ABSTRACT
BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
Subject(s)
Cognitive Behavioral Therapy , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/drug therapy , Stress Disorders, Post-Traumatic/psychology , Psychiatrists , Europe , Antidepressive Agents/therapeutic useABSTRACT
Se ha demostrado que la alta capacidad de mentalización del personal educativo pre-escolar(PEd) incide en el desarrollo socioemocional de la teoría de la mente y del lenguaje del infante y que tiene efecto compensador en contextos sociales y familiares desfavorables. Pocos estudios evalúan los efectos de formaciones en la mentalización en PEd. Este estudio evaluó el efecto de una formación que promueve la observación y comprensión de la subjetividad propia y del infante en una muestra de 17 educadoras de tres guarderías de Barcelona. Se encuentra una mejora estadísticamente significativa en la mentalización global y diferentes dimensiones. Se proponen líneas de investigación que incluyan la mentalización en PEd y su impacto en la infancia.(AU)
The high mentalization capacity of pre-school education (PEd) staff has been shown to have an impact onthe socio-emotional development of the infant's theory of mind and language and to have a compensatory effect in unfavourable social and family contexts. Few studies have evaluated the effects of training on mentalization in ECD. This study evaluated the effect of training that promotes observation and understanding of self and infant subjectivity in a sample of 17 educators from three nurseries in Barcelona. A statistically significant improvement was found in global mentalization and different dimensions. Lines of research that include mentalization in PEdand its impact on children are proposed.(AU)
S'ha demostrat que l'alta capacitat de mentalització del personal educatiu preescolar (PEd)incideix en el desenvolupament socioemocional de la teoria de la ment i del llenguatge de l'infant i que té un efectecompensador en contextos socials i familiars desfavorables. Pocs estudis avaluen els efectes de formacions en lamentalització a PEd. Aquest estudi va avaluar l'efecte d'una formació que promou l'observació i la comprensióde la subjectivitat pròpia i de l'infant en una mostra de 17 educadores de tres escoles bressol de Barcelona. Hi hauna millora estadísticament significativa en la mentalització global i diferents dimensions. Es proposen línies derecerca que incloguin la mentalització a PEd i el seu impacte a la infància.(AU)
Subject(s)
Humans , Male , Female , Child Day Care Centers , Theory of Mind , Observation , Child, Preschool , Mental Health , PsychopathologyABSTRACT
Las relaciones de apego y la crianza en la infancia condicionan el desarrollo emocional y la aparición o no de trastornos mentales. Algunas experiencias adversas en la infancia se consideran factores de riesgo de salud en general y de salud mental en particular. Se sabe que dichas adversidades tienen un reflejo en el sistema fisiológico y provocan cambios epigenéticos en el ADN. Se realiza un estudio retrospectivo en una muestra de 29 pacientes ya diagnosticados de trastorno mental grave en la edad adulta, la mayoría hombres, de edad media de 25,2 años. Su finalidad es observar cuáles son los factores de riesgo encontrados con mayor frecuencia. Estos fueron: depresión y/o estrés de la madre durante el embarazo, separaciones tempranas y prolongadas de las figuras de cuidado, y padre emocionalmente ausente. Todos ellos afectan a los procesos de vinculación y relación dentro de la familia. Se concluye que este tipo de estudios son necesarios, ya desde la infancia, para detectar y prevenir alteraciones en las relaciones de apego que ocasionarán cambios emocionales y fisiológicos que condicionarán la salud mental de la persona
Attachment relationships and upbringing during childhood condition emotional development and incidences of mental disorders or lack thereof. Some adverse experiences in childhood are considered general health risk factors and mental health risk factors in particular. Said adversities are known to be reflected in the physiological system and to provoke epigenetic changes in the DNA. A retrospective study was conducted in a sample of 29 patients who had been diagnosed with severe mental disorders during adulthood. The majority of them were male, and their average age was 25.2 years old. Risk factors found at higher rates were: mothers depression and/or stress during pregnancy, early and prolonged separations of care figures, and emotionally absent fathers. These adversities affect the processes of attachment and relationships within the family. We conclude that these kinds of studies are necessary, starting in childhood, to detect and prevent alterations in attachment relationships that will cause emotional and physiological changes that will condition the persons mental health
Subject(s)
Humans , Male , Female , Adult , Child Rearing/psychology , Object Attachment , Neurodevelopmental Disorders/diagnosis , Psychological Trauma/epidemiology , Mental Disorders/etiology , Adverse Childhood Experiences , Risk Factors , Parenting/psychology , Stress Disorders, Post-Traumatic/epidemiology , Adult Survivors of Child Abuse , Social Environment , Psychometrics/methodsABSTRACT
La prevención en salud mental es un objetivo prioritario que al utilizar actividades accesibles a la población evita la estigmatización y favorece la detección y tratamiento precoz. En el ámbito escolar la Educación Secundaria Obligatoria es el último escalón social donde se vinculan todos los ciudadanos.El taller se realiza en base a una actividad grupal con estímulo previo: el cuestionario de autopercepción de salud, el GHQ-28 y la técnica de lluvia de ideas. Posteriormente, en grupo, se comentan las vivencias de los adolescentes. La actividad se realiza con alumnos de la ESO, de una zona de Barcelona, en colaboración con los Equipos de Asesoramiento Psicopedagógico.Resultados: un 35% obtienen puntuaciones de rango patológico en la autopercepción de salud y quieren saber que les ocurre. Las valoraciones cualitativas del grupo muestran un alto grado de satisfacción, tanto del profesorado como del alumnado ya que hablan de temas, a menudo, estigmatizantes (AU)
Promotion of Mental Health has become a priority of social and health policies. The aim is to avoid the mental disorders stigma associated and bring awareness to improve early detection and treatment. School institution, particularly High School, is the last step required for citizens. Workshop on mental health based on a group activity with two steps of intervention: a pre encouragement, students must answer the GHQ-28 and participate in a brainstorming. Later the students ideas and experiences are discussed in group. This intervention was taken place in three different Barcelona neighbourhoods in collaboration with Psycho pedagogical Counselling Equipment. The results show that about 35% of teenagers have a pathological range scores on their own perception of mental health and are interested to know more about themselves. The qualitative evaluations about the group show a high satisfaction in both teachers and pupils, to discuss issues whom often are stigmatizing(AU)
