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Revista Clínica y Salud

Revista Clínica y Salud

Portada de la revista en español “Clínica y Salud”

Clínica y Salud

Clínica y Salud es una revista que publica contribuciones empíricas originales sobre investigación básica o aplicada, revisiones teóricas sobre el “estado de la cuestión” de algún tópico puntual o general de un campo de estudio, y estudios de casos clínicos dentro del ámbito de la psicología clínica y de la salud.


Tablas de contenidos de la revista

ABSTRACT Background: Peripartum depression (PPD) is a prevalent, heterogeneous disorder with various underlying mechanisms and unwanted outcomes. Substantial uncertainty surrounding PPD aetiology exists. To comprehensively investigate PPD, research is adopting the biopsychosocial theoretical model highlighting the interplay between biological and psychosocial factors. This paper aims to provide an overview of risk factors and biopsychosocial models of PPD. Method: A literature search was conducted in databases to identify risk factors and biopsychosocial models of PPD. Results: The most robust biological and psychosocial risk factors of PPD and findings from integrative studies are outlined. Several biopsychosocial models are identified, explaining antepartum, postpartum or peripartum depression. Integrative models show promise but differ in conceptualisation and proposed aetiological pathways underlying PPD. Conclusion: Biopsychosocial principles should be applied throughout the perinatal research and healthcare provision as a necessary landmark towards guiding future theory, improving maternal mental health care and ensuring better outcomes for mothers and children.RESUMEN Antecedentes: La depresión perinatal (DPN) es un trastorno predominante heterogéneo al que subyacen diversos mecanismos y consecuencias indeseadas. Hay una gran incertidumbre sobre la etiología de la DPN. Con el fin de investigar exhaustivamente el trastorno, la investigación asume el modelo teórico biopsicosocial, que destaca la interacción entre los factores biológicos y psicosociales. El estudio pretende presentar un resumen de los factores de riesgo y de los modelos psicosociales de la DPN. Método: Se llevó a cabo una búsqueda de las publicaciones en las bases de datos para localizar los factores de riesgo y los modelos biopsicosociales. Resultados: Se describen los factores biológicos de riesgo psicosocial más consistentes de la DPN y los resultados de los estudios integradores. Se detectaron diversos modelos biopsicosociales que explicaban la depresión preparto, posparto y perinatal. Los modelos integradores son prometedores pero difieren en la conceptualización y las trayectorias propuestas que subyacen a la DPN Conclusión: Deberían aplicarse los principios biopsicosociales a lo largo de la investigación perinatal y facilitar asistencia sanitaria como hito necesario que sirva de guía a la teoría futura, mejorando la asistencia mental materna y garantizando los mejores resultados para madres e hijos. [...]
Mar, Feb 27, 2024, Continue reading at the source
ABSTRACT Background: Infertility generates high levels of stress to women. The aim was to explore optimism and resilience among women undergoing assisted reproductive technology (ART). Method: Participants were recruited in a private fertility clinic. The sample consisted of 229 women under medical treatment for fertility who completed the following self-report instruments: a sociodemographic and clinical questionnaire, Resilience Scale (RS), Life Orientation Test (LOT-R), Perceived Stress Scale (PSS), and STAI State and STAI Trait. Results: Our data revealed that high resilience levels were associated with a reduced psychological stress (β = .02, p < .001, 95% CI [.34, .13]). A significant negative correlation between perceived stress and resilience (r = -.320, p = .001) was found. Conclusion: The findings highlight the protective mediating role of resilience when women are confronted with the negative effects of infertility diagnosis and assisted reproductive technology (ART), and therefore the potential utility of resilience to reduce infertility-specific stress.RESUMEN Antecedentes: La infertilidad genera un nivel de estrés elevado en la mujer. El objetivo era explorar el optimismo y la resiliencia en las mujeres que se someten a técnicas de reproducción asistida (TRA). Método: Los participantes fueron reclutados en una clínica de fertilidad privada. La muestra estuvo conformada por 229 mujeres en tratamiento médico para de fertilidad que cumplimentaron los siguientes instrumentos de autoinforme: cuestionario sociodemográfico y clínico, Escala de Resiliencia (RS), Test de Orientación a la Vida (LOT-R), Escala de Estrés Percibido (PSS) y STAI Estado y Rasgo. Resultados: Los datos revelaron que un nivel elevado de resiliencia se asociaba con menos estrés psicológico (β = .02, p < .001, IC del 95 % [.34, .13]). Se obtuvo una correlación negativa significativa entre estrés percibido y resiliencia (r = -.320, p = .001). Conclusión: Los hallazgos resaltan el papel mediador protector de la resiliencia cuando las mujeres se enfrentan a los efectos negativos del diagnóstico de infertilidad y las técnicas de reproducción asistida (TRA) y, por lo tanto, la utilidad potencial de la resiliencia para reducir el estrés específico de la infertilidad. [...]
Mar, Feb 27, 2024, Continue reading at the source
ABSTRACT Background: Fear of childbirth (FOC) has adverse effect on delivery, maternal and infant health. This study aimed to examine the prevalence of FOC and to examine the role of perfectionism, intolerance of uncertainty, and preparedness for childbirth in explaining FOC in non-pregnant and pregnant women, as well as the role of mode of delivery in multiparous women. Method: In the cross-sectional study, 197 non-pregnant, 168 nulliparous and 124 multiparous pregnant women filled out questionnaires on FOC (W-DEQ), perfectionism (PNPS), intolerance of uncertainty (IUS), and a question on preparedness for childbirth. Results: More important determinants of FOC were personality traits (perfectionism and intolerance of uncertainty) in non-pregnant and nulliparous pregnant women, as opposed to previous childbirth experience (emergency caesarean section) in multiparous women. However, preparedness for childbirth was associated with FOC in all three sub-groups. Conclusion: Preparedness for childbirth should be the target in prenatal classes in order to alleviate FOC.RESUMEN Antecedentes: El miedo al parto (MP) influye de un modo adverso en el mismo y en la salud materna e infantil. El estudio tiene por objeto analizar la prevalencia del MP y el papel del perfeccionismo, la intolerancia a la incertidumbre y la preparación para el parto para explicar el MP en mujeres embarazadas y no embarazadas así como el papel que juega el modo de alumbramiento en mujeres multíparas. Método: En el estudio transversal 197 mujeres no encintas, 168 embarazadas nulíparas y 124 multíparas cumplimentaron cuestionarios sobre MP (W-DEQ), perfeccionismo (PNPS), intolerancia a la incertidumbre (IUS) y una pregunta sobre preparación para el parto. Resultados: Los determinantes más importantes del MP fueron los rasgos de personalidad (perfeccionismo e intolerancia a la incertidumbre) en mujeres no encintas y en embarazadas nulíparas en oposición a la experiencia previa de parto (cesárea de emergencia) en mujeres multíparas. No obstante, la preparación para el parto se asociaba al MP en los tres subgrupos. Conclusión: La preparación para el parto debería abordarse en las clases prenatales para aliviar el MP. [...]
Mar, Feb 27, 2024, Continue reading at the source
ABSTRACT Background: Perinatal depression is a major public health problem, with an estimated prevalence of approximately 15% during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding assessment and treatment in the Spanish context. The General Council of Psychology of Spain convened a working group of experts in the field, including both academics and healthcare professionals, to review and propose recommendations based on evidence and best practices that could be applied in the Spanish context. Method: A literature search was completed in various databases (e.g., Medline, PsychInfo) including a combination of terms related to peripartum depression (PPD) assessment and diagnosis, prevention, treatment, and cost-effectiveness. A narrative synthesis of the literature has been conducted together with a critical overview of PPD with a special focus on the Spanish context. Results: In this consensus report, developing questions including prevalence and assessment tools, comparative effectiveness of preventive and treatment interventions, and cost-effectiveness of PPD management have been analyzed. Conclusions: The General Council of Psychology of Spain network advocates the establishment of compulsory screening protocols in all the autonomous regions. Also, it is necessary to promote the inclusion in maternal education of programs for the promotion of mental well-being and selective/indicated prevention carried out by a psychology professional with specialized training in the area. This consensus document also promotes the presence of a psychology professional with specialized training in the area.RESUMEN Antecedentes. La depresión perinatal es un importante problema de salud pública, con una prevalencia estimada de aproximadamente el 15% durante el primer año posparto. A pesar de la gran prevalencia de depresión posparto (DPP), no existe consenso sobre la evaluación y el tratamiento en el contexto español. El Consejo General de Psicología de España convocó a un grupo de trabajo de expertos en la materia, tanto académicos como profesionales sanitarios, para revisar y proponer recomendaciones basadas en evidencias y mejores prácticas que puedan aplicarse en el contexto español. Método. Se realizó una búsqueda bibliográfica en varias bases de datos (p. ej., Medline, PsychInfo) que incluía una combinación de términos relacionados con la evaluación y el diagnóstico de la DPP, prevención, tratamiento y coste-eficacia. Se ha realizado una síntesis narrativa de la literatura junto con una visión crítica de la DPP con un enfoque especial en el contexto español. Resultados. Las preguntas de desarrollo que incluyen prevalencia y herramientas de [...]
Mar, Feb 27, 2024, Continue reading at the source
ABSTRACT Few studies have shown the psychological impact of the COVID-19 pandemic on new mothers' health, but the long-term consequences of the crisis are yet unknown. This study aimed at evaluating the changes experienced in perinatal mental health 6 months after the start of the COVID-19 pandemic in Spain. Women (n = 176, average age = 33.80) were recruited during the pandemic. Participants completed the Edinburgh Postnatal Depression Scale, the Satisfaction With Life Scale and Positive, and the Negative Affect Schedule. Results showed a decrease in depressive symptoms, t(174) = 2.58, p = .01, d = 0.02, whereas anxiety symptoms remained high, t(174) = 1.31, p = .19. In terms of psychological well-being, the results showed a decrease in life satisfaction, t(175) = 2.58, p = .011, d = 0.16, and negative affect, t(175) = 3.15, p = .002, d = 0.26, and an increase in positive affect, t(175) = -4.45, p < .001, d = 0.35. This study is expected to shed light on the design of future interventions aimed at the prevention of symptoms and to enhance life satisfaction during the perinatal stage.RESUMEN Algunos estudios han mostrado el impacto psicológico de la pandemia de COVID-19 en la salud mental perinatal, pero aún se desconocen las consecuencias a largo plazo de esta crisis sanitaria. El presente estudio tuvo como objetivo evaluar los cambios en la salud mental perinatal tras 6 meses del inicio de la pandemia de la COVID-19 en España. Se reclutaron mujeres en etapa perinatal (n = 176, edad promedio = 33.80) durante la pandemia. Las participantes cumplimentaron la Escala de Depresión Postparto de Edimburgo, una escala de satisfacción con la vida y otra de afecto positivo y negativo. Los resultados mostraron una disminución de los síntomas depresivos a los 6 meses, t(174) = 2.58, p = .01, d = 0.02, mientras que los síntomas de ansiedad se mantuvieron elevados, t(174) = 1.31, p = .19. En cuanto al bienestar psicológico, los resultados mostraron una disminución en la satisfacción con la vida, t(175) = 2.58, p = .01, d = 0.16, y en el afecto negativo, t(175) = 3.15, p = .002, d = 0.26, y un aumento en el afecto positivo, t(175) = -4,45, p < .001, d = 0.35. Se espera que este estudio arroje luz sobre el diseño de futuras intervenciones dirigidas a la prevención de síntomas y a la mejora de la satisfacción [...]
Mar, Feb 27, 2024, Continue reading at the source
ABSTRACT Rationale: Pregnant women are especially vulnerable to mental health problems, including stress, anxiety, and depression. This risk has been increased during the COVID-19 pandemic and differences in psychological symptoms in pregnancy and postpartum before and during COVID-19 exists. Mental health problems can have adverse effects on both the woman, and the neonate, including miscarriages, premature births, low birth weight, and higher rates of cesarean sections and instrument-assisted deliveries. Aim: To evaluate the prevalence of psychological symptoms of pregnant women before and during the COVID-19 pandemic. Method: A cross-sectional study was carried out to assess the psychological profile in a sample of pregnant women selected before the pandemic and a sample of women studied during the first wave of the pandemic. A total of 122 women were selected prior to the pandemic and 181 women during the COVID-19 outbreak. The Symptom Checklist-90 Revised (SCL-90-R) was used to assess depression and anxiety during pregnancy and in the postpartum period. Results: The prevalence of symptoms of depression and anxiety during pregnancy were higher in the sample of women studied during the pandemic (SCL-90-R: M = 54.6 vs. 42.6 and M = 62.6 vs. 51.7 respectively). In the postpartum the difference between both samples of women was even higher for depression and anxiety (SCL-90-R: M = 50.4 vs. 35.0 and M = 51.3 vs. 36.0 respectively). Being a pregnant woman at the COVID-19 outbreak was directly associated with a higher score of depression symptoms (aOR = 8.67, 95% CI [3.26, 23.02], p < .001). Anxiety during childbirth was more frequently reported by women before the pandemic (aOR = 5.13, 95% CI [2.53, 10.44], p < .001). The variable stage (before /during pandemic) was also associated with having a clinical SCL-90-R score above 70 (aOR = 7.61, 95% CI [2.7, 21.47], p < .001). Conclusion: During the pandemic, pregnancy and postpartum were associated with the presence of anxiety and depression. The main factor associated with postpartum depression was maternal age. These finding highlights the vulnerability of pregnant in front of the pandemic, in which psychological health and mental well-being are affected, not only during pregnancy, but also in the postpartum.RESUMEN Justificación: Las mujeres embarazadas son especialmente vulnerables a los problemas de salud mental, como el estrés, la ansiedad y la depresión. Este riesgo se ha incrementado durante la pandemia de COVID-19, habiendo diferencias en los síntomas psicológicos en [...]
Mar, Feb 27, 2024, Continue reading at the source

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