Maria Fe Bravo Ortiz

Hospital Universitario La Paz. UAM. IdiPAZ

Background and aims The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers’ mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme...

Introduction Long-term COVID-19 effects has been recently described as persistent and prolonged symptoms after an acute and severe SARS-COV-2 (1). An important concern is that the sequelae of severe COVID-19 may suppose a substantial outpatient 's burden for the specialized services in reopening pandemic phase (2). Objectives To describe the frequ...

Introduction Spain went into lockdown in March of 2020 due to the COVID-19 outbreak. We had to stop the third randomization of our ongoing clinical trial (Mediavilla et al., 2019), pausing weekly group psychotherapy for 12 people with a first episode of psychosis. Only 5 weekly sessions had been delivered, thus many were just starting to form a the...

Introduction Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 pandemic outbreak. Long-term consequences of the pandemic will include increases in mental healthcare needs especially among especially vulnerable groups such as children and adolescents. Objectives This study examined changes in th...

Introduction Social functioning is severely affected in psychotic disorders. Negative symptoms and social cognition seem to play an important role in social functioning, although the preponderance and relationship between these three domains is not clear. In this study, we sought to assess the interrelation between social cognition, social function...

Background Healthcare workers (HCWs) from COVID-19 hotspots worldwide have reported poor mental health outcomes since the pandemic's beginning. The virulence of the initial COVID-19 surge in Spain and the urgency for rapid evidence constrained early studies in their capacity to inform mental health programs accurately. Here, we used a qualitative r...

Introduction Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 outbreak. Long-term consequences of the COVID-19 pandemic will include increases in mental healthcare needs, especially among vulnerable groups such as children and adolescents. Aim This study examined changes in the number of overa...

Objective: To characterize the evolution of healthcare workers’ mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible particip...

We examined whether excess chronic medical comorbidity mediated excess COVID-19 inpatient mortality among people with mental disorders in the early phase of the pandemic, a question with important implications for public health and clinical decision-making. Using records of 2599 COVID-19 hospitalized patients, we conducted a formal causal mediation...

Objetivo: evaluar la efectividad de la introducción del instrumento de feedback formal PCOMS en psicoterapia en el sistema nacional de salud español. Método: se trató de un estudio clínico aleatorizado y controlado simple ciego en cuatro centros de salud mental y atención primaria del Hospital Universitario La Paz, España. Los pacientes asignados a...

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 identifyin...

Background Healthcare workers (HCWs) from COVID-19 pandemic hotspots across the globe have reported mental health problems, including anxiety, depression, or sleep problems. Many studies have focused on identifying modifiable risk factors, such as being afraid of getting infected or reporting shortage of personal protective equipment, but none have...

Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible particip...

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups. Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public...

Introduction: Few controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment. Material and methods: randomized, prospective, multicenter, single-blinded trial that included BP-outpatien...

Background : During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access...

Background: During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare work...

Introduction Suicidal phenomena help seeking depends on a broad array of factors, which include climatic variables. Our aim was to analyse the effect of precipitation with help seeking in patients suffering from suicidal behaviour Objectives Our aim was to analyse the effect of precipitation with help seeking in patients suffering from suicidal be...

IntroductionPsychiatric emergency care visits have been associated to several climate variables. However, the influence of precipitation has been understudied Objectives To study the association between precipitation and number of emergency care psychiatric visits. Methods Daily urgency visits were extracted from electronic medical records of Hospi...

Introduction Psychiatric emergency visits have been associated to several climate variables. However, the influence of relative humidity has been not well stablished. Objectives The analyse the influence of relative humidity on emergency care visits. Methods Daily urgency visits were extracted from electronic medical records of Hospital Universit...

Introduction Suicidal seeking help seeking behaviour has with associated with seasonal pattern that reflect an array of psychosocial factors. Its understanding is paramount for improving psychiatric emergency care. Objectives Our aim was to analyse weekly and monthly seasonality on emergency department visits due to autolytic phenomena Methods Da...

Introduction Psychiatric emergency visits have with associated with seasonal pattern that reflect psychosocial factors. Its knowledge could proving valuable insight about help seeking behaviour of patiens suffering with mental illness. Objectives Our aim was to analyse weekly and monthly seasonality Methods Daily urgency visits were extracted fro...

Mechanical restraint is a coercive procedure in psychiatry, which despite being permitted in Spain, raises significant ethical conflicts. Several studies argue that non-clinical factors - such as professionals’ experiences and contextual influences - may play a more important role than clinical factors (diagnosis or symptoms) in determining how the...

The links between psychosis and socio-economic disadvantage have been widely studied. No previous study has analysed the interrelationships and mutual influences between functioning dimensions in first episode of psychosis (FEP) according to their neighbourhood household income, using a multidimensional and transdiagnostic perspective. 170 patients...

Objective: To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students. Methods: The authors conducted a single-blind, randomised controlled trial with three paral...

Objective: This study explores whether social cognition and social functioning improve after a mindfulness-based social cognition training (SocialMIND). Methods: Thirty-eight outpatients with psychosis completed an assessment with social cognition (Eyes Test, Ambiguous Intentions and Hostility Questionnaire [AIHQ], and Hinting Task) and social f...

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...

Objective To determine the cost-effectiveness of 2 strategies for post-discharge suicide prevention, an Enhanced Contact intervention based on repeated in-person and telephone contacts, and an individual 2-month long problem-solving Psychotherapy program, in comparison to facilitated access to outpatient care following a suicide attempt. Methods W...

Introduction: The COVID-19 outbreak is having an impact on the well-being of healthcare workers. Mindfulness-based interventions have shown effectiveness in reducing stress and fostering resilience and recovery in healthcare workers. There are no studies examining the feasibility of brief mindfulness-based interventions during the COVID-19 outbreak...

The measures to contain the spread of the COVID-19 outbreak have no precedent in the recent history of many countries. Around 2,000 million people in the world are in isolation or quarantine, and gatherings of people have been expressly banned in many countries. In Spain, this prohibition affects workplaces, schools, and the national health system,...

Background.: Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations...

Introduction: This study evaluates the degree of compliance and effectiveness of the ARSUIC Suicide Risk Care Program. ARSUIC seeks to reduce the relapse risk that follows a suicide attempt by scheduling a high priority outpatient visit following hospital discharge. Method: Hospital-based retrospective study conducted between years 2012 and 2015...

Background: People who suffer a first episode of psychosis experience higher levels of distress and suffering. Early intervention programs combine pharmacological and psychosocial strategies that include different components, such as cognitive-behavioural therapy, psychosocial interventions, medication adherence, family psychoeducation, counsellin...

Introduction: Difficulties in social functioning are common among people with psychosis. Negative symptoms such as blunted affect or social withdrawal are often linked to these difficulties and worsen real-life outcomes. One important dimension associated with social functioning is social cognition, which refers to the psychological processes that...

Objective: To determine the comparative effectiveness of 3 real-practice preventive programs aimed at lowering the relapse risk following a suicide attempt: a single priority appointment with an outpatient psychiatrist, an enhanced contact intervention, and an individual psychotherapy program. Methods: This observational study was conducted in a...

Objective According to randomized trials, contact after a suicide attempt lowers relapse risk. However, effectiveness studies based on real clinical data can provide additional external validity. Method We conducted an observational study to determine if an emergency department (ED)‐initiated intervention for suicide attempt risk reduction, consis...

Introduction Several US studies have investigated the criminal behaviour among homeless individuals with severe mental illness. But to date, no studies have been carried out in Spain. Method A retrospective observational study was conducted on a sample of 118 patients selected from a psychiatric care programme for homeless individuals with sever...

Resumen Introducción Varios estudios estadounidenses han investigado la conducta delictiva en las personas sin hogar con trastorno mental grave. Pero hasta la fecha ninguno se ha realizado en España. Metodología Estudio observacional retrospectivo, en una muestra de 118 pacientes, seleccionados de un programa de atención psiquiátrica para persona...

Methods: This is a cohort prospective study of women giving birth by C-section. 48-72h after delivery, sociodemographic variables were collected, Mother-to-Infant Bonding Scale and newborn's response to separation test were performed. 10-12weeks after delivery Mother-to-Infant Bonding Scale and questions about baby's feeding were completed. Resul...

Suicide is the second most frequent cause of death among the youth and its rates among adolescents have recently risen. Up to 30% of adolescents who attempt suicide will try it again within a year. Our objective is to analyze how previous attempts and diagnosed psychiatric disorder behave as markers of risk of reattempts and their statistical inter...

Catatonia is a rare but potentially lethal neuropsychiatric syndrome. Despite its historical association with schizophrenic disorders, it is more frequent in affective ones, and is currently considered an independent pathological entity. The basis of the treatment, regardless of the cause, is the use of benzodiazepines and electroconvulsive therapy...

Background Mindfulness-based cognitive therapy (MBCT) is a psychotherapeutic intervention that has been shown effective in several clinical conditions. Nevertheless, research is still needed on its effectiveness on cognition. Objective To analyze possible effects on cognition of the addition of MBCT intervention versus a brief structured group psy...

Introduction Journeys have been considered life-changing experiences since the first chronicles of humanity. Interest towards the relationship between travels and mental illness started off with the publication, in 1897, of Les aliénés voyageurs. Case report We report the case of a 52-year-old gentleman, married and without children, who works as...

Schizophrenia is a clinically heterogeneous syndrome affecting multiple dimensions of patients’ life. Therefore, its treatment might require a multidimensional approach that should take into account the efficacy (the ability of an intervention to get the desired result under ideal conditions), the effectiveness (the degree to which the intended eff...

Schizophrenia is a clinically heterogeneous syndrome affecting multiple dimensions of patients' life. Therefore, its treatment might require a multidimensional approach that should take into account the efficacy (the ability of an intervention to get the desired result under ideal conditions), the effectiveness (the degree to which the intended eff...

Objective This study examined the emotional and behavioral functioning among 10–14 year-old children who were born with very low birth weight (VLBW, <1500). Method Prospective and cross-sectional study of 90 VLBW (<1500 g) survivors born at the Hospital Universitario la Paz in Madrid, Spain, from 2000 to 2005 who were assessed by interviewers usin...

Introduction Suicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use. Objective To describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis. Aims To i...

Introduction Acute suicidality or a condition after attempted suicide frequently leads patients to both voluntary or involuntary inpatient admission. Emergency room psychiatrists decide whether such patients can be treated on an outpatient basis. Objectives To identify if immigration status is associated with the decision whether a patient needs a...

Introduction Epilepsy is considered a complex neurological disorder, and its clinical picture can resemble many different cerebral dysfunctions, including those associated to major psychiatric disorders. Case report We report the case of a 52-year-old gentleman, with a 30-year history of schizoaffective disorder and of complex partial epilepsy wit...

Introduction Psychiatric symptoms set forth brain dysfunction at several levels. Behavioral disturbances, although frequently associated to primary psychiatric disorders, call for a previous discard of neurologic treatable causes. Case report We report the case of a 30-year-old gentleman, receiving outpatient psychological treatment and follow-up...

Introduction Episodes of time-limited acute psychosis, with full recovery in between, are categorized as acute polymorphic psychotic or brief psychotic disorders. Leonhard described the three forms of cycloid psychosis (CP). Perry considers it a separate entity. Case report We report the case of a 54-year-old male, with a 9-year history of brief p...

Background In the current epidemic of Ebola virus disease, health-care workers have been transferred to Europe and the USA for optimised supportive care and experimental treatments. We describe the clinical course of the fi rst case of Ebola virus disease contracted outside of Africa, in Madrid, Spain.

Background The presence of depressive subsyndromal symptoms (SS) in bipolar disorder (BD) increases the risk of affective relapse and worsens social, cognitive functioning, and quality of life. Nonetheless, there are limited data on how to optimize the treatment of subthreshold depressive symptoms in BD. Mindfulness-Based Cognitive Therapy (MBCT) i...

Introduction: Two statistical sources provide data on hospital stays and discharges for all Spanish hospitals: Hospital Morbidity Survey (acronym in Spanish: EMH) and Statistics of Health Establishments providing Inpatient Care (acronym in Spanish: EESCRI). Our aim is to contrast these two statistical sources to define their accuracy and relevance...

Introduction Two statistical sources provide data on hospital stays and discharges for all Spanish hospitals: Hospital Morbidity Survey (acronym in Spanish: EMH) and Statistics of Health Establishments providing Inpatient Care (acronym in Spanish: EESCRI). Our aim is to contrast these two statistical sources to define their accuracy and relevance i...

Introduction Primary Insomnia is difficulty in initiating, or maintaining sleep, waking up too early, or sleep that is chronically nonrestorative or of poor quality (AASM, 2005) that can not be explained by another mental disorder, medical illness or substance abuse disorder. Psychological factors, such as depression, anxiety and excessive worry, c...

Introduction Kleine–Levin syndrome without compulsive eating (KLS WOCE) is characterized by recurrent hypersomnia with cognitive abnormalities but not compulsive eating. The disease is typically described in adolescents. Here, we present a 2 year follow-up case of KLS WOCE in a middle age woman with extreme hypersomnia documented by actigraphy and...

El trastorno bipolar es una enfermedad crónica y recurrente del estado de ánimo, que generalmente limita seriamente la funcionalidad del paciente y que afecta aproximadamente al 1,6% de la población. Se ha detectado un gran retraso en el diagnóstico y una excesiva disparidad en el tratamiento de estos pacientes. Dentro del Plan de Calidad del Siste...

Bipolar disorder is a chronic and recurrent mood disorder, which may severely impact on the patient's global functioning. It has been estimated that approximately 1.6% of the population is affected. A long delay in diagnosis and an excessive disparity in the treatment of these patients have been detected. Within the Quality Plan of the Spanish Nati...

The present study investigate several socio-demographics, clinical and therapeutics factors that converge in the emergencies of the Psychiatric Hospital of Madrid on June, 1989 and 1990. Also, the study approach the changes about the demand of attendance, experienced by these emergencies during the period 1979-1990, related to the introduction of a...

This study aimed to investigate quality of life and burden on caregivers in Spanish outpatients with schizophrenia, treated with different antipsychotics. Sociodemographic and clinical data were collected for 1865 patients diagnosed with schizophrenia. Patients answered the EuroQol-5D questionnaire and caregivers answered questionnaires assessing c...

p>Si bien hace ya varios años que la crisis está instalada en nuestras vidas, es ahora cuando tras los cambios políticos producidos en las elecciones autonómicas se vislumbra que ésta puede incidir de manera drástica en el desarrollo de los sistemas de atención a la salud mental con los que contamos en nuestro país.</p

To assess the impact of the Continuity-of-Care Program (CCP; a clinical case management model) on hospital use of persons with schizophrenia in three Community Mental Health Services in Madrid (Spain). Using data provided by the Psychiatric Case Register, we analyzed the use of hospitalization in 250 individuals before and after the date of inclusi...

La aprobación de la Estrategia en Salud Mental del Sistema Nacional de Salud en Diciembre de 2006, a la que nuestra Asociación contribuyó decisivamente, ha supuesto sin lugar a dudas un hito significativo en el desarrollo de un Modelo Comunitario de Atención a la Salud Mental en nuestro país, que ha venido a consolidar y mejorar el modelo de nuestr...