Enric Aragonès

Institut Universitari d'investigació en Atenció Primària "Jordi Gol" | IDIAP Jordi Gol · USR Tarragona-Reus. Atenció Primària Camp de Tarragona

FUNDAMENTOS // Existe bibliografía que apoya un retraso diagnóstico y terapéutico en mujeres con alto riesgo cardiovascular. El objetivo de este trabajo fue conocer la incidencia de la enfermedad cardiovascular (ECV) y la mortalidad en una cohorte con Síndro-me Metabólico (SM), así como analizar posibles diferencias de género y lugar de residencia,...

Background: The Covid-19 pandemic has increased stress levels in GPs, who have resorted to different coping strategies to deal with this crisis. Gender differences in coping styles may be contributing factors in the development of psychological distress. Objectives: To identify differences by gender and by stress level in coping strategies of GP...

Background: Chronic pain and depression are frequent comorbidities in primary care. Depression and other clinical, psychological and social factors influence the clinical course of chronic pain. Objective: To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculosk...

The dearth of child and adolescent mental health services (CAMHS) is a global problem. Integrating CAMHS in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues around the world. Our findings include various models of integrated care namely: the stepped care model in Australia; shared care in the Unit...

Aims: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. Methods: 8996 healthc...

Background Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care progra...

Background The COVID-19 pandemic has had a major impact on the mental health of healthcare workers. However, studies in primary care workers are scarce. Aim To investigate the prevalence and associated factors of psychological distress in primary care workers during the first COVID-19 outbreak. Design and setting A multicentre, cross-sectional, web...

Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW par...

Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care progr...

Objective To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared...

Background Healthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID‐19 outbreak (March–July 2020). Methods Data come from the baseline assessment of a cohort of Spanish hospital workers (n =...

To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effe...

Introduction Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. Methods All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surv...

Introduction Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. Methods All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surv...

Introduction Healthcare workers are vulnerable to adverse mental health impacts of COVID-19. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. Methods All workers in 18 healthcare institutions (6 AACC) in Spain were invited to a series of online surveys...

Introducción: En el marco de una estrategia para implementar un nuevo programa clínico para la depresión en atención primaria, desarrollamos un curso onlinecon clases videograbadas dirigido a los médicos y enfermeras que van a introducir el programa en su práctica clínica. Sujetos y métodos: La evaluación del curso se realizó mediante un cuestiona...

Background We designed a collaborative care program for the integrated management of chronic musculoskeletal pain and depression, which frequently coexist in primary care patients. The aim of this study was to evaluate the cost-effectiveness of this program compared with care as usual. Methods We performed a cost-effectiveness analysis alongside a...

● El diagnóstico de la depresión se basa en la cuidadosa evaluación de los síntomas que presenta el paciente. ● La efectividad de un antidepresivo en un paciente concreto es difícil de predecir a priori porque la variabilidad interpersonal es muy alta. ● La determinación de serotonina en sangre periférica no tiene ningún fundamento científico ni ut...

Objective: The aims of this study were twofold: 1) to better understand the associations between pain-related cognitions and pain severity, and psychological and physical function, and 2) to determine the extent to which these cognitions function as mediators in the association between pain severity and depression in a sample of primary care adult...

Introducción: En el marco de una estrategia para implementar un nuevo programa clínico para la depresión en atención primaria, desarrollamos un curso online con clases videograbadas dirigido a los médicos y enfermeras que van a introducir el programa en su práctica clínica. Sujetos y métodos: La evaluación del curso se realizó mediante un cuestion...

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Un estudio cualitativo en el que identificamos las necesidades y dificultades para la implementación de un programa de collaborative care para la depresión

Tribuna de opinión en El Economista - Sanidad

Background: Depression and chronic musculoskeletal pain commonly occur as comorbid conditions, which increases their negative effects on health outcomes. The objective of this study was to assess the effectiveness of the DROP (DepRessiOn and Pain) programme designed for the management of major depression and chronic musculoskeletal pain in primary...

OBJECTIVE: To examine how catastrophic thinking and other beliefs about pain determine the presence of severe pain and severe functional repercussion in patients with chronic musculoskeletal pain and depression. MATERIAL AND METHODS: Baseline data analysis of a sample recruited for a clinical trial that will assess a program for the integrated man...

Background: In order to clarify the relation between deprivation and morbillity and mortality, in function of different residence places, we design this study. Main objective is to analyze the influence of place of residence on the incidence of cardiovascular events (CVD) and general mortality from any cause, in a cohort with metabolic syndrome....

Objectives To determine the role of anxiety and depression on the incidence of cardiovascular events (CVE) in a Catalonian population with metabolic syndrome (MetS) over a five-year follow-up according to the number/type of MetS criteria. Methods Prospective study to determine the incidence of CVE according to the presence of anxiety and depressio...

El texto y el contenido de este documento están orientados fundamentalmente a mejorar nuestra comunicación con personas afectas de una enfermedad crónica como la diabetes y, por ende, con las connotaciones y los condicionantes que este hecho supone para la relación terapéutica que pretendemos establecer. Los autores desean que los contenidos y méto...

Background: Primary care is the principal clinical setting for the management of depression. However, significant shortcomings have been detected in its diagnosis and clinical management, as well as in patient outcomes. We developed the INDI collaborative care model to improve the management of depression in primary care. This intervention has bee...

Impact of stress on the metabolic syndrome. Five-year follow-up of the StreX Project. Objectives: To determine the role of anxiety and depression on the incidence of cardiovascular events in people with metabolic syndrome in a five-year follow-up in Catalonia and evaluate the association of the incidence of cardiovascular events with the number and...

Resumen A pesar de su relevancia clínica y de su importancia como problema de salud pública existen importantes deficiencias en el abordaje de la depresión. Las guías clínicas basadas en la evidencia son útiles para mejorar los procesos y los resultados clínicos, y para facilitar su implementación se ha ensayado su transformación en sistemas inform...

No es infrecuente la situación en que por problemas de eficacia o tolerabilidad un antidepresivo deba ser sustituido por otro. En este artículo exponemos estrategias para realizar esta sustitución con seguridad para el paciente. Optar por una de ellas ante un paciente concreto implica valorar la situación clínica, el motivo de la sustitución y las...

Background Chronic musculoskeletal pain and depression are very common in primary care patients. Furthermore, they often appear as comorbid conditions, resulting in additive effect on adverse health outcomes. On the basis of previous studies, we hypothesise that depression and chronic musculoskeletal pain may benefit from an integrated management p...

INTRODUCTION: Suicidal ideation is common in depressed patients and this issue must be properly handling in the primary care settings. Our group has developed and tested a structured model for improving the management of depression in primary care (the INDI Program), which is effective to improve the severity of depressive symptoms and quality of l...

Puntos clave • La atención primaria es el ámbito donde se manejan principalmente los trastornos mentales más comunes en la población, entre ellos los trastornos somatomorfos. • La somatización es la expresión del malestar psicológico a través de síntomas físicos. • La somatización es extraordinariamente frecuente en atención primaria. • El impacto...

● La atención primaria es el ámbito donde se manejan principalmente los trastornos mentales más comunes en la población, entre ellos los trastornos somatomorfos. ● La somatización es la expresión del malestar psicológico a través de síntomas físicos. ● La somatización es extraordinariamente frecuente en atención primaria. ● El impacto de la somatiz...

Los trastornos de la personalidad son importantes para el médico de familia, tanto por su frecuencia como por su relevancia clínica. Además de su sintomatología propia, los trastornos de personalidad condicionan el funcionamiento del individuo respecto a su propia salud, el uso de servicios sanitarios y la relación entre el médico y el paciente. A...

To describe nurse attitudes toward depression, using a standardized questionnaire and to evaluate how a training workshop can modify or influence these attitudes. A prospective study based on the application of the Depression Attitude Questionnaire, before and six months after, participating in a training day on the nursing role in the management o...

Borderline Personality Disorder (BPD) has been associated with an intensive use of health resources and a high economic burden. The aim of this study is to analyze the use of mental healthcare resources by BPD patients, to identify the information gaps on BPD at the regional health databases and to describe specific indicators and patterns of care...

Introduction The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006. Methods This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative ‘top...

OBJECTIVE To estimate the proportion of positive results in the screening of bipolar disorder (BD) among primary care patients presenting with psychological symptoms, and to analyze their characteristics. DESIGN Multicenter cross-sectional study. SETTINGS Nineteen Primary Care clinics in different Spanish regions. PATIENTS A total of 360 consecu...

Objetivo: Estimar la proporción de resultados positivos en el cribado del trastorno bipolar (TB) entre los pacientes de atención primaria que consultan por problemas de naturaleza psicológica, y analizar sus características. Diseño: Estudio descriptivo transversal multicéntrico. Emplazamiento: Diecinueve consultas de atención primaria en diferentes...

Un breu vídeo on s'exposen les característiques principals del model INDI per al maneig de la depressió en atenció primària així com dades sobre la seva eficàcia clínica

Un breve vídeo donde se exponen las características principales del modelo INDI para el manejo de la depresión en atención primaria así como datos sobre su eficacia clínica

Because the media influences society's perceptions of reality, the treatment of mental illness in the news can have an effect on the societal stigma related to it. This study aimed to analyze the content and form of news items related to mental illness in Spanish newspapers in order to understand their role in propagating or attenuating stereotypes...

Benzodiazepines are extensively used in primary care, but their long-term use is associated with adverse health outcomes and dependence. To analyse the efficacy of two structured interventions in primary care to enable patients to discontinue long-term benzodiazepine use. A multicentre three-arm cluster randomised controlled trial was conducted, wi...

● La fobia es un miedo desproporcionado e irracional a un estímulo concreto y delimitado (objeto, actividad o situación). ● Ante el estímulo fóbico aparecen de forma automática, inmediata e incontrolable síntomas psicológicos y vegetativos de ansiedad. ● En el trastorno fóbico emergen conductas contrafóbicas, destinadas a que se evite el objeto de...

AIMS. To estimate the proportion of adult patients in primary care with a positive screening test for attention deficit hyper-activity disorder (ADHD) and to analyse their characteristics. PATIENTS AND METHODS. A cross-sectional descriptive study was performed in nine primary care clinics in the province of Tarragona. The sample consisted of 432 co...

Aims. To estimate the proportion of adult patients in primary care with a positive screening test for attention deficit hyperactivity disorder (ADHD) and to analyse their characteristics. Patients and methods. A cross-sectional descriptive study was performed in nine primary care clinics in the province of Tarragona. The sample consisted of 432 co...

Objective: Borderline personality disorder (BPD) is a common personality disorder, with a population prevalence of 1.4-5.9%, although the epidemiology of this disorder in primary care is insufficiently known. Our objective was to determine the registered prevalence of BPD in primary care databases and to study the demographic and clinical character...

Systematic screening for depression in high-risk patients is recommended but remains controversial. The aim of this study was to assess the effectiveness of such screening in everyday clinical practice on depression recognition. A pragmatic, cluster randomized, controlled study that randomized primary care physicians (PCPs) in Spain either to an in...

BACKGROUND: There are significant shortcomings in the management and clinical outcomes of depressed patients. The objective is to assess the effectiveness of a multi-component programme to improve the management of depression in primary care. METHODS: This is a cluster-randomized controlled trial, conducted between June 2007 and June 2010. Twenty p...