Perfiles de Personalidad en adolescentes con Trastornos por Ansiedad en Población General y Clínica / Personality Profiles in Adolescents with Anxiety Disorders in General and Clinical population

La personalidad es el trasfondo que determina la forma de pensar, sentir y comportarse e influye en la psicopatología. En este contexto, resulta relevante el estudio de la relación entre personalidad y ansiedad en la adolescencia. El principal objetivo de nuestro estudio es analizar las diferencias entre casos con Trastornos por Ansiedad (TA) y una muestra de población general (PG) en los diferentes perfiles / prototipos de personalidad (PRP) derivados del el Inventario clínico para adolescentes de Millon (MACI). Un segundo objetivo fue estudiar el modelo más parsimonioso de PRP capaz de predecir TA. Para responder a estos objetivos se utilizó un diseño observacional analítico y se realizó un muestreo aleatorio de adolescentes en PG (n = 461) y consecutivo de pacientes con TA, valorados según criterios DSM-5 (n = 77). Los instrumentos de medida utilizados fueron el MACI y Adolescent Symptom Inventory. Los PRP Introvertidos, Inhibidos, Pesimistas, Sumisos, Oposicionistas, Autopunitivos y Límites presentan una media significativamente mayor en TA y los PRP Histriónico y Egocéntrico en PG. El modelo más parsimonioso de PRP que mejor predice TA está conformado por tener mayor edad y los PRP más límite y menos rebelde. El estudio ofrece una imagen novedosa de los PRP en casos de TA que invitan a su estudio clínico, favoreciendo nuevos caminos de investigación que incluyan la personalidad en la heterogeneidad del trastorno. (AU)

Personality is the background that determines the way we think, feel and behave and influences psychopathology. In this context, the study of the relationship between personality and anxiety in adolescence is important. The main objective of our study is to analyse the differences between cases with Anxiety Disorders (AD) and a sample of general population (GP) in the different personality profiles / prototypes (PRP) derived from the Millon Adolescent Clinical Inventory (MACI). Secondary objective: to study the most parsimonious predictive model of PRP to predict AD. To respond to these objectives, an observational analytical design was used and a random sampling of adolescents in GP (n = 461) and consecutive sampling of patients with AD, assessed according to DSM-5 criteria (n = 77) was performed. The measurement instruments used were the MACI and the Adolescent Symptom Inventory. Introverted, Inhibited, Doleful, Submissive, Oppositional, Self-demeaning and Borderline PRPs present a significantly higher mean in AD and the Dramatizing and Egotistic PRPs in GP. The most parsimonious PRP model that best predicts AD is shaped by having older age and the most Borderline and least Unruly PRPs. The study offers a novel picture of PRPs in AD cases that invite their clinical study, favoring new paths of research that include personality in the heterogeneity of the disorder. (AU)

Rasgos de personalidad en adolescentes con trastorno por déficit de atención con hiperactividad / Personality traits in adolescents with Attention Deficit Hyperactivity Disorder

Antecedentes: Existen pocos estudios que relacionen personalidad y trastorno por déficit de atención con hiperactividad (TDAH) en adolescentes. Objetivo: estudiar diferencias entre casos con TDAH y población general en prototipos de personalidad (PRP) derivados del Inventario clínico para adolescentes de Millon (MACI). Material y Método: Diseño observacional analítico. Muestreo aleatorio en población general (n = 461) y consecutivo de pacientes con TDAH valorados según criterios DSM-5 (n = 85), en adolescentes entre 13 y 17 años. Instrumentos de medida: MACI y Adolescent Symptom Inventory. Resultados: los PRP Pesimista, Rudo, Rebelde, Oposicionista, Autopunitivo y Límite presentan una media significativamente mayor en TDAH y los PRP Sumiso y Conformista, en población general. El modelo de PRP que mejor prediceTDAH está conformado por tener sexo masculino y los PRP Rudo, Límite, Sumiso y Autopunitivo, clasificando el 82.4% de los casos. Conclusión: Los casos de TDAH tienen PRP diferenciales con la población general que invitan a su estudio clínico e intervención terapéutica. El estudio ofrece una imagen novedosa de los PRP en casos de TDAH y abre nuevos caminos de investigación que incluyan la personalidad al explicar la heterogeneidad del trastorno. (AU)

Background: There are few studies linking personality and Attention Deficit Hyperactivity Disorder (ADHD) in adolescents. Research objective: to study differences between cases with ADHD and the general population in personality prototypes (PRP) derived from the Millon Clinical Inventory for Adolescents (MACI). Material and Method: Analytical observational design. Random sampling in the general population (n = 461) and consecutive of patients with ADHD evaluated according to DSM-5 criteria (n = 85), in adolescents between 13 and 17 years old. Measurement instruments: MACI and Adolescent Symptom Inventory. Results: ADHD presents a significantly higher mean in Doleful, Forceful, Unruly, Oppositional, Self-demeaning and Borderline PRP and the general population in Submissive and Conforming PRP. The PRP model that best predicts ADHD includes male sex and the Forceful, Borderline, Submissive and Self-demeaning PRP. The model classifies 82.4% of the cases. Conclusion. ADHD cases have differential PRP in comparison with the general population, which invites their clinical study and therapeutic intervention. The study offers a novel image of PRP in ADHD and opens new lines of research that include personality when explaining the heterogeneity of the disorder. (AU)

Personalidad en adolescentes en muestra general y clínica / Personality in adolescents in a general and clinical sample

El objetivo principal del estudio fue analizar las diferencias entre muestra general y clínica en los prototipos de personalidad (PRP) del “Inventario clínico para adolescentes de Millón” (MACI). La metodología incluyó un diseño observacional y analítico, utilizando un muestreo de participantes (13-17 años) aleatorio polietápico, estratificado y proporcional por conglomerados en muestra general (n= 461) y un muestreo consecutivo en muestra clínica (n= 219). Encontramos que los PRP introvertido, inhibido, pesimista, rudo, oposicionista, autopunitivo y límite presentan una media significativamente mayor en muestra clínica y los PRP histriónico y conformista en muestra general. Se observa ausencia de diferencias significativas en los PRP egocéntrico, sumiso y rebelde. En la variable sexo observamos más diferencias significativas de PRP en muestra clínica que en la general y en la variable edad encontramos una tendencia lineal significativa descendente en los PRP sumiso o conformista y ascendente en los PRP rebelde y rudo en muestra general. El clínico debe estar alerta ante la interpretación de los PRP del MACI que no diferencian entre muestra general y clínica. (AU)

The main objective of the study was to analyze the differences between samples from general and clinical sample in personality prototypes (PRP), derived from the Millon Adolescent Clinical Inventory (MACI). The methodology included an analytical and observational design with a random, multi-stage, stratified and proportional cluster sampling in general sample (n= 461) and consecutive sampling of clinical sample (n= 219), in adolescents between 13 and 17 years of age. We found introvert, inhibited, doleful, forceful, oppositional, self-demeaning and borderline PRP in the clinical sample and dramatizing and conforming PRP in the general sample present a significantly higher mean. There is a relevant absence of significant differences in egotistic, submissive and unruly PRP. By sex, more significant differences in PRP are observed in the clinical sample. By age, a significant downward linear trend in the submissive and conforming PRP is observed, as well as an upward trend in the unruly and forceful PRP in the general sample. The clinician must be alert in the interpretation of the MACI PRP that do not differentiate between general and clinical samples. (AU)

Calidad de vida relacionada con la salud en casos de trastorno por déficit de atención con hiperactividad con/sin tratamiento farmacológico / Health-related quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment

Introducción: La calidad de vida relacionada con la salud (CVRS) es un marcador relevante para valorar los efectos de una intervención terapéutica. El objetivo del estudio es analizar la CVRS comparando casos con trastorno por déficit de atención con hiperactividad (TDAH) tratados farmacológicamente con metilfenidato (TDAH-T), casos no tratados (TDAH-N) y controles. Material y métodos: Muestra de 228 participantes entre 8 y 14 años (114 controles, 57 TDAH-T y 57 TDAH-N). Muestreo consecutivo de TDAH según DSM-IV (ADHD Rating Scales IV) y muestreo aleatorio de controles emparejados por sexo y edad. Evaluación de CVRS mediante KIDSCREEN-52 versión padres. Resultados: La intensidad de síntomas de TDAH es significativamente menor en TDAH-T que en TDAH-N y se observa correlación significativa moderada entre mayor intensidad de síntomas de TDAH y peor CVRS. Los casos de TDAH tienen significativamente peor CVRS que los controles en bienestar psíquico, estado de ánimo, relación con padres, relación con amigos, entorno escolar y aceptación social. Los casos de TDAH-T presentan significativamente mejor CVRS que TDAH-N en la dimensión escolar, pero no se diferencian significativamente en otras dimensiones del KIDSCREEN-52. Conclusiones: Sería recomendable que el tratamiento del TDAH integrase modelos terapéuticos multidimensionales que mejoren los síntomas básicos del trastorno y la CVRS

Introduction: The health-related quality of life (HRQoL) questionnaire is important in order to assess the effects of therapeutic intervention. The aim of this study is to analyse HRQoL, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (ADHD-T), untreated cases (ADHD-N), and controls. Material and methods: The study included a sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T, and 57 ADHD-N). Consecutive sampling was used in ADHD according to DSM-IV criteria (ADHD Rating Scales IV), and random sampling of controls matched by gender and age. The evaluation of HRQoL was made by using KIDSCREEN-52 parent version. Results: The intensity of ADHD symptoms is significantly lower in ADHD-T than in ADHD-N. There is a moderate significant correlation between greater intensity of ADHD symptoms and worse HRQoL. ADHD cases have significantly worse HRQoL than controls on psychic well-being, mood, relationship with parents and friends, school environment, and social acceptance. The cases of ADHD-T have significantly better HRQoL than ADHD-N in the school dimension, but do not differ significantly in other dimensions of KIDSCREEN-52. Conclusions: It would be advisable that the treatment of ADHD integrates multi-dimensional therapeutic models that improve the basic symptoms of the disorder, as well as the HRQoL

[Health-related quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment]. / Calidad de vida relacionada con la salud en casos de trastorno por déficit de atención con hiperactividad con/sin tratamiento farmacológico.

INTRODUCTION: The health-related quality of life (HRQoL) questionnaire is important in order to assess the effects of therapeutic intervention. The aim of this study is to analyse HRQoL, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (ADHD-T), untreated cases (ADHD-N), and controls. MATERIAL AND METHODS: The study included a sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T, and 57 ADHD-N). Consecutive sampling was used in ADHD according to DSM-IV criteria (ADHD Rating Scales IV), and random sampling of controls matched by gender and age. The evaluation of HRQoL was made by using KIDSCREEN-52 parent version. RESULTS: The intensity of ADHD symptoms is significantly lower in ADHD-T than in ADHD-N. There is a moderate significant correlation between greater intensity of ADHD symptoms and worse HRQoL. ADHD cases have significantly worse HRQoL than controls on psychic well-being, mood, relationship with parents and friends, school environment, and social acceptance. The cases of ADHD-T have significantly better HRQoL than ADHD-N in the school dimension, but do not differ significantly in other dimensions of KIDSCREEN-52. CONCLUSIONS: It would be advisable that the treatment of ADHD integrates multi-dimensional therapeutic models that improve the basic symptoms of the disorder, as well as the HRQoL.

Predicción de deterioro cognitivo en esquizofrenia: retrospectiva de 31 años / Prediction of cognitive damage in patient with schizophrenia: A thirty-one year retrospective

Este trabajo pretende averiguar qué subpruebas de la "Escala de inteligencia de Wechsler para adultos" (WAIS) forman el modelo cognitivo más parsimonioso capaz de predecir el importante deterioro cognitivo presentado por pacientes con esquizofrenia en edades avanzadas. Evaluamos con el "Mini-examen cognoscitivo" (MEC-35) a un grupo de 30 mujeres institucionalizadas diagnosticadas de esquizofrenia que 31 años antes habían sido valoradas con el WAIS. Encontramos que el 53,3% de las pacientes muestran deterioro significativo y 31 años antes puntuaciones más bajas en todas las pruebas del WAIS. Estas diferencias eran significativas (p< 0,05) en todas las medidas de cociente intelectual. A través del análisis de regresión logística encontramos que el modelo cognitivo que mejor predicción hizo lo forman las subpruebas de Semejanzas, Rompecabezas y Aritmética del WAIS, clasificando el 96,7% de los casos y presentando excelente validez de criterio con una sensibilidad del 93,8% y especificidad del 100%. Concluimos que el aumento de deterioro cognitivo en pacientes ancianas con esquizofrenia parece asociarse con una baja inteligencia fluida previa

The purpose of this study is to find out which tests from the Wechsler Intelligence Scale define the most detailed cognitive model that is able to predict the relevant cognitive impairment in elderly people with schizophrenia. A group of 30 institutionalised women who were diagnosed with schizophrenia were assessed with MEC-35; they had been previously assessed 31 years before using the WAIS. It was found that 53.3% of the patients showed significant cognitive impairment and 31 years ago their scores were lower in all the subtests from the WAIS. Those differences are significant (p< .05) in all of the IQ measurements. Throughout the logistical regression analysis we found that the cognitive model that made the best prediction was produced from the following subtests: Similarities, Puzzles and Arithmetic, classifying 96.7% of the cases and showing an excellent criterion validity, a sensitivity of 93.8% and a 100% of specificity. We conclude that the increase of the cognitive impairment in elderly patients with schizophrenia seems to be associated with previous low fluid intelligence

Criterion validity and clinical usefulness of Attention Deficit Hyperactivity Disorder Rating Scale IV in attention deficit hyperactivity disorder (ADHD) as a function of method and age / Validez de criterio y utilidad clínica del Attention Deficit Hiperactivity Disorder Rating Scales IV en el Trastorno por Déficit de Atención con Hiperactividad en función del método y la edad

BACKGROUND: The aim of this research is to analyze Attention Deficit Hyperactivity Disorder Rating Scales IV (ADHD RS-IV) criteria validity and its clinical usefulness for the assessment of Attention Deficit Hyperactivity Disorder (ADHD) as a function of assessment method and age. METHODOLOGY: A sample was obtained from an epidemiological study (n = 1095, 6-16 years). Clinical cases of ADHD (ADHD-CL) were selected by dimensional ADHD RS-IV and later by clinical interview (DSM-IV). ADHD-CL cases were compared with four categorical results of ADHD RS-IV provided by parents (CATPA), teachers (CATPR), either parents or teachers (CATPAOPR) and both parents and teachers (CATPA&PR). Criterion validity and clinical usefulness of the answer modalities to ADHD RS-IV were studied. RESULTS: ADHD-CL rate was 6.9% in childhood, 6.2% in preadolescence and 6.9% in adolescence. Alternative methods to the clinical interview led to increased numbers of ADHD cases in all age groups analyzed, in the following sequence: CATPAOPR> CATPRO> CATPA> CATPA&PR> ADHD-CL. CATPA&PR was the procedure with the greatest validity, specificity and clinical usefulness in all three age groups, particularly in the childhood. CONCLUSIONS: Isolated use of ADHD RS-IV leads to an increase in ADHD cases compared to clinical interview, and varies depending on the procedure used

ANTECEDENTES: se estudia la validez de criterio y utilidad clínica del Attention Deficit Hiperactivity Disorder Rating Scales IV (ADHD RS-IV) en el Trastorno por Déficit de Atención con Hiperactividad (TDAH) en función del método y edad. MÉTODO: muestra extraída de un estudio epidemiológico (n = 1095, 6-16 años). Los casos de TDAH clínico (TDAH-CL) fueron seleccionados mediante ADHD RS-IV dimensional y entrevista clínica (DSM-IV) y fueron comparados con cuatro modalidades categoriales de respuesta al ADHD RS-IV implementado por padres (CATPA), profesores (CATPR), padres o profesores indistintamente (CATPAOPR) y/o conjuntamente (CATPAYPR). Se estudió la validez de criterio y utilidad clínica de las modalidades de respuesta. RESULTADOS: la tasa de TDAHCL es 6,9% en infancia, 6,2% en preadolescencia y 6,9% en adolescencia. Los procedimientos alternativos a la entrevista clínica aumentan los casos de TDAH en los tres grupos de edad, siguiendo la sucesión CATPAOPR > CATPRO > CATPA > CATPAYPR > TDAH-CL. El procedimiento con mayor índice de validez, especifidad, utilidad clínica y capacidad predictiva de TDAH fue CATPAYPR. CONCLUSIONES: la utilización de una versión categorial del ADHD RS-IV produce un incremento de casos de TDAH respecto a la entrevista clínica que varía en función del método utilizado

Longitudinal Study of Cognitive Variables in Women with Schizophrenia: 31-Year Follow-Up Study.

OBJECTIVE: To longitudinally analyze the course of cognitive dimensions in schizophrenic women over a period of 31 years. METHOD: Accidental sampling. Developmental longitudinal design. Diagnosis according to the ICD-10. Thirty institutionalized women were evaluated using the WAIS on three separate occasions (in 1981, 1997, and 2012). The data were analyzed using a repeated measures split-plot method. RESULTS: Patients scored one to two standard deviations below the average on the WAIS. At all three evaluation times, they scored consistently, significantly worse on Performance IQ scales than on Verbal IQ in the following sequence: Processing Speed (PS) < Perceptual Organization (PO) < Working Memory (WM) < Verbal Comprehension (VC). Longitudinally, there was a significant, linear average trend that was stable between the first and second assessments, with a significant drop in scores at the third evaluation on Performance IQ (η2 = .586) and Verbal IQ scales (η2 = .299). The same trend was observed in PS (η2 = .655) and WM (η2 = .438), while PO decreased across the three evaluations (η2 = .509) and no difference in VC was found (η2 = .126). CONCLUSION: Patients with schizophrenia presented with a low cognitive level. Longitudinally, they had a stable, differential profile of WAIS factors until late life, when performance dropped significantly.

Longitudinal study of cognitive variables in women with schizophrenia: 31-year follow-up study

Objective: To longitudinally analyze the course of cognitive dimensions in schizophrenic women over a period of 31 years. Method: Accidental sampling. Developmental longitudinal design. Diagnosis according to the ICD-10. Thirty institutionalized women were evaluated using the WAIS on three separate occasions (in 1981, 1997, and 2012). The data were analyzed using a repeated measures split-plot method. Results: Patients scored one to two standard deviations below the average on the WAIS. At all three evaluation times, they scored consistently, significantly worse on Performance IQ scales than on Verbal IQ in the following sequence: Processing Speed (PS) < Perceptual Organization (PO) < Working Memory (WM) < Verbal Comprehension (VC). Longitudinally, there was a significant, linear average trend that was stable between the first and second assessments, with a significant drop in scores at the third evaluation on Performance IQ (η2 = .586) and Verbal IQ scales (η2 = .299). The same trend was observed in PS (η2 = .655) and WM (η2 = .438), while PO decreased across the three evaluations (η2 = .509) and no difference in VC was found (η2 = .126). Conclusion: Patients with schizophrenia presented with a low cognitive level. Longitudinally, they had a stable, differential profile of WAIS factors until late life, when performance dropped significantly (AU)

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