Publications by authors named "G Lahera"

65 Publications

Spanish Versions of the Outcome Rating Scale and the Session Rating Scale: Normative Data, Reliability, and Validity.

Front Psychol 2021 13;12:663791. Epub 2021 Aug 13.

The International Center for Clinical Excellence, Chicago, IL, United States.

Routine outcome monitoring (ROM) uses standardized measures to both track and inform mental health service delivery. Use of ROM has been shown to improve the outcome of psychotherapy when applied to different types of patients. The present research was designed to determine the reliability and validity of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) in a sample of Spanish patients. After a controlled process of translation into the Spanish that is spoken and written in Spain (i.e., in Europe, as distinct from, e.g., Latin American Spanish), both measures were completed by patients of an outpatient mental health unit during eight sessions of psychotherapy. Sixty mental health patients filled out the ORS and 59 the SRS. In addition, the ORS was completed by 33 people who constituted the non-clinical sample. The cut-off of the ORS was 24.52 points, and the Reliable Change Index (RCI) was 9.15 points. ORS and SRS scores exhibited excellent internal consistency. The temporal stability of the SRS was adequate. The convergent and discriminant validity of the two measures were adequate. Regarding the factorial validity of the ORS and the SRS, in the third psychotherapy session, confirmatory factor analyses evidenced the existence of a unifactorial model. The predictive validity of SRS was acceptable. The ORS was sensitive to changes in patients' symptoms. In conclusion, compared to the original English versions of the ORS and SRS measures, the Spanish versions of the measures are also reliable and valid.
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http://dx.doi.org/10.3389/fpsyg.2021.663791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414252PMC
August 2021

Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients: Results from a randomized controlled trial.

Rev Psiquiatr Salud Ment 2021 Aug 28. Epub 2021 Aug 28.

Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain; CIBERSAM, IRyCIS, Madrid, Spain; Principe de Asturias University Hospital, Alcalá, Spain.

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-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation.

Results: Eighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either.

Conclusions: In our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning.
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http://dx.doi.org/10.1016/j.rpsm.2021.08.001DOI Listing
August 2021

Exploring the Role of Nutraceuticals in Major Depressive Disorder (MDD): Rationale, State of the Art and Future Prospects.

Pharmaceuticals (Basel) 2021 Aug 21;14(8). Epub 2021 Aug 21.

Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain.

Major depressive disorder (MDD) is a complex and common disorder, with many factors involved in its onset and development. The clinical management of this condition is frequently based on the use of some pharmacological antidepressant agents, together with psychotherapy and other alternatives in most severe cases. However, an important percentage of depressed patients fail to respond to the use of conventional therapies. This has created the urgency of finding novel approaches to help in the clinical management of those individuals. Nutraceuticals are natural compounds contained in food with proven benefits either in health promotion or disease prevention and therapy. A growing interest and economical sources are being placed in the development and understanding of multiple nutraceutical products. Here, we summarize some of the most relevant nutraceutical agents evaluated in preclinical and clinical models of depression. In addition, we will also explore less frequent but interest nutraceutical products which are starting to be tested, also evaluating future roads to cover in order to maximize the benefits of nutraceuticals in MDD.
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http://dx.doi.org/10.3390/ph14080821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399392PMC
August 2021

Social Cognition and Interaction Training (SCIT) versus Training in Affect Recognition (TAR) in patients with schizophrenia: A randomized controlled trial.

J Psychiatr Res 2021 Oct 23;142:101-109. Epub 2021 Jul 23.

Department of Psychology and Neuroscience, University of North Carolina - Chapel Hill, USA; Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia.

Introduction: Training in Affect Recognition (TAR) is a "targeted" and computer-aided program that has been shown to effectively attenuate facial affect recognition deficits and improve social functioning in patients with schizophrenia. Social Cognition and Interaction Training (SCIT) is a group "broad-based" intervention, that has also been shown to improve emotion recognition, theory of mind (ToM), and social functioning. To date, no study has compared the efficacy of two different social cognitive interventions.

Objectives: We aim to compare the efficacy of TAR and SCIT on schizophrenia patients' performance on facial affect recognition, theory of mind, attributional style and social functioning before, after treatment, and three months thereafter.

Methods: One hundred outpatients with a diagnosis of schizophrenia were randomly assigned to the TAR or SCIT condition and completed pre- (T0) and posttreatment (T1) assessments and a 3-month follow up (T2) of emotion recognition (ER-40), theory of mind (Hinting Task), attributional style (AIHQ) and social functioning (PSP).

Results: The entire sample, receiving TAR or SCIT, showed improvements in theory of mind, attributional style, clinical symptoms and social functioning. This effect was maintained at three-months. The TAR intervention was more efficacious than the SCIT program in improving the recognition of facial emotions (ER-40). The TAR intervention also demonstrated a lower drop-out rate than the SCIT intervention.

Conclusions: There were improvements in social cognition, symptomatology and functioning of patients in the entire sample, receiving SCIT or TAR. Both TAR and SCIT appear as valuable treatments for people with schizophrenia and social cognitive deficits.
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http://dx.doi.org/10.1016/j.jpsychires.2021.07.029DOI Listing
October 2021

Functioning and Happiness in People with Schizophrenia: Analyzing the Role of Cognitive Impairment.

Int J Environ Res Public Health 2021 07 20;18(14). Epub 2021 Jul 20.

Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain.

Schizophrenia is associated with marked functional impairment and low levels of subjective happiness. The aim of the current study was to evaluate the relationship between subjective happiness and functioning in patients with schizophrenia, while considering the role of cognitive functioning.

Methods: In total, 69 schizophrenia patients and 87 matched healthy controls participated in the study. Patients' clinical status was assessed, and a series of self-report questionnaires were administered to both patients and healthy controls to measure subjective happiness, satisfaction with life, well-being, functioning, and cognitive impairment. A multiple linear regression model identified significant predictors of subjective happiness and related constructs.

Results: Schizophrenia participants endorsed lower levels of happiness and well-being, and higher perceived stress compared to healthy controls. In schizophrenia patients, there was an inverse and significant correlation (r = -0.435; = 0.013) between subjective happiness and functioning in a subgroup of patients without cognitive impairment. This correlation was not significant (r = -0.175; = 0.300) in the subgroup with cognitive impairment. When controlling for other clinical variables (by multiple lineal regression), the severity of symptoms and level of insight failed to demonstrate significant relationships with happiness; meanwhile, perceived stress and some specific cognitive dominions (as verbal learning and processing speed) were associated with satisfaction of life of the patients.

Conclusions: The relationship between subjective happiness and functioning in schizophrenia patients was influenced by level of cognitive impairment. Findings from this study suggest that rehabilitation programs may improve recovery outcomes with a focus on subjective happiness and functioning, especially in patients with cognitive impairment. Future research is needed to better understand the complex interplay between subjective happiness, functioning, and cognitive impairment in patients with schizophrenia.
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http://dx.doi.org/10.3390/ijerph18147706DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303973PMC
July 2021
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