Background: Very little research has been conducted in patients with first-episode psychosis using a dimensional approach. Affective dimensional representations might be useful to predict the clinical course and treatment needs in such patients. Methods: Weincluded 112 patients with first-episode psychosis in a longitudinal-prospective study with a five-year follow-up (N = 82). Logistic analyses were performed to determine the predictive factors associated with depressive, manic, activation, and dysphoric dimensions. Results: High scores on the depressive dimension were associated with the best prognosis. On the other hand, high scores on the activation dimension and the manic dimension were associated with a poorer prognosis in terms of relapses. Only the dysphoric dimension was not associated with syndromic or functional prognosis. Conclusion: Ourresults suggest that the pattern of baseline affective symptoms helps to predict the course of psychotic illness. Therefore, the systematic assessment of affective symptoms would enable us to draw important conclusions regarding patients’ prognosis. Interventions for patients with high scores on manic or activation dimensions could be beneficial in decreasing relapses in first-episode psychosis.

BackgroundThe high rate of cannabis use among patients with first-episode psychosis (FEP), as well as the associated negative impact on illness course and treatment outcomes, underlines the need for effective interventions in these populations. However, to date, there have been few clinical treatment trials (of pharmacological or psychological interventions) that have specifically focused on addressing comorbid cannabis use among these patients. The aim of this paper is to describe the design of a study protocol for a randomized controlled trial in which the objective is to assess the efficacy of a specific cognitive behavioral therapy program for cannabis cessation in patients with FEP compared to standard treatment (psychoeducation).Methods/designThis is a single-blind randomized study with 1 year of follow-up. Patients are to be randomly assigned to one of two treatments: (1) specific cognitive behavioral therapy for cannabis cessation composed of 1-hour sessions once a week for 16 weeks, in addition to pharmacological treatment scheduled by the psychiatrist, or (2) a control group (psychoeducation + pharmacological treatment) following the same format as the experimental group. Participants in both groups will be evaluated at baseline (pre-treatment), at 16 weeks (post-treatment), and at 3 and 6 months and 1 year of follow-up. The primary outcome will be that patients in the experimental group will have greater cannabis cessation than patients in the control group at post-treatment. The secondary outcome will be that the experimental group will have better clinical and functional outcomes than the control group.DiscussionThis study provides the description of a clinical trial design based on specific cognitive behavioral therapy for cannabis cessation in FEP patients, aiming to improve clinical and functional outcome, as well as tackling the addictive disorder.Trial registrationNCT02319746 ClinicalTrials.gov Identifier. ClinicalTrials.gov Protocol and Results Registration System (PRS) Receipt Release Date: 15 December 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1507-x) contains supplementary material, which is available to authorized users.

ObjectivesTo assess the prescription of benzodiazepines (BZD) in elderly patients, and to explore any gender differences.MethodsSix hundred and fifty-four patients (≥ 65) admitted in an emergency service of a general hospital due to a fall. BZD use information was collected (dose, half-life profile).ResultsBZD are significantly more prescribed to women (47.6%) than men (36.1%) (X2 = 8.097, P = 0.004). We conducted a logistic regression analysis using as dependent variable taking or not BZD and sex as the independent one, covariating the model by age. We noted that sex remains significant despite enter the age variable in the model (OR = 1.5, P = 0.013). A total of 21.6% of patients consumed intermediate or long half-life BZDs, appearing a greater tendency to prescribe such BZD to women (X2 = 3.606, P = 0.058). In the 58.0% of prescriptions, prescribed dose was higher than the recommended for the elderly. The percentage is significantly higher for men (70.0%) than women (53.1%). Furthermore, a total of 54 prescriptions (15.8%) were even higher than the recommended adult dose, with no significant differences between men and women.ConclusionsWe found evidence of a higher prescription of BZD in women independently of age. Despite not being recommended, prescription of intermediate or long half-life BZD continues, in a slightly higher manner in women. BZD are prescribed above the recommended dose for elderly in a large number of patients, especially in men. A considerable proportion of elderly patients (15.8%) consume BZD doses even higher than the recommended for adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe bipolar disorder (BD) has an important effect over the lives of patients and families. The attitude of the family is a modifiable factor through specific interventions and it has been related with BD prognosis.ObjectivesStudy a sample of families and patients with BD.AimsCompare between two groups its course of burden of caring for family members with BD. Also, we will see the course of the functionality in patients.MethodsSample of 148 individuals who caring a familiar with BD. Seventy-six of these followed psychoeducation session are going to be experimental group (EG), and the others 72 did not followed any session are going to be control group (CG). There is a follow-up at 6 months and one year. To see the course of the burden and the functionality it will be used mixed models.ResultsAt baseline, there were not significant differences between CG and EG in objective and subjective burden and functionality. But over time there were significant results in the three cases. For objective burden (b = −0.016; P = 0.0001) EG presented a drop (b = −0.014; P = 0.0062), while CG did not show changes (b = 0.002; P = 0.4691). For subjective burden (b = −0.014; P = 0.0058) without significant results for CG (b = −0.352; P = 0.3203) and a significant decrease in EG (b = −0.017; P = 0.003). For the functionality (b = 1.474; P = 0.000) there was a significant increase in EG (b = 1.349; P = 0.000) but not for CG (b = −0.125; P = 0.3828).ConclusionsTwo groups did not differ at baseline however after the psychoeducation sessions appear clear differences, decreasing the burden for EG group and the functionality also improved for EG.Disclosure of interestThe authors have not supplied their declaration of competing interest.