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BACKGROUND: An early and prolonged lockdown was adopted in Argentina during the first wave of COVID-19. Early reports evidenced elevated psychological symptoms. AIMS: To explore if the prolonged lockdown was associated with elevated anxiety and depressive symptoms; if mental fatigue was associated with lockdown adherence (a phenomenon called 'behavioural fatigue'); and if financial concerns were associated with lockdown adherence and emotional symptoms. METHOD: The survey included standardised questionnaires to assess depressive (PHQ-9) and anxious (GAD-7) symptoms, mental fatigue, risk perception, lockdown adherence, financial concerns, daily stress, loneliness, intolerance to uncertainty, negative repetitive thinking and cognitive problems. LASSO regression analyses were carried out to predict depression, anxiety and lockdown adherence. RESULTS: The survey reached 3617 adults (85.2% female) from all provinces of Argentina after 72 days of lockdown. Data were collected between 21 May 2020 and 4 June 2020. In that period, Argentina had an Oxford stringency index of 85/100. Of those surveyed, 45.6% and 27% met the cut-offs for depression and anxiety, respectively. Mental fatigue, cognitive failures and financial concerns were correlated with psychological symptoms, but not with adherence to lockdown. In regression models, mental fatigue, cognitive failures and loneliness were the most important variables to predict depression, intolerance to uncertainty and lockdown difficulty were the most important for anxiety, and perceived threat was the most important for predicting lockdown adherence. CONCLUSIONS: During the extended lockdown, psychological symptoms increased, being enhanced by mental fatigue, cognitive difficulties and financial concerns. We found no evidence of behavioural fatigue. Thus, feeling mentally fatigued is not the same as being behaviourally fatigued.
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INTRODUCTION: Identifying affective temperaments could be useful both for understanding the normal behavioral variations in the general population and to establish if there is a clinical predisposition to certain disorders. Five affective temperaments have been proposed: depressive, cyclothymic, hyperthymic, irritable and anxious. Original instrument for measuring them (TEMPS-A) is a 110-item scale but many short versions in different languages have been validated. The aim of this study was to obtain a short self-administered Spanish version of TEMPS-A with good psychometric properties. MATERIALS AND METHODS: A sample of 550 students who answered the argentinean version of TEMPS-A was included, after psychometric analysis a comparison between inpatients with major depression and their matched controls by sex and age who answered the brief version was performed to get an external validation. RESULTS: The sample was composed by 298 (54.2%) women. The mean age was 23.3 year (SD=6.2). A forced five factor analysis was performed. The 7 items with the highest factorial load (more than 0.350) for each subscale were included in the brief version. The Cronbach alpha's ranged from 0.690 to .800. The most prevalent temperament was hyperthymic followed by cyclothymic for students sample. Similarities between students and controls sample were observed, but not with patients with major depression. CONCLUSIONS: This brief Spanish version of TEMPS-A (35 items) has good psychometric properties and can be used in general and clinical population.
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Ketogenic diet (KD) is comprised of a distinct macronutrient combination: i.e. 90% fat, 8% of protein and 2% of carbohydrates, typically characterized as a high-fat low-carbohydrate diet. KD's efficacy was largely established for treatment resistant epilepsy in children, but its mental, emotional and behavioral effects remain largely unknown. Nevertheless, the efficacious effects of KD in childhood epilepsy provide rationale for repurposing this approach for other brain-based disorders. Consequently, clinicians and researchers should be aware of the evidence regarding efficacy, as well as the benefits and risks of adopting this diet. Results from animals and humans studies provide equivocal evidence across multiple domains of psychopathology. Conceptually, KD shows promise to serve as an efficacious treatment for mental disorders.
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Conducta , Dieta Cetogénica , Emociones , Trastornos Mentales/dietoterapia , Trastornos Mentales/psicología , Química Encefálica , Dieta Cetogénica/efectos adversos , Humanos , Resultado del TratamientoRESUMEN
From the ancient Greeks (V to III centuries BC), through Hippocrates to the Roman physician Aulo Cornelius Celso (I century), the term paranoia has been used as a manifestation of mental illness. After many centuries, Robert Burton in 1621 introduces the concept with a more modern meaning. Only with Heinroth (1818) the syndrome enters into the psychiatric nosology as a disorder of thought with unaltered perceptions. French and German psychiatry agree on the concept of paranoia as a partial psychosis with a maintained level of functioning and absence of deterioration. With this meaning the term is introduced in the modern psychiatry in Kahlbaum's work (1863). Jasper contributes with the introduction of paranoid development that can be influenced by the environment or previous experiences (1910). But to Kraepelin (1921) is owed the most precise description in a specifc essay based on his clinical experience. The German psychiatrist speaks of both a psychogenic and a more biological component. In modern psychiatric classifcations gradually the syndrome has disappeared and encompassed in the generic delusional disorder, clearly distinct from schizophrenia, and only if the delusions are understandable. The consequences of the absence of a diagnostic recognition implies that there is no specific research on this syndrome with difficulties in developing psychotherapeutic and pharmacological treatments.
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Psiquiatría , Trastornos Psicóticos , Deluciones , Historia del Siglo XVII , Historia del Siglo XIX , Historia del Siglo XX , Historia Antigua , Historia Medieval , Humanos , Trastornos Paranoides , Psiquiatría/historia , Trastornos Psicóticos/historia , Esquizofrenia ParanoideRESUMEN
Affective temperament has been suggested as a potential mediator of the effect between genetic predisposition and neurocognitive functioning. As such, this report seeks to assess the extent of the correlation between affective temperament and cognitive function in a group of bipolar II subjects. 46 bipolar II outpatients [mean age 41.4 years (SD 18.2); female 58.9%] and 46 healthy controls [mean age 35.1 years (SD 18); female 56.5%] were evaluated with regard to their demographic and clinical characteristics, affective temperament, and neurocognitive performance. Crude bivariate correlation analyses and multiple linear regression models were constructed between five affective temperament subscales and eight neurocognitive domains. Significant correlations were identified in bipolar patients between hyperthymic temperament and verbal memory and premorbid IQ; cyclothymic temperament and attention; and irritable temperament, attention, and verbal fluency. In adjusting for potential confounders of the relationship between temperament and cognitive function, the strongest mediating factors among the euthymic bipolar patients were found to be residual manic and depressive symptoms. It is therefore concluded that affective temperaments may partially influence the neurocognitive performance of both healthy controls and euthymic patients with bipolar disorder type II in several specific domains.
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Síntomas Afectivos/psicología , Trastorno Bipolar/psicología , Cognición , Trastorno Ciclotímico/psicología , Temperamento , Adulto , Anciano , Atención , Estudios de Casos y Controles , Femenino , Predisposición Genética a la Enfermedad , Humanos , Genio Irritable , Modelos Lineales , Masculino , Persona de Mediana EdadRESUMEN
In recent years, investigators have begun to consider the possibility of explaining the physiopathology of bipolar disorder from a neuroprogressive perspective. The evidence that supports the feasibility of such an approach is varied, and arises from neuroimaging studies, batteries of neurocognitive evaluations, and tests to identify the specific biomarkers of the disorder. The present article seeks to perform a review of the research that investigates the cognitive deficits in bipolar disorder. A bibliographic revision was performed of articles published between 1990 and 2015. Levels of cognitive performance were explored in both cross-sectional and longitudinal studies. The compiled studies signal the presence of altered cognitive function, even during periods of euthymia. However, there are contradictory results as to whether bipolar disorder presents a degenerative course. New lines of investigation suggest that only a percentage of individuals with bipolar disorder are affected in a progressive manner. It is of paramount importance to perform new longitudinal studies in high-risk populations, so as to validate or refute a neuroprogressive model of cognitive deficits in patients with bipolar disorder.
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Trastorno Bipolar/complicaciones , Trastorno Bipolar/psicología , Trastornos del Conocimiento/etiología , Cognición , Progresión de la Enfermedad , HumanosRESUMEN
BACKGROUND: Bipolar disorder presents with diverse clinical manifestations. Numerous investigators have sought to identify variables that may predict a more severe illness course. METHODS: With the objective of studying the clinical characteristics of bipolar patients between South and North America, a comparison was performed between a sample from Argentina (n = 449) and a sample from the United States (n = 503) with respect to demographics and clinical characteristics, including presence of comorbidities. RESULTS: The Argentinian sample had more unfavorable demographics and higher rates of prior psychiatric hospitalization and prior suicide attempt but a better social outcome. However, the sample from the United States had a higher rate of prior year rapid cycling, as well as younger bipolar disorder onset age (mean ± SD, 17.9 ± 8.4 vs. 27.1 ± 11.4 years) and more severe clinical morbidity, though there was no significant difference in terms of the total duration of the illness. Argentinian compared to American patients were taking more mood stabilizers and benzodiazepines/hypnotics, but fewer antipsychotics and other psychotropic medications, when considering patients in aggregate as well as when stratifying by illness subtype (bipolar I versus bipolar II) and by illness onset age (≤21 vs. >21 years). However, there was no significant difference in rate of antidepressant prescription between the two samples considered in aggregate. CONCLUSIONS: Although possessing similar illness durations, these samples presented significant clinical differences and distinctive prescription patterns. Thus, though the Argentinian compared to North American patients had more unfavorable demographics, they presented a better social outcome and, in several substantive ways, more favorable illness characteristics. In both samples, early onset (age ≤ 21 years) was a marker for poor prognosis throughout the illness course, although this phenomenon appeared more robust in North America.
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Clinical psychiatric evaluations of patients have changed dramatically in recent decades. Both initial assessments and follow-up visits have become brief and superficial, focused on searching for categorical diagnostic criteria from checklists, with limited inquiry into patient-reported symptomatic status and tolerability of treatments. The virtually exclusive therapeutic task has become selecting a plausible psychotropic, usually based on expert consensus guidelines. These guidelines and practice patterns rest mainly on published monotherapy trials that may or may not be applicable to particular patients but are having a profound impact, not only on modern psychiatric practice but also on psychiatric education, research, and theory.
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Psiquiatría/tendencias , Psicofarmacología/tendencias , Garantía de la Calidad de Atención de Salud/tendencias , Canadá , Lista de Verificación/tendencias , Competencia Clínica , Predicción , Adhesión a Directriz/tendencias , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/tratamiento farmacológico , Trastornos Mentales/psicología , Pautas de la Práctica en Medicina/tendencias , Psicotrópicos/efectos adversos , Psicotrópicos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto/tendencias , Resultado del TratamientoRESUMEN
BACKGROUND: Anxiety commonly co-occurs with bipolar disorders (BDs), but the significance of such "co-morbidity" remains to be clarified and its optimal treatment adequately defined. METHODS: We reviewed epidemiological, clinical, and treatment studies of the co-occurrence of BD and anxiety disorder through electronic searching of Pubmed/MEDLINE and EMBASE databases. RESULTS: Nearly half of BD patients meet diagnostic criteria for an anxiety disorder at some time, and anxiety is associated with poor treatment responses, substance abuse, and disability. Reported rates of specific anxiety disorders with BD rank: panic ≥ phobias ≥ generalized anxiety ≥ posttraumatic stress ≥ obsessive-compulsive disorders. Their prevalence appears to be greater among women than men, but similar in types I and II BD. Anxiety may be more likely in depressive phases of BD, but relationships of anxiety phenomena to particular phases of BD, and their temporal distributions require clarification. Adequate treatment trials for anxiety syndromes in BD patients remain rare, and the impact on anxiety of treatments aimed at mood stabilization is not clear. Benzodiazepines are sometimes given empirically; antidepressants are employed cautiously to limit risks of mood switching and emotional destabilization; lamotrigine, valproate, and second-generation antipsychotics may be useful and relatively safe. CONCLUSIONS: Anxiety symptoms and syndromes co-occur commonly in patients with BD, but "co-morbid" phenomena may be part of the BD phenotype rather than separate illnesses.
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Trastornos de Ansiedad/epidemiología , Trastorno Bipolar/epidemiología , Comorbilidad , Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/tratamiento farmacológico , Trastorno Bipolar/clasificación , Trastorno Bipolar/tratamiento farmacológico , HumanosRESUMEN
Evidence concerning efficacy of antidepressants in bipolar disorder remains inconsistent and inconclusive. As the appropriate clinical use for such patients remains unclear, we characterized outpatients with bipolar disorders who were or were not treated with antidepressants. Clinical data were collected systematically from consecutive outpatients in 11 participating Argentine mood-disorder clinics in 2007-2008. Diagnoses met DSM-IV criteria, supported by structured interviews based on the MINI-500. Of 338 outpatients diagnosed with bipolar I (45.0%), II (29.3%), or not-otherwise-specified (NOS) (25.7%) disorder, 128 (37.9%) received antidepressants. Subjects given antidepressants or not did not differ significantly by presence or severity of current depression or being suicidal but were more likely to be women. Bipolar I disorder patients were three times less likely than types II or NOS to receive an antidepressant, with or without a mood-stabilizer or antimanic agent. Despite inconclusive evidence for efficacy and safety of antidepressants in various phases of bipolar disorders, 37.9% of such patients were receiving an antidepressant in 11 Argentine outpatient clinics. Antidepressant treatment was least likely with type I disorder and was independent of current depression and not associated with more use of mood-stabilizing or antimanic agents.
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Antidepresivos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Antidepresivos/efectos adversos , Antimaníacos/uso terapéutico , Argentina , Trastorno Bipolar/fisiopatología , Estudios Transversales , Depresión/tratamiento farmacológico , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Índice de Severidad de la Enfermedad , Factores SexualesRESUMEN
INTRODUCTION: Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. METHODS: A review of the literature was conducted in Medline/PubMed for articles published during 2000-2010 that respond to the combination of "bipolar disorder" with the following key words: "psychosocial intervention", "psychoeducational intervention" and "psychotherapy". RESULTS: Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients' functionality. CONCLUSIONS: Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patient's specific characteristics.
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Trastorno Bipolar/terapia , Psicoterapia , Terapia Cognitivo-Conductual , Humanos , Psicoterapia/métodosRESUMEN
AIMS: To describe the frequency of depressive symptoms compatible with a postpartum depression diagnosis, the associated factors and the temporal stability. METHODS: During 2006-2007 398 hospitalized puerperal women who attended CEMIC were interviewed 5 days after childbirth using the Edinburgh Postnatal Depression Scale and a socio-demographic questionnaire. A logistic regression analysis was performed to identify associated factors with a positive screening. During the following 6-12 months a follow up was carried with two groups of similar characteristics. RESULTS: The frequency of depressive symptoms at post partum was 17.8% (cut off = 10). Depressive history and neonatal intensive care were significantly related to a positive screening. From the 110 interviewed women, 24 were positive in the follow-up. CONCLUSION: The prevalence of risk for postpartum depression in the sample of patients surveyed is within the parameters reported in international literature. At the 6 month follow up, 6 previously asymptomatic women during the first screening turned on positive. It is theorize the existence of potential postpartum depression cases that can manifest up to a year after childbirth.
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Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Prevalencia , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: The aim of this study was to investigate the characteristics of affective temperaments in general non-clinical population in different countries METHOD: We performed a detailed search of published studies (one unpublished) investigating affective temperaments in non-clinical populations by administering the Temperament Evaluation of Memphis, Paris and San Diego Auto-questionnaire (TEMPS-A) in its 110-items version. We have included a total of six studies published from different countries (Argentina, Germany, Hungary, Korea, Lebanon, and Portugal) and one unpublished with preliminary data from Spain. We analyzed the combined data from the collected studies. RESULTS: We found significant gender differences, with men scoring higher in irritable and hyperthymic, and women in anxious, depressive and cyclothymic temperaments. Age had a significant effect in women with depressive temperament. Correlations among temperament scores have shown positive associations between depressive and anxious, and cyclothymic and irritable. CONCLUSIONS: There was a similarity in gender differences and the association between different affective temperaments. Our results indicate that affective temperaments show both universal and distinctive characteristics. LIMITATION: The sample populations in different countries were not homogeneous for age and socio-economic composition. In the Korean study of Kang et al. the version of the TEMPS was not validated.
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Afecto , Determinación de la Personalidad/estadística & datos numéricos , Personalidad , Adolescente , Adulto , Argentina , Europa (Continente) , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , República de Corea , Factores Sexuales , Temperamento , Adulto JovenRESUMEN
BACKGROUND: Since the current epidemiology of depression is not well documented in Latin America, we conducted a community-based survey study in Argentina. METHODS: The Beck Depression Inventory (BDI) and a general health questionnaire were completed by 1335 adult participants, representing most of the neighborhoods of Buenos Aires. RESULTS: Prevalence of high total BDI scores (≥13) indicating probable current clinically significant depression was 20.0% (women: 20.6%; men: 19.6%). Probable depression was associated with being unmarried and older, less educated, reporting recent stressors and significant medical illness. LIMITATIONS: Sampling was cross-sectional and by convenience; probable depression was not verified by clinical assessment. CONCLUSIONS: Within methodological limits, probable current clinically significant depression was highly prevalent in an urban community sample in Argentina, at rates and with risk factors similar to those found in other world regions.
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Depresión/epidemiología , Adulto , Argentina/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Características de la Residencia , Población UrbanaRESUMEN
Bipolar Disorder (BD) is a severe and recurrent medical illness with relevant impact on quality of life and functioning for patients. However, we still have significant deficits on its detection. One of the ways to improve the accurate recognition of the disease consists on the administration of screening tools such as the Mood Disorder Questionnaire (MDQ). The main aim of this investigation was to validate the Argentine version of the MDQ and determine the optimal cut off for outpatients who suffer from mood disorders in our country. The total sample consisted of 354 adult outpatients with diagnosis of BD type I, II and NOS, and Unipolar - Major Mood Disorders (MDD), enrolled between 2007 and 2008, from 11 sites of Argentina. The MDQ positively detected 53.6% of BD patients and 96.6% of MDD patients. The best cut off for our sample was established in 5 points for item 1 of the MDQ. By deleting the item 3 of the questionnaire, the performance was significantly improved. In conclusion, the Argentine version of the MDQ has demonstrated the same ability for detecting patients with BD of the English original version on a psychiatric population.
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Calidad de Vida , Sensibilidad y Especificidad , Trastorno Bipolar/diagnóstico , Humanos , Trastornos del Humor/diagnóstico , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To assess the sensitivity and specificity of two self-report instruments for detection of bipolarity in a sample of Argentinean patients. METHOD: Spanish versions of the MDQ and the BSDS were administered over four months at 11 sites in Argentina. Diagnoses were made using DSM-IV criteria and the MINI. The study sample consisted of patients diagnosed with Bipolar Disorder (BD) Types I, II, or NOS. BDNOS diagnoses were made using extended guidelines for bipolar spectrum symptoms. Unipolar patients were used as a control group. Of 493 patients screened, 354 completed evaluation by MDQ and MINI, and 363 by BSDS and MINI. RESULTS: Specificity of MDQ was 0.97 and BSDS was 0.81. MDQ sensitivity was 0.70 for bipolar type I (BD-I), 0.52 for bipolar II (BD-II) and 0.31 for bipolar not otherwise specified (BDNOS). BSDS sensitivities were 0.75, 0.70 and 0.51 respectively. LIMITATIONS: This study was performed in specialized outpatient settings and thus its results are not necessarily representative for other clinical settings. There was not a systematic evaluation of comorbid psychiatric disease or test-retest reliability. CONCLUSION: The local versions of the MDQ and the BSDS showed a sensitivity and specificity comparable to previous research. Our results indicate that in this sample, MDQ was more specific for BD and BSDS was more sensitive to detect BD-II and NOS. Since BD-I is more readily recognized than bipolar spectrum disorders, enhanced sensitivity of BSDS for soft bipolarity may be an advantage.
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Trastorno Bipolar/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Argentina , Trastorno Bipolar/etnología , Trastorno Bipolar/psicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor , Pacientes Ambulatorios , Psicometría/instrumentación , Sensibilidad y Especificidad , Pesos y MedidasRESUMEN
Recent data show that biomarkers differ in early and late-stage bipolar disorder (BD). Here we propose a model of staging for bipolar disorder that emphasizes the potential use of biomarkers for differentiating early and late-stage BD patients in the inter-episodic period. The proposed model includes a Latent phase: patients at "ultra-high-risk" for developing BD, characterized by a family history of BD, temperament traits, mood, and anxiety symptoms as well as genetic vulnerability for developing the disorder; Stage I: patients who return to their baseline level of functioning when mood episodes resolve; Stage II: biomarkers and functioning impairment are related to comorbidities or rapid-cycling presentations; Stage III: persistent cognitive and functioning impairment in the inter-episode period as well as changes in biomarkers; and Stage IV: same findings as in Stage III associated with extreme cognitive and functioning impairment, to the point that patients are unable to live autonomously. Empirical testing will determine the ability of the present model to inform patients and clinicians about both prognosis and response to treatment.
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Biomarcadores , Trastorno Bipolar/complicaciones , Trastorno Bipolar/diagnóstico , Trastornos del Conocimiento/etiología , Modelos Biológicos , Afecto/fisiología , Ansiedad/etiología , Biomarcadores/metabolismo , Trastorno Bipolar/psicología , Citocinas/metabolismo , Progresión de la Enfermedad , Humanos , Factores de Crecimiento Nervioso/metabolismo , Factores de Riesgo , Temperamento/fisiologíaRESUMEN
BACKGROUND: The purpose of this study is to examine the prevalence of affective temperaments between clinically unaffected relatives of bipolar patients and secondarily to investigate the impact of these "subaffective" forms on their quality of life (QoL). METHODS: The study was performed in seven sites across Argentina. We administered the scales TEMPS-A and Quality of Life Index to a sample of 114 non-ill first degree relatives of bipolar disorder patients ("cases") and 115 comparison subjects without family history of affective illness ("controls"). We used The Mood Disorder Questionnaire to rule out clinical bipolarity. RESULTS: Mean scores on all TEMPS-A subscales were significantly higher in cases, except for hyperthymia. The prevalence of affective temperaments, according to Argentinean cut-off points, was also higher, with statistical significance for cyclothymic and anxious temperaments. Regarding QoL, we found no significant differences between both groups, except for interpersonal functioning, which was better in controls. A detailed subanalysis showed significant effects of QoL domains for all temperaments, except for the hyperthymic. LIMITATIONS: We used self-report measures. A larger sample size would have provided us greater statistical power for certain analyses. CONCLUSIONS: Our findings support the concept of a spectrum of subthreshold affective traits or temperaments - especially for the cyclothymic and anxious - in bipolar pedigrees. We further demonstrated that, except for the hyperthymic, quality of life was affected by these temperaments in "clinically well" relatives. Overall, our data are compatible with the "endophenotype" and "subaffective" theses for affective temperaments.
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Trastorno Bipolar/genética , Trastornos del Humor/genética , Fenotipo , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Temperamento , Adulto , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/genética , Trastornos de Ansiedad/psicología , Argentina , Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Estudios de Casos y Controles , Estudios Transversales , Trastorno Ciclotímico/diagnóstico , Trastorno Ciclotímico/epidemiología , Trastorno Ciclotímico/genética , Trastorno Distímico/epidemiología , Trastorno Distímico/genética , Trastorno Distímico/psicología , Femenino , Humanos , Relaciones Interpersonales , Genio Irritable , Masculino , Persona de Mediana Edad , Trastornos del Humor/epidemiología , Trastornos del Humor/psicología , Calidad de Vida/psicología , Encuestas y CuestionariosRESUMEN
BACKGROUND: The TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego) is a 110-item questionnaire in five scales which has been translated into over 25 language versions: American, Italian (only for Interview version or TEMPS-I), French, Lebanese, Hungarian, Japanese and Turkish versions have already been validated. There are two Spanish versions, one from Barcelona, and the present one from Buenos Aires. This study represents the first attempt at validating the TEMPS-A in Spanish. METHODS: 932 clinically well subjects were studied, of both sexes (62% female) with mean+/-SD age of 35.4+/-18.1. Standard psychometric tests of reliability and validation were performed. RESULTS: Chronbach alphas were 0.7 (depressive) and 0.8 (anxious, cyclothymic, irritable and hyperthymic). In exploratory factor analyses, the hyperthymic was distinct from the others. As expected, the depressive and anxious correlated strongly, so did the cyclothymic and anxious. Dominant temperaments ranged from 2.1% to 4.5% of the population under study, except for the hyperthymic which had a negligible rate of 0.2% (but accounted for 13% between +1 SD and +2 SD). LIMITATION: We did not examine test-to-test reliability. CONCLUSIONS: This is the first validation of the TEMPS-A in Spanish, the Buenos Aires version with the original 110 items, with very good psychometric properties.
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Lenguaje , Trastornos del Humor/diagnóstico , Trastornos del Humor/psicología , Encuestas y Cuestionarios , Temperamento , Adulto , Argentina , Femenino , Humanos , Masculino , Trastornos del Humor/etnología , Vigilancia de la Población/métodos , Psicometría , Reproducibilidad de los ResultadosRESUMEN
It was commonly believed that no more than 1% of the general population has bipolar disorder. New data are beginning to provide confirming evidence for a higher prevalence of up to at least 5%. Several overlapping subtypes of bipolar disorder with hypomanic (rather than manic) features have been described, and more complex evolutive forms of the illness have also received greater clinical attention. The recognition of the entire clinical spectrum of bipolar disorders is of major public health concern because, despite the increasing availability of new treatments, under diagnosis or long delay in diagnosis, and gross under treatment continue to plague our field. Lesser manifestations and subaffective forms usually precede the overt manifestations of the illness in the offspring and biological kin of adult bipolars. In the last decades, a great body of data justifies considerable widening beyond the conservative positions of current nosological classifications, such as DSM IV and ICD10.