Papers by javier garcia campayo
BMC Psychiatry, 2015
Background: Clinical practice guidelines for the treatment of major depressive disorder (MDD) rec... more Background: Clinical practice guidelines for the treatment of major depressive disorder (MDD) recommend antidepressants for patients with moderate-severe depression and active monitoring for patients with mild-moderate symptoms. The feasibility and efficiency of active monitoring has not been proven conclusively. The aim of this study is to evaluate the cost-effectiveness of active monitoring in comparison to antidepressants for primary care patients with mild-moderate MDD. Methods/Design: This is a 12-month follow-up multicenter observational prospective controlled trial. Patients are enrolled in 12 primary care centers in Barcelona (Spain). Eligible patients are adults (≥18 years-old) with a new episode of MDD that sign a written consent to participate. This is a naturalistic study in which general practitioners (GPs) use their professional judgment to allocate patients into active monitoring or antidepressants groups. GPs treat the patients following their clinical criteria. At baseline, GPs complete a questionnaire (sociodemographic/job characteristics, training, attitude towards depression, interest on mental health and participation in communication groups). Patients' measurements take place at baseline and after six and 12 months. Main outcome measures include severity of depression (PHQ-9), health-related quality of life (EuroQol-5D) and use of healthcare and social care services (Client Service Receipt Inventory). Secondary outcomes include diagnosis of MDD according to DSM-IV diagnostic criteria (SCID-I), disability (WHO-DAS), anxiety (BAI), comorbidities, medication side-effects and beliefs about medicines (BMQ). The analysis will be done according to the intention to treat analysis. Missing data will be imputed using multiple imputation by chained equations. To minimize the bias resulting from the lack of randomization, a propensity score will be used. Incremental effects and costs between groups will be modelled in each of the imputed databases using multivariate generalized linear models and then combined as per Rubin's rules. Propensity scores will be used to adjust the models. Incremental cost-effectiveness ratios will be calculated by dividing the difference in costs between groups by the difference in effects. To deal with the uncertainty, resampling techniques with bootstrapping will be used and cost-effectiveness planes and cost-effectiveness acceptability curves will be constructed. A series of sensitivity analyses will be performed.
La personalidad y su influencia en la búsqueda de ayuda médica en las enfermedades médico-quirúrgicas
Trastornos de personalidad, 2003, ISBN 84-9706-061-X, págs. 793-809, 2003
Aspectos psicosomáticos de la hipertrofia mamaria
El tratamiento de la hipertrofia mamaria constituye, en la actualidad, una de las practicas quiru... more El tratamiento de la hipertrofia mamaria constituye, en la actualidad, una de las practicas quirurgicas mas comunes del trabajo de los cirujanos plasticos. En estas pacientes, ademas de confirmar se una sintomatologia fisica evidente, como es dolor de espalda y/o cuello, lesiones cutaneas y adormecimiento en las manos, las repercusiones esteticas asociadas condicionan una evaluacion negativa de la autoimagen corporal que, junto a vivencias de ansiedad y depresion, producen diversos grados de malestar psicosocial. Es por esto que la mamoplastia de reduccion, ademas de disminuir significativamente el volumen mamario, proporciona grandes beneficios, segun todas las series revisadas, mejorando los sintomas fisicos asociados a la macromastia y aumentando la calidad de vida, nivel de salud y autoestima de las pacientes.
Docencia de habilidades de comunicación en enfermería
We describe the roots and foundaments of the Tibetan medical tradition, emphasizing the balance o... more We describe the roots and foundaments of the Tibetan medical tradition, emphasizing the balance of the three elements («Nyespa») for the physical Shealth and the concept of mental health for this culture, strongly intertwined with Buddhist doctrine. Afterwards, we have compared psychiatric disorders described in the most famous medical text from Tibet, the "rGyud-bShi", with diagnostic criteria from the most important nosotaxic classification of the modero Westem psychiatry, the DSM-IV. Amazingly, sirnilarities are so evident that sorne of the main Tibetan mental disorders could be diagnosed at present. Differences are discussed on a cross-cultural bases.
Salud mental e inmigración
El proceso de inmigracion como causante de patologia psiquiatrica Las revisiones recientes de la ... more El proceso de inmigracion como causante de patologia psiquiatrica Las revisiones recientes de la literatura concluyen que la emigracion per se no produce un incremento del riesgo de padecer enfermedades mentales (Marsella, Bornemann y Ekblad, 1994; National Institute of Mental Health, 1991), sino que dicho riesgo depende, al menos en parte, de las experiencias traumaticas sufridas durante el proceso migratorio (Cervantes, Salgado de Snyder y Padilla, 1989) y, por tanto, los refugiados serian los inmigrantes que presentarian mayor patologia.
La experiencia del practicum en la enseñanza de la medicina de familia
Mindful eating: comer sano y disfrutando
Utilidad de la realidad virtual en la enseñanza y práctica de mindfulness: una revisión
espanolA pesar de que el interes y las investigaciones en mindfulness han crecido exponencialment... more espanolA pesar de que el interes y las investigaciones en mindfulness han crecido exponencialmente en los ultimos anos, demostrando sus multiples beneficios, en la actualidad siguen existiendo dificultades u obstaculos asociados a su practica. La Realidad Virtual (RV) se plantea como una herramienta que puede contribuir al aprendizaje y uso de esta tecnica. Este articulo tiene como principal objetivo realizar una revision de la literatura de aquellos estudios que aplican un sistema de realidad virtual que favorece el desarrollo de la atencion plena. De esta forma, se han encontrado un total de 10 articulos que han sido analizados. Aunque estos estudios han arrojado resultados positivos, no podria afirmarse que existe suficiente evidencia empirica que apoye su uso en mindfulness. Esto puede ser debido principalmente a que la tecnologia de RV se encuentra en sus primeras fases de desarrollo en el ambito de mindfulness. Es por ello que deben realizarse nuevas investigaciones que incluy...
Progressive impairment of visual function in fibromyalgia
Acta Ophthalmologica, 2019
ObjectivesTo evaluate visual fuction affectation in patients with fibromyalgia during 5 years of ... more ObjectivesTo evaluate visual fuction affectation in patients with fibromyalgia during 5 years of follow‐up.MethodsOne hundred and eighteen eyes of 118 patients (96.7% women) with fibromyalgia were analysed at a baseline visit and another at 5 years of follow‐up. They underwent visual acuity (VA) measurement with the best correction and with the ETDRS test at 100% and 2.5% of saturation, contrast sensitivity evaluation with Pelli Robson and CSV1000E tests, chromatic vision analysis with the Farnsworth test 15D and Lanthony 15D (using the Color Vision Recorder software), intraocular pressure (IOPmeasurement, visual field with the Easyfield perimeter, stereopsis with TNO test and macular ganglion cell thickness with optica coherence tomography (OCT) of Fourie Domain (Cirrus, Zeiss). All measurements were made by the same observer. In addition, epidemiological and clinical variables such as age at diagnosis, duration of the disease, and quality of life scale (with EQ‐5D test), were reco...
Retina (Philadelphia, Pa.), Jan 13, 2018
To evaluate visual and retinal changes in patients with bipolar disorder. To analyze the correlat... more To evaluate visual and retinal changes in patients with bipolar disorder. To analyze the correlation between structural changes and visual function parameters. Thirty patients with bipolar disorder and 80 healthy controls underwent visual function evaluation with Early Treatment Diabetic Retinopathy Study charts at 100%, 2.50%, and 1.25% contrast, Pelli-Robson chart, and color vision Farnsworth and Lanthony tests. Analysis of the different retinal layers was performed using Spectralis optical coherence tomography with automated segmentation software. Correlation analysis between structural and functional parameters was conducted. Patients with bipolar disorder presented worse color vision compared with controls (Lanthony's index, P = 0.002). Full macular thickness, the retinal nerve fiber layer (RNFL), ganglion cell layer, and inner plexiform layer were reduced in patients compared with healthy individuals (P < 0.005). The inner nuclear layer was significantly thickened in pa...
Mindfulness and Neuroimaging
Psychiatry and Neuroscience Update, 2015
The scientific community has recently begun to unveil the numerous changes that occur while one i... more The scientific community has recently begun to unveil the numerous changes that occur while one is meditating. The ability to measure functional activity in the brain by the signal produced by changes of blood oxygenation levels has become a useful tool in cognitive neuroscience. With functional magnetic resonance imaging, researchers are able to identify associations between activation and/or deactivation of brain areas and different stimuli or responses during the performance of specific cognitive tasks or even at rest (default mode network). Structural magnetic resonance images reveal how much grey or white matter is present in different parts of the brain. Magnetic resonance spectroscopy of the brain may provide a window into the biochemical changes associated with neuronal integrity. Although these techniques are commonly known, in this chapter we will try to better explain the results provided by these neuroimaging techniques in relation to the effects produced in the brain by the practice of mindfulness.
[Mental health prevention programme in primary care]
Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria, 2007
[Attitudes of Spanish doctors towards immigrant patients: an opinion survey]
Actas españolas de psiquiatría
We assess the attitudes of Spanish doctors towards immigrant patients. cross-sectional descriptiv... more We assess the attitudes of Spanish doctors towards immigrant patients. cross-sectional descriptive study carried out in January-June 2003. Family doctors and third-year residents of 15 health care centers in Zaragoza, Spain. specifically designed interview answered in anonymously and on a voluntary basis. A total of 62.3 % of the sample responded. Nearly 75 % of the doctors had received training on immigration, mainly from a theoretical point of view. Almost 25 % of immigrant consultations are not related to health matters. Doctors think that immigrant patients somatize more than Spanish ones but they do not suffer from more psychiatric illness. They also think immigrants show less treatment compliance and are more demanding. They disagree about possible racial biases in diagnosis or treatment of these patients. Spanish doctors consider that the different ethnic groups present similar management difficulties. The group with the most negative stereotype was the patients from Muslim N...
[Effectiveness of group psychoanalytic therapy in somatizing patients]
Actas españolas de psiquiatría
Somatizers are a kind of patients very prevalent, expensive for the health system and difficult t... more Somatizers are a kind of patients very prevalent, expensive for the health system and difficult to treat. In recent years, several treatment approaches, such as cognitive, psychodynamic or educative therapy, have demonstrated effectiveness for the management of these patients. This paper aims to analyze the research studies on group psychotherapy for the treatment of somatizers. Most of these studies are not solid from a methodological point of view. Based on these data, the authors summarize the indications, methodology, limitations and effectiveness of group psychotherapy in the treatment of somatizing patients.
[Prevention of mental health disorders in primary health care. Group for Prevention in Mental Health of the PAPPS]
Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria, 1999
[Anxiety scales and Goldberg's depression: an efficient interview guide for the detection of psychologic distress]
Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria, Jan 15, 1993
Validation of Goldberg's Anxiety and Depression scales in our settings. Transverse study. Two... more Validation of Goldberg's Anxiety and Depression scales in our settings. Transverse study. Two phases screening at population previously stratified and randomly allocated. SITE. National Health Institute's Primary Care Centres at the city of Zaragoza. 444 patients, aged 19 and older, who attend their general practitioner for a new episode of illness. The sample has been previously stratified by sex and age. At the first stage the sample has been studied with a Health Survey consisting of a variety of sound validity (General Health Questionnaire-28 items version, spanish version of Folstein's mini Mental Status Examination, CAGE and another drug and over the counter products screening questionnaire) and the new scales, that we attempt to validate. At the second stage "the possible cases" chosen at the first phase and 10% of possible non cases are assessed with a comprehensive Psychiatric Interview: EPEP (Standardized Polyvalent Psychiatric Interview). The new sca...
Interdisciplinary consensus document for the treatment of fibromyalgia
Actas españolas de psiquiatría
Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, tog... more Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.Objective. To develop a consensus on the treatment of fibromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry,rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes,having specific symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.Methods. The different clinical class...
Aten Primaria, 2007
-Pérdida de funciones psicofísicas. Atención al paciente y a sus familiares. -Cuidado del pacient... more -Pérdida de funciones psicofísicas. Atención al paciente y a sus familiares. -Cuidado del paciente terminal y de su familia. -Pérdida de un familiar o allegado. -Jubilación. -Cambios frecuentes de domicilio en los ancianos. -Violencia doméstica. Violencia en la pareja. -Malos tratos a los ancianos. -Detección precoz de los trastornos de ansiedad-depresión. -Prevención del suicidio.
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Papers by javier garcia campayo