención breve en la práctica clínica

Tobacco consumption is the main preventable factor of mortality in smokers with bipolar disorder (BD), and any possible solutions are often blocked by prejudices over desire, and the possibilities and risks for these patients in giving up tobacco consumption. Adults with BD were recruited at 8 Mental Health Centres. Smokers were evaluated before and after a brief intervention based on the 3 A’s and classified into a ‘Stage of Change’ (SOC) and their ‘Readiness to Change’ (RTC). A multiple linear regression was used to analyze the progression in their RTC and the independent effect of different variables (pharmacological treatment, history of psychotic symptoms, current anxiety symptoms, willingness, self-perceived capacity to quit smoking and subjective perception of cognitive functioning). Of 212 stable patients diagnosed with BD, current smokers (n=101; 47.6%) were included in the intervention phase, and 80.2% completed it. At baseline, 75.2% were considering the idea of giving up smoking and, after the brief intervention, 30.9% of the patients progressed in their SOC. A significant increase in the level of RTC was observed (53.3 vs 59.3, P=0.019). Perception of cognitive performance (β=- 0.35;P=0.002), the degree of willing to quit (β=0.32;P=0.008), selfperceived capacity to quit tobacco smoking (β=-0.30;P=0.012), the patient’s age (β=-0.72;P=0.004), the age of onset of smoking (β=0.48;P=0.022) and years as a smoker (β=0.48;P=0.025) were all factors that significantly influenced the chances of improving after the short intervention. Smokers with BD consider the idea of quitting and a brief intervention developed in the every day mental health care setting improves the level of readiness. The neurocognitive dysfunction associated with BD may limit patients’ readiness to quit smoking.El consumo de tabaco es el principal factor prevenible de mortalidad en pacientes con trastorno bipolar (TB), y las posibles soluciones se encuentran bloqueadas por prejuicios acerca del deseo, posibilidades y riesgos al dejar el consumo de tabaco en estos pacientes. En 8 Centros de Salud Mental se reclutaron consecutivamente pacientes con TB. Los fumadores fueron evaluados antes y después de una intervención breve basada en las 3 As y clasificados según los “estadios de cambio” (EC) y su “disposición para el cambio” (DC). Mediante una regresión lineal múltiple se analizó la evolución del DC y su efecto sobre otras variables independientes (tratamiento farmacológico, historias de síntomas psicóticos, presencia de síntomas de ansiedad, deseo de abandono, capacidad auto-percibida y la percepción subjetiva de funcionamiento cognitivo). Se incluyeron 212 pacientes con TB estabilizados, los fumadores activos (n=101; 47.6%) pasaron a la fase de intervención, y un 80.2% la completaron. Basalmente, 75.2% consideraban la idea de dejar de fumar, después de la intervención breve, el 30.9% de los pacientes progresó en su EC. Se observó un incremento significativo del nivel de DC (53.3 vs 59.3, P=0.019). La autopercepción del rendimiento cognitivo (β=-0.35;P=0.002), el deseo de abandono (β=0.32;P=0.008), la autopercepción de la capacidad para dejar de fumar (β=-0.30;P=0.012), la edad del paciente (β=-0.72;P=0.004), la edad de inicio del tabaquismo (β=0.48;P=0.022) y los años fumando (β=0.48;P=0.025) fueron los factores que influyeron significativamente en la posibilidad de cambio tras la intervención breve. Los fumadores con TB consideran la idea de dejar de fumar y una intervención breve desarrollada en el marco de la atención a la salud mental diaria, mejoraría el nivel de preparación. La disfunción neurocognitiva asociada con el TB podría limitar la disposición de los pacientes a dejar de fumar

Análisis de la demanda en el equipo de salud mental de Andújar: Evolución y estudio comparativo a los 20 años de apertura.

Se presentan los resultados de un análisis de la evolución de la demanda asistencial en un ESMD para la población general desde su creación en 1981 hasta 2001, analizando variables sociodemográficas, clínicas y psicoterapéuticas de 200 historias clínica

Análisis de la demanda en el equipo de salud mental de Andújar: Evolución y estudio comparativo a los 20 años de apertura.

Se presentan los resultados de un análisis de la evolución de la demanda asistencial en un ESMD para la población general desde su creación en 1981 hasta 2001, analizando variables sociodemográficas, clínicas y psicoterapéuticas de 200 historias clínica

Lifestyle in Undergraduate Students and Demographically Matched Controls during the COVID-19 Pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles

Lifestyle in undergraduate students and demographically matched controls during the covid-19 pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 +- 8.1 vs. 77.2 +- 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles

Smoking cessation opportunities in severe mental illness (tobacco intensive motivational and estimate risk — TIMER—): study protocol for a randomized controlled trial

There is an increased risk of premature death in people with severe mental illness (SMI). Respiratory disorders and cardiovascular disease are leading causes of increased mortality rates in these patients, and tobacco consumption remains the most preventable risk factor involved. Developing new tools to motivate patients towards cessation of smoking is a high priority. Information on the motivational value of giving the lung age and prevention opportunities is unknown in this high-risk population. In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provide patients with SMI with a better chance of quitting smoking.This study receives funding by the Spanish Ministry of Economy, Industry and Competitiveness, Instituto Carlos III (FIS PI16/00802)

Análisis de la demanda en el equipo de salud mental de Andújar: Evolución y estudio comparativo a los 20 años de apertura.

Se presentan los resultados de un análisis de la evolución de la demanda asistencial en un ESMD para la población general desde su creación en 1981 hasta 2001, analizando variables sociodemográficas, clínicas y psicoterapéuticas de 200 historias clínica

Biochemical changes in the cingulum in patients with schizophrenia and chronic bipolar disorder.

Biochemical changes have been reported in vivo in the brain in schizophrenia patients using 1H-magnetic resonance spectroscopy (MRS). The aim of this study was to assess the specificity of biochemical changes occurring in schizophrenia patients, in a direct comparison with bipolar disorder patients. Fourteen patients with chronic paranoid schizophrenia, 17 euthymic type I bipolar patients with no previous history of psychotic symptoms and 15 healthy controls were included, most of them were female. They underwent a study with MRS: proton spectra were acquired using a Signa 1.5 T CVI scanner, with a localised single voxel PRESS sequence. N-acetyl aspartate (NAA), Creatine (Cr), and Choline (Cho) metabolite resonance intensities were all quantified in the cingulum, a region of interest in schizophrenia and bipolar disorder. Schizophrenia patients showed a significantly higher Cho/Cre as well as lower NAA/Cho ratios as compared with controls and bipolar patients. No significant differences were found among the three groups as regards NAA/Cre levels. These data are consistent with an increase in the concentration of choline in the cingulum in chronic schizophrenia, at least in this predominantly female group. Such an increase seems to be more intense than in psychosis-free bipolar disorder patients