DPsiq - Artículos
https://hdl.handle.net/10481/31064
2024-03-29T12:11:56ZSuicidal Risk and Depression in Pregnant Women in Times of Pandemic
https://hdl.handle.net/10481/83824
Suicidal Risk and Depression in Pregnant Women in Times of Pandemic
Solis, Mirta; Gutiérrez Rojas, Luis; Jiménez Fernández, Sara
PurposePregnancy is a risk period for the development of mental disorders. About 10% of pregnant women worldwide experience a mental disorder, mainly depression, and this percentage has been aggravated by the COVID-19 pandemic. This study aims to understand the impact of COVID-19 on the mental health of pregnant women.MethodsThree hundred and one pregnant women in the week 21.85 +/- 9.9 were recruited through social media and pregnant women forums from September 2020 to December 2020. A multiple-choice questionnaire was administered to evaluate the sociodemographic characteristics of the women, the care provided, and different aspects related to COVID-19. A Beck Depression Inventory was also delivered.ResultsOf the pregnant women 23.5% had seen or had considered seeing a mental health professional during pregnancy. Predictive models using multivariate logistic regression found that this fact was associated with an increased risk of depression (OR = 4.22; CI 95% 2.39-7.52; P < 0.001). Among women with moderate-severe depression, it was associated with an increased risk of having suicidal thoughts (OR = 4.99; CI 95% 1.11-27.9; P = 0.044) and age was found to be a protective variable (OR = 0.86; CI 95% 0.72-0.98; P = 0.053).ConclusionsThe COVID-19 pandemic represents a major mental health challenge for pregnant women. Despite the decrease in face-to-face visits, there are opportunities for health professionals to identify the existence of psycho-pathological alterations and suicidal ideation by asking the patient if she is seeing or considering seeing a mental health professional. Therefore, it is necessary to develop tools for early identification to ensure correct detection and care.
SignificanceAmong women with moderate-severe depression, considered seeing a mental health professional during pregnancy was associated with an increased risk of having suicidal thoughts and age was found to be a protective variable. Despite the decrease in face-to-face visits during COVID-19 pandemic, there are opportunities for health professionals to identify the existence of psycho-pathological alterations and suicidal ideation by asking the patient if she is seeing or considering seeing a mental health professional. Asking about their intention to seek specialized assistance can help to identify those women at risk of suffering affective disorders such as depression and suicidal ideation and to individually plan future medical visits.
Cigarette smoking and risk of suicide in bipolar disorder: a systematic review
https://hdl.handle.net/10481/82974
Cigarette smoking and risk of suicide in bipolar disorder: a systematic review
García Jiménez, Jesús; Gutiérrez Rojas, Luis
Objective: Bipolar disorder (BD) is a highly prevalent, chronic and recurrent
mental illness. The smoking rates in patients with BD are much higher than those
of the general population, and BD is associated with an increased risk of suicide.
An association between smoking and suicidal behavior has been found in the
general population, this systematic review examines whether there is evidence of
an association between smoking and suicide behavior in patients with BD.
Method: A database search was carried out in Medline, Embase, The Cochrane
Library, Scopus, and Web of Science, updated until December 31st, 2021, according
to the 2020 PRISMA guidelines. We identified prospective and retrospective studies
that included patients diagnosed with BD types I, II, and not otherwise specified,
and in which smoking and suicidal behavior were correlated. Articles that focused
exclusively on other mental disorders were excluded. The Ottawa-Newcastle scale
was used to assess the methodological quality of the included articles.
Results: Fifteen articles (n = 7,395) met all the inclusion criteria. In nine of these
articles, the authors found an association between smoking and suicidal behavior in
BD, while in the remaining six articles, this association was not found. A great deal of
variability was observed between articles, particularly in the measurement of suicidal
behavior and tobacco consumption. The risk of bias, as assessed by the NOS, was
high for most of the included articles, except for two papers, whose risk was low.
Conclusion: It was not possible to establish a clear relationship between tobacco
use and the risk of suicide in BD patients due to the heterogeneity of the
articles included in this systematic review, which had different sample sizes and
methodological issues. However, both conditions are highly prevalent and have
a negative impact on the prognosis of BD. Therefore, a systematic approach is
needed, based on accurate measurement of a patient’s smoking habits and their
risk of suicidal behavior, in order to establish an appropriate therapeutic plan.
Additional information: This research received no specific grant from any funding
agency in the public, commercial, or not-for-profit sectors and was registered on
PROSPERO with the CRD42022301570 on January 21th 2022.
Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review
https://hdl.handle.net/10481/82943
Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review
Gutiérrez Rojas, Luis
Attitudes of mothers and health care providers towards behavioural interventions promoting breastfeeding uptake: A systematic review of qualitative and mixed-method studies
https://hdl.handle.net/10481/81825
Attitudes of mothers and health care providers towards behavioural interventions promoting breastfeeding uptake: A systematic review of qualitative and mixed-method studies
Rojas García, Antonio; Lingeman, Sabrina; Kassianos, Angelos P.
Purpose: Recommendations for exclusive breastfeeding
are not often adhered to despite the robust evidence of its
benefits. This systematic review aims to collate evidence on
the attitudes mothers and health care providers have towards
breastfeeding interventions to understand what aspects best
contribute to acceptability and feasibility.
Methods: This review further investigates the value of
identifiable behaviour change techniques (BCTs) to uncover
which components of an intervention are perceived to be
most useful and acceptable. The main biomedical databases
were searched, and 17 (n = 17) studies met the inclusion
criteria.
Results: A total of nine BCTs were identified within the
interventions. The thematic analysis produced four main
domains: usefulness, accessibility, value and sustainabil-
ity. Women discussed the importance of the support they
received in these interventions and demonstrated a positive
view towards three BCTs: ‘social support (unspecified)’,
‘instruction on how to perform behaviour’ and ‘demon-
stration of behaviour’. Additionally, women highlighted
the benefit of personal, non-clinical and flexible emotional
and practical support from peers, lactation consultants and
support groups. Health care providers echoed these opinions
and specifically highlighted the usefulness of interventions
that allowed for continuity of care and more personal breast-
feeding support.
Conclusions: These findings suggest that ongoing practical
as well as emotional support is crucial for standard in-hospital support to succeed at increasing breastfeeding rates. Future
research would need to better understand the nuances of the
interventions among women and providers to enhance their
implementation.
Additional supporting information can be found online in the Supporting Information section at the end
of this article.
Current Opinions about the Use of Duloxetine: Results from a Survey Aimed at Psychiatrists
https://hdl.handle.net/10481/80861
Current Opinions about the Use of Duloxetine: Results from a Survey Aimed at Psychiatrists
Álvarez Mon, M. A.; Gutiérrez Rojas, Luis
Major depressive disorder (MDD) is a complex psychiatric disorder that, presented alone
or with other comorbidities, requires different adjustments of antidepressant treatments. Some
investigations have demonstrated that psychoactive drugs, such as serotonin and norepinephrine
reuptake inhibitors (SNRIs), can exert more effective and faster antidepressant effects than other
common medications used, such as serotonin selective reuptake inhibitors (SSRIs), although these
differences are still controversial. During the last five years, the SNRI duloxetine has shown favorable
results in clinical practice for the treatment of MDD, anxiety, and fibromyalgia. Through an online selfcompleted
survey, in the present article, we collected information from 163 psychiatrists regarding
the use of duloxetine and its comparison with other psychiatric drugs, concerning psychiatrists’
knowledge and experience, as well as patients’ preferences, symptoms, and well-being. We discussed
and contrasted physicians’ reports and the scientific literature, finding satisfactory concordances,
and finally concluded that there is agreement regarding the use of duloxetine, not only due to its
tolerability and effectiveness but also due to the wide variety of situations in which it can be used
(e.g., somatic symptoms in fibromyalgia, diabetes) as it relieves neuropathic pain as well.