Papers by BLANCA MELLOR MARSÁ
International Journal of Geriatric Psychiatry, 2012
ObjectiveThe objective of this article is to study which factors are associated with depression a... more ObjectiveThe objective of this article is to study which factors are associated with depression and anxiety in older adults with intellectual disabilities (ID).MethodsDepressive and anxiety symptoms were studied in 990 participants with borderline to profound ID, aged ≥ 50 years, using self‐report and informant‐report screening questionnaires. In 290 participants, major depression and anxiety disorders were assessed with a standardised psychiatric interview. Associations with personal, medical and psychosocial factors, which were collected through questionnaires and participants' medical and psychological records, were studied using multiple logistic regression analysis.ResultsIncreased depressive symptoms were positively associated with increased anxiety symptoms, number of life events during the past year and chronic diseases (heart failure, stroke, chronic obstructive pulmonary disease, coronary artery disease, diabetes mellitus and malignity in the previous 5 years) and nega...
Epidemiology and Psychiatric Sciences
Aims To investigate potential age, period and birth cohort effects in the prevalence of suicide i... more Aims To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population. Methods A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences. Results The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65–79 years) showed lower suicide ideation than middle-aged people (50–64 years). No significative differences were found for suicide ideation between middle-aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively....
Additional file 1: Table S1. Description of exploited studies and waves. Table S2. Univariable lo... more Additional file 1: Table S1. Description of exploited studies and waves. Table S2. Univariable logistic regression results. Table S3. Multivariable logistic regression results. Table S4. Descriptive statistics, China Health and Retirement Longitudinal Study (CHARLS). Table S5. Descriptive statistics Collaborative Research on Ageing in Europe Study (COURAGE in Europe). Table S6. Descriptive statistics Health and Retirement Study (HRS). Table S7. Descriptive statistics Health 2000/2011 study (Health 2000/2011). Table S8. Descriptive statistics Mexican Health and Aging Study (MHAS). Table S9. Descriptive statistics Survey of Health, Ageing and Retirement in Europe (SHARE).
International Journal of Epidemiology, 2020
Background Research efforts to measure the concept of healthy ageing have been diverse and limite... more Background Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts. Methods In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-sc...
Copyright © 2014 Kaloyan Kamenov et al. This is an open access article distributed under the Crea... more Copyright © 2014 Kaloyan Kamenov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Despite all the knowledge on depression, it is still unclear whether current literature covers all the psychosocial difficulties (PSDs) important for depressed patients. The aim of the present study was to identify the gaps in the recent literature concerning PSDs and their related variables. Psychosocial difficulties were defined according to the World Health Organization International Classification of Functioning, Disability and Health (ICF). A comparative approach between a systematic literature review, a focus group, and individual interviews with depressed patients was used. Literature reported the main psychosocial difficulties almost fully, but not in the same degree of importance as patients ’ reports. Furthermore, the cove...
Journal of Psychiatric Research, 2021
The relationship between psychotic symptoms and global measures of functioning has been widely st... more The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were "conceptual disorganization", "emotional withdrawal", "lack of spontaneity and flow of conversation", "delusions", "unusual thought content", "dealing with strangers" and "poor rapport". Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this population.
Dada la creciente relevancia de los indicadores subjetivos de felicidad a la hora de evaluar y co... more Dada la creciente relevancia de los indicadores subjetivos de felicidad a la hora de evaluar y comparar el nivel de progreso de las sociedades, esta investigacion tuvo como objetivo un acercamiento al estudio de la importancia que las sociedades europeas brindan, en los ultimos tiempos, al bienestar de sus habitantes, los metodos que permiten evaluarlo, las condiciones que subyacen a la felicidad y su impacto en variables relevantes como el estado de salud. Para ello se desarrollo un mapeo de la investigacion reciente sobre bienestar subjetivo en el ambito de la salud mental en el contexto europeo; se examinaron las propiedades psicometricas y la invarianza factorial de una medida del bienestar subjetivo -la version abreviada del Day Reconstruction Method (DRM)- en tres muestras nacionales representativas europeas y a traves de distintas condiciones de aplicacion; y se estudio la relacion entre los distintos componentes del bienestar subjetivo y la salud en los tres paises analizado...
Schizophrenia Research, 2021
BACKGROUND Persistent psychotic symptomatology might be present in a group of patients with borde... more BACKGROUND Persistent psychotic symptomatology might be present in a group of patients with borderline personality disorder (BPD) according to recent research findings. AIMS Investigate whether psychotic symptoms could be associated to greater cognitive and functional impairment in BPD patients. METHOD In this observational, cross-sectional study (PI14/01449 and PI17/01023), we investigated the incidence of persistent psychotic symptoms in BPD patients and its association with specific neurocognitive impairments. A sample of 120 patients with diagnosis of BPD according to DSM IV TR was studied. RESULTS A substantial number of BPD patients (52, 43,3%) presented psychotic symptoms for a period longer than 6 months. Among BPD patients with psychotic symptoms, 25 (48%) presented hallucinations, 35 (67,3%) presented delusional thoughts and 8 patients (15%) presented both. BPD psychotic patients had greater global severity at the CGI than non-psychotic patients (p 0.02). Psychotic BPD patients had greater impairment in attention (Hedges g = -0.36, 95% CI = -0.72 to 0.00) and in the executive functions domain (Hedges g = -0.48, 95% CI = -0.84 to -0.12) including working memory and cognitive flexibility. There were no differences of neurocognitive performance between patients with hallucinations and patients with delusional thoughts. CONCLUSIONS Persistent psychotic symptoms are present in one third of BPD patients and are probably associated with neurocognitive and social impairment. Thus, it is a priority to extensively investigate the nature of interactions between psychosis, BPD psychopathology and neurocognitive impairment, in order to better understand BPD phenotypes and to design adjusted treatment interventions.
Frontiers in Psychiatry, 2020
Purpose: The aim of the present study is to investigate whether the presence of psychopathic feat... more Purpose: The aim of the present study is to investigate whether the presence of psychopathic features in BPD is related to dysfunction in executive functions and other neuropsychological functions in these patients.Methods: 82 patients diagnosed with borderline personality disorder and 54 control subjects were studied through clinical and neuropsychological evaluation protocols and the Levenson Psychopathy Inventory.Results: BPD patients showed significantly higher scores on both primary (F1) and secondary (F2) global rates of psychopathy, than controls. The results for these patients also showed a statistically significant association between high scores in primary psychopathy and deficits in executive functions. However, no associations were found between the scores of secondary psychopathy and executive dysfunction.Conclusion: Primary psychopathic features present in patients with BPD are associated with patterns of executive dysfunction. It would therefore be interesting to inve...
BMC Public Health, 2021
Background Torture methods have traditionally been quantified using checklists. However, checklis... more Background Torture methods have traditionally been quantified using checklists. However, checklists fail to capture accurately both the almost infinite range of available methods of torture and the victims’ subjective experience. The Torturing Environment Scale (TES) was designed as a multidimensional alternative that groups torture methods according to the specific human function under attack. This study aims to do an exploratory assessment of the internal consistency reliability and discriminatory validity of the TES as part of a construct validity assessment in a sample of Basque torture survivors. Methods We applied the TES to a sample of 201 torture survivors from the Istanbul Protocol Project in the Basque Country Study (IPP-BC) to profile torturing environments in detention. To estimate the internal consistency reliability of the scale, categorical omega values were obtained for each subscale of the TES. To assess its discriminatory validity, the “known groups” method was use...
The Journal of Headache and Pain, 2020
Background Pain is a common symptom, often associated with neurological and musculoskeletal condi... more Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. Methods We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psycho...
The Journal of Headache and Pain, 2020
Background Pain is a common symptom, often associated with neurological and musculoskeletal condi... more Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates. Methods We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content “self-reported pain experienced at the time of the interview”, with a dichotomous (yes or no) modality. Results Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for w...
BMC Medicine, 2019
Background: The World Health Organization (WHO) International Classification of Diseases and Rela... more Background: The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by overarching principles of increasing clinical utility and global applicability, the 11th revision of the ICD proposes major changes that incorporate empirical advances since the previous revision in 1992. To test recommended changes in the Mental, Behavioral, and Neurodevelopmental Disorders chapter, multiple vignettebased case-controlled field studies have been conducted which examine clinicians' ability to accurately and consistently use the new guidelines and assess their overall clinical utility. This manuscript reports on the results from the study of the proposed ICD-11 guidelines for feeding and eating disorders (FEDs). Method: Participants were 2288 mental health professionals registered with WHO's Global Clinical Practice Network. The study was conducted in Chinese, English, French, Japanese, and Spanish. Clinicians were randomly assigned to apply either the ICD-11 or ICD-10 diagnostic guidelines for FEDs to a pair of case vignettes designed to test specific clinical questions. Clinicians selected the diagnosis they thought was correct for each vignette, evaluated the presence of each essential feature of the selected diagnosis, and the clinical utility of the diagnostic guidelines. Results: The proposed ICD-11 diagnostic guidelines significantly improved accuracy for all FEDs tested relative to ICD-10 and attained higher clinical utility ratings; similar results were obtained across all five languages. The inclusion of binge eating disorder and avoidant-restrictive food intake disorder reduced the use of residual diagnoses. Areas needing further refinement were identified.
Schizophrenia Research, 2017
The description of longitudinal bio-psycho-social profiles in FEP samples may be useful for the p... more The description of longitudinal bio-psycho-social profiles in FEP samples may be useful for the prediction of disability trajectories. This study aimed to describe the differences between disability status of FEP patients at baseline and their change over time, analysing how variables associated to the psychological status, and the environment of the patient can affect his or her disability trajectory, once the influence of health condition and socio-demographic variables has been controlled for. Using data from a 3-year follow-up study on early psychosis (PAFIP), a multilevel structure in which the longitudinal measurements (within level) were nested within the individuals (between level), was modeled. The contribution of the different time-varying and time-invariant variables to the patients' disability outcomes was tested through eight nested models. Consecutive models, that successively added health related, socio-demographic, psychological and environmental variables to the unconditional model were estimated, by means of deviance and fit statistics. The present work revealed the importance of psychological and environmental factors in the explanation of disability changes in the context of FEP. We may conclude that longitudinal assessments of time-varying predictorsliving situation (b = − 0.10, p b 0.05), economic support (b = 0.11, p b 0.01) and insight (b = −0.08, p b 0.05)explain a relevant amount of disability variation over time, independently from symptoms' severity, duration of untreated psychosis, age, gender and years of education. Additionally, the level of premorbid adjustment (b = 0.05, p b 0.001) was associated to differences in disability outcomes among FEP patients.
Journal of Happiness Studies, 2015
Revista de la Asociación Española de Neuropsiquiatría, 2009
Encontrándonos a las puertas de la publicación del DSM-V, que se espera alrededor de 2010, se ha ... more Encontrándonos a las puertas de la publicación del DSM-V, que se espera alrededor de 2010, se ha solicitado a los investigadores que contribuyan a la documentación base que los planificadores del DSM-V deberán utilizar para su revisión 1. Esto implica tanto consideraciones teóricas, como estudios empíricos. Una visión general sobre el actual debate pone de manifiesto que dos puntos de vista opuestos están ahora en conflicto. Por un lado, está el «enfoque conservador», que insiste en que los cambios en los criterios del actual sistema de diagnóstico tienen muchas posibles desventajas 2 : a) los cambios deberían ser aprendidos por miles de clínicos; b) las formas de registro médico, entrevistas estructuradas y otros documentos relacionados con la salud tendrían que ser modificados; los metaanálisis, estudios longitudinales y de las comparaciones entre los pacientes seleccionados con los nuevos y antiguos criterios podrían verse afectados; c) cambios demasiado frecuentes podrían desacreditar el proceso de revisión y ridiculizar el sistema DSM. Como consecuencia de ello, los investigadores que proponen un enfoque conservador sugieren modificar el cumplimiento de los criterios diagnósticos DSM sólo en los pocos casos en que la evidencia empírica de la necesidad de cambio es convincente 3. RESUMEN: Las profundas anomalías a las que se enfrenta la nosografía psiquiátrica y la proliferación de propuestas alternativas y revolucionarias-así el diagnóstico dimensional-, pueden comprenderse a través de un análisis kuhniano. PALABRAS CLAVE: Nosografía, diagnóstico, categoría, dimensión. SUMMARY: The deep anomalies which the current psychiatric nosography is facing and the proliferation of alternative and revolutionary proposals-including the dimensional diagnosis-, can be understood through a kuhnian analysis.
International Journal of Clinical and Health Psychology, 2015
As part of A Roadmap for Mental Health Research in Europe project, the aim of the present study w... more As part of A Roadmap for Mental Health Research in Europe project, the aim of the present study was to perform a systematic mapping of the main publications in peer-reviewed journals for well-being research within the area of mental health or mental disorders in Europe. The PubMed and PsycINFO databases were used to identify papers on well-being within the area of mental health and mental disorders published from January 2007 to September 2014. Mean 5-year impact factors were obtained. The number of publications for each country was analysed by population size and gross domestic product (GDP). A total of 4,423 unique publications were identified. The number of publications increased for the analysed time period. France and the Netherlands had the highest 5-year mean impact factor. Publications per capita were higher in the Nordic countries, Ireland and the Netherlands. After adjusting for GPD, the most productive countries were the Nordic countries and the Netherlands. There is a marked variation in well-being publications by country in Europe. Eastern European countries produce little research taking into consideration the levels of resources available. Research on older adults was underrepresented and should be prioritised.
BioMed Research International, 2014
Despite all the knowledge on depression, it is still unclear whether current literature covers al... more Despite all the knowledge on depression, it is still unclear whether current literature covers all the psychosocial difficulties (PSDs) important for depressed patients. The aim of the present study was to identify the gaps in the recent literature concerning PSDs and their related variables. Psychosocial difficulties were defined according to the World Health Organization International Classification of Functioning, Disability and Health (ICF). A comparative approach between a systematic literature review, a focus group, and individual interviews with depressed patients was used. Literature reported the main psychosocial difficulties almost fully, but not in the same degree of importance as patients’ reports. Furthermore, the covered areas were very general and related to symptomatology. Regarding the related variables, literature focused on clinical variables and treatments above all but did not report that many psychosocial difficulties influence other PSDs. This study identified...
Journal of Affective Disorders, 2012
Despite the great burden of depression on sufferers and society, there is a lack of reliable info... more Despite the great burden of depression on sufferers and society, there is a lack of reliable information regarding the full range of psychosocial difficulties associated with depression and their related variables. This systematic review aimed to demonstrate the utility of the International Classification of Functioning, Disability and Health (ICF) in describing the psychosocial difficulties that shape the lived experience of persons with depression. An electronic search that included publications from 2005 to 2010 in the MEDLINE and PsycHINFO databases was conducted to collect psychosocial outcomes. Quality of studies was also considered. 103 studies were included. 477 outcomes referring psychosocial difficulties were extracted and grouped into 32 ICF related categories. Emotional functions (19% of studies), followed by energy and drive (17% of studies), were the most frequent psychosocial outcomes. The onset, course, determinants, and related variables of the most important psychosocial difficulties, reported in at least 10% of studies, were described. Medication played a dual role as determinant of onset and change in some psychosocial areas, e.g. in pain, sleep, and energy and drive. The search was limited by year of publication and focused only on minor and major depression diagnoses: other depressive disorders were not included. Some underresearched, but relevant psychosocial areas could have not been analyzed. The present systematic review provides information on the psychosocial difficulties that depressive patients face in their daily lives. Future studies on depression should include outcome instruments that cover these relevant areas in order to comprehensively describe psychosocial functioning.
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Papers by BLANCA MELLOR MARSÁ