The role of incidental variables of time in mood assessment

Determining what influences mood is important for theories of emotion and research onsubjective well-being. We consider three sets of factors: activities in which people areengaged; individual differences; and incidental variables that capture when mood ismeasured, e.g., time-of-day. These three factors were investigated simultaneously in a studyinvolving 168 part-time students who each responded 30 times in an experience samplingstudy conducted over 10 working days. Respondents assessed mood on a simple bipolarscale from 1 (very negative) to 10 (very positive). Activities had significant effects but,with the possible exception of variability in the expression of mood, no systematicindividual differences were detected. Diurnal effects, similar to those already reported inthe literature, were found as was an overall Friday effect. However, these effects weresmall. Lastly, the weather had little or no influence. We conclude that simple measures ofoverall mood are not greatly affected by incidental variables.

Mood and anxiety disorders across the adult lifespan: a European perspective

BACKGROUND: The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries. METHOD: Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries. RESULTS: No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ≥ 80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age. CONCLUSIONS: Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.

La construcció del funcionari. Un estudi de cas : INSS Barcelona

El treballador públic és sotmès, des que comença la seva particular relació laboral, a un món fortament estructurat i amb una cultura, unes característiques i un tarannà propis i particulars. És en aquest procés que les forces socialitzadores del seu lloc de treball, juntament amb les del món exterior, el van formant com a treballador públic, fins al punt que es pot parlar del funcionari com d'una construcció. Això produeix una manera de veure i entendre el món laboral molt diferent de la que es té en l'empresa privada. Així, les aptituds, les actituds, les maneres de fer, les dèries i les manies només tenen sentit dins el seu entorn, que ell mateix comprèn com a totalment diferent. L'oposició com a ritual de pas, la socialització secundària, la percepció de l'alteritat, el qui és l'altre, el quan i el perquè, i els trets de la seva cultura - el temps, el treball, la normativa són algunes de les claus estudiades en aquest treball que ens ajuden a comprendre el perquè i el com d'aquesta construcció.

La influència de les emocions, els aliments emocionals i la publicitat emocional en l'elecció d'aliments i el comportament alimentari

D'ençà que el sobrepès és un factor de risc per a moltes malalties mortals, la investigació ha intentat identificar els factors que fan a les persones vulnerables de la sobreingesta. Aquest treball es basa en una revisió sistemàtica d'estudis qualitatius amb la intenció de resumir l'evidència existent sobre les relacions que s'estableixen entre les emocions i el comportament alimentari. Els resultats indiquen que hi ha una correlació positiva entre emocions i ingesta, sent aquesta última, moltes vegades, influenciada per diferents estats emocionals. També existeix una correlació positiva entre estats d'ànim negatius i elecció d'aliments d'un alt contingut calòric. Els fabricants i venedors, conscients d'aquesta relació, han utilitzat aquestes necessitats humanes en el seu propi benefici. Entendre la manera en què les emocions es relacionen amb el comportament alimentari pot augmentar l'efectivitat de les intervencions dissenyades per a millorar les recomanacions i hàbits alimentaris que determinaran la salut i la qualitat de vida de la població.

Lack of CB1 receptor activity impairs serotonergic negative feedback

Serotonergic and endocannabinoid systems are important substrates for the control of emotional behavior and growing evidence show an involvement in the pathophysiology of mood disorders. In the present study, the absence of the activity of the CB1 cannabinoid receptor impaired serotonergic negative feedback in mice. Thus, in vivo microdialysis experiments revealed increased basal 5-HT extracellular levels and attenuated fluoxetine-induced increase of 5-HT extracellular levels in the prefrontal cortex of CB1 knockout compared to wild-type mice. These observations could be related to the significant reduction in the 5-HT transporter binding site density detected in frontal cortex and hippocampus of CB1 knockout mice. The lack of CB1 receptor also altered some 5-HT receptors related to the 5-HT feedback. Extracellular recordings in the dorsal raphe nucleus revealed that the genetic and pharmacological blockade of CB1 receptor induced a 5-HT1A autoreceptor functional desensitization. In situ hybridization studies showed a reduction in the expression of the 5-HT2C receptor within several brain areas related to the control of the emotional responses, such as the dorsal raphe nucleus, the nucleus accumbens and the paraventricular nucleus of the hypothalamus, whereas an overexpression was observed in the CA3 area of the ventral hippocampus. These results reveal that the lack of CB1 receptor induces a facilitation of the activity of serotonergic neurons in the dorsal raphe nucleus by altering different components of the 5-HT feedback as well as an increase in 5-HT extracellular levels in the prefrontal cortex in mice.

Emotion and reason in everyday risk perception

Although research has documented the importance of emotion in risk perception, little is knownabout its prevalence in everyday life. Using the Experience Sampling Method, 94 part-timestudents were prompted at random via cellular telephones to report on mood state and threeemotions and to assess risk on thirty occasions during their working hours. The emotions valence, arousal, and dominance were measured using self-assessment manikins (Bradley &Lang, 1994). Hierarchical linear models (HLM) revealed that mood state and emotions explainedsignificant variance in risk perception. In addition, valence and arousal accounted for varianceover and above reason (measured by severity and possibility of risks). Six risks were reassessedin a post-experimental session and found to be lower than their real-time counterparts.The study demonstrates the feasibility and value of collecting representative samples of data withsimple technology. Evidence for the statistical consistency of the HLM estimates is provided inan Appendix.

Estudi sobre la qualitat de vida de les persones amb demència ateses a la Unitat d'avaluació de deteriorament cognitiu de l'Hospital de la Santa Creu

OBJECTIU: determinar la qualitat de vida de les persones amb demència ateses en una unitat avaluadora de deteriorament cognitiu. MÈTODE: estudi descriptiu transversal amb una mostra consecutiva no probabilística, formada per 42 persones amb demència tipus Alzheimer lleu o moderada i els seus cuidadors. La Qualitat de Vida (QV) es va avaluar amb el qüestionari QoL-AD (Quality of Life Alzheimer’s Disease) en les versions per al pacient (QoL-ADp) i per al cuidador (QoL-ADc). RESULTATS: la mitjana de puntuació del QoL-ADp va ser de 35,38 punts (DE = 5,24) i del QoL-Adc, de 30,60 (DE 5,33). La diferència entre aquests resultats és significativa (p&0,001). Els pacients amb simptomatologia depressiva i els seus cuidadors van puntuar significativament més baix el QoL-AD (p&0,001). En les freqüències per ítems del QoL-ADp s’observa que: més del 75% van valorar com a bona/excel·lent les condicions de vida, família, matrimoni/relació estreta, vida social, situació financera i vida en general; el 61% valoraren bona/excel·lent la capacitat per realitzar tasques a casa; prop del 50% pensava que l’estat d’ànim, l’energia, la salut física, la capacitat per fer coses per diversió i la visió de si mateixos era dolenta/regular, i el 85,7% opinava que la seva memòria era dolenta/regular. CONCLUSIONS: els resultats obtinguts en el QoL-AD no difereixen dels obtinguts en altres investigacions. Suggereixen que les intervencions que genera l’avaluació de la QV en la pràctica clínica inclouen aspectes centrats pròpiament en la malaltia i aspectes vinculats amb les relacions socials.

El rol del paciente experto en el tratamiento de las adicciones: una propuesta para paliar las altas tasas de abandono prematuro en comunidades terapéuticas

El objetivo de este estudio recae en cómo y de qué forma el ex adicto a sustancias alteradoras del ánimo (E-ASAA), cursando por el estadio de mantenimiento, puede ejercer el rol de asesor y promotor de salud, como “Paciente Experto”, conjuntamente con los profesionales especializados en drogodependencias. Paralelamente este “cómo y de qué forma” viene a dar respuesta a una necesidad existente en las Comunidades Terapéuticas, a saber, reducir las Altas Voluntarias (AV) de los residentes recién incorporados y tras su Alta Terapéutica (AT). Sin embargo, se requiere de una investigación de tipo cualitativo para determinar los factores desencadenantes que inducen a esta prevalencia de AV y recaídas post-AT. Los resultados extraídos de la investigación a informantes clave muestran como existe un deficitario asesoramiento pre-entrada y acompañamiento post-AT. El E-ASAA, debidamente formado, podría dar respuesta a estas demandas asistenciales, mejorando así la completa reinserción de los usuarios de CCTT. La Propuesta del Proyecto “Mi amigo de Comunidad” integra este conocimiento aportando soluciones.

Beneficis de la realització d'un programa d'activitat física per persones maniacodepressives

Proposit: L'objectiu d'aquest treball és analitzar quins efectes produeix un programa d'activitat física en pacients amb trastorn bipolar de tipus II. Mètodes: Per la realització d'aquest estudi he comptat amb una mostra petita (n=14), la qual estava dividida en grup control (n=7) i grup intervenció (n=7). Es va realitzar una valoració inicial de la mostra per mitjà del Yesavage i SF-12. Posteriorment el grup intervenció va participar en 20 sessions d'activitat física (freq: 2/set). Un cop finalitzat el programa es va tornar a valorar la mostra per mitjà del Yesavage i SF-12. Resultats: Els subjectes del grup intervenció van millorar en: Estat d'ànim (Yesavage), Percepció de la pròpia salut, nivell d'energia i sentiment de tristesa i desànim. En l'estat de tranquil·litat i calma no van mostrar una gran variació. Conclusions: La pràctica d'activitat física en grup millora l'estat d'ànim, percepció de pròpia salut, redueix l'estat de tristesa i desànim i nivell d'energia.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607.

Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder:a meta-analysis of randomized controlled trials

The purpose of this meta-analysis was to examine the efficacy of maintenance treatments for bipolar disorder. Placebo-controlled or active comparator bipolar maintenance clinical trials of ≥6 months' duration with at least 15 patients/treatment group were identified using Medline, EMBASE, clinicaltrials.gov, and Cochrane databases (1993 to July 2010). The main outcome measure was relative risk for relapse for patients in remission. Twenty trials (5,364 patients) were identified. Overall, lithium and quetiapine were the most studied agents (eight and five trials, respectively). The majority of studies included patients who had previously responded to treatment for an acute episode. All interventions, with the exception of perphenazine+mood stabilizer, showed a relative risk for manic/mixed or depressive relapse below 1.0, although there was variation in the statistical significance of the findings vs. placebo. No monotherapy was associated with a significantly reduced risk for both manic/mixed and depressed relapse. Of the combination treatments, only quetiapine+lithium/divalproex, was associated with a significantly reduced risk vs. comparator (placebo+lithium/valproate) for relapse at both the manic/mixed and depressed poles of bipolar illness. Limitations for the analysis include differences in study durations and definitions of relapse. In conclusion, available maintenance therapies show considerable variation in efficacy. The efficacy of lithium and divalproex has been confirmed, but newer therapies, such as a number of atypical antipsychotics were also shown to be effective in bipolar disorder. Efficacy of all maintenance interventions needs to be balanced against the safety and tolerability profiles of individual agents.

Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: a voxel-based morphometry study

Music is a highly complex and versatile stimulus for the brain that engages many temporal, frontal, parietal, cerebellar, and subcortical areas involved in auditory, cognitive, emotional, and motor processing. Regular musical activities have been shown to effectively enhance the structure and function of many brain areas, making music a potential tool also in neurological rehabilitation. In our previous randomized controlled study, we found that listening to music on a daily basis can improve cognitive recovery and improve mood after an acute middle cerebral artery stroke. Extending this study, a voxel-based morphometry (VBM) analysis utilizing cost function masking was performed on the acute and 6-month post-stroke stage structural magnetic resonance imaging data of the patients (n = 49) who either listened to their favorite music [music group (MG), n = 16] or verbal material [audio book group (ABG), n = 18] or did not receive any listening material [control group (CG), n = 15] during the 6-month recovery period. Although all groups showed significant gray matter volume (GMV) increases from the acute to the 6-month stage, there was a specific network of frontal areas [left and right superior frontal gyrus (SFG), right medial SFG] and limbic areas [left ventral/subgenual anterior cingulate cortex (SACC) and right ventral striatum (VS)] in patients with left hemisphere damage in which the GMV increases were larger in the MG than in the ABG and in the CG. Moreover, the GM reorganization in the frontal areas correlated with enhanced recovery of verbal memory, focused attention, and language skills, whereas the GM reorganization in the SACC correlated with reduced negative mood. This study adds on previous results, showing that music listening after stroke not only enhances behavioral recovery, but also induces fine-grained neuroanatomical changes in the recovering brain.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607.

Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

El sentit de l'humor més agut s'amaga al cervell

Un estudi indica que les persones amb més matèria grisa en certes regions del cervell tenen una capacitat humorística més aguda i desenvolupada