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1.
Healthcare (Basel) ; 11(13)2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37444743

RESUMO

The aim of this study was to analyze the attitudes of professionals in Mental Health Services throughout Spain who are directly or indirectly involved in the use of mechanical restraint and the barriers perceived to reduce its use. The study involved an online anonymous survey using Google Forms completed by Spanish mental health professionals working with service users; the survey assessed their involvement in and general attitudes and beliefs towards mechanical restraint. The survey was completed by 225 participants. Only 13.30% of the participants considered that mechanical restraint use was never necessary to guarantee the safety of users/staff in dangerous situations. Poor staff training (38.0%) and a lack of resources/staff (34.7%) were the most frequent barriers identified for the reduction of mechanical restraint. In the multivariate analysis, participation in learning programs to prevent the use of mechanical restraint was associated with lower acceptance of the use of mechanical restraint, but the result was barely significant (p = 0.050). A high percentage of mental health staff still consider mechanical restraint use necessary for safety reasons. According to the results, the participants perceived that more staff and resources and better training could reduce the use of mechanical restraint in Mental Health Hospitalization Services.

2.
Front Psychol ; 14: 1128158, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874811

RESUMO

Homelessness continues to be a major social and clinical problem. The homeless population has a higher burden of disease that includes psychiatric disorders. In addition, they have a lower use of ambulatory health services and a higher use of acute care. Few investigations analyze the use of services of this population group in the long term. We analyzed the risk of psychiatric readmission of homeless individuals through survival analysis. All admissions to a mental health hospitalization unit in the city of Malaga, Spain, from 1999 to 2005, have been analyzed. Three analyses were carried out: two intermediate analyses at 30 days and 1 year after starting follow-up; and one final analysis at 10 years. In all cases, the event was readmission to the hospitalization unit. The adjusted Hazard Ratio at 30 days, 1-year, and 10-year follow-ups were 1.387 (p = 0.027), 1.015 (p = 0.890), and 0.826 (p = 0.043), respectively. We have found an increased risk of readmission for the homeless population at 30 days and a decreased risk of readmission at 10 years. We hypothesize that this lower risk of long-term readmission may be due to the high mobility of the homeless population, its low degree of adherence to long-term mental health services, and its high mortality rate. We suggest that time-critical intervention programs in the short term could decrease the high rate of early readmission of the homeless population, and long-term interventions could link them with services and avoid its dispersion and abandonment.

3.
Biomedicines ; 11(2)2023 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-36830990

RESUMO

Psychosis and substance use disorders are two diagnostic categories whose association has been studied for decades. In addition, both psychosis spectrum disorders and drug abuse have recently been linked to multiple pro-inflammatory changes in the central nervous system. We have carried out a narrative review of the literature through a holistic approach. We used PubMed as our search engine. We included in the review all relevant studies looking at pro-inflammatory changes in psychotic disorders and substance use disorders. We found that there are multiple studies that relate various pro-inflammatory lipids and proteins with psychosis and substance use disorders, with an overlap between the two. The main findings involve inflammatory mediators such as cytokines, chemokines, endocannabinoids, eicosanoids, lysophospholipds and/or bacterial products. Many of these findings are present in different phases of psychosis and in substance use disorders such as cannabis, cocaine, methamphetamines, alcohol and nicotine. Psychosis and substance use disorders may have a common origin in an abnormal neurodevelopment caused, among other factors, by a neuroinflammatory process. A possible convergent pathway is that which interrelates the transcriptional factors NFκB and PPARγ. This may have future clinical implications.

4.
J Dual Diagn ; 18(2): 92-100, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35387575

RESUMO

OBJECTIVE: Substance use disorders are highly prevalent in people living with a mental health disorder. Co-occurring substance use disorders have been associated with a worse prognosis and poorer adherence to treatment. The aim of this study was to analyze the temporal trends in the prevalence of substance use disorders in patients admitted to a psychiatric inpatient unit between 1998 and 2020. METHODS: This is a retrospective study based on the registry of 18,367 hospitalizations and 7,124 patients with a mental health disorder admitted during the period 1998 to 2020 in Malaga, Spain. Time trend analysis by gender and substance used was calculated using a segmented regression model. The permutation test was used to determine inflection points. A sensitivity analysis was performed based on the assumptions of autocorrelation and homoscedasticity. RESULTS: A total of 22.2% of admissions had a diagnosis of mental health disorder and co-occurring substance use disorders. Prevalence was higher among males (30.0%) than females (9.4%; p < .001). Patients with both disorders had a shorter length of stay by 2 days (p < .001) and a younger age at first admission (by 6.5 years; p < .001) compared to patients without substance use disorders. There was no difference in the total number of hospitalizations between the two groups. Psychotic disorders and multiple drug use disorders were the most prevalent diagnoses in men compared to women, whereas personality disorders and alcohol use were the most common diagnoses in women. We observed an increase in the prevalence of dual diagnosis between 2005 and 2020. There was a 3.0% increase in cannabis-related admissions per year during the whole study period (p < .001). Cannabis and cocaine use disorders have become the most prevalent in the last 10 years, while opioid and alcohol use disorders have decreased. CONCLUSIONS: Co-occurring substance use disorders are highly prevalent among hospitalized patients. In recent years, the pattern of substance use has shifted, with cannabis being the most prevalent, while opiates and alcohol substance use have decreased. We need to devise a specialized approach and integrative treatment for patients with co-occurring disorders.


Assuntos
Alcoolismo , Cannabis , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Alcoolismo/epidemiologia , Analgésicos Opioides/uso terapêutico , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Feminino , Hospitalização , Humanos , Masculino , Transtornos Mentais/psicologia , Prevalência , Estudos Retrospectivos , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
5.
Int J Ment Health Syst ; 14(1): 82, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33292372

RESUMO

BACKGROUND: Patients with schizophrenia and related disorders have more physical problems than the general population. Primary care professionals play an important role in the care of these patients as they are the main entry point into the healthcare system. We aimed to identify patient, general practitioner, and primary care centre factors associated with the number of visits of patients with schizophrenia and related disorders to general practitioners. METHODS: A descriptive, cross-sectional study was conducted in 13 primary care centres belonging to the Clinical Management Unit of Mental Health of the Regional Hospital of Málaga, Spain. The eligible population was composed of patients with schizophrenia and related disorders attending the primary care centres in the study area, and the general practitioners who attend these patients. Our dependent variable was the total number of general practitioner visits made by patients with schizophrenia and related disorders during the 3.5-year observation period. The independent variables were grouped into three: (a) patient variables (sociodemographic and clinical), (b) general practitioner variables, and (c) primary care centre characteristics. Descriptive, bivariate, and multivariate analyses using the random forest method were performed. RESULTS: A total of 259 patients with schizophrenia and related disorders, 96 general practitioners, and 13 primary care centres were included. The annual mean was 3.9 visits per patient. The results showed that younger general practitioners, patients who were women, patients who were married, some primary care centres to which the patient belonged, taking antipsychotic medication, presenting any cardiovascular risk factor, and more frequency of mental health training sessions at the primary care centre were associated with an increased number of visits to general practitioners. CONCLUSIONS: The only general practitioner variable that was associated with the number of visits was age, the older the less contact. There were also patient variables involved in the number of visits. Finally, mental health training for general practitioners was important for these professionals to manage patients with schizophrenia and related disorders.

6.
J Nerv Ment Dis ; 208(1): 65-69, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31834191

RESUMO

The early prediction of patients at risk may facilitate the efficient use of interventions that have been demonstrated to reduce readmissions. The aim of the study was to analyze variables during first admissions associated with further high use of an inpatient hospitalization psychiatric unit in Málaga, Spain. The risk of having three or more psychiatric admissions was analyzed in a sample of 1535 first-time admissions with multivariate Cox regression. In the multivariate model, the variables associated with the risk of high use were age at admission (p < 0.001), length of stay (p < 0.001), place of residence (p < 0.001), and previous history with mental health services (p < 0.001). The results suggest that there are several easily accessible characteristics at first admission that are potentially useful in detecting patients at risk.


Assuntos
Hospitais Psiquiátricos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Tempo de Internação , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Espanha , Adulto Jovem
7.
Int J Ment Health Syst ; 13: 27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31011366

RESUMO

BACKGROUND: General practitioners (GPs) play an important role in the physical care of patients with severe mental illness, so our aim was to analyse the relationships between GPs' sociodemographic status and worked-related variables and their perceptions about mental illness. METHODS: A descriptive, cross-sectional study was conducted in the Clinical Management Unit of Mental Health (CMU-MH) of the Regional Hospital of Malaga (Spain). The eligible population comprised all GPs working in the 13 primary care centres (PCCs) in the hospital's catchment area during the study period. GPs were interviewed to collect data on their attitudes to and knowledge of mental illness, psychiatry and the local mental health team, as well as their sociodemographic status, professional qualifications and experience. Bivariate analysis was carried out. RESULTS: 145 GPs answered the questionnaire (77%). ANOVA revealed that most of the PCCs with the best relationship with their mental health team and best attitude to mental illness were in the Central Community Mental Health Unit, which operated a collaborative model of care. CONCLUSIONS: These results indicated that GPs who worked more closely with their specialist mental health team had a better perception of their relationship with the mental health centre and less stigmatisation in regard to mental illness.

8.
An. psicol ; 34(2): 258-263, mayo 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172796

RESUMO

Antecedentes: El objetivo de este estudio es la adaptación y el análisis de las propiedades psicométricas de un cuestionario para medir las opiniones y percepciones de los médicos de atención primaria hacia la salud mental. Método: Se trata de un estudio observacional, descriptivo y transversal. Han participado 145 médicos de atención primaria pertenecientes al área de referencia del Hospital Regional de Málaga, que contestaron un cuestionario de 25 items. Con dicho cuestionario se realizó un análisis factorial exploratorio y de consistencia interna. Resultados: Las condiciones de adecuación muestral y esfericidad se cumplieron de forma satisfactoria. En el análisis factorial se obtuvieron 3 dimensiones medidas por 14 items que explican el 55.1% de la varianza total: el cuestionario MAPSAM-14 (Cuestionario de Médicos de Atención Primaria y Salud Mental). Conclusiones: Este cuestionario puede ser una herramienta de rápida aplicación, válida y fiable, para conocer la satisfacción de los médicos de atención primaria respecto a su relación con los equipos de salud mental, sus creencias hacia la enfermedad mental y su percepción del nivel de formación en relación con la esquizofrenia y trastornos afines


Background: The aim of this study is to adapt and analyze the psychometric properties of a questionnaire on the perceptions of general practitioners towards mental health. Method: This is a descriptive crosssectional, observational study. A total of 145 general practitioners from the reference area of Malaga Regional Hospital answered this 25-item questionnaire; a factorial analysis was then conducted and its internal consistency reliability was tested. Results: The adequacy of sampling and sphericity were satisfactorily met. Three dimensions measured by 14 items were found in the factorial analysis explaining 55.1% of its variance: the MAPSAM-14 questionnaire. Conclusions: This questionnaire may be a proper tool with which to determine the satisfaction of general practitioners in relation to mental health services, their beliefs and stigma towards mental illness and their level of training in the field of schizophrenia and related disorders


Assuntos
Humanos , Psicometria/instrumentação , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Esquizofrenia/epidemiologia , Atitude do Pessoal de Saúde , Atenção Primária à Saúde/estatística & dados numéricos , Médicos de Família/estatística & dados numéricos , Reprodutibilidade dos Testes
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