Introduction. Sleep quality is commonly impaired in medical disorders, and the HIV-positive population is particularly vulnerable to complaint from sleep disturbances. Objective. To determine the prevalence of poor sleep quality and the factors associated with it, in a population of HIV positive Mexican out patients. Method. A cross sectional study was done. A sample of 367 HIV-positive subjects over 18 years completed a set of self-administered questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Athens Insomnia Scale, and the Beck Depression Inventory. Sociodemographic and clinical data were recorded. Results. Of the respondents, 82.8% (n = 304) were male. The mean age of the patients was 36.6 (SD = 9.4) years, and the mean educational level was 12.2 (SD = 3.8) years. According to the PSQI, 58.6% (n = 215) had poor sleep quality. Poor sleep quality was more common in those who had lived longer with HIV, had started their antiretroviral treatment later, had suboptimal antiretroviral adherence, had a CD4 cell count < 200 cells/µL, reported illicit drug use, had concomitant medications, or had insomnia, sleepiness, or depressive symptoms. In multivariate analyses, poor sleep quality was associated with depressive symptoms, illicit drug use, a CD4 count < 200 cells/µL, and time elapsed since HIV diagnosis. Discussion and conclusion. Poor sleep quality is common in HIV patients. Early identification of patients with poor sleep quality through vigilance for factors associated with it might facilitate prompt treatment.

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Background In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America. Methods We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela. Results The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006). Conclusions Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.

Introducción. La esquizofrenia es un trastorno mental que posee múltiples dimensiones sintomáticas y las alteraciones cognitivas son características cardinales en la evolución del trastorno. El uso de clinimetría para evaluar dichas deficiencias puede aportar información en la investigación en este campo. Objetivo. Determinar la validez y confiabilidad de la Escala de Evaluación Cognitiva Montreal (MoCA) para la evaluación del déficit cognitivo en pacientes con el diagnóstico de esquizofrenia. Material y métodos. Se evaluaron cien pacientes con diagnóstico de esquizofrenia reclutados en la Clínica de Esquizofrenia del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Se aplicaron las escalas de MoCA, MMSE y PANSS para la valoración de las funciones cognitivas. Se estableció la confiabilidad del MoCA con el Alfa de Cronbach y se estableció su validez concurrente con el MMSE y la subescala cognitiva de la PANSS. Resultados. De acuerdo al MMSE (con ajuste de escolaridad) el 8% de los pacientes fueron clasificados con deterioro cognitivo en contraste con el puntaje total del MoCA que reporto 69% de la muestra con deterioro cognitivo. La escala MoCA obtuvo una confiabilidad (Alfa de Cronbach=0.71) similar a la observada por el MMSE (?=0.70) y adecuada validez concurrente. Conclusiones. La MoCA es un instrumento confiable y válido para establecer la presencia de deterioro cognitivo leve en pacientes con esquizofrenia, sencillo y de fácil aplicación en la práctica clínica psiquiátrica cotidiana.

SUMMARY IntroductionCurrent evidence suggests a relationship between emotional factors and drugs consumption, although at least both emotional competence and social magazine of emotions have not been studied in cocaine users, in part due to the recent generation of tools for their measure.

Goals:The aim of this study was to describe mental health factors associated with the development of fatigue in inflammatory bowel disease (IBD) patients.Background: IBD includes ulcerative colitis and Crohn's disease. Patients with chronic diseases can present fatigue differently and qualitatively more severely than those typically represented by healthy populations.Study: This was a cross-sectional study in which 200 Mexican patients were attending the Inflammatory Bowel Disease Clinic at the National Institute of Medical Sciences and Nutrition. All patients answered 3 instruments: the first IBD-fatigue, HADS (Hospital Anxiety and Depression Scale), and PSQI (Pittsburgh Sleep Quality Index). The statistical analysis was carried out in the statistical program SPSS v 24.Results: The percentage of fatigue in our patients was 55.5% (n = 111) for mild-moderate fatigue, 31.5% (n = 63) for severe fatigue, and only 13% (n = 26) had no fatigue. Sleep disturbance and sleep latency were the most important predictors of fatigue in IBD patients.Conclusions: Sleep quality and depression have an impact on fatigue in Mexican patients with IBD. It is important for multidisciplinary management to reduce these symptoms and improve the quality of life of patients with IBD.

IntroductionSchizophrenia is a health and social problem of great dimensions, affecting not only the patient but their family and social environment. Within the psychotherapeutic approaches for patients with schizophrenia, Cognitive Behavioral Therapy (CBT) has most evidence of effectiveness for different porpoises and stages of the disorder. ObjectiveAnalyze the specific techniques and outcome on negative symptoms of the major CBT for patients with schizophrenia: Psychoeducation, Social Skills Training, Cognitive Remediation, CBT for positive symptoms and Cognitive Behavioral Recovery Oriented Therapy (CBT-R). MethodA searching and analysis of scientific literature published in English and Spanish between 1990 and 2014 were performed in PSYCLIT, MEDLINE, EBSCO-HOST and PROQUEST, employing as key words the names of the different CBT for schizophrenia and the diagnosis. Relevant literature included in review articles was also included. ResultsDespite the advances of CBT, the problems generated by negative symptoms of patients with schizophrenia are not completely solved. Discussion and conclusionCBT-R is considered a promising therapeutic style to achieve the objectives of recovery in patients with low psychosocial functioning and predominance of negative symptomatology.Key words: Cognitive Behavioral Therapy, schizophrenia, negative symptoms, recovery. RESUMEN IntroducciónLa esquizofrenia constituye un problema sanitario y social de grandes dimensiones que afecta no sólo al paciente sino a su entorno familiar y social. Dentro de las aproximaciones psicoterapéuticas dirigidas a pacientes con esquizofrenia, las terapias cognitivo conductuales (TCC) son las que cuentan con mayor evidencia de efectividad para diferentes propósitos y etapas del trastorno. ObjetivoAnalizar las técnicas y efectos específicos sobre síntomas negativos de las principales TCC para pacientes con esquizofrenia: Psicoeducación, Entrenamiento en Habilidades Sociales, Rehabilitación Cognitiva, TCC para Síntomas Positivos y TCC orientada a la Recuperación (TCC-R). MétodoSe llevó a cabo una búsqueda y análisis de literatura científica en PSYCLIT, MEDLINE, EBSCO-HOST y PROQUEST publicada entre 1990 y 2014 en revistas indexadas en inglés y español, utilizando como palabras clave los nombres de las diferentes TCC para la esquizofrenia que se cruzaron en todos los casos con el diagnóstico. Se recopiló también la literatura relevante citada en estos artículos, sobre todo en las revisiones de literatura antecedentes. ResultadosA pesar de los avances que han presentado las TCC en la recuperación de pacientes con diagnóstico de esquizofrenia, los problemas generados por la sintomatología negativa no han sido resueltos por completo. Discusión y conclusiónLa TCC-R se considera un estilo terapéutico prometedor para alcanzar los objetivos de recuperación de los pacientes con bajo funcionamiento psicosocial y predominio de sintomatología negativa.Palabras clave: Terapia cognitivo conductual, esquizofrenia, sínto-mas negativos, recuperación.

Background Rheumatoid arthritis (RA) patients commonly report medicinal cannabis use (MCU). Personality has been independently associated with both RA-related outcomes and MCU, but there is no information available on how they interact in RA patients. This study aimed to investigate a potential association between personality traits and MCU in RA outpatients, as well as to identify additional factors associated with its use. Methods This cross-sectional study was performed between June 2020 and August 2021. Consecutive RA outpatients had standardized evaluations using an interview format to collect sociodemographic information, comorbidities, risk of recreational substance use, RA-related disease activity/severity, health-related quality of life, depressive and anxiety symptoms, five personality traits, and MCU in the 12 months before the interview. Multivariable logistic regression estimated adjusted odds ratios (aOR). The study was IRB-approved. Results 180 patients were included; 160 (88.9%) were women with a mean age of 53.4 ± 13 years. Fifty-three (29.4%) patients reported MCU. Among them, 52 (98.1%) used topical formulations. Neuroticism had the highest overall score (x¯ = 3.47 ± 0.34). Openness to experience trait was higher in MCU patients in the comparative analysis (p = 0.007). In the multivariable regression, higher openness trait (aOR: 2.81, 95%CI: 1.11–7.10) along with moderate risk in tobacco use (aOR: 3.36, 95%CI: 1.04–10.7) and higher RA disease activity/severity (aOR: 1.10, 95%CI: 1.01–1.19) were independently associated with MCU. Conclusions In the current study, personality influenced the seeking of MCU for pain relief, associating dynamically with higher disease activity/severity and tobacco use. Contrary to other available information, it did not relate to psychopathology or the recreational use of cannabis. Proactive interdisciplinary clinical evaluations around MCU in RA outpatients should include personality, besides standard clinical assessments, to understand patients’ motivations for its use as they may reveal important clinical information.