Objectives: Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. Methods: A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. Results: Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. Conclusions: MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
Highlights Review adherence to pharmacological treatment during quarantine, and adjust or amend medication depending on the patient's current state. Monitor the risk of pharmacological interaction (if the patient is being treated for COVID-19 disease). Promote sleep hygiene practices and regularize the daily activities. Spend a few minutes teaching patients how to identify relapse prodromes and devise an action plan.
The goal of our research was to adapt the short forms of the Working Alliance Inventory into the Spanish language for patients and therapists (WAI-S-P and WAI-S-T). The psychometric properties of scores from these measurement instruments were evaluated in Spanish outpatients with depressive disorders and their therapists. The scores of both measures exhibited excellent reliability in terms of internal consistency and excellent convergent validity. Their discriminant validity exhibited some limitations, particularly when the scores of both short measures correlated with those of two empathy measures. Regarding predictive validity, the scores of the overall WAI-S-P and WAI-S-T significantly correlated with residual gain scores of patients in the Beck Depression Inventory (BDI) after the tenth psychotherapy session. Additionally, the overall WAI-S-T scores explained a moderate percentage of the variance in patient BDI score changes. These results are satisfactory and similar to those found in the studies that have utilized the respective original versions of WAI-S in English.
Título: Adaptación española del Working Alliance Inventory (WAI). Propiedades psicométricas de las versiones del paciente y del terapeuta (WAI-P y WAI-T). Resumen: La alianza de trabajo es uno de los constructos más estudiados en investigación de procesos en psicoterapia. El objetivo de nuestra investigación fue adaptar las versiones del paciente y del terapeuta del Working Alliance Inventory (WAI-P y WAI-T) a la lengua española. Ambos instrumentos de medida fueron traducidos al español mediante un proceso reglado de traducción. Sus propiedades psicométricas fueron examinadas en un estudio piloto y en un estudio clínico en el que participaron pacientes ambulatorios con trastornos depresivos y sus correspondientes terapeutas. En el estudio clínico, los pacientes completaron la adaptación española del Beck Depression Inventory (BDI) antes del tratamiento y después de la tercera y de la décima sesión de psicoterapia. El WAI-P y el WAI-T en español exhibieron altas puntuaciones medias. Un elevado número de sus ítems correlacionó de manera adecuada con la puntuación total de su respectiva subescala. Ambas pruebas evidenciaron una excelente fiabilidad (consistencia interna) y una excelente validez convergente. Su validez discriminante exhibió algunas limitaciones cuando ambas medidas correlacionaron con dos pruebas de empatía. En cuanto a la validez predictiva, el WAI-P total y la subescala tareas del WAI-T explicaron por separado un porcentaje moderado de la varianza del cambio de los pacientes en el BDI después de la décima sesión de psicoterapia. Estos resultados fueron satisfactorios y coherentes con los hallados en los estudios que han empleado las correspondientes versiones originales del WAI en inglés. Palabras clave: Adaptación española; Working Alliance Inventory; WAI. Abstract:The working alliance is one of the most widely studied constructs in psychotherapy process research. The purpose of our study was to adapt the patient and therapist forms of the Working Alliance Inventory (WAI-P and WAI-T) into Spanish. Both measurement instruments were translated into Spanish through a systematic translation process. The psychometric properties of the instruments were evaluated in both a pilot study and a clinical study involving Spanish outpatients with depressive disorders and their therapists. In the clinical study, patients completed the Spanish-language Beck Depression Inventory (BDI) prior to initiating therapy and after the third and tenth psychotherapy sessions. High average scores were obtained with the Spanish-language WAI-P and WAI-T. A large number of individual items correlated satisfactorily with the overall score for the corresponding subscale. Both measures demonstrated excellent reliability (internal consistency) and convergent validity. There were some limitations in the discriminant validity of the measures vs. measures of empathy. Regarding predictive validity, the overall WAI-P and the Task subscale of the WAI-T separately explained a moderate percentage of the variance in patient change in the BD...
These results are consistent with studies using the original English versions of the HAq-II.
Background. Distinguishing prodromes of bipolar disorder (BD) specific to children/adolescents, adults, and elderly patients is essential. The primary objective of this systematic review was to determine initial and relapse prodromes identifying adult patients with BD. Methods. PubMed, PsycINFO, and Web of Science databases were searched using a predetermined strategy. A controlled process of study selection and data extraction was performed. Results. The 22 articles selected included 1,809 adult patients with BD. Initial prodromes cited most frequently in these studies showed low specificity. Among relapse prodromes cited most frequently, more talkative than usual, increased energy/more goal-directed behavior, thoughts start to race, increased self-esteem, strong interest in sex, increase in activity, and spending too much were identified exclusively before a manic/hypomanic episode, while loss of interest and hypersomnia were detected only before a depressive episode. Initial prodromal phases lasted longer than prodromal relapse phases. In the selected studies, the most used prodrome identification procedure was the clinical interview. Conclusions. For adult patients with BD, initial and relapse prodromes of manic, hypomanic, and depressive episodes were identified. It is proposed that the most frequent prodromes found in this review be incorporated into a smartphone app that monitors the functioning of people at risk of BD and patients who have already been diagnosed. Data from this app would constitute a relevant source of big data.
This study aimed to examine perceptions of the working alliance in a sample of Spanish patients and therapists. The alliance was measured after the third and tenth psychotherapy sessions using patient and therapist versions of the Spanish adaptation of the Working Alliance Inventory (WAI). After both sessions, correlations between the patients' and therapists' ratings, both of total alliance and of the various dimensions of the alliance, were moderate at best. Moreover, after the third psychotherapy session, patients' scores for the total alliance and the Goal and Task subscales were significantly higher than the scores from their therapists in these dimensions. Following the tenth session, patient ratings exceeded those of their therapists only on the Task subscale. Finally, in contrast to the ratings of patients, therapists' alliance ratings increased significantly between the third and tenth sessions of psychotherapy. Certain recommendations are presented to improve the study of patient and therapist perceptions of the working alliance and to increase the convergence between them with regard to this central treatment variable.
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