RESUMO

AIM: Cognitive disturbances typically precede the onset of overt psychotic symptoms and represent a neurobiological marker for psychosis risk that is also associated with poor functional outcomes. The Measure of Insight into Cognition-Self Report (MIC-SR) is a widely used 12-item questionnaire that assesses the perceived frequency of cognitive impairment in the domains of executing functioning, attention, and memory. However, the MIC-SR is not available in Spanish, one of the most widely spoken languages worldwide. The present study aimed to provide a Spanish version of the MIC-SR and examine its psychometric properties in psychosis-risk and non-clinical Mexican young adults. METHODS: The sample comprised 621 participants who completed a battery of self-report measures via an online survey. Of the participants, 478 were non-clinical, and 143 met the screening criteria for a clinical high-risk for psychosis (CHR-positive). RESULTS: Confirmatory Factor Analyses supported a one-factor model, consistent with the findings for the original MIC-SR. The results showed adequate fit indices for the general model and the independent models for both groups, with high Cronbach's alpha coefficients. Furthermore, the CHR-positive group showed more frequent subjective cognitive problems on each of the 12 items, higher total scores, and higher average frequency than the non-clinical group. CONCLUSION: To our knowledge, this is the first translation of the MIC-SR into Spanish. Using the MIC-SR at the CHR stage may contribute to our understanding of cognitive processes associated with the onset of a psychotic disorder and provide valuable information in the context of detection and early intervention efforts.

RESUMO

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.

Antecedentes/Objetivo: Las guías diagnósticas CIE-11 para trastornos mentales y del comportamiento de la Organización Mundial de la Salud deben ser evaluadas en pacientes reales alrededor del mundo a fin de asegurar que son clínicamente útiles y genuinamente globales. Se evalúa la consistencia inter-evaluadores y la utilidad clínica de las guías para los trastornos psicóticos, afectivos, de ansiedad y relacionados con el estrés en pacientes mexicanos. Método: Voluntarios con síntomas psicóticos, afectivos, de ansiedad o relacionados con el estrés derivados de una unidad de pre-consulta de un hospital psiquiátrico, para una entrevista con una pareja de clínicos, quienes posteriormente asignaron diagnósticos de manera independiente y evaluaron la utilidad clínica de las guías aplicadas a cada caso en particular, con base en una escala desarrollada para este propósito. Resultados: 23 clínicos evaluaron 153 pacientes. Los coeficientes Kappa fueron fuertes para trastornos psicóticos (0,83), moderados para los relacionados con el estrés (0,77) y afectivos (0,60), y débiles para los de ansiedad y relacionados con el miedo (0,43). Una alta proporción de clínicos consideró que las guías eran bastante o extremadamente útiles. Conclusiones: Las guías CIE-11 para dichos trastornos permiten una adecuada consistencia inter-evaluadores en clínicos mexicanos, quienes les consideran herramientas clínicamente útiles.

RESUMO

Objetivo Identificar y analizar las principales situaciones de crisis que enfrentan los familiares de pacientes con esquizofrenia, así como sus necesidades en la atención psiquiátrica en momentos de crisis. Método Con metodología cualitativa de recolección y análisis, la técnica utilizada fue la creación de un grupo de discusión con ocho familiares de pacientes con esquizofrenia. Las sesiones grupales se grabaron y transcribieron para analizar posteriormente la información. Además, se realizaron entrevistas individuales a cada familiar. Resultados Los familiares destacaron tres principales situaciones de crisis: 1. La crisis psicótica; 2. La crisis familiar ante el diagnóstico y en el proceso de aceptación de la enfermedad; 3. La crisis ante las recaídas subsecuentes. También se detallan: 4. Las deficiencias en la atención en situaciones de crisis y 5. Las necesidades de los familiares en estas situaciones. Conclusiones Desde la narrativa de los familiares se puede destacar la experiencia de una falta de información tanto a familiares y a pacientes como a la población en general, para que se conozcan los principales rasgos y síntomas que caracterizan a la esquizofrenia, para lograr con ello una detección temprana que facilite el tratamiento y la prevención de crisis posteriores. Es conveniente desarrollar intervenciones en los momentos de crisis y establecer una red social de apoyo en la comunidad.

Objetive This article presents the main crisis situations faced by the relatives of schizophrenic patients, as well as their needs in psychiatric attention at moments of crisis. Method Qualitative study. A discussion group of eight parents of patients with schizophrenia was conformed. The group sessions were recorded and transcribed to analyze the information later on. In addition, the information was complemented with individual interviews of the relatives. Results Parents emphasized three main crisis situations: 1. a first psychotic crisis, 2. family crisis facing the diagnosis and in the process of acceptance of the disease, and 3. subsequent relapses. 4. Deficiencies in the care crisis, and 5. needs of families in crisis situations are also detailed. Conclusions According to the narratives related by the relatives of the discussion group, we can conclude that it is necessary to provide information to the family, the patients and the general population, so that there is a knowledge of the main characteristics and symptoms of schizophrenia. This should be carried out with the purpose of obtaining an early detection that facilitates the treatment and prevents later crises interventions and creating a social support network in the community.