Scielo RSS <![CDATA[The European Journal of Psychiatry]]> vol. 28 num. 3 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>Complex posttraumatic stress disorder in traumatised asylum seekers</b>: <b>a pilot study</b>]]> Background and Objectives: Complex posttraumatic stress disorder (cPTSD), a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture. Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5%) agreed. The structured interview for disorders of extreme stress (SIDES) was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview. Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6%) participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7%) had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence. Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers. <![CDATA[<b>Severity of negative symptoms significantly affects cognitive functioning in patients with chronic schizophrenia</b>: <b>the slowing in cognitive processing</b>]]> Background and Objectives: Studies in patients with schizophrenia have shown a decreased overall cognitive performance, and it was found that processing speed and working memory functions are affected. The aim of this study was to describe the general cognitive performance of patients with chronic schizophrenia and analyze its relationship with the severity of psychotic symptoms. Methods: Forty-eight patients diagnosed with DSM IV-TR schizophrenia disorder were examined for symptom improvement, measured by scales SAPS and SANS. Participants also completed the full scale WAIS-III. Results: The results show a generalized cognitive deficit, reflected in the low level of general intelligence, as well as the different index that comprise the scale. The most compromised index was the processing speed. The correlations showed that the overall severity of negative symptoms significantly affects cognitive functioning of chronic patients. The formal thought disorder and alogia significantly correlated with almost all the WAIS-III measures. Conclusions: Multiple studies of specific cognitive domains in schizophrenia have shown that deficits in processing speed are the core element of cognitive impairment in schizophrenia. We support the hypothesis about the slowing in cognitive processing affect both the performance of the basic and more complex cognitive task. <![CDATA[<b>Verbal fluency in chronic schizophrenia and severity of psychotic symptoms</b>: <b>consideration of their relationship with errors in the tasks</b>]]> Background and Objectives: There are many associations between psychotic symptoms and performance in Verbal Fluency (VF) tasks. However, most of these are found are with negative symptoms. In this study we examined the relationship between the performance in four VF tasks and the severity of both positive and negative symptoms. Methods: To compare performance in different VF tasks, two groups of participants were matched for age, sex and educational level, a Healthy Control Group (N = 83) and a Chronic Schizophrenia Group (N = 83). We examined the correlation between cognitive performance in these verbal tests and the severity of psychotic symptoms in the group of patients. Results: The results show that the performance of patients with chronic schizophrenia in VF tests is significantly lower than for healthy individuals. The analysis of correlations between tasks showed a significant correlation between the severity of negative symptoms and poor performance in VF tasks. Another interesting result was the association between the severity of formal thought disorder and poor performance in semantic VF. A particularly striking result was the correlation between the severity of positive symptoms and the number of errors in VF tasks in the patient group. Conclusions: These results have provided evidence for some of the proposed hypotheses and are in accordance with previous investigations. The correlations between the positive symptoms and the number of errors in the different VF tasks have not been previously reported. It is important to note that most of these correlations are between the severity of positive symptoms and intrusion errors. <![CDATA[<b>Anxiety in patients with acute coronary syndromes</b>]]> Background and Objectives: Anxiety is frequently encountered in acute coronary syndrome. It is believed that the prevalence of anxiety among cardiac patients is between 15 and 50%. The goal of our study was to determine whether there is an association between current anxiety and anxiety tendency in patients with acute coronary syndrome. A secondary goal was to establish possible distinct features of acute coronary syndromes in patients with the anxiety. Methods and results: Our study included 30 patients suffering from acute coronary syndrome. To obtain additional data on physical and mental health, we applied specially designed and validated questionnaires. In a groups without the anxiety and intensive anxiety there were no patients, while in the group with mild anxiety there were 21 patients (70%) and 9 patients had moderate anxiety (30%). The average number of hospital treatments was significantly higher in patients with moderate anxiety (average 2.3). Patients who were first time hospitalized due to cardiovascular disease, at the highest percentage (81%) had low current anxiety. Those patients who had intensive anxiety traits and propensity to anxiety response had the highest average number of hospital days (9 days). Patients who had intensive anxiety traits had the lowest values ​​of internal locus of control (had feeling that only themselves were cause of the disease). Conclusions: Current anxiety and anxious personality structure are strongly associated with the course of the coronary heart disease. In particular, this refers to the length of hospital stay and number of hospitalizations. <![CDATA[<b>A proposal of basic guidelines for training in psychosomatic and liaison psychiatry in Spanish psychiatry training programs</b>]]> Background and Objectives: The Psychosomatic and Liaison Psychiatry is an emerging psychiatric subspecialty. This article is intended to summarize the philosophy supporting training programmes in Spain, and the recommended training guidelines. Methods: Review of the literature and teaching experience. Results: The increasing complexity of diagnosis and treatment, and the demand by patients and providers of resources for higher and more efficient quality of care, make skills training a key tool for achieving these goals. The human being is biology, feelings, thoughts, experiences and thus individuality when sick. Understanding all this is the core on which to base our competencies in this exciting crossroads between psychiatry and other medical specialties. We propose a set of competencies to achieve, and point learning spaces and evaluation mechanisms. Conclusions: Based on accumulated experiences in Spain, and the review of European and international literature, it is possible to summarize a realistic set of norms and directions for training in Psychosomatic and Liaison Psychiatry in residency programmes. <![CDATA[<b>A 7 year follow-up of children and adolescents with obsessive-compulsive disorder</b>: <b>an analysis of predictive factors in a clinical prospective study</b>]]> Background and Objectives: Obsessive compulsive disorder (OCD) is a frequent psychiatric disorder. Despite its significant influence on personal development, little is known about its long-term course in children and adolescents. The aim was to follow children and adolescents with OCD for 7 years and to compare patients gaining remission with patients experiencing symptoms. Methods: The study was a prospective follow-up study in which the patients were interviewed 7 years after their initial contact with the healthcare system. The patients had been described at baseline. Results: Among the 95 participants, 53 participants described symptoms at follow-up and 44 participants described remission. More patients with persistent symptoms described an anxious personality trait. The schizoid/compulsive personality traits were represented at a higher rate in the group with persistent symptoms than in the group with remission symptoms. Important predictive factors included predisposition to OCD, the occurrence of comorbid disorders and older referral age. The occurrence of magic obsessions and repetitive compulsions increased the risk of OC symptoms at follow-up. The group ┬ôlate responders┬ö differed from the non-responder group by predisposition to depression. Conclusions: The present clinical study is one of the longest follow-up studies conducted in children and adolescents with OCD. In addition to confirming several previous findings, the study added new knowledge about the importance of phenotypic presentation, personality traits and quality of life. Furthermore, the late responder group has been described in relation to the remission group and to the group with persistent symptoms.