ABSTRACT
El acceso de los usuarios con trastorno mental grave (TMG) a los dispositivos sociosanitarios viene determinado por unos criterios preestablecidos que pueden estar opacando la existencia de perfiles clínicos con diferentes necesidades terapéuticas. En esta línea, desde el Centro San Juan de Dios de Ciempozuelos (CSJD), se ha realizado un estudio descriptivo de tipo transversal en el que se han encontrado cinco tipologías clínicas mediante la aplicación de un análisis de conglomerados en dos fases. En el estudio participaron 413 personas con TMG ingresadas en diferentes dispositivos de la Unidad de Cuidados Psiquiátricos Prolongados -UCPP- del CSJD (en función de su autonomía y necesidades) y que presentaban una media de edad de 53.78 años (95.4% varones y 4.4% mujeres) y altos niveles de institucionalización (media de 13.06 años). El diagnóstico principal encontrado fue el de esquizofrenia residual (38.3%; n= 158), seguido de esquizofrenia paranoide (26.6%; n= 110). También había un número significativo de trastornos de la personalidad (35 casos). Las cinco tipologías de usuarios se denominaron en función de sus características más destacadas: Rehab (R), Rehab Behav (RB), Young Care (YC), Old Care (OC) y Young Behav (YB). En función de estos resultados se debate la idoneidad de los recursos existentes a la par que se proponen alternativas que maximicen la efectividad de los mismos en relación a casos de TMG complejos, como los de trastorno límite de la personalidad. (AU)
Institutions dedicated to the care of serious mental illness (SMI) have admission criteria that determine the users who are admitted. A thorough analysis of the patients may reveal the existence of different clinical profiles with diverse therapeutic needs. In order to determine the existence of different clinical profiles in the UCPP of the Centro San Juan de Dios de Ciempozuelos (CSJD), a cross-sectional descriptive study was carried out, finding five clinical typologies by applying a two-stage cluster analysis. 413 people with SMI, admitted in different devices of the Prolonged Psychiatric Care Unit (according to their autonomy and needs), with a mean age of 53.78 years (95.4% males and 4.4% females) and high levels of institutionalization (mean 13.06 years), took part in the study. The main diagnosis found was residual schizophrenia (38.3%; n= 158), followed by paranoid schizophrenia (26.6%; n= 110). There was also a significant number of personality disorders (35 cases). The five typologies of users were named according to their most salient characteristics: Rehab (R), Rehab Behav (RB), Young Care (YC), Old Care (OC) and Young Behav (YB). A discussion on the implications of the determination of these profiles for a better use of existing resources is held. In addition, different alternatives for particularly difficult cases of SMI, such as borderline personality disorder, are proposed. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Mental Disorders/diagnosis , Mental Disorders/rehabilitation , Epidemiology, Descriptive , Cross-Sectional Studies , Cluster Analysis , Spain , Borderline Personality Disorder , SchizophreniaABSTRACT
(1) Background: There is increasing interest in the practice of mindfulness-based interventions (MBIs) to treat people with schizophrenia, as evidenced by the publication of different randomized controlled trials (RCTs). However, no meta-analysis of RCTs has been carried out to date with the exclusive inclusion of this type of interventions. (2) Objective: To analyze empirical evidence regarding the effectiveness of MBIs for the improvement of clinical parameters associated with schizophrenia. Method: A systematic review and meta-analysis was conducted of RCTs published in the databases PsycINFO, PubMed, WOS, and Cochrane Library. (3) Results: A total of 10 articles (n = 1094) fulfilled the criteria for inclusion in the review. The analysis of these studies suggests that MBIs combined with standard interventions are able to generate significant improvements in a variety of clinical schizophrenia-related parameters, such as the intensity of overall symptomatology (g = 0.72), positive symptoms (g = 0.32), negative symptoms (g = 0.40), functioning level (g = 1.28), and awareness of illness (g = 0.65). (4) Conclusions: There is evidence that supports the effectiveness and safety of MBIs for the treatment of people with schizophrenia. The results obtained by MBIs are comparable to those obtained by cognitive-behavioral therapy for psychosis. However, given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution.
Subject(s)
Mindfulness , Psychotic Disorders , Schizophrenia , Cognitive Behavioral Therapy , Humans , Schizophrenia/therapyABSTRACT
En los últimos 20 años ha crecido el interés por los tratamientos basados en mindfulness. El objetivo de este trabajo fue hacer una revisión sistemática de la bibliografía científica actual que mostrara la evidencia disponible respecto a la eficacia de los tratamientos psicológicos basados en mindfulness cuando son aplicados específicamente en trastornos de ansiedad. De diversas bases de datos se obtuvieron 269 artículos potencialmente relevantes, de los cuales se seleccionaron 8 que cumplían los criterios de inclusión. El análisis de estos estudios sugiere que las intervenciones psicológicas basadas en mindfulness son un tratamiento eficaz para los trastornos de ansiedad generalizada, angustia, fobia social y estrés postraumático, cuando son usadas como coadyuvantes del tratamiento farmacológico. Aun así se plantea la necesidad de realizar estudios que, mediante un control metodológico riguroso, permitan el establecimiento de conclusiones sólidas respecto de la eficacia de este de tipo intervenciones para el tratamiento de trastornos de ansiedad
During the last 20 years, interest in mindfulness-based therapy has grown. The objective of this study was to systematically review the current scientific literature that shows evidence concerning the efficacy of mindfulness-based psychological therapy when applied specifically to the treatment of anxiety disorders. A total of 269 potentially relevant articles were gathered from various databases. Of these, 8 articles fulfilled the inclusion criteria. The analysis of these studies suggests that mindfulness-based psychological therapy is efficacious in the treatment of general anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder when they are used in conjunction with pharmacological treatments. Nevertheless, the authors suggest the need for further studies that, following rigorous methodological review, would allow firm conclusions to be reached concerning the efficacy of this type of treatment for anxiety disorders
