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J Giner

Publications and source records attributed to J Giner.

69 records · Page 4Linked to original sources
PubMedDate not supplied

[Seville Quality of Life Questionnaire: historic outlook of its establishment].

We describe how we developed a new instrument for measuring quality of life, the Seville Quality of Life Questionnaire (SQCQ), and the results we obtained when we applied it to a group of schizophrenic patients. The questionnaire was designed by a group of researchers who set out from the premise that the quality of life of schizophrenic patients is perceived differently from that of healthy people, and tried first of all to demarcate the kind of area which is abnormal in these patients. We then devised a set of items which were assessed for clarity and pertinence by a series of experts, and the questionnaire was assembled in the form of a set of statements, response to which is in the form of a Lickert-type 5-stage scale. The finished questionnaire was administered to 279 schizophrenic patients. At the same time, these patients were also evaluated using the AMDP Psychopathology Scale, the positive and negative symptoms evaluation scale (PANS), Lehman's structured quality of life interview (QOLY), Ruiz and Baca's quality of life questionnaire (QLQ), Camberwell's scale of needs analysis (CANr) and the WHO's handicap assessment scale (DDS). These questionnaires were used to judge the different types of validity of the Seville Questionnaire. The reliability of the questionnaire was measured using Cronbach's alpha coefficient (internal consistency: 0,85 scale of favourable aspects, 0,96 scale of unfavourable aspects). As far as validity was concerned, both scales of the questionnaire were found to have a high level of validity. We also examined the extent to which the psychopathological disorders affected the quality of the schizophrenic person's life, the extent to which his/her needs were being met by the health services, and the patient's degree of disability. From the results obtained, we can say that the SQCQ is a reliable and valid instrument, which is sufficiently sensitive to the clinical changes produced in the course of the natural history of the disease. The SQCQ stands out from the other quality of life questionnaires in that it takes into account aspects of the disease which the patient him/herself is aware of as affecting his/her quality of life.

Humans↗
PubMedDate not supplied

[Subjective experience and quality of life in schizophrenia].

The term quality of life has been gradually introduced in the field of Psychiatry. This term tries to integrate not only the symptoms in Psychiatric patients, but also other aspects, like individual perceptions, personal expectations, degree of independence, etc., in order to achieve a global understanding of the patient. The are few studies on quality of life in schizophrenia, especially there is a lack of self assessment scales that the patients can fill out about themselves and their psychological environment. The Seville Quality of Life Questionnaire tries to evaluate the subjective experience of patients with schizophrenia about their illness. The Seville Quality of Life Questionnaire also checks the presence or absence of groups of patients with schizophrenia with a better or worst quality of life. We have assessed 222 subjects that meet ICD-10 criteria diagnostic for schizophrenia, with the Seville Quality of Life Questionnaire, the Positive and Negative Symptom Scale specific psychopathology scale and the AMDP system general psychopathology scale. Our results show two clearly differentiate groups: one with better (Group 2: 108 patients) and one with worse (Group 1: 81 patients) quality of life. However, 33 patients could not be included in any of the two groups. In the worse quality of life group the most prominent factors were: lack of cognitive grasp, perplexity, fear of loss of control, and contained hostility. These four factors have a great influence on the worse quality of life. When we compare the Seville Quality of Life Questionnaire data with several the Positive and Negative Symptom Scale scores, we saw that the group of worse quality of life presents higher scores on both Negative and Positive Symptoms of schizophrenia, and also in the Positive and Negative Symptom Scale general psychopathology scale. In the AMDP system general psychopathology scale we saw three groups of significant symptoms in the Seville Quality of Life Questionnaire: 1. Difficult relationships with the external world, 2. Difficulty to understand what it happening (loss of associations); and 3. Affective alterations (ambivalence).Finally, these data suggests that it is probable that the Seville Quality of Life Questionnaire could be able to build a typology of patients with schizophrenia more centred in their pathology that in their psychophatology.

Adult↗
PubMedDate not supplied

[Impact of olanzapine on quality of life of patients with schizophrenia: one-year follow-up with the Seville Quality of Life Questionnaire].

INTRODUCTION: Our objective is to present the impact on quality of life of long-term olanzapine treatment in a significant number of schizophrenics as determined by the Seville Quality of Life Questionnaire (SQLQ), an instrument that addresses the aspects that particularly affect these patients, and to evaluate the sensitivity of this instrument to the changes induced by this treatment. METHODS: Three hundred and seventy two patients with the diagnosis of schizophrenia as per the ICD-10 classification were evaluated in a 1 year prospective study after switching to olanzapine. The SQLQ, Lehman's structured interview and short version of the discapacity assessment scale were used to evaluate patient's subjective experience; in addition, other instruments were used to evaluate psychopathology. RESULTS: Significant increases in the scores of the favorable scale and decreases in the unfavorable scale of the SQLQ were found. There were also significant improvements in quality of life as measured with Lehman's structured interview. This improvement continued until the end of the 1 year follow-up after switching to olanzapine. Both instruments show a good correlation. Changes in psychopathology were also remarkable, including the negative symptoms. CONCLUSIONS: The SQLQ has proven to be a sensitive instrument to measure quality of life in schizophrenic patients treated with olanzapine. It focuses on aspects that are relevant for patients that were frequently overlooked by treating physicians. This drug has been proven to have a favorable subjective impact upon patients, besides improving psychopathology.

Adolescent↗
PubMedDate not supplied

Ziprasidone: from pharmacology to the clinical practice. One year of experience.

More than a year after the marketing of the atypical anti-psychotic ziprasidone, data from research studies and clinical practice have provided a fair amount of useful information for its practical use in the treatment of schizophrenia. Its pharmacodynamical characteristics and the results from clinical trials with a flexible dose seem to justify the need to administer doses in a range higher than what was initially foreseen, with an initial minimum of 120 mg per day and a fast titulation up to 160 mg per day. Such doses make it possible to achieve sufficient plasma concentrations to occupy at least 60 % of the D2 receptors from which the anti-psychotic effect derives. Moreover, its anti-depressive activity and its non-sedative profile have been confirmed, with a favorable effect on attention and other cognitive functions of the patient, according to its high affinity for 5HT1A and D1 receptors and the inhibition of serotonin and noradrenaline re-uptake. Finally, the low affinity of this drug for alpha-adrenergic, histaminergic and muscarinic receptors favors a good tolerability profile, with a neutral effect on weight, and a lack of anti-cholinergic effects. Results from different clinical trials show that the use of doses in the higher range is associated to a faster and more pronounced clinical improvement without adding a higher risk of adverse events.

Antipsychotic Agents↗
PubMedDate not supplied

[Treatment adherence in schizophrenia. A comparison between patient's, relative's and psychiatrist's opinions].

INTRODUCTION: Patients with psychiatric illness typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. Due to the lack of insight in schizophrenia, adherence to treatment is especially important. We try to analyze and compare the opinion on adherence and compliance of psychiatrists, patients with schizophrenia and relatives. METHOD: A direct, anonymous survey specifically designed for the project was administered to psychiatrists, patients and relatives from all over Spain through different associations of patients and family legally constituted in Spain. Analysis was done separately for variables corresponding to the three groups. RESULTS: The psychiatrists (n = 844) considered that 56.8 % of their evaluated patients (n = 7.439) were noncompliers in the past month, as opposed to 43.2% of these patients who were considered good compliers (3,215 patients). Ninety-five percent of the patients (n = 938) stated that they took their medication regularly, while 5 % answered no to this question. Eighty-two percent of relatives (n = 796) think that patients regularly take their medication, but 47% state that they sometimes forget to take it. CONCLUSIONS: Treatment adherence should be evaluated in clinical trials and in research on treatment of diseases, particularly in chronic mental diseases such as schizophrenia. It seems clear that only programs aimed at detection and resolution of the problems involved in treatment adherence will be able to improve the mid- and long-term prognosis of patients with schizophrenic disorders.

Adolescent↗
PubMedDate not supplied

Treatment adherence in schizophrenia. Spanish clinical consensus.

Objective. Establish a Spanish Consensus on Therapeutic Compliance in Schizophrenia. Material and methods. An experts committee designed a specific questionnaire having 40 questions and 293 options. The questions referred to the definition and general assessment of compliance in schizophrenia, factors involved, intervention strategies in outpatients and in acute units and management of oral and long duration injectable antipsychotic drugs and other non-pharmacological therapies. First, second or third line strategy values of choice were assigned according to the answers obtained for each item. The questionnaire was sent to 383 psychiatrists of a Therapeutic Compliance Work Group. A total of 326 answers were received with an electronic system that guaranteed their confidentiality. Results and conclusions. There is maximum agreement on considering the seriousness of the compliance problem, its repercussion in relapses, the patient's course and increase in health care costs. The strategies preferred to evaluate compliance are: counting of the injectable drug administration and determination of plasma concentrations. The Consensus considers that specific intervention is necessary when the patient has already suffered several relapses due to low therapeutic compliance, when null awareness of disease is detected or if there is comorbidity with toxic consumption. Psychoeducational is the non-pharmacological strategy having the greatest consensus grade if intervention is needed. Treatments with atypical injectable, long duration, antipsychotic drugs obtain the best grade in accordance with pharmacological strategies of first choice, in different clinical situations to avoid or improve therapeutic adherence. Key words: Adherence. Compliance. Schizophrenia. Consensus.

Antipsychotic Agents↗
PubMedDate not supplied

In vitro and in vivo testing of an electrocatalytic glucose sensor.

A prerequisite for the development of an implantable artificial pancreas is the availability of a stable, long-life glucose sensor. Platinum (Pt) catalyzed electrodes have been demonstrated in vitro to show high sensitivity to glucose and long cycle life but are more sensitive to co-reactants compared with enzymatic methods. The authors developed a special data processing method (compensated net charge ratio, or CNCR) in which the measured electrode response is very sensitive to glucose, completely insensitive to urea, and only moderately sensitive to amino acids. Other endogenous and exogenous co-reactants show only minor interferences. The CNCR method involves the determination of the ratio of net oxidation charge to total charge during one complete cycle of a cyclic voltammogram. Prototype electrodes tested in vitro in spiked plasma have shown typical sensitivities of greater than 2 x 10(-4) CNCR units per 1 mg/dl change in glucose concentration, with linear response up to 400 mg/dl. For in vivo testing, a modified 5 F vascular catheter with membrane covered surface mounted electrodes was used at a vena cava site in swine. Several sensor designs were tested in vivo, with sensitivities of 1-5 x 10(-4) CNCR units (mg/dl).

Animals↗
PubMedDate not supplied

Evaluation of a new piston-type spirometer.

A new dry spirometer (DS) incorporating a microcomputer for automatic calculation and direct read-out of spirometric parameters was compared to a calibrated Fleisch pneumotachograph (PT). Twenty-eight volunteers, including healthy subjects, obstructive and non-obstructive patients, performed a total of 48 spirometric tests with the two apparatuses randomly alternated. DS values for FVC were lower than those of the PT with a mean difference of 0.177 1 +/- 0.171 SD (p less than 0.0001). Mean FEV1 values were very similar in both apparatuses with a non significant difference of 0.003 1 +/- 0.182 FEF25-75 values were higher with the DS, showing a mean difference with the PT of 0.407 1 . s-1 +/- 0.324 (p less than 0.00001). The DS also gave slightly higher PEFR values than the PT, with a mean difference of 0.310 1 . s-1 +/- 0.830 (p less than 0.02). Differences in FVC readings between DS and PT were greater in severely obstructed patients (0.350 1 +/- 0.084, p less than 0.0001) than among healthy subjects (0.120 1 +/- 0.051, p less than 0.0002). On the contrary, in absolute figures DS values for FEF25-75 showed a greater difference with those of the PT in normals (0.547 1 . s-1 +/- 0.320, p less than 0.001) than in obstructed patients (0.288 1 . s-1 +/- 0.244, p less than 0.05). DS flow resistance was 2.67 cmH2). s. 1-1 for a flow of 8.8 1. s-1. Based on the spirometric differences observed, and on the high flow resistance and volume limitation imposed by its 6 1 capacity, we concluded that the apparatus tested cannot be recommended for clinical spirometry.

Adult↗
PubMedDate not supplied

[Treatment with tianeptine for depressive disorders in the elderly].

Depression is frequent in the elderly but difficult both to diagnose and treat due to a number of distinctive features. Tianeptine is a novel antidepressant with a reverse mode of action to that of the selective serotonin reuptake inhibitors yet with proven efficacy and safety. 63 elderly patients (mean age: 68.8 years; range: 65-80 years) with depressive symptoms (major depression: 55.6%; dysthymia: 44.4%) were included in a 3-month open multicenter study with tianeptine (25 mg daily). 43 patients (68.2%) completed the study. There were no drop-outs due to side-effects. Total Montgomery and Asberg depression rating scale scores were significantly decreased (p < 0.01) on day 14, with a response rate of 76.7%. Improvements were also observed in anxiety and cognitive performance. Side-effects were seen in only 11.7% of patients, with no changes in laboratory or ancillary safety parameters. Tianeptine is thus effective and well tolerated in this category o patient.

Aged↗