Cómo son los niños que atendemos y que residen en un centro de infancia? Conocer para ayudar / Foster care children in treatment: what are they like? Understanding in order to help / Com són els nens que atenem i que resideixen en un centre d’infància?

En este trabajo se comparan, dentro de una población clínica, las características sociales, demográficas y clínicas de dos subgrupos, uno de menores en acogimiento residencial (grupo caso) y otro que reside en un entorno familiar (grupo control). Encontramos un perfil de mayor gravedad clínica en el grupo caso. Los trastornos neuróticos y reacciones de estrés, diagnosticados en un tercio de los pacientes, son los que alcanzan la mayor prevalencia en ambos grupos. El trastorno de la vinculación, también muy presente en el grupo caso, pero prácticamente inexistente en el de control, es el que provoca la discrepancia de mayor significación entre ambos grupos

This study features a comparison of the the social, demographic and clinical characteristics of two subgroups within a clinical population: one group of children in residential care (case group) versus another group of children living in a family environment (control group). We observed a more severe clinical profile in the case group. Anxiety and adjustment disorders were the most prevalent diagnosis in both groups, and were present in a third of all patients. Attachment disorder was highly prevalent in the case group, while virtually non-existent in the control group. This was the most significant difference between the two groups

Conèixer-los per ajudar-los. En aquest treball es comparen, dins d’una població clínica, les característiques socials, demogràfiques i clíniques de dos subgrups, un de menors en acolliment residencial (grup cas) i un altre que resideix en un entorn familiar (grup control). Trobem un perfil de més gravetat clínica en el grup cas. Els trastorns neuròtics i reaccions d’estrès, diagnosticats en un terç dels pacients, són els de més prevalença en tots dos grups. El trastorn de la vinculació, també molt present en el grup cas, però pràcticament inexistent en el de control, és el que provoca la discrepància més significativa entre els dos grups

Effect of chronic escitalopram versus placebo on personality traits in healthy first-degree relatives of patients with depression: a randomized trial.

INTRODUCTION: The serotonergic neurotransmitter system is closely linked to depression and personality traits. It is not known if selective serotonin reuptake inhibitors (SSRI) have an effect on neuroticism that is independent of their effect on depression. Healthy individuals with a genetic liability for depression represent a group of particular interest when investigating if intervention with SSRIs affects personality. The present trial is the first to test the hypothesis that escitalopram may reduce neuroticism in healthy first-degree relatives of patients with major depressive disorder (MD). METHODS: The trial used a randomized, blinded, placebo-controlled parallel-group design. We examined the effect of four weeks escitalopram 10 mg daily versus matching placebo on personality in 80 people who had a biological parent or sibling with a history of MD. The outcome measure on personality traits was change in self-reported neuroticism scores on the Revised Neuroticism-Extroversion-Openness-Personality Inventory (NEO-PI-R) and the Eysenck Personality Inventory (EPQ) from entry until end of four weeks of intervention. RESULTS: When compared with placebo, escitalopram did not significantly affect self-reported NEO-PI-R and EPQ neuroticism and extroversion, EPQ psychoticism, NEO-PI-R openness, or NEO-PI-R conscientiousness (p all above 0.05). However, escitalopram increased NEO-PI-R agreeableness scores significantly compared with placebo (mean; SD) (2.38; 8.09) versus (-1.32; 7.94), p = 0.046), but not following correction for multiplicity. A trend was shown for increased conscientiousness (p = 0.07). There was no significant effect on subclinical depressive symptoms (p = 0.6). CONCLUSION: In healthy first-degree relatives of patients with MD, there is no effect of escitalopram on neuroticism, but it is possible that escitalopram may increase the personality traits of agreeableness and conscientiousness. TRIAL REGISTRATION: Clinicaltrials.gov NCT00386841.

Sense of coherence and depression in the framework of immigration: Turkish patients in Germany and in Turkey.

The present study explores sense of coherence (SOC) levels in two clinical samples (outpatients with neurotic disorders) with the same Turkish cultural background in comparison to the German reference values as well as the association between SOC and depression and the protective role of SOC. A total of 96 Turkish patients in Germany (36.67 ± 9.52 years) as well as 60 local Turkish patients (38.57 ± 10.15 years) have been examined for SOC measured with the Sense of Coherence scale (SOC-29) and depression with the Beck Depression Inventory (BDI). Both samples scored significantly lower for SOC compared to the normal Turkish and German population and to German subjects with psychiatric symptoms (p < 0.001) but did not differ significantly from each other. Negative significant correlations were found between SOC and the degree of depressiveness in both groups (immigrants: r = -0.59, p < 0.001; Turks: r = -0.51, p < 0.001). Multiple regression analyses including SOC, age, gender, education, marital and employment status have demonstrated SOC to be the strongest predictor for depressiveness. SOC can be regarded as a protective factor for depression in patients with Turkish migration background in Germany and in local Turkish patients. However, further studies are needed to clarify if the concept SOC can be used adequately in collectivistic cultures as, for example, the Turkish one.

Caffeine, cognition, and socioeconomic status.

There is interest in age-related cognitive decline and environmental risk factors for Alzheimer's disease (AD). This interest is focused on individual differences in exposure to agents that may harm or protect cognitive function. Caffeine is used as a short acting mental stimulant and may possess longer-term properties that protect against age-related decline and, possibly, AD. The current study aimed to: 1) examine current cognitive function in a narrow age range sample (n=351) without dementia (MMSE>25) who are, by reason of age, entering the period of increased risk of AD; and 2) link cognitive function to self-reported intake of caffeine and socioeconomic status (SES). Possible confounding by gender, childhood intelligence, education, and symptoms of anxiety and depression was introduced into the statistical model. There were significant differences between SES groups in caffeine intake (p< 0.05) and cognitive performance (p< 0.001). Higher quartiles of caffeine intake were associated with slower digit symbol speed (F =3.38, p< 0.02) but this finding was removed after allowing for SES. The results are discussed in terms of the withdrawal effects of caffeine during cognitive testing and strong links between SES and cognitive performance. No evidence in support of cognitive enhancing effects of caffeine was found.

Regular exercise, anxiety, depression and personality: a population-based study.

OBJECTIVES: To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age. METHODS: The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from The Netherlands Twin Registry (1991-2002). Exercise participation, anxiety, depression and personality were assessed with self-report questionnaires. RESULTS: The overall prevalence of exercise participation (with a minimum of 60 min weekly at 4 METs (Metabolic Energy Expenditure Index)) in our sample was 51.4%. Exercise participation strongly declined with age from about 70% in young adolescents to 30% in older adults. Among adolescents, males exercised more, whereas, among older adults, females exercised more. Exercisers were on average less anxious (-0.18 SD), depressed (-0.29 SD) and neurotic (-0.14 SD), more extraverted (+0.32 SD) and were higher in dimensions of sensation seeking (from+0.25 SD to+0.47 SD) than non-exercisers. These differences were modest in size, but very consistent across gender and age. CONCLUSIONS: This study corroborates and extends previous findings: regular exercise is cross-sectionally associated with lower neuroticism, anxiety and depression and higher extraversion and sensation seeking in the population.

[Trends of mental and somatic diseases during therapy of endemic goiter]. / Dinamika psikhicheskikh i vegetativnykh narushenii na fone lecheniia endemicheskogo zoba.

The trend of mental and somatic diseases was studied in 70 patients with epidemic goiter (EG) treated with L-thyroxine or iodides during 1-5-year follow-up. Borderline mental disorders (diminished memory and attention, emotional and intellectual disorders) were found to be stable in these patients. The most delicate functions of the brain, such as the capacity for analysis and synthesis, are particularly vulnerable. Irrespective of the age of a patient, his/her educational level, occupation, the size of goiter, concrete rather than abstract logic thinking are prevalent in patients with EG. Drug treatment of EG only improves the patients' health status, but fails to eliminate evolving mental disorders even if the sizes of the thyroid can be brought to the normal values, the use of L-thyroxine is more effective that that of iodides.

The implementation of game in a 20-day head-down tilting bed rest experiment upon mood status and neurotic levels of rest subjects.

This study evaluated the effect of the implementation of game on mental health among participants in a bedrest (BR) experiment. Subjects were 12 healthy males aged 20-26, who participated in a 20-day 6-degrees head-down tilting BR experiment. The participants were asked to complete psychometrical questionnaires before, during, and after the experiment. We entrusted the participants to manage their leisure time and they intended a game in which all of them could take part over the experiment period. The general conversation and light-hearted mood among the subjects continued during the experimental period. Longitudinal data analysis showed that levels of neurosis and mood status did not deteriorate during the experiment, while our previous experiments, which were performed under the same protocol as this study except for the implementation of the game showed a distinct deterioration in psychosocial status. We consider that the implementation of game autonomously contributes to the positive effects on the mental health among the participants.

Childhood trauma and neuroticism as an adult: possible implication for the development of the common psychiatric disorders and suicidal behaviour.

BACKGROUND: Neuroticism is an important personality dimension associated with depressive and anxiety disorders. Both genetic and social factors are thought to contribute to neuroticism. This study aims to examine whether early childhood adversity may be a determinant of neuroticism. METHOD: Five hundred and thirty-two abstinent substance dependent patients completed both the Childhood Trauma Questionnaire (CTQ) and the Eysenck Personality Questionnaire (EPQ). RESULTS: There was a significant relationship between total childhood trauma scores on the CTQ and neuroticism scores on the EPQ. There were also significant relationships between neuroticism and CTQ subscores for emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. CONCLUSIONS: Childhood trauma may be a determinant of neuroticism. This may be one way in which childhood trauma plays a role in the development of psychiatric disorders. General population studies are needed.

Perfil de personalidad neurótica y su prevención en la edad adulta / Profile of the neurotic personality and its prevention in adulthood

La personalidad neurótica conlleva múltiples problemas de comportamiento en la población infantil y juvenil. Percatados de que dicho perfil no está descrito en los manuales de psicopatología, ofrecemos nuestros criterios para su detección y tratamiento. Se trata de pacientes que viven anclados en un egocentrismo infantil, intolerantes a las frustraciones y altamente insatisfechos. Estos síntomas fundamentales se complementan con algunos que describimos en nuestro cuestionario: Q-2-O ("QUESTIONARI 2, D' Osona") que puede ayudar a evaluar la intensidad de los mismos: ansiedad, inquietud psicomotora, distimia, indisciplina, agresividad y pereza. Este estancamiento madurativo se acompaña de la certeza que no pueden cambiar, porque "ellos son así". Con un super-yo muy vigilante, pueden lograr una adaptación socio-escolar perfecta, mientras en la vida familiar su tiranía los hace insoportables. Apuntamos una etiología de base genética, pero el trastorno tiene mucho de aprendido. Es por ahí, donde enfocamos su tratamiento. Es preciso corregir esta conducta antes de llegar a la vida adulta. (AU)

Changes in mood status and neurotic levels during a 20-day bed rest.

This study evaluated changes of mood status and depressive and neurotic levels in nine young male subjects during a 20-day 6 degrees head-down tilting bed rest and examined whether exercise training modified these changes. Participants were asked to complete psychometrical inventories on before, during, and after the bed rest experiment. Depressive and neurotic levels were enhanced during bed rest period according to the Japanese version of Zung's Self-rating Depression Scale and the Japanese version of the General Health Questionnaire. Mood state "vigor" was impaired and "confusion" was increased during bed rest and recumbent control periods compared to pre-bed rest and ambulatory control periods according to the Japanese version of Profiles of Mood State, whereas the mood "tension-anxiety", "depression-dejection", "anger-hostility" and "fatigue" were relatively stable during experiment. Isometric exercise training did not modify these results. Microgravity, along with confinement to bed and isolation from familiar environments, induced impairment of mental status.

[Prophylactic effect of antioxidant Aekol on behavioral (psychoemotional) disturbances caused by chronic stress in rats]. / Profilakticheskoe deistvie antioksidantnogo preparata "Aekol" na povedencheskie (psikhoémotsional'nye) narusheniia, vyzyvaemye khronicheskim stressom u krys.

Antioxidant preparation "Aekol" containing vitamins A, E, and K3, was shown to possess antidepressant properties and to exert a prophylactic effect on behavioural (psychoemotional) disturbances induced by a chronic stress in rats: a depressive condition associated with an enhanced anxiety, elimination of individual differences in behaviour, weakening of the relationships among behavioural parameters recorded in the same animal in three different tests.

[Mental status of patients with iodine-deficiency goiter]. / Osobennosti psikhicheskogo statusa u bol'nykh iododefitsitnym zobom.

Personality and intellectual characteristics were examined in 76 patients with iodine-deficiency goiter (IDG). Subclinical hypothyroidism forming as early as IDG of the 1st degree impairs abstractive and integral thinking, psychological maladaptation to the disease, high anxiety, neurotism, diminished intellectual performance, deterioration of memory, attention, predominance of thinking of concrete-action type. To prevent intellectual disturbances, IDG patients should receive replacement therapy with adequate doses of thyroid hormones preparations.

The effects of a stress-management training program in individuals at risk in the community at large.

In this study we examine the effects of a stress-management training program on individuals without serious (mental) health complaints but with an increased chance of developing them as a consequence of stress. Potential subjects were randomly selected from the community at large and, then screened for participation in the training program if some of several (mental) health risk factors could be attributed to them: past life-events, neuroticism, inassertiveness, avoidant coping style and lack of social support. The control group, which did not take part in the training program, consisted of individuals with a similar risk profile as those in the training group. The training program consisted of several stress-management techniques: changing unhealthy life-style, relaxation training, problem-solving training and social skills-training. Multivariate analyses of variance showed that the training group, as compared to the control group, reported significantly less distress, less trait anxiety, less daily hassles, more assertiveness and more satisfaction with social support at follow-up. There were, however, no significant changes found in the coping skills of either group.

[The prevention of borderline psychoneurotic disorders in servicemen]. / Profilaktika pogranichnykh nervno-psikhicheskikh rasstroistv u voennosluzhashchikh.

The border psychic disorders are the main cause of the personnel discharge. Its frequency for many years remains on the high level and has no tendency towards decrease. To solve the problem of maintaining psychic health of servicemen is possible by psychiatric care reorganization with participation of social and military psychologists, specialists in professional selection, psychotherapy, etc. For introduction of highly effective psychodiagnostic, corrective and therapeutic methods into practice it is reasonable to create the psychoprophylactic centers (main, district, army, divisional).

[The diagnosis of premorbid psychosomatic states in ship-based specialists]. / Diagnostika predboleznennykh psikhosomaticheskikh sostoianii u korabel'nykh spetsialistov.

The formation of premorbid state was traced in 89 seamen from the whole crew number of 399 by the end of cruise. In 41 seamen abdominal microsystems have appeared for the first time in their life 2-3 weeks after the development of preneurotic state in the course of cruise. The following terminology is proposed: forming psychosomatic abdominal syndrome in combination with preneurotic state with microsymtomocomplex, which didn't obtain the level of functional disorders of stomach, intestinal or biliary tract, and formed psychosomatic abdominal syndrome to denominate the combination of preneurotic or neurotic state with some functional disorders of stomach, intestinal or biliary tract. It is recommended to apply psychotherapy during treatment, primary and secondary prophylaxis in seamen.

[Results of infant research and its clinical relevance for psychoanalysis with reference to the concept of intentionality (Schultz-Hencke)]. / Ergebnisse der Säuglingsforschung und ihre klinische Relevanz für die Psychoanalyse unter dem Blickwinkel des Konzepts der Intentionalität (Schultz-Hencke).

The reception of results put forward by empirical infant research has been gaining increased significance for Psychoanalysis. This applies to analytic theory formation as well as to the clinical-therapeutic field. In this context convergencies between Schultz-Henckes concept of intentionality and new views in analytic developmental theory seem to emerge. The paper presented discusses before this background the significance of the visual domain, the affects and the explorative motivational system. The consequences of pathogenic impacts within these fields shall receive special consideration with regard to later neurotic developments.

Pregnant inmates: risk factors and pregnancy outcomes.

OBJECTIVE: To document the risk factors and outcomes of pregnant women incarcerated in a maximum-security prison. DESIGN: Descriptive correlational study. SETTING: Women's correctional facility. PARTICIPANTS: Eighty-nine pregnant women incarcerated during the third trimester of pregnancy. MAIN OUTCOME MEASURES: Medical, obstetric, life-style, and psychologic risk factors during pregnancy; birth weight; weeks of gestation at delivery; and presence of congenital anomalies in the newborn. RESULTS: Numerous risk factors during pregnancy, including chemical dependency, poor nutritional status, poor obstetric histories, high levels of anxiety and depression, and inadequate prenatal care. CONCLUSIONS: There is a need for intensive prenatal education for incarcerated women and for chemical dependency treatment programs designed specifically for incarcerated pregnant women. Interventions that address psychologic distress also are needed.