Gasol Foundation

BackgroundEvaluating the decision-making capacity of individuals with Severe Mental Disorder (SMD) is essential for compliance with the 2006 Convention on the Rights of People with Disabilities. In Spain, capacity was historically determined through judicial procedures, resulting in partial or total capacity modification (CM). The abolition of this procedure in 2021 has left a gap in addressing the needs of this population, creating challenges under the new legal framework.AimThe RECAPACITA project studied the clinical, neuropsychological, and functional profiles of individuals with SMD and CM, focusing on differences between partial (pCM) and total (tCM) modifications.MethodsA cross-sectional study was conducted with 77 adult patients with SMD and CM (47 tCM, 30 pCM) from the Parc Sanitari Sant Joan de Déu mental health network (Spain). Sociodemographic, clinical, functional, and neuropsychological data were collected, along with an independent assessment of mental capacity.ResultsAround 87% of sample had a schizophrenia spectrum disorder; pCM patients presented more substance-related and personality disorders as a secondary diagnosis. While no statistically significant differences were observed between groups, clinically, tCM group presents greater clinical alteration, lower insight, sustained attention, coding capacity, processing speed and resistance to interference compared to pCM group. tCM group had worse social functioning, and lower scores in reasoning and appreciation when assessing mental capacity.ConclusionsIndividuals with tCM show greater clinical impairment and higher support needs compared to those with pCM. With the practical and legal abolition of tCM, it is essential to ensure that these individuals’ persistent challenges are adequately addressed, as their needs remain significant despite the disappearance of this legal category.

Diet is considered a determinant of weight status, however, more evidence is needed for children. The Mediterranean diet (MedDiet) is one of the healthiest worldwide. This study analyzes the prospective association between adherence to the MedDiet at baseline and changes in standardized body mass index (zBMI) and the incidence of excessive weight. 1389 children participated with a follow-up of 15 months. Weight, height, and adherence to the MedDiet were measured (baseline and follow-up). Multiple logistic regression analysis revealed that a high increase in zBMI was associated with lower odds of eating vegetables once [OR 0.74 (95% CI 0.57-0.98)] or more a day [OR 0.68 (95% CI 0.49-0.95)], nuts 2-3 times/week [OR 0.74 (95% CI 0.56-0.97)] or 2 cups of yogurt or/and cheese daily [OR 0.74 (95% CI 0.55-0.99)]. Not consuming each food item was used as reference. Multiple linear regression analysis showed a negative (β = -0.010, p = 0.040) association between the MedDiet at baseline and changes in zBMI at follow-up, significance disappeared (p = 0.082) after final adjustment for baseline zBMI. Baseline MedDiet was not significantly associated with the incidence of excessive weight at follow-up. The MedDiet was positively associated with changes in zBMI, however the effect size was small. The present longitudinal study contributes knowledge regarding the adherence to Mediterranean diet as a predictive variable of weight status evolution in children. Higher adherence to the Mediterranean diet at baseline was prospectively and inversely associated with changes in zBMI after 15 months of follow-up. Consuming vegetables, nuts, and yoghurt/cheese according to the recommendations reduces the likelihood of having a high increase in zBMI after 15 months of follow-up.