Introduction. The DSM-5 replaced the Global Assessment of Functioning (GAF) with the World Health Organization Disability Assessment Questionnaire (WHODAS) 2.0 as a measure of functioning because of the shortcomings of the former. However, further evidence of how GAF and WHODAS 2.0 scores are correlated and how both instruments are associated with sociodemographic and clinical variables. particularly in children and adolescents, is required to support this change. Objective. To correlate GAF and WHODAS 2.0 scores in a sample of children and adolescents, and to determine which sociodemographic and clinical variables are associated with the scores of each instrument. Method. Using reports obtained from a secondary database analysis of a cross-sectional, multicentric study, we calculated the correlation between WHODAS 2.0 and GAF scores in a clinical sample of children and performed a general linear model analysis to evaluate the association between the sociodemographic and clinical variables with functioning scores. Results. Sixty-six participants completed the evaluation. The correlation between WHODAS 2.0 and GAF (r = -.69, 95% CI = [-.82, -.49], p () .001) was moderate to large and significant. Only poor peer relationships and a higher number of diagnoses were significantly associated with low functioning in both instruments. The results suggest that WHODAS 2.0 and GAF scores reflect different aspects of functioning and disability. Discussion and conclusion. Both instruments can provide an accurate assessment of disability/functionality. We propose that, for pediatric cases, WHODAS could provide more information on the self-care domain.

BACKGROUND:Bipolar Disorder (BD) represents the seventh major cause of disability life-years-adjusted. Lithium remains as a first-line treatment, but clinical improvement occurs only in 30 % of treated patients. Studies suggest that genetics plays a major role in shaping the individual response of BD patients to lithium. METHODS:We used machine-learning techniques (Advance Recursive Partitioned Analysis, ARPA) to build a personalized prediction framework of BD lithium response using biological, clinical, and demographical data. Using the Alda scale, we classified 172 BD I-II patients as responders or non-responders to lithium treatment. ARPA methods were used to build individual prediction frameworks and to define variable importance. Two predictive models were evaluated: 1) demographic and clinical data, and 2) demographic, clinical and ancestry data. Model performance was assessed using Receiver Operating Characteristic (ROC) curves. RESULTS:The predictive model including ancestry yield the best performance (sensibility = 84.6 %, specificity = 93.8 % and AUC = 89.2 %) compared to the model without ancestry (sensibility = 50 %, Specificity = 94.5 %, and AUC = 72.2 %). This ancestry component best predicted lithium individual response. Clinical variables such as disease duration, the number of depressive episodes, the total number of affective episodes, and the number of manic episodes were also important predictors. CONCLUSION:Ancestry component is a major predictor and significantly improves the definition of individual Lithium response in BD patients. We provide classification trees with potential bench application in the clinical setting. While this prediction framework might be applied in specific populations, the used methodology might be of general use in precision and translational medicine.

Background: The COVID-19 pandemic has had negative effects on mental health. Understanding sex and age differences in the perception of stressors, the use of coping strategies, and the prevalence of depression and anxiety can lead to detecting at-risk groups.Methods: A cross-sectional online study surveyed perceived stressors, coping strategies, and the PHQ-9 and GAD -7 rating scales for symptoms of depression and anxiety. The study was open from Spring 2020 to Spring 2021 and was aimed at children, adolescents and young adults of Latin America.Results: The survey was completed by 3965 participants (63.8% females). The sample was divided into children (N = 621, 15.7%), adolescents (N = 1123, 28.3%) and young adults (N = 2021, 56%). Moderate to severe symptoms of depression and anxiety were found in 43.53% and 27%, respectively, being more frequent in females. Children of both sexes showed the lowest scores in rating scales. Adult females reported a higher level of stress in regards to pandemic news, having someone close diagnosed with COVID-19,the possibility of getting sick, academic delays, economic impact, and depression, while female adolescents reported a higher level of stress regarding the lockdown, losing contact with peers and anxiety. In juxtaposition, females also reported a higher frequency of positive coping strategies. A multivariate analysis confirmed the association of several variables with the presence of depression and anxiety.Conclusion: A high prevalence of depression and anxiety was found among young people. Specific intervention programs must be created taking into account age and sex differences.

ObjectivesThe objective of this study is to establish the prevalence of psychiatric disorders in the mothers of ADHD probands and their high-risk sibling (HRS).MethodsWe recruited 205 triplets made of an ADHD proband, a high-risk sibling (aged 6-21 years), and their biological mother. They were evaluated with a semi-structured diagnostic interview to determine the presence of mental disorders in each trio.ResultsA total of 68% of the mothers have at least 1 psychiatric disorder, the most common being depression, ADHD, anxiety disorder, borderline personality disorder, and suicidal behavior. Maternal psychiatric disorder is associated with a 2- to 6-fold risk in ADHD probands for developing ODD, conduct disorder, learning disorder, sleep disorder, and tics in probands. Maternal psychiatric disorder is associated with a 7- to 35-fold risk in the HRS for developing depression, substance use disorder, panic disorder, or ASD.ConclusionsHRSs are at increased risk for psychiatric disorders when the mother has 1 or more psychiatric diagnoses. This study recommends that family members of an ADHD proband be screened early for diagnosis and treatment.ADHD, RF, GS ObjectivesThe objective of this study is to establish the prevalence of psychiatric disorders in the mothers of ADHD probands and their high-risk sibling (HRS). The objective of this study is to establish the prevalence of psychiatric disorders in the mothers of ADHD probands and their high-risk sibling (HRS). MethodsWe recruited 205 triplets made of an ADHD proband, a high-risk sibling (aged 6-21 years), and their biological mother. They were evaluated with a semi-structured diagnostic interview to determine the presence of mental disorders in each trio. We recruited 205 triplets made of an ADHD proband, a high-risk sibling (aged 6-21 years), and their biological mother. They were evaluated with a semi-structured diagnostic interview to determine the presence of mental disorders in each trio. ResultsA total of 68% of the mothers have at least 1 psychiatric disorder, the most common being depression, ADHD, anxiety disorder, borderline personality disorder, and suicidal behavior. Maternal psychiatric disorder is associated with a 2- to 6-fold risk in ADHD probands for developing ODD, conduct disorder, learning disorder, sleep disorder, and tics in probands. Maternal psychiatric disorder is associated with a 7- to 35-fold risk in the HRS for developing depression, substance use disorder, panic disorder, or ASD. A total of 68% of the mothers have at least 1 psychiatric disorder, the most common being depression, ADHD, anxiety disorder, borderline personality disorder, and suicidal behavior. Maternal psychiatric disorder is associated with a 2- to 6-fold risk in ADHD probands for developing ODD, conduct disorder, learning disorder, sleep disorder, and tics in probands. Maternal psychiatric disorder is associated with a 7- to 35-fold risk in the HRS for developing depression, substance use disorder, panic disorder, or ASD. ConclusionsHRSs are at increased risk for psychiatric disorders when the mother has 1 or more psychiatric diagnoses. This study recommends that family members of an ADHD proband be screened early for diagnosis and treatment.ADHD, RF, GS HRSs are at increased risk for psychiatric disorders when the mother has 1 or more psychiatric diagnoses. This study recommends that family members of an ADHD proband be screened early for diagnosis and treatment.

ObjectivesThe aim of this presentation is to describe the demographic and clinical characteristics of pediatric inpatients with a diagnosis of somatic symptom and related disorders (SSRD).MethodsWe conducted a descriptive cross-sectional study in which we reviewed the medical records of hospitalized pediatric patients with a diagnosis of SSRD. We included patients admitted to the Hospital San Vicente Fundación in Medellín-Colombia between 2018 and 2021. Patients were included if they had an evaluation by a child and adolescent psychiatrist.ResultsA total of 83 medical records were included. Most patients were female (72%), with a median age of 12 years old. The most frequent comorbidities were anxiety and depression (83% and 75%, respectively). Their mothers had antecedent of anxiety and depression (25% and 26%, respectively). The majority of patients had exposure to family stressors at home (83%). A great majority of patients required interventions of multiple medical specialties and therapeutic supports, with the use of varied diagnostic aids.ConclusionsPediatric patients hospitalized with SSRD are generally female adolescents with depression or anxiety who are surrounded by adverse family and social contexts. These patients require interdisciplinary care using a comprehensive biopsychosocial model.SOM, CON, AD ObjectivesThe aim of this presentation is to describe the demographic and clinical characteristics of pediatric inpatients with a diagnosis of somatic symptom and related disorders (SSRD). The aim of this presentation is to describe the demographic and clinical characteristics of pediatric inpatients with a diagnosis of somatic symptom and related disorders (SSRD). MethodsWe conducted a descriptive cross-sectional study in which we reviewed the medical records of hospitalized pediatric patients with a diagnosis of SSRD. We included patients admitted to the Hospital San Vicente Fundación in Medellín-Colombia between 2018 and 2021. Patients were included if they had an evaluation by a child and adolescent psychiatrist. We conducted a descriptive cross-sectional study in which we reviewed the medical records of hospitalized pediatric patients with a diagnosis of SSRD. We included patients admitted to the Hospital San Vicente Fundación in Medellín-Colombia between 2018 and 2021. Patients were included if they had an evaluation by a child and adolescent psychiatrist. ResultsA total of 83 medical records were included. Most patients were female (72%), with a median age of 12 years old. The most frequent comorbidities were anxiety and depression (83% and 75%, respectively). Their mothers had antecedent of anxiety and depression (25% and 26%, respectively). The majority of patients had exposure to family stressors at home (83%). A great majority of patients required interventions of multiple medical specialties and therapeutic supports, with the use of varied diagnostic aids. A total of 83 medical records were included. Most patients were female (72%), with a median age of 12 years old. The most frequent comorbidities were anxiety and depression (83% and 75%, respectively). Their mothers had antecedent of anxiety and depression (25% and 26%, respectively). The majority of patients had exposure to family stressors at home (83%). A great majority of patients required interventions of multiple medical specialties and therapeutic supports, with the use of varied diagnostic aids. ConclusionsPediatric patients hospitalized with SSRD are generally female adolescents with depression or anxiety who are surrounded by adverse family and social contexts. These patients require interdisciplinary care using a comprehensive biopsychosocial model.SOM, CON, AD Pediatric patients hospitalized with SSRD are generally female adolescents with depression or anxiety who are surrounded by adverse family and social contexts. These patients require interdisciplinary care using a comprehensive biopsychosocial model.

OBJECTIVE:Limited prosocial emotions (LPE) has been recently incorporated into international classifications as a specifier for conduct disorder in the DSM-5 and for all disruptive behavioural disorders in the ICD-11. The aims of the current work were to determine (a) the accuracy of each of the characteristics used to assess the LPE specifier and (b) whether the manner in which symptoms group together supports the idea of LPE having core characteristics.METHOD:Trained clinicians conducted interviews and determined LPE characteristics using responses from 74 parent/guardian and child/adolescent participants.RESULTS:The distribution of LPE characteristics among those participants with LPE (n = 13) was compared to those with only one LPE characteristic (n = 11). The proposal of callous lack of empathy (CLE) and shallow deficient affect (SDA) as core characteristics was supported by strong associations with the presence of the LPE specifier, larger specificity, and sensitivity indices than those for unconcerned about performance and lack of remorse or guilt, as well as by a robust aggregation in a latent class analysis.CONCLUSIONS:CLE and SDA could be considered as core characteristics of LPE in children and adolescents.

Attention deficit hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children, with genetic factors accounting for 75-80% of the phenotypic variance. Recent studies have suggested that ADHD patients might present with atypical central myelination that can persist into adulthood. Given the essential role of sphingolipids in myelin formation and maintenance, we explored genetic variation in sphingolipid metabolism genes for association with ADHD risk. Whole-exome genotyping was performed in three independent cohorts from disparate regions of the world, for a total of 1520 genotyped subjects. Cohort 1 (MTA (Multimodal Treatment study of children with ADHD) sample, 371 subjects) was analyzed as the discovery cohort, while cohorts 2 (Paisa sample, 298 subjects) and 3 (US sample, 851 subjects) were used for replication. A set of 58 genes was manually curated based on their roles in sphingolipid metabolism. A targeted exploration for association between ADHD and 137 markers encoding for common and rare potentially functional allelic variants in this set of genes was performed in the screening cohort. Single- and multi-locus additive, dominant and recessive linear mixed-effect models were used. During discovery, we found statistically significant associations between ADHD and variants in eight genes (GALC, CERS6, SMPD1, SMPDL3B, CERS2, FADS3, ELOVL5, and CERK). Successful local replication for associations with variants in GALC, SMPD1, and CERS6 was demonstrated in both replication cohorts. Variants rs35785620, rs143078230, rs398607, and rs1805078, associated with ADHD in the discovery or replication cohorts, correspond to missense mutations with predicted deleterious effects. Expression quantitative trait loci analysis revealed an association between rs398607 and increased GALC expression in the cerebellum.

BACKGROUND:Severe mental illness diagnoses have overlapping symptomatology and shared genetic risk, motivating cross-diagnostic investigations of disease-relevant quantitative measures. We analysed relationships between neurocognitive performance, symptom domains, and diagnoses in a large sample of people with severe mental illness not ascertained for a specific diagnosis (cases), and people without mental illness (controls) from a single, homogeneous population. METHODS:In this case-control study, cases with severe mental illness were ascertained through electronic medical records at Clínica San Juan de Dios de Manizales (Manizales, Caldas, Colombia) and the Hospital Universitario San Vicente Fundación (Medellín, Antioquía, Colombia). Participants were assessed for speed and accuracy using the Penn Computerized Neurocognitive Battery (CNB). Cases had structured interview-based diagnoses of schizophrenia, bipolar 1, bipolar 2, or major depressive disorder. Linear mixed models, using CNB tests as repeated measures, modelled neurocognition as a function of diagnosis, sex, and all interactions. Follow-up analyses in cases included symptom factor scores obtained from exploratory factor analysis of symptom data as main effects. FINDINGS:Between Oct 1, 2017, and Nov 1, 2019, 2406 participants (1689 cases [schizophrenia n=160; bipolar 1 disorder n=519; bipolar 2 disorder n=204; and major depressive disorder n=806] and 717 controls; mean age 39 years (SD 14); and 1533 female) were assessed. Participants with bipolar 1 disorder and schizophrenia had similar impairments in accuracy and speed across cognitive domains. Participants with bipolar 2 disorder and major depressive disorder performed similarly to controls, with subtle deficits in executive and social cognition. A three-factor model (psychosis, mania, and depression) best represented symptom data. Controlling for diagnosis, premorbid IQ, and disease severity, high lifetime psychosis scores were associated with reduced accuracy and speed across cognitive domains, whereas high depression scores were associated with increased social cognition accuracy. INTERPRETATION:Cross-diagnostic investigations showed that neurocognitive function in severe mental illness is characterised by two distinct profiles (bipolar 1 disorder and schizophrenia, and bipolar 2 disorder and major depressive disorder), and is associated with specific symptom domains. These results suggest the utility of this design for elucidating severe mental illness causes and trajectories. FUNDING:US National Institute of Mental Health.

Genetic factors are strongly implicated in the susceptibility to develop externalizing syndromes such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, and substance use disorder (SUD). Variants in the ADGRL3 (LPHN3) gene predispose to ADHD and predict ADHD severity, disruptive behaviors comorbidity, long-term outcome, and response to treatment. In this study, we investigated whether variants within ADGRL3 are associated with SUD, a disorder that is frequently co-morbid with ADHD. Using family-based, case-control, and longitudinal samples from disparate regions of the world (n = 2698), recruited either for clinical, genetic epidemiological or pharmacogenomic studies of ADHD, we assembled recursive-partitioning frameworks (classification tree analyses) with clinical, demographic, and ADGRL3 genetic information to predict SUD susceptibility. Our results indicate that SUD can be efficiently and robustly predicted in ADHD participants. The genetic models used remained highly efficient in predicting SUD in a large sample of individuals with severe SUD from a psychiatric institution that were not ascertained on the basis of ADHD diagnosis, thus identifying ADGRL3 as a risk gene for SUD. Recursive-partitioning analyses revealed that rs4860437 was the predominant predictive variant. This new methodological approach offers novel insights into higher order predictive interactions and offers a unique opportunity for translational application in the clinical assessment of patients at high risk for SUD.

Acquired demyelinating CNS syndromes include a broad spectrum of clinical phenotypes and different entities can overlap. Therefore, differential diagnosis is still challenging. A humoral immune reaction against myelin oligodendrocyte glycoprotein (MOG) is present in a subgroup of these patients, particularly in children. Anti-MOG antibodies indicate a non-multiple sclerosis disease course. Indeed, early publications have suggested that anti-MOG antibodies argue for a monophasic course; recently an association with a high risk for recurrent non-MS disease has been shown. According new data, antibody analysis was included in a diagnostic algorithm for the diagnosis of acquired demyelinating CNS syndromes in children. Here, recent data from the implementation of anti-MOG antibodies in daily clinical practice are reviewed.

Background: There are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation. Methods: K-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients. Results: A total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders. Conclusions: The factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.

Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America. The Spanish version of the K-SADS-PL was modified to integrate changes made to the DSM-5. Clinicians received training in the K-SADS-PL-5 and 90% agreement between raters was obtained. A total of 80 patients were recruited in four different countries in Latin America. All items from each of the six disorders were included in a factor analysis. Parent-child agreement was calculated for every item of the six disorders, including the effect of sex and age. The factor analysis revealed 6 factors separately grouping the items defining each of the new or modified disorders, with Eigenvalues greater than 2. Very good parent-child agreements (r>0.8) were found for the large majority of the items (93%), even when considering the sex or age of the patient. This independent grouping of disorders suggests that the manner in which the disorders were included into the K-SADS-PL-5 reflects robustly the DSM-5 constructs and displayed a significant inter-informant reliability. These findings support the use of K-SADS-PL-5 as a clinical and research tool to evaluate these new or modified diagnoses.

The objective of this study was to compare the sleep-wake cycle profile between offspring of parent with bipolar disorder (BO) and offspring of parent controls (PCO).

Back to table of contents Previous article Next article Book ForumFull AccessIACAPAP Textbook of Child and Adolescent Mental HealthJuan David Palacio, M.D., M.Sc.Juan David PalacioSearch for more papers by this author, M.D., M.Sc.Published Online:1 Jul 2017https://doi.org/10.1176/appi.ajp.2017.17030361AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail edited by Joseph M. Rey, M.D., Ph.D. Geneva, International Association for Child and Adolescent Psychiatry and Allied Professions, 2015 (downloadable PDFs).The e-textbook from the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), freely available online, is an easily accessible e-book for any professional working in the field of child and adolescent mental health. In the book, world authorities in child and adolescent psychiatry cover diverse topics from the clinical assessment and development of children and youths to major psychiatric disorders. The book also covers some cultural, social, legal, and administrative aspects of this field.Reviewing the chapter on bipolar disorder, I found basic concepts, clear and updated information, and tables that allow readers to readily appreciate the content. In addition, the authors suggest illustrative and valuable links to videos of authorities in bipolar disorder and to other documentaries, which exquisitely complement and deepen the text. In this way, reading becomes easy, concise, and enjoyable. The chapter on attention deficit hyperactivity disorder (ADHD) accurately covers the main literature on the subject, illustrating the evolution of ADHD throughout life, explaining the different presentations of the disorder, and also covering current controversies about ADHD. Once again, the suggested links to expert videos, guidelines from the National Institute for Health and Care Excellence, and other materials make it a versatile and very novel chapter.In general, the manner in which this book has been developed makes it a good basic text to support the teaching of future psychiatrists. Some sections also contain self-assessment questions to reinforce knowledge, and some offer additional teaching material such as downloadable PowerPoint presentations, “ready to go” material to teach future generations. Some chapters have been translated into French, Portuguese, Japanese, Spanish, Russian, and Hebrew. This strength is in turn a huge challenge for the future: to cover different languages ​​in all chapters.The intention of Joseph M. Rey to develop a high-quality, innovative, didactic textbook of child infant mental health and to reach various countries of the world is well fulfilled through this effort of the IACAPAP.Dr. Palacio is Director of the child psychiatry training program at the University of Antioquia, Medellin, Colombia.The author reports no financial relationships with commercial interests. FiguresReferencesCited byDetailsCited byPrevention of Intellectual Development Disorder18 May 2022 | enadakulturaInternet Addiction as One of the Main Types of Addiction in Modern High-School Students31 March 2022 | Scientific Bulletin of Mukachevo State University Series “Pedagogy and Psychology”, Vol. 8, No. 1Features of affective disorders correction in patients with epilepsy (therapy, rehabilitation, prevention)31 March 2021 | Medicine Today and Tomorrow, Vol. 90, No. 1Psychometric Evaluation of the Malay Version of the Multidimensional Beck Youth Inventories-2 (BYI-2 Malay): Measuring Self-Concept, Anxiety, Depression, Anger, and Disruptive Behaviour among Adolescents in Sheltered Homes26 March 2021 | Pertanika Journal of Social Sciences and Humanities, Vol. 29, No. 1Is the Progress of Children with ASD in a Behavioural Therapy Programme Influenced by Parents’ Hyper-Systemizing?1 September 2020 | Journal of Evidence-Based Psychotherapies, Vol. 20, No. 2 Volume 174Issue 7 July 01, 2017Pages 698-698 Metrics KeywordsOther Psychological IssuesAdministrationTextbookChild PsychiatryAdolescentsTeachingMental HealthPsychiatric DisorderPDF download History Accepted 1 March 2017 Published online 1 July 2017 Published in print 1 July 2017

Bipolar disorder and schizophrenia are causes of major suffering in patients. Nevertheless, they also affect family and caregiver functioning. This is important because the participation and involvement of families and caregivers is essential to achieve an optimal treatment. To describe the level of expressed emotions, burden, and family functioning of bipolar and schizophrenic patients and, to evaluate the efficacy of the multimodal intervention (MI) versus traditional intervention (TI) in family functioning and its perception by patients and caregivers. A prospective, longitudinal, therapeutic-comparative study was conducted with 302 patients (104 schizophrenic and 198 bipolar patients) who were randomly assigned to a MI or TI groups of a multimodal intervention programme PRISMA. MI group received care from psychiatry, general medicine, neuropsychology, family therapy, and occupational therapy. TI group received care from psychiatry and general medicine. Hamilton, Young and SANS, SAPS scales were applied to bipolar and schizophrenic patients, respectively. The EEAG, FEICS, FACES III and ECF were also applied at the initial and final time. There were statistically significant differences in socio-demographic and clinical variables in schizophrenia vs bipolar group: 83% vs 32.2% were male, 37 vs 43 mean age, 96% vs 59% were single, 50% vs 20% unemployed, and 20% vs 40% had college studies. In addition, 2 vs 2.5 numbers of hospitalisations, 18 vs 16 mean age of substance abuse onset and, 55 vs 80 points in EEAG. There were no statistically significant differences in family scales after conducting a multivariate analysis on thr initial and final time in both groups. This study did not show changes in variables of burden and family functioning between bipolar and schizophrenic groups that were under TI vs MI. El trastorno afectivo bipolar (TAB) y la esquizofrenia son causas importantes de sufrimiento para los pacientes y sus familias, pues se afectan su funcionamiento y su dinámica normal. Esto es importante, ya que la implicación de la familia es esencial para un tratamiento óptimo del paciente. Describir el nivel de emociones expresadas, la carga y el funcionamiento de las familias de los pacientes bipolares y esquizofrénicos y evaluar la eficacia de la intervención multimodal (IM) en comparación con la intervención tradicional (IT) en el funcionamiento familiar y en la percepción que de este tienen el paciente y sus cuidadores. Se realizó un estudio prospectivo, longitudinal, terapéutico-comparativo, con una muestra de 302 pacientes (104 con diagnóstico de esquizofrenia y 198 con TAB) aleatorizados a un grupo de IM y otro de IT dentro de un programa de salud mental con énfasis en reducción de la carga, el daño y el gasto social de la enfermedad mental (PRISMA). Los pacientes asignados a la IM recibían atención por psiquiatría, medicina general, neuropsicología, terapia de familia y terapia ocupacional, y los pacientes asignados a IT recibían atención por psiquiatría y medicina general. Las escalas realizadas al inicio y al final de las intervenciones fueron las de Hamilton y Young, SANS y SAPS, para pacientes bipolares y esquizofrénicos respectivamente. A ambos grupos se aplicaron las escalas EEAG, FEICS, FACES III y ECF. Se encontraron diferencias estadísticamente significativas en las variables sociodemográficas y clínicas entre los grupos de pacientes con TAB y con esquizofrenia. Tras hacer un análisis multivariable MANCOVA, no se observaron diferencias estadísticamente significativas en los resultados entre los momentos inicial y final en los grupos de pacientes con TAB y con esquizofrenia según las escalas FEICS, FACES III y ECF. Este estudio no evidencia un cambio en la carga y el funcionamiento familiar entre los grupos sometidos a IM y a IT de pacientes bipolares y esquizofrénicos.

BACKGROUND:Bipolar Disorder (BD) and schizophrenia are included in the group of severe mental illness and are main causes of disability and morbidity in the local population due to the bio-psycho-social implications in patients. In the last 20 years or so, adjunctive psychological interventions been studied with the purpose of decreasing recurrences, stabilising the course of the disease, and improving the functionality in these patients.OBJECTIVE:To analyse the psychological effect of a multimodal intervention (MI) vs a traditional intervention (TI) program in BD I and schizophrenic patients.METHODS:A prospective, longitudinal, therapeutic-comparative study was conducted with 302 patients (104 schizophrenic and 198 bipolar patients) who were randomly assigned to the MI or TI groups of a multimodal intervention program PRISMA. The MI group received care from psychiatry, general medicine, neuropsychology, family therapy, and occupational therapy. The TI group received care from psychiatry and general medicine. The Hamilton and Young scales, and the Scales for the Assessment of Negative Symptoms (SANS) and Postive Symptoms (SAPS) were used on bipolar and schizophrenic patients, respectively. The scales AQ-12, TEMPS-A, FAST, Zuckerman sensation seeking scale, BIS-11, SAI-E and EEAG were applied to measure the psychological variables. The scales were performed before and after the interventions. The psychotherapy used in this study was cognitive behavioural therapy.RESULTS:There were statistically significant differences in socio-demographic and clinical variables in the schizophrenia and bipolar disorder group. There were no statistically significant differences in the psychological scales after conducting a multivariate analysis between the intervention groups and for both times (initial and final).CONCLUSION:This study did not show any changes in variables of psychological functioning variables between bipolar and schizophrenic groups, who were subjected to TI vs MI (who received cognitive behavioural therapy). Further studies are needed with other psychological interventions or other psychometric scales.