Propiedades psicométricas del cuestionario de afrontamiento al estrés para pacientes oncológicos (CAEPO) / Psychometric properties of the coping to stress questionnaire for oncologic patients

Los objetivos del estudio fueron: 1) analizar la estructura factorial de la escala CAEPO mediante análisis factorial exploratorio y confirmatorio; 2) estimar la consistencia interna de los factores; 3) describir la distribución de los factores; 4) analizar las diferencias de medias de las estrategias de afrontamiento entre hombres y mujeres. El Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO) de González (2004) fue aplicado a 148 pacientes oncológicos. Se sugiere reducir la escala a 35 ítems. Se encontró una estructura de cuatro factores correlacionados con consistencias internas de adecuadas a altas. La distribución de los factores se ajustó a una curva normal y no se encontraron diferencias significativas entre hombre y mujeres. En futuras investigaciones, se sugiere su empleo en muestras clínicas de España y otros países hispanoparlantes

The goals of the study are: 1) to analyze the factorial structure of the Coping to Stress Questionnaire for Oncologic Patients instrument by the use of a factorial exploratory and confirmatory analysis; 2) to estímate the internal reliability of the factors; 3) to describe the distribution of the factors; 4) to analyze the mean differences of the coping strategies between men and women. The Coping to Stress Questionnaire for Oncologic Patients (González, 2004) was used for 148 oncologic patients. It is given suggestions to reduce the questionnaire to 35 items, It was found four correlationated factors estructure with internal reliability from adecuated to high. The factors distribution was adjusted to the normal curve and it was not found significative differences between men and women. In future investigation, it is suggested to use this questionnaire un clinic samples from Spain and others Spanish speaking countries

Alteraciones emocionales y psicopatológicas en pacientes oncológicos laringectomizados / Emotional and psychopathological disorders in laryngectomized oncological patients

Introducción y objetivos: Se desconoce si afrontar un cáncer de laringe y someterse a laringectomía total son experiencias tan impactantes emocionalmente para el paciente como los cánceres de otras localizaciones. El objetivo del estudio fue identificar la incidencia de sufrimiento emocional y psicológico en pacientes laringectomizados y describir sus matices sintomatológicos. Métodos: Estudio transversal descriptivo de la respuesta emocional y psicopatológica de 100 pacientes oncológicos sometidos a laringectomía total, evaluados inmediatamente tras la cirugía (N = 35), al iniciar la rehabilitación comunicativa (N = 23) y a los 5 años del diagnóstico (N = 42) frente a un grupo control de 55 sujetos sanos. La batería de evaluación psicopatológica para ansiedad, depresión, trastorno por estrés postraumático, intrusión, evitación y excitación constó de una entrevista específica, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y el Inventario de Estrés Postraumático (IES-R). Resultados: Los pacientes laringectomizados presentaron baja incidencia de alteraciones emocionales y psicológicas como ansiedad (6,9%), depresión (5,9%) y/o trastorno por estrés postraumático (28,4%) con intensidad suficiente para constituir un diagnóstico psicopatológico. Un 57,4% de los pacientes presentaba malestar emocional difuso de carácter postraumático (el 52,6% de ellos), más prevalente e intenso en el grupo en rehabilitación. Conclusiones. Los síntomas de ansiedad, depresión y trastorno por estrés postraumático tras una laringectomía total no son de suficiente intensidad y cualidad para constituir entidades clínicas diagnosticables, sino cuadros de trastorno adaptativo. Son menores que los de pacientes afectados por cáncer de otras localizaciones y se presentan fundamentalmente en la fase de rehabilitación, donde deberían centrarse las actuaciones psicológicas preventivas y de apoyo (AU)

Introduction and objectives: It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances. Methods: A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n = 35), when initiating communicative rehabilitation (n = 23) and 5 years after diagnosis (n = 42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R). Results: Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group. Conclusions: Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused (AU)

Emotional and psychopathological disorders in laryngectomized oncological patients.

INTRODUCTION AND OBJECTIVES: It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances. METHODS: A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n=35), when initiating communicative rehabilitation (n=23) and 5 years after diagnosis (n=42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R). RESULTS: Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group. CONCLUSIONS: Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused.

Consenso español de salud física del paciente con depresión / Spanish consensus on the physical health of patients with depressive disorders

La comorbilidad entre depresión y enfermedades físicas es muy frecuente y tiene un impacto importante en el deterioro de la salud así como en la atención y tratamiento recibidos. Impulsado por las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, y la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) se realizó un consenso sobre la salud física en el paciente con depresión, que de forma resumida se expone en el presente trabajo. La revisión de la literatura puso de manifiesto la elevada frecuencia en pacientes con depresión de trastornos cardiovasculares y trastornos endocrinometabólicos como la obesidad y la diabetes, de tal modo que en pacientes con depresión serían aplicables las recomendaciones de prevención primaria y secundaria establecidas para los individuos con riesgo cardiovascular o metabólico. También es frecuente la comorbilidad entre depresión y dolor crónico, que obliga a la detección activa de ambos trastornos y a una intervención terapéutica integral. La presencia de esta comorbilidad puede condicionar, aunque no impedir el tratamiento farmacológico en cuya elección se deberá tener en cuenta los efectos secundarios y las interacciones de los distintos antidepresivos. Por su parte, la psicoterapia puede contribuir a la recuperación integral del enfermo. Globalmente, en el proceso de atención al paciente con depresión y enfermedades físicas comórbidas es fundamental la coordinación del médico de atención primaria, el psiquiatra y otros especialistas o profesionales implicados (AU)

Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness (AU)

Spanish consensus on the physical health of patients with depressive disorders.

Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.

[Personality and coping in neuropathic chronic pain: a predictable divorce]. / Personalidad y afrontamiento en dolor crónico neuropático: un divorcio previsible.

We approach the problem about relationships between personality dimensions and the use of coping strategies in chronic pain patients. The most frequently used theoretical model in the area of stress and its relation to pain is the transactional model, taking into account that the incorporation of personality traits improves predictions via coping in the stress process. Following the Big Five model, the relationships between personality and coping strategies in patients with chronical neuropathic pain were established. The results showed slight relationships between the Big-Five dimensions and coping. A vulnerable personality profile in patients with chronic neuropathic pain was obtained, consisting of high neuroticism, low extraversion, openness to experience and responsibility, and moderate agreeableness.

Personalidad y afrontamiento en dolor crónico neuropático: un divorcio previsible / Personality and coping in neuropathic chronic pain: a predictable divorce

Se aborda la problemática referida a las relaciones existentes entre las dimensiones de personalidad y el empleo de las estrategias de afrontamiento en enfermos con dolor crónico. El modelo teórico más empleado en el ámbito del estrés y su relación con el dolor es el modelo transaccional, considerando que la inclusión de rasgos de personalidad mejoraría las predicciones mediante el afrontamiento en el proceso del estrés. Siguiendo el modelo de los cinco grandes se establecen las relaciones existentes entre las dimensiones de personalidad y las estrategias de afrontamiento en enfermos con dolor crónico de tipo neuropático. Los resultados arrojan relaciones débiles entre dichas dimensiones y el afrontamiento. Se obtiene un perfil de personalidad vulnerable en enfermos con dolor crónico neuropático consistente en alto neuroticismo, baja extraversión, apertura y responsabilidad y moderada amabilidad (AU)

We approach the problem about relationships between personality dimensions and the use of coping strategies in chronic pai patients. The most frequently used theoretical model in the area of stress and its relation to pain is the transactional model, taking into account that the incorporation of personality traits improves predictions via coping in the stress process. Following the Big Five model, the relationships between personality and coping strategies in patients with chronical neuropathic pain were established. The results showed slight relationships between the Big-Five dimensions and coping. A vulnerable personality profile in patients with chronic neuropathic pain was obtained, consisting of high neuroticism, low extraversion, openness to experience and responsibility, and moderate agreeableness (AU)