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Introducción: Estudios epidemiológicos recientes destacan el aumento de prevalencia de trastornos psiquiátricos en presos. El objetivo del presente estudio es determinar los trastornos psiquiátricos principales y secundarios más prevalentes, datos sociodemográficos y estancia media, de los pacientes ingresados en el Módulo Penitenciario de un hospital general a cargo del Servicio de Psiquiatría. Material y método: Estudio descriptivo transversal retrospectivo. La muestra está compuesta por los pacientes ingresados en el Módulo Penitenciario a cargo de Psiquiatría durante 5 años, siendo n=136. Resultados: El 90,4% fueron hombres y el 9,6% mujeres. La edad media fue de 34,18 años. Los diagnósticos psiquiátricos principales más prevalentes fueron: Tr. Personalidad 22%, Tr. Esquizofrénicos 16,3%. Como diagnósticos psiquiátricos secundarios más prevalentes encontramos: Tr. Personalidad 11,9%, Abuso de drogas 10,7%. Conclusiones: El diagnóstico psiquiátrico principal y secundario más prevalente fue el trastorno de personalidad. Se documentó la existencia de una alta comorbilidad con el abuso-dependencia de tóxicos. Actualmente las prisiones carecen de equipos multidisciplinares en Salud Mental, con lo que en muchas ocasiones se hace necesario el traslado del preso al hospital con la carga asistencial y el incremento de costes que esto supone.Introduction: recent epidemiological studies highlight an increase in the prevalence of psychiatric disorders amongst prison inmates. The objective of this study to determine the most prevalent primary and secondary psychiatric disorders, socio-demographic data and average stay period amongst patients admitted to the Prison Unit of a general hospital as charges of the Psychiatric Service. Materials and Methods: retrospective cross-sectional descriptive study. The sample group consisted of a number of patients admitted into the Prison Unit as charges of the Psychiatric Service during a five year period (n=136). Results: 90,4% were men and 9,6% were women. The average age was 34,18 years. The most prevalent primary psychiatric diagnoses were: Personality Disorder 22%, and Schizophrenic Disorder 16,3%. The most prevalent secondary psychiatric diagnoses were: Personality Disorder 11,9%, Substance Abuse 10,7%. Conclusions: the most prevalent primary and secondary psychiatric diagnosis was personality disorder. The existence of a high level of comorbidity of substance abuse-dependence was recorded. Prisons currently lack Mental Health multidisciplinary teams. This often means that the inmate must be transferred to a hospital with the increased work load and financial cost that this implies.

Introduction: There is a growing interest in the emotional state of cancer patients. The main objective of this pilot study is to assess the feasibility, acceptability, and preliminary efficacy of Meaning-Centered Psychotherapy and Essential Care (MCP-EC) in patients with advanced cancer compared with usual psychological support. We define "Essential Care" as the promotion of patient care and self-care through the recall of good care experiences and discussion of the concepts: responsibility, self-compassion, kindness, and attitude., Method: Pilot, single-center, and prospective study of 30 patients with advanced cancer and emotional distress. Our adaptation consisted in three session Meaning-Centered Psychotherapy-Palliative Care, plus a fourth session named "Essential Care". The study was carried out in two phases. First, 20 patients were randomized to one of the two arms: individual MCP-EC (experimental, n = 10) or usual psychological supportive (control, n = 10). In a second phase, 10 patients were assigned consecutively to Group MCP-EC ( n = 10). All patients were evaluated at baseline (pre-) and post-intervention with questionnaires for sociodemographic data and clinical scales., Results: Nineteen patients completed the 4 sessions of MCP-EC, 9 individual format and 10 group format. Usual supportive intervention was delivered to 10 control patients. Total 28 patients completed pre- and post-treatment evaluations. There were no pre- vs. post-differences in the evaluations of the control group. In the experimental group, significant pre- vs. post-differences were found in EQ-5D-3L, HADS, FACIT, DM, HAI, SCS-SF, and TD questionnaires. These results indicated that MCP-EC reduced anxiety and depression symptoms, hopelessness, demoralization, as well as increased spiritual well-being and sense of meaning. Participants were satisfied and found the MCP-EC intervention positively., Conclusions: This pilot study suggests that the MCP-EC has feasibility, acceptability, and preliminary efficacy reducing the emotional distress in advanced cancer patients. Larger studies are warranted to clarify the strengths and limitations of this psychotherapy.

The aim of the study was to assess a Spanish adaptation of a method that determines the categorical capacity status of potential participants in research projects. The sample consisted of 120 subjects (40 general medicine inpatients, 40 psychiatric inpatients, and 40 healthy controls). The MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview and Mini-Mental State Examination (MMSE) were used. A feasibility study was carried out and reliability and validity calculations were made against the expert-judgment gold standard. The mean duration of the MacCAT-CR was 13 min. For the MacCAT-CR understanding, appreciation, reasoning, and expressing a choice subscales, the intraclass coefficient correlation (interrater reliability) was .93, .88, .90, and .50, respectively, and internal consistency (Cronbach's alpha) was .96, .94, and .95, respectively. Patients considered to be incompetent for expert-judgment obtained lower scores in the MacCAT-CR interview. The Spanish version of the MacCAT-CR is feasible, reliable, and valid for assessing the capacity of patients to give consent in research.

Background and Objective: To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice)., Sample: 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls)., Instruments: MacCAT-T, Mini-Mental Status Examination (MMSE)., Procedure: Feasibility study, reliability and validity calculations (against to gold standard of clinical expert)., Results: Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE., Conclusions: Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)

Introduction: Many studies have reported excessive consumption of psychotropic drugs in the elderly but none have related psychotropic drug use to psychiatric symptoms and sleep disorders in community-dwelling patients aged more than 65 years old in Spain., Material and Methods: We performed a cross sectional study in a representative sample (9,739 persons) from the population aged more than 55 years old in the city of Zaragoza in 2001. A total of 3,714 persons aged more than 65 years old were interviewed. The data belonged to the ZARADEMP project., Results: The mean age of the sample was 76.9 years (59.2% women and 40.8% men). Anxiolytics or antidepressants were consumed by 22.6% of the sample. A diagnosis of depression was made in 12.9%, anxiety in 1.6% and insomnia in 36%. We found high consumption of anxiolytics, especially in persons with depression (42.2%) and low consumption of antidepressants, especially in persons with a diagnosis of depression (15.4%) and in those with depressive symptoms (8.2%)., Conclusions: A correct psychiatric diagnosis is essential before psychotropic drugs are used to ensure appropriate treatment of the elderly with psychiatric symptoms.

Objective: To describe excessive alcohol consumption in the geriatric population and its association with treatment with psychiatric drugs., Design: Transversal, descriptive study., Setting: Community., Participants: A representative sample of the population over 59 years old in the city of Zaragoza, Spain., Main Measurements: Using a personal clinical questionnaire, we collected the following data: age, sex, marital status, educational status, economic level, occupation, people who live together, and drug, psychiatric drug, and alcohol consumption., Results: In our sample there were 2.4% with excessive alcohol consumption. This excessive alcohol consumption was associated with sex (men) (P< .001), with age (higher in young patients) (P< .001), with marital status (P< .001), with educational status (P=.009), with economic level (P=.002), with occupation (P< .001) and with people who live together (P< .001). On correcting these variables by sex, we found that there was a statistically significant association with age and economic level in men, and with marital status in women. Patients with excessive alcohol consumption used fewer drugs and psychiatric drugs than patients without excessive alcohol consumption, though the figure for psychiatric drugs had no statistical significance., Conclusions: Excessive alcohol consumption is higher in men, in separated and divorced people, and in those with a high economic level and becomes lower with age. Patients with excessive alcohol consumption use fewer drugs and psychiatric drugs.

Objects: Demonstrate the reliability of cerebral SPECT using 99 mTc-HMPAO., Methods & Materials: Evaluation of cerebral blood flow using SPECT in 24 patients with schizophrenia, 24 patients with bipolar disorder and 20 controls. In the study we have reliability between observers and intraobserver. In both cases kappa statistic has been applied for measuring reliability., Results: reliability between observers represents a kappa coefficient of 0.71. Intraobserver reliability, with a medium grade concordance slightly superior, shows a medium kappa coefficient of 0.74., Conclusions: Visual evaluation of SPECT images using 99mTc--HMPAO is a trustworthy technique to document the different patterns of regional cerebral blood flow. Reliability is determinate by the improvement, during visual analysis of reliability between observers (kappa: 0.71) and intraobservers (kappa: 0.74).