Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7.

The aim of the study was to determine the criterion validity of a computerized version of the General Anxiety Disorder-7 (GAD-7) questionnaire to detect general anxiety disorder in Spanish primary care centers. A total of 178 patients completed the GAD-7 and were administered the Composite International Diagnostic Interview (CIDI) for DSM-IV Axis I Disorders, which was used as a reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A cut-off of 10 yielded a sensitivity of .87, a specificity of .78, a positive predictive value of .93, a negative predictive value of .64, a positive likelihood ratio of 3.96 a negative likelihood ratio of .17 and Younden's Index of .65. The GAD-7 performed very well with a cut-off value of 10, the most frequently used cut-off point. Thus, a computerized version of the GAD-7 is an excellent screening tool for detecting general anxiety disorder in Spanish primary care settings.

Sensibilidad química múltiple: evaluación clínica de la gravedad y perfil psicopatológico / Multiple chemical sensitivity: Clinical evaluation of the severity and psychopathological profile

Introducción y objetivo: La sensibilidad química múltiple (.SQM) es un trastorno multisistémico de etiología controvertida que afecta a algunos sujetos al exponerse a productos químicos a concentraciones no perjudiciales. El objetivo de este trabajo es describir las características epidemiológicas, clínicas y psicológicas de una muestra de pacientes con SQM, para un posterior tratamiento grupal específico. Pacientes y método: Estudio descriptivo de los pacientes diagnosticados de SQM en una unidad de toxicología, mediante la administración del cuestionario Quick Environmental Exposure and Sensitivity Inventory, junto con la entrevista estructurada SCID-II, la escala de ansiedad HAS y el test de personalidad tipo A, PCTA. Resultados: Se incluyeron 73 pacientes, con una edad media de 52,6 años (rango 33-77; DE 9,29), siendo 66 mujeres (90,4%). El 53% estaban clasificados como grado i-ii y ii. Sesenta y un pacientes (83%) presentaron algún tipo de comorbilidad, fundamentalmente dolor crónico, fibromialgia y fatiga crónica, con niveles de ansiedad mayores (puntuación media 19,2), predominio de rasgos de personalidad fóbico-evitativo y patrón de conducta tipo A (31,1%). Conclusiones: La SQM afecta principalmente a mujeres de mediana edad, con comorbilidades (dolor crónico, fibromialgia y fatiga crónica), elevada ansiedad y conductas de evitación. Este análisis previo debería ayudar a ofrecer un abordaje psicoterapéutico específico a estos pacientes (AU)

Introduction and objective: Multiple chemical sensitivity (MCS) is a multisystem disorder of controversial etiology, affecting some subjects when exposed to chemicals at no harmful concentrations. The objective of this paper is to describe the epidemiological, clinical and psychological features of a sample of patients with MCS for further specific group treatment. Patiens and method: Descriptive study of patients diagnosed with MCS in a toxicology unit. We administered the Quick Environmental Exposure and Sensitivity Inventory, the structured interview SCID-II, the anxiety scale HAS and the type A personality test, PCTA. Results: Seventy-three patients were included. The mean age was 52,6 years (range 33-77; SD 9.29). Sixty-six were females (90.4%). Fifty-three percent were classified as i-ii and ii grade. Sixty-one patients (83%) presented some type of comorbidity, mainly chronic pain, fibromyalgia and chronic fatigue. They exhibited higher levels of anxiety (average score of 19.2), prevalence of phobic-avoidant traits of personality and type A behavior in 31.1%. Conclusions: MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue) and high anxiety and avoidance behaviors. This preliminary analysis should help provide a specific therapeutic approach to these patients (AU)

[Multiple chemical sensitivity: Clinical evaluation of the severity and psychopathological profile]. / Sensibilidad química múltiple: evaluación clínica de la gravedad y perfil psicopatológico.

INTRODUCTION AND OBJECTIVE: Multiple chemical sensitivity (MCS) is a multisystem disorder of controversial etiology, affecting some subjects when exposed to chemicals at no harmful concentrations. The objective of this paper is to describe the epidemiological, clinical and psychological features of a sample of patients with MCS for further specific group treatment. PATIENS AND METHOD: Descriptive study of patients diagnosed with MCS in a toxicology unit. We administered the Quick Environmental Exposure and Sensitivity Inventory, the structured interview SCID-II, the anxiety scale HAS and the type A personality test, PCTA. RESULTS: Seventy-three patients were included. The mean age was 52,6 years (range 33-77; SD 9.29). Sixty-six were females (90.4%). Fifty-three percent were classified as i-ii and ii grade. Sixty-one patients (83%) presented some type of comorbidity, mainly chronic pain, fibromyalgia and chronic fatigue. They exhibited higher levels of anxiety (average score of 19.2), prevalence of phobic-avoidant traits of personality and type A behavior in 31.1%. CONCLUSIONS: MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue) and high anxiety and avoidance behaviors. This preliminary analysis should help provide a specific therapeutic approach to these patients.

Estrategias de afrontamiento de una muestra de pacientes con trastorno límite de personalidad en terapia dialéctico conductual / No disponible

Introducción: el uso adecuado de estrategias de afrontamiento está relacionado con una mayor sensación de bienestar. Esta relación podría ser muy importante para el tratamiento de pacientes con trastorno límite de la personalidad. Las personas diagnosticadas con TLP tienen dificultades para el manejo del estrés. Este estudio trata de averiguar si existen diferencias entre las estrategias de afrontamiento que emplea la población no-clínica y los pacientes con TLP. El cuestionario COPE lo evalúa. Metodología: Se analizan las puntuaciones del cuestionario COPE en 58 pacientes con diagnóstico de trastorno límite de personalidad en terapia dialéctico-conductual. Resultados: en los pacientes con TLP evaluados existe un predominio de estrategias de afrontamiento basadas en el afrontamiento emocional y evitación cognitiva. Conclusiones: los pacientes con TLP emplean estrategias de afrontamiento más desadaptativas que la población no-clínica. Un entrenamiento en habilidades de afrontamiento podría suponer una mejoría en el bienestar de estos pacientes. En la terapia dialéctico-conductual de Linehan se promueven el aprendizaje y desarrollo de habilidades de afrontamiento. Son necesarios estudios que evalúen la eficacia del entrenamiento en habilidades de afrontamiento al estrés en pacientes con TLP

Introduction: The proper use of coping strategies is related to a greater sense of wellbeing. This relationship could be very important for the treatment of patients with borderline personality disorder. Individuals diagnosed with BPD have significant difficulty managing stress. The current study seeks to ascertain whether there are indeed differences between the coping strategies employed by the non-clinical population and patients with BPD. The COPE is a questionnaire that assesses. Methodology: We analyzed COPE questionnaire scores in 58 patients diagnosed with borderline personality disorder treated with dialectical behavioral therapy. Results: BPD patients assessed there is a predominance of coping strategies based on emotional and cognitive avoidance coping. Conclusions: Patients with BPD use more maladaptive coping strategies than non-clinical population. A coping skills training could lead to an improvement in the welfare of these patients. In dialectical behavioral therapy learning are promoved and skills development adaptive stress coping. Studies are needed to evaluate the effectiveness of training in stress coping skills in patients with BPD