Deep-brain stimulation of the human nucleus accumbens-medial septum enhances memory formation.

Deep-brain stimulation (DBS) is a potential novel treatment for memory dysfunction. Current attempts to enhance memory focus on stimulating human hippocampus or entorhinal cortex. However, an alternative strategy is to stimulate brain areas providing modulatory inputs to medial temporal memory-related structures, such as the nucleus accumbens (NAc), which is implicated in enhancing episodic memory encoding.

The new profile of psychiatric disorders in patients with HIV infection.

Nowadays, HIV infection is largely considered as a chronic condition rather than a deadly disease, given that effective antiretroviral treatment allows almost complete and persistent suppression of viral replication and restoration of nearly normal CD4+ T-cell counts. Being HIV a "condition", we imply that other illnesses are more frequently seen in persons living with HIV (PLHIV), among which mental health disorders are particularly common. Despite very successful antiretroviral therapy, HIV infection may still cause a wide range of neurocognitive dysfunctions and accelerated brain ageing.

Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions.

Background: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally.

Methods: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported.

The black hole of the transition process: dropout of care before transition age in adolescents.

Recent evidence confirms the risks of discontinuity of care when young people make a transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS), although robust data are still sparse. We aimed to identify when and how patients get lost to care during transition by tracking care pathways and identifying factors which influence dropping out of care during transition. This is a retrospective observational study of 760 patients who reached the transition age boundary within 12 months before transition time and being treated at CAMHS for at least during preceding 18 months.

Nucleus Accumbens Stimulation Modulates Inhibitory Control by Right Prefrontal Cortex Activation in Obsessive-Compulsive Disorder.

Inhibitory control is considered a compromised cognitive function in obsessive-compulsive (OCD) patients and likely linked to corticostriatal circuitry disturbances. Here, 9 refractory OCD patients treated with deep brain stimulation (DBS) were evaluated to address the dynamic modulations of large-scale cortical network activity involved in inhibitory control after nucleus accumbens (NAc) stimulation and their relationship with cortical thickness. A comparison of DBS "On/Off" states showed that patients committed fewer errors and exhibited increased intraindividual reaction time variability, resulting in improved goal maintenance abilities and proactive inhibitory control.

Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established therapy?

A consensus has yet to emerge whether deep brain stimulation (DBS) for treatment-refractory obsessive-compulsive disorder (OCD) can be considered an established therapy. In 2014, the World Society for Stereotactic and Functional Neurosurgery (WSSFN) published consensus guidelines stating that a therapy becomes established when "at least two blinded randomized controlled clinical trials from two different groups of researchers are published, both reporting an acceptable risk-benefit ratio, at least comparable with other existing therapies. The clinical trials should be on the same brain area for the same psychiatric indication.

The relationships between sociodemographic, psychosocial and clinical variables with personal-stigma in patients diagnosed with schizophrenia.

Background: Studies suggest that people with a diagnosis of schizophrenia are one of the most stigmatized groups in society.

Aim: To comprehensively analyze personal stigma in patients diagnosed with schizophrenia.

Method: Data were obtained from 89 patients.

Staging of depressive disorders: Relevance of resistance to treatment and residual symptoms.

Background: Clinical staging model for depression helps to better define the clinical situation of patients. The objectives of this study are: to correlate the Hetrick's staging model of depression with the severity of depression, associated disability, and resistance to treatment in the established disease stages and to test the modification introduced by our group consisting in the introduction of a substage for recurrence from a previous episode that was stabilized with a complete remission.

Methods: A Cross-sectional study with 133 adult subjects having a current and primary diagnosis of Depressive disorder was developed.

Validation of the spanish version of the discrimination and stigma scale (DISC 12).

Aims: The "Discrimination and Stigma Scale" (DISC) was the first instrument specifically designed to evaluate reported experiences of discrimination by people with mental disorders. This study aims to validate DISC-12 version in Spanish population with Schizophrenia and, as specific objectives, to do the external validation with the Self-Stigma Questionnaire (SSQ) scale and Link PDD scale and to validate their internal consistency, temporal and inter-rater reliability.

Methods: 86 individuals with schizophrenia were interviewed at two time points (between one to two weeks) by two raters.

Personalized striatal targets for deep brain stimulation in obsessive-compulsive disorder.

Background: Psychiatric conditions currently treated with deep brain stimulation (DBS), such as obsessive-compulsive disorder (OCD), are heterogeneous diseases with different symptomatic dimensions, indicating that fixed neuroanatomical DBS targets for all OCD cases may not be efficacious.

Objective/hypothesis: We tested whether the optimal DBS target for OCD is fixed for all patients or whether it is individualized and related to each patient's symptomatic content. Further, we explored if the optimal target can be predicted by combining functional neuroimaging and structural connectivity.

[Ability to detect psychiatric disorders by the family physician].

Objective: To determine the ability of family physicians to detect psychiatric disorders, comparing the presence of psychiatric disorders detected using validated tests and referrals by family physicians.

Design: Cross-sectional, two-phase study.

Location: Primary healthcare centres in an urban area of Madrid.

Dynamic risk control by human nucleus accumbens.

Real-world decisions about reward often involve a complex counterbalance of risk and value. Although the nucleus accumbens has been implicated in the underlying neural substrate, its criticality to human behaviour remains an open question, best addressed with interventional methodology that probes the behavioural consequences of focal neural modulation. Combining a psychometric index of risky decision-making with transient electrical modulation of the nucleus accumbens, here we reveal profound, highly dynamic alteration of the relation between probability of reward and choice during therapeutic deep brain stimulation in four patients with treatment-resistant psychiatric disease.

A new time limited psychotherapy for BPD: preliminary results of a randomized and controlled trial.

Introduction: Psychic Representation focused Psychotherapy (PRFP) is a new time limited dynamic psychotherapy for the treatment of Borderline Personality Disorder. It is a psychodynamic technique based on brief psychoanalytic psychotherapy principles. It is manualized and designed to be applied in the framework of public health care services.

Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey.

Background: Depression is the third leading contributor to the worldwide burden of disease. We assessed the nature and severity of experienced and anticipated discrimination reported by adults with major depressive disorder worldwide. Moreover, we investigated whether experienced discrimination is related to clinical history, provision of health care, and disclosure of diagnosis and whether anticipated discrimination is associated with disclosure and previous experiences of discrimination.

Factors predicting drop-out in community mental health centres.

This study aimed to identify treatment, therapist and patient factors associated with dropping out of treatment in four outpatient mental health services. The experimental group comprised all 789 individuals who attended for the first time the mental health services during one year and dropped out of treatment in the same year or during the two following ones. The control group consisted of the same number of individuals, chosen at random from patients who, in the same year, attended for the first time the services and did not subsequently drop out of treatment.

Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys.

The DSM-IV diagnoses generated by the fully structured lay-administered Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) in the WHO World Mental Health (WMH) surveys were compared to diagnoses based on follow-up interviews with the clinician-administered non-patient edition of the Structured Clinical Interview for DSM-IV (SCID) in probability subsamples of the WMH surveys in France, Italy, Spain, and the US.

[Prevalence and physical-mental comorbidity of chronic back and neck pain in Spain: results from the ESEMeD Study].

Background And Objective: Chronic back pain (CBP) and chronic neck pain (CNP) are highly prevalent among the adult population. However, less is known about its comorbidity with other diseases and its impact on global functioning. The objectives of following study, that is part of the ESEMeD-Spain study, are to estimate CBP-CNP prevalence among Spanish population, its comorbidity with other physical and mental conditions, and its impact on global functioning.

Psychiatry in Spain.

Spain covers an area of some 506 000 km and has a population of just over 41 million. It is a high-income country (according to World Bank criteria) and devotes 7.5% of its gross domestic product to health.

[Gender and mental health in a changing world].

It is well established that human psychological development, violence and sexual abuse, the experience of reproduction and parenting, as well as psychopathology and psychiatric morbidity are different for men and women, both in quality and quantity. In this chapter some of these differences, including disability and the use of services in the Spanish population are described and analysed. Whether there is a need for a new discipline to study psychiatric illness and psychiatric treatment from the point of view of gender is discussed.