ABSTRACT
Objetivo: Se examina el perfil de personalidad asociado a diferentes diagnósticos clínicos en una muestra de pacientes ambulatorios del Centro de Salud Mental Infanto-Juvenil. Material y métodos: 77 adolescentes entre 13 y 17 años fueron evaluados con el MMPI-A. Hemos realizado un análisis retrospectivo de las historias clínicas para obtener los datos sociodemográficos y clínicos (edad, sexo, cronicidad y diagnóstico CIE-10 y CFTMIA). Mostramos el perfil global y por diagnóstico, los estadísticos descriptivos y comparamos las medias para los diferentes diagnósticos (test de Kruskal- Wallis, Median test, Kolmogorov- Smirnov y test de Mann Whitney) y edades (correlaciones divariadas de Pearson, test de Kruskal- Wallis y test de Mann Whitney). Resultados: El total de la muestra presenta elevaciones moderadas en las escalas de depresión y desviación psicopática. Se asocian diferentes perfiles a cada diagnóstico edad. Los trastornos psicóticos y los trastornos mixtos de la conducta y las emociones muestran un perfil más psicopatológico en las escalas clínicas y mayor deterioro psicosocial reflejado en las escalas de contenido. Los adolescentes más mayores (edades de 16 y 17) tienen puntuaciones más altas que los adolescentes jóvenes (13 a 15 años) en depresión e introversión. Discusión: Los estudios revisados sugieren que hay un sustancial grado de asociación entre el inicio de los trastornos del eje I y la psicopatología del eje II en el final de la adolescencia y el inicio de la primera adultez. Comentamos nuestros resultados y discutimos la asociación entre trastornos mentales en la infancia y adolescencia y alteraciones de la personalidad. Conclusiones: Identificar y tratar con éxito los trastornos en la infancia puede ayudar a reducir el riesgo de desarrollar un trastorno de personalidad adulto. Se necesita más investigación para desarrollar recomendaciones de evaluación y tratamiento para las manifestaciones tempranas de las alteraciones de la personalidad (AU)
Objective: We examined the personality profile associated to diferents diagnoses in a sample of outpatients of the Mental Health Center for Children and adolescents. Method: 77 adolescents with ages from 13 to 17 were assessed with the MMPI-A. We made a prospective analysis of each clinical report to obtain sociodemographic and clinical data (age, gender, cronicity, diagnostic with CIE- 10 and CFTMA).We show the profiles of both the total sample and of each diagnostic cathegory using descriptive statistics and compared means for the diffe- 201 rent diagnoses (using Kruskal- Wallis test, Median test, Mann-Whitney test and Kolmogorov- Smirnov test) and for ages (using Pearson bivariate correlations, Kruskal- Wallis test and Mann- Whitney test). Results: All the sample show moderate elevations in Depression and Psychopatic deviation. Differents profiles are associated to each diagnosis and age: psychotic and mixed disorders of conduct and emotions show more severe psychopathology profile in clinical scales and more psychosocial impairment reflected in content scales. Older adolescents (age 16 and 17) have more elevated and significative scores than younger adolescents (age 13 to 15) in depression and introversion. Discussion: Studies revised suggest a substantial degree of association between early onset axis I disorders and axis II psychopathology in late adolescence and young adults. We comment our results and discuss the association between mental disorders in childhood and adolescence and personality disfunction. Conclusions: Identification and successful treatment of childhood disorders and severe early impairment, may help to reduce the risk of subsequent development of an adult personality disorder. More research is needed to develop assessment and treatment recommendations addressing the early manifestations of personality disturbance (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adolescent Behavior/psychology , Personality Assessment , Psychiatric Status Rating Scales/statistics & numerical data , MMPI , Personality Disorders/epidemiology , Neurodevelopmental Disorders/epidemiologyABSTRACT
INTRODUCTION: In recent years we have seen an increasing demand for mental health care in patients with fibromyalgia and psychiatric symptoms, although it is not clear if the symptoms are primary or secondary to the presence of the syndrome. This fact has led mental health providers to think that there would be some psychological factors influencing the vulnerability of suffering this painful syndrome, because its etiology is quite non-specific. Bradley et al. (1978) identified different psychopathological profiles within chronic pain syndromes with the MMPI, which were subsequently adapted by Yunus et al. (1991) for fibromyalgia. This present work studied the clinical profile in patients with fibromyalgia. SAMPLE: 75 patients with fibromyalgia from the community mental health center and 55 healthy subjects. Tools: STAI-E/R, BDI, MMPI-2, MMPI-2 personality disorders, MMPI-2 PSY-5. STATISTICAL ANALYSIS: descriptive statistics and mean comparison (Student's t test). Confirmatory cluster analysis. Discriminative analysis of subgroups. RESULTS: Two different patterns were obtained: group A (32 %) with a typical chronic pain profile (CP) and group B (68 %) with a psychological maladjustment profile (PM). With the discriminative analysis, we obtained the coefficients of the discriminative canonical functions that maximize the differences between both groups. CONCLUSIONS: We confirmed Bradley's classification, obtaining two different psychopathological patterns in the fibromyalgia syndrome sample we studied. We obtained an index of psychopathological profile in fibromyalgia, which would form a new scale, from MMPI-2 for discriminating psychopathological severity in fibromyalgia.
Subject(s)
Community Mental Health Centers , Fibromyalgia/diagnosis , Fibromyalgia/epidemiology , Adult , Aged , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , Demography , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Female , Fibromyalgia/psychology , Humans , MMPI , Male , Middle Aged , Predictive Value of Tests , Severity of Illness IndexABSTRACT
Introducción. En los últimos años se ha visto incrementada la demanda asistencial en salud mental de pacientes que presentan fibromialgia y sintomatología psiquiátrica, y no queda claro en la mayoría de los casos si esta patología es primaria o secundaria a la aparición del síndrome. Esto ha hecho plantearse a los profesionales de la salud mental la influencia de distintos factores psicológicos de vulnerabilidad a padecer este síndrome doloroso dada la inespecificidad a nivel etiológico. Bradley et al. (1978) identificaron a través del MMPI distintos perfiles psicopatológicos dentro de síndromes con dolor crónico que posteriormente fueron adaptados por Yunus et al. (1991) para la fibromialgia. En el presente trabajo se estudian los perfiles clínicos en pacientes con fibromialgia. Método. Muestra: 75 pacientes derivados al centro de salud mental que presentan fibromialgia; 55 sujetos control sanos. Instrumentos: STAI-E/R; BDI, MMPI-2, MMPI-2 trastornos de la personalidad, MMPI-2 PSY-5. Análisis estadísticos: estadísticos descriptivos y comparación de medias (t de Student). Análisis de clúster confirmatorio. Análisis discriminante de los subgrupos. Resultados. Se obtienen dos patrones diferenciales: grupo A (32 %) con un perfil típico del dolor crónico (DC) y grupo B (68 %) con un perfil de desajuste psicológico (DP). Mediante el análisis discriminante obtuvimos los coeficientes de las funciones canónicas discriminantes que maximizan las diferencias entre los dos grupos. Conclusiones. Se confirma la clasificación de Bradley obteniendo dos patrones psicopatológicos diferenciales en la muestra de síndrome de fibromialgia estudiada. Se obtiene un índice de perfil psicopatológico en fibromialgia que configura una nueva escala a partir del MMPI-2, que discrimina gravedad psicopatológica en la fibromialgia
Introduction. In recent years we have seen an increasing demand for mental health care in patients with fibromyalgia and psychiatric symptoms, although it is not clear if the symptoms are primary or secondary to the presence of the syndrome. This fact has led mental health providers to think that there would be some psychological factors influencing the vulnerability of suffering this painful syndrome, because its etiology is quite non-specific. Bradley et al. (1978) identified different psychopathological profiles within chronic pain syndromes with the MMPI, which were subsequently adapted by Yunus et al. (1991) for fibromyalgia. This present work studied the clinical profile in patients with fibromyalgia. Method. Sample: 75 patients with fibromyalgia from the community mental health center and 55 healthy subjects. Tools: STAI-E/R, BDI, MMPI-2, MMPI-2 personality disorders, MMPI-2 PSY-5. Statistical analysis: descriptive statistics and mean comparison (Student's t test). Confirmatory cluster analysis. Discriminative analysis of subgroups. Results. Two different patterns were obtained: group A (32 %) with a typical chronic pain profile (CP) and group B (68 %) with a psychological maladjustment profile (PM). With the discriminative analysis, we obtained the coefficients of the discriminative canonical functions that maximize the differences between both groups. Conclusions. We confirmed Bradley's classification, obtaining two different psychopathological patterns in the fibromyalgia syndrome sample we studied. We obtained an index of psychopathological profile in fibromyalgia, which would form a new scale, from MMPI-2 for discriminating psychopathological severity in fibromyalgia
