Scielo RSS <![CDATA[The European Journal of Psychiatry]]> vol. 30 num. 4 lang. es <![CDATA[SciELO Logo]]> <link></link> <description/> </item> <item> <title><![CDATA[<b>Cognitive distortions mediate the relationship between defense styles and depression in female outpatients</b>]]> Background and Objectives: Some clinicians use different psychotherapeutic methods in combination in their practice. These combinations reflect the need for more rigorous research on the common pathways which these different therapy orientations may be utilizing, and one way to identify these pathways would be to investigate some core assessment tools or conceptual foundations of these two different approaches. Aim: The aim of the present study was to evaluate the relationship between defense mechanisms and cognitive distortions, and to identify the mediating role of cognitive distortions between defense styles and depression. Methods: A total of 342 female psychiatric outpatients aged 18 and older were recruited. A diagnostic interview and rating of the depression severity were undertaken, and the Cognitive Distortion Scales and the Defense Style Questionnaire were completed by the participants. Hierarchical regression analyses were conducted to test for the direct and indirect effects of the defense styles. Results Cognitive distortions and defense mechanisms were both correlated with the severity of depression, but the correlations were stronger for the former. Conclusions The findings are suggestive of the mediating effect of cognitive distortions between defense mechanisms and the severity of depression. <![CDATA[<b>Comparisons of verbal fluency brain correlates between adults and adolescents suffering from schizophrenia spectrum disorders</b>: <b>a pilot study</b>]]> Background and Objectives: Prefrontal cortex (PFC) dysfunctions leading to cognitive deficits refer to a core feature of schizophrenia spectrum disorders (SSD). This exploratory study compares the effect of SSD on two stages of maturation of PFC. Methods: Using functional magnetic resonance imaging (fMRI), we measured the brain correlates related to a verbal fluency task (a hallmark executive function test) in 12 patients with SSD: 6 adolescents (SSD-ado) and 6 adults (SSD-adu). Results SSD-ado showed greater activation in insula, thalamus and hIP1 whereas SSD-adu recruited more intensively precentral gyrus and temporal pole to resolve the task. Thus, adolescents with SSD seem to adopt less frontal mediated strategic processes. In contrast, adults seem to be able to use PFC mediated strategy despite the well-known deleterious effect of SSD on the PFC. Conclusions This first exploratory study revealed that adults and adolescents with SSD seemed not to use the same strategy to resolve a verbal fluency task. Thus, despite the illness, which is known to have a deleterious influence on PFC, adult patients seem to be able to recruit these resources to perform an executive function task. Further studies are needed in order to confirm and extend these new and preliminary results. <![CDATA[<b>Social determinants of mental health</b>: <b>a review of the evidence</b>]]> Background and Objectives: The aim of this study is to present a non-systematic narrative review of the published evidence on the association between mental health and sociodemographic and economic factors at individual- and at area-level. Methods: A literature search of PubMed and Web of Science was carried out to identify studies published between 2004 and 2014 on the impact of sociodemographic and economic individual or contextual factors on psychiatric symptoms, mental disorders or suicide. The results and methodological factors were extracted from each study. Results Seventy-eight studies assessed associations between individual-level factors and mental health. The main individual factors shown to have a statistically significant independent association with worse mental health were low income, not living with a partner, lack of social support, female gender, low level of education, low income, low socioeconomic status, unemployment, financial strain, and perceived discrimination. Sixty-nine studies reported associations between area-level factors and mental health, namely neighbourhood socioeconomic conditions, social capital, geographical distribution and built environment, neighbourhood problems and ethnic composition. Conclusions Most of the 150 studies included reported associations between at least one sociodemographic or economic characteristic and mental health outcomes. There was large variability between studies concerning methodology, study populations, variables, and mental illness outcomes, making it difficult to draw more than some general qualitative conclusions. This review highlights the importance of social factors in the initiation and maintenance of mental illness and the need for political action and effective interventions to improve the conditions of everyday life in order to improve population's mental health. <![CDATA[<b>An ecological study of Hungarian suicide data using complex statistical methods</b>]]> Background and Objectives: According to a number of psychiatrists, the decrease in the number of suicides can almost exclusively be ascribed to the increasing use of new antidepressants (ADs). Several ecological studies have been carried out to lend support to this claim; unfortunately, many of these started out from either methodologically or statistically flawed assumptions. The purpose of the current study is to demonstrate the examined relationships using complex time-series techniques on Hungarian national sample. Methods: When investigating the relationships between our time series, first we ensured their stationarity using several methods. We used two methods for the analysis involving several independent variables. Results When using dynamic regression to ensure stationarity, the residuals of the suicide and AD time series showed a significant negative correlation. At the same time, when using the more robust technique of time series differentiation, the stationary time series showed no significant relationship between the use of antidepressants and suicide rates. Conclusions The models fitting our data showed somewhat mixed results. The vagueness of ecological models is well demonstrated by the fact that even those sociological variables (number of divorces, alcohol consumption) failed to show a significant relationship with suicides here, which are usually significant in analyses using micro data. <![CDATA[<b>Analysis of errors in verbal fluency tasks in patients with chronic schizophrenia</b>]]> Background and Objectives: Even if verbal fluency deficits have been described in Schizophrenia, error pattern in this test has not been analyzed in detail in the literature. The pattern analysis of such errors could contribute to the understanding of the factors that influence poor task performance in schizophrenia. In this study we analyzed the intrusion and perseveration errors in verbal fluency tasks in patients with chronic schizophrenia. Methods: 87 patients diagnosed with Chronic Schizophrenia and 87 healthy controls were included in this investigation and were assessed with four Phonological and Semantic Verbal Fluency tasks. Results The results of this study showed that at least half of schizophrenic patients produced perseverative errors on verbal fluency and about made intrusion errors. The severity of negative symptoms, the severity of Formal Thought Disorder and pharmacological variables were significant moderators to errors in Verbal Fluency performance. Conclusions Errors in Verbal Fluency can be explained by the interaction of different variables in patients with schizophrenia. Schizophrenia is a psychological pathology with great phenomenological complexity and its particularities can only be explained by the consideration of the multiple factors involved in its manifestation. <![CDATA[<b>How the exposure to trauma has hindered physicians' capacity to heal</b>: <b>prevalence of PTSD among healthcare workers</b>]]> Background and Objectives: Post-traumatic stress disorder (PTSD) is a condition affecting individuals exposed to trauma in the past. This article evaluates the prevalence of PTSD in practicing physicians and how it influences work performance. Methods: A review of the literature, followed by data extraction and meta-analysis were performed. Articles were searched for in PubMed, Web of Science, and Medline using keywords: ("physician" AND "ptsd"), as well as Meshterms ("stress disorders, post-traumatic" AND "physicians"). Since 1980, 1363 unique hits published in English were identified and filtered by pre-specified inclusion criteria to yield a sample of 110 full-text articles examining the prevalence of PTSD among healthcare workers. Among these, 9 articles represented an accurate examination of the prevalence of PTSD among physicians only. Information was extracted on the demographic, as well as PTSD prevalence data, from these studies for final comparison. Results Across all studies (n = 9) we examined, the prevalence of PTSD among physicians of both genders (n = 1616) was 14.8%, and the range was between 4.4% to 28%. This estimation is higher than the general prevalence of PTSD in the adult population of 3-4%, yet lower than prevalence found among people traumatized by war or torture, a range of 20-45%. Since only 50% of the studies examined here stratified PTSD prevalence among physicians by gender, we could not accurately conclude gender differences. Conclusions Our findings prompt a need for further investigation into the development of support programs for healthcare providers, aimed at reducing the traumatic stress experienced by physicians at work.