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Bulbena A, Rosado S, Cabaleiro M, Martinez M, Baeza-Velasco C, Martin LM, Batlle S, Bulbena-Cabré A. Corrigendum: Validation of the neuroconnective endophenotype questionnaire (NEQ): a new clinical tool for medicine and psychiatry resulting from the contribution of Ehlers-Danlos syndrome. Front Med (Lausanne) 2023; 10:1338616. [PMID: 38143448 PMCID: PMC10740201 DOI: 10.3389/fmed.2023.1338616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2023.1039223.].
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Affiliation(s)
- Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Silvia Rosado
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
- Doctorate Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
| | - Marina Cabaleiro
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - María Martinez
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Paris, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Luis-Miguel Martin
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Santiago Batlle
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
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Castaño-Asins JR, Sanabria-Mazo JP, Luciano JV, Barceló-Soler A, Martín-López LM, Del Arco-Churruca A, Lafuente-Baraza J, Bulbena A, Pérez-Solà V, Montes-Pérez A. Effectiveness of Acceptance and Commitment Therapy (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study). J Clin Med 2023; 12:4066. [PMID: 37373758 DOI: 10.3390/jcm12124066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/01/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Research on the use of Acceptance and Commitment Therapy (ACT) for patients with degenerative lumbar pathology awaiting surgery are limited. However, there is evidence to suggest that this psychological therapy may be effective in improving pain interference, anxiety, depression, and quality of life. This is the protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of ACT compared to treatment as usual (TAU) for people with degenerative lumbar pathology who are candidates for surgery in the short term. A total of 102 patients with degenerative lumbar spine pathology will be randomly assigned to TAU (control group) or ACT + TAU (intervention group). Participants will be assessed after treatment and at 3-, 6-, and 12-month follow-ups. The primary outcome will be the mean change from baseline on the Brief Pain Inventory (pain interference). Secondary outcomes will include changes in pain intensity, anxiety, depression, pain catastrophizing, fear of movement, quality of life, disability due to low back pain (LBP), pain acceptance, and psychological inflexibility. Linear mixed models will be used to analyze the data. Additionally, effect sizes and number needed to treat (NNT) will be calculated. We posit that ACT may be used to help patients cope with the stress and uncertainty associated with their condition and the surgery itself.
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Affiliation(s)
| | - Juan P Sanabria-Mazo
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 St. Boi de Llobregat, Spain
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain
- Centre of Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Juan V Luciano
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 St. Boi de Llobregat, Spain
- Centre of Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Clinical & Health Psychology, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain
| | | | | | | | | | - Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain
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Bulbena A, Rosado S, Cabaleiro M, Martinez M, Baeza-Velasco C, Martin LM, Batlle S, Bulbena-Cabré A. Validation of the neuroconnective endophenotype questionnaire (NEQ): a new clinical tool for medicine and psychiatry resulting from the contribution of Ehlers-Danlos syndrome. Front Med (Lausanne) 2023; 10:1039223. [PMID: 37234249 PMCID: PMC10206165 DOI: 10.3389/fmed.2023.1039223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/22/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction The link between anxiety disorders and joint hypermobility syndrome (now under hypermobility spectrum disorders, which include hypermobile Ehlers-Danlos syndrome) has been widely replicated over the past 30 years and has grown beyond the initial nosological limits. To integrate clinical and research progress in this field, a new neuroconnective endophenotype (NE) and its corresponding instrument, the Neuroconnective Endophenotype Questionnaire (NEQ), have been developed. This new clinical construct, created with the active participation of patients, includes both somatic and psychological dimensions and symptoms and resilience items. Methods The NE includes five dimensions: (1) sensorial sensitivity, (2) body signs and symptoms, (3) somatic conditions, (4) polar behavioral strategies, and (5) psychological and psychopathological dimensions. The NEQ information is collected through four self-administered questionnaires (sensorial sensitivity, body signs and symptoms, polar behavioral strategies, and psychological characteristics) and a structured diagnostic part that should be completed by a trained observer. This hetero-administered part incorporates (a) psychiatric diagnoses (using structured criteria, e.g., MINI), (b) somatic disorders diagnosis, using structured criteria, and (c) assessment of joint hypermobility criteria. Results In a sample of 36 anxiety cases with 36 matched controls, the NEQ obtained high scores for test-retest, inter-rater reliability, and internal consistency. As for predictive validity, cases and controls significantly differed in all five dimensions and hypermobility measurements. Discussion We can conclude that the NEQ has achieved acceptable reliability and validity values and, therefore, is ready to be used and tested in different samples. This original and consistent construct including somatic and mental items may improve clinical specificity, the search for more comprehensive therapies, and their genetic and neuroimaging bases.
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Affiliation(s)
- Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Silvia Rosado
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
- Doctorate Program in Psychiatry, Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
| | - Marina Cabaleiro
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - María Martinez
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Paris, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Luis-Miguel Martin
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
| | - Santiago Batlle
- Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions (INAD) CIBERSAM, Barcelona, Spain
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Guinchat V, Baeza-Velasco C, Bulbena A, Castori M. Editorial: Neurodevelopmental, neuropsychiatric and psychosocial correlates of joint hypermobility and related disorders. Front Psychiatry 2022; 13:1109515. [PMID: 36578299 PMCID: PMC9791253 DOI: 10.3389/fpsyt.2022.1109515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Vincent Guinchat
- Psychiatric Section of Mental Development, Psychiatric University Clinic, Lausanne University Hospital, Lausanne, Switzerland
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.,Anxiety Unit, Hospital del Mar, Institute Neuropsychiatry and Addictions, Barcelona, Spain
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, Foggia, Italy
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Bulbena-Cabré A, Baeza-Velasco C, Rosado-Figuerola S, Bulbena A. Updates on the psychological and psychiatric aspects of the Ehlers-Danlos syndromes and hypermobility spectrum disorders. Am J Med Genet C Semin Med Genet 2021; 187:482-490. [PMID: 34806831 DOI: 10.1002/ajmg.c.31955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022]
Abstract
The field of the psychiatric and psychological aspects of Ehlers-Danlos syndromes (EDS) has been understudied and neglected for many years. People with EDS are often classified as "somatizers" by untrained clinicians. However, research on the biological basis of EDS is improving our understanding of the physiology and psychopathology of the disorder. In this article, we consider the literature on the psychopathological dimensions associated with EDS as well as the EDS symptoms in psychiatric conditions since our review in 2017. Literature confirms that psychological processes (i.e., fear, emotional distress, or negative emotions) in EDS have a significant impact on the outcomes of EDS. Common systemic associations are found between anxiety disorders and EDS as well as significant correlations with neurodevelopmental, eating, mood, and sleep disorders. There is limited but increasing evidence of an association between EDS and suicidal thoughts and behaviors, which should be further explored. The broad spectrum of human anxiety and associated somatic symptoms (beyond anxiety disorders) appears to be the core of the psychopathology in EDS and therefore, detecting and assessing EDS might be a new opportunity for psychiatric nosology to develop more inclusive phenotypes like the Neuroconnective Phenotype that include both somatic and psychological manifestations.
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Affiliation(s)
- Andrea Bulbena-Cabré
- Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Metropolitan Hospital, New York City Health and Hospitals, New York, New York, USA
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université de Paris, Paris, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | | | - Antonio Bulbena
- Institut Neuropsychiatry and Addictions, Parc Salut Mar, Hospital del Mar, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autónoma Barcelona, Barcelona, Spain
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Bowen J, Bulbena A, Fatjó J. The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain. Front Psychiatry 2021; 12:622060. [PMID: 33935828 PMCID: PMC8081030 DOI: 10.3389/fpsyt.2021.622060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/11/2021] [Indexed: 12/31/2022] Open
Abstract
Dogs are a source of companionship and comfort for their owners, but the degree to which this might translate into real emotional and social support has not been quantified. Emotional and social support are essential to help people to get through personal crises such as bereavement. In this study we characterize the social support owners obtain from their dogs, provide evidence of how widespread this social support is amongst dog-owners, and show how social support from dogs can increase during a crisis (using the COVID-19 pandemic as an example). We collected data from a representative population-based sample of Spanish dog-owners and found that most respondents said that their dogs helped them to get through tough times. They got comfort from physical contact with their dogs, shared activities with them and treated them as confidants in a similar way to friends and family. These are all key aspects of social support, and dogs offer the advantage of being more available than human sources of support. It would be expected that the support that dogs provide would be increased during a time of personal crisis and when we looked at data collected from a convenience sample of Spanish dog-owners during the COVID-19 confinement that is what we found; during the confinement owners engaged in more shared activities with their dogs, hugged them more often and turned to them more as a source of companionship and comfort (p < 0.0001 in all cases). However, although owners did confide more in their dogs (p < 0.0001), the effect was not as great as for other aspects of social support. We suspect that this is because people were able to use telecommunications such as video conferencing to maintain their human confidant relationships. Our findings indicate that dogs can substitute for humans as sources of some kinds of social support when conventional sources are unavailable. Our conclusion is that where a dog is present in a household, it should be regarded as an important resource for social support. This should be considered when designing clinical interventions and when public health decisions are being made.
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Affiliation(s)
- Jonathan Bowen
- Affinity Foundation Chair for Animals and Health, Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Queen Mother Hospital for Small Animals, Royal Veterinary College, North Mymms, United Kingdom
| | - Antonio Bulbena
- Affinity Foundation Chair for Animals and Health, Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques - Institut de Neuropsiquiatria i Addiccions, Mar Health Park, Barcelona, Spain
| | - Jaume Fatjó
- Affinity Foundation Chair for Animals and Health, Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques - Institut de Neuropsiquiatria i Addiccions, Mar Health Park, Barcelona, Spain
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Arumi A, Bulbena-Cabre A, Bulbena A. First Person Account COVID 19 Delirium in a Doctor: When Death Stalks the Mind. Front Psychiatry 2021; 12:626648. [PMID: 33584389 PMCID: PMC7876059 DOI: 10.3389/fpsyt.2021.626648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies reported that 20-30% of COVID-19 patients will develop delirium during the hospitalization, achieving 70% in cases of severe illness. The risks factors and the consequences of delirium are well-documented in the literature; however, little is known about the personal experience of delirium. Delirium burden is common and tends to be distressing even after the delirium episode has resolved. Taking this in mind, the present work provides a first-person account of a doctor who acquired Covid-19 and developed bilateral pneumonia and had delirium and a complicate course of illness. During the course of his delirium, the patient recalled experiences of reality and unreality, complete disorientation, lack of control, strong emotions, and intense fear of dying which was significantly distressing. We anticipate that delirium burden will be common on these patients and family members and clinicians should be aware of this phenomenon in order to evaluate the neuropsychiatric consequences of this condition.
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Affiliation(s)
- Antonio Arumi
- Instituto Trastornos Alimentacion, Salud Mental, Barcelona, Spain
| | - Andrea Bulbena-Cabre
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Metropolitan Hospital NYC Health and Hospitals, New York, NY, United States
| | - Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona, Barcelona, Spain.,Institute Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain
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Malagon A, Córcoles D, Pérez E, Mollà L, Bergé D, González A, Bellsolà M, Martín L, Bulbena A, Pérez V. Social withdrawal and suicide risk: A descriptive study. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionSocial withdrawal is a major health problem that has been related with higher morbidity and mortality rates. There are few studies about the relationship between suicidal behavior and social isolation.AimTo describe the existence of suicidal risk in subjects with social isolation.MethodParticipants were 187 subjects referred to a Crisis Resolution Home Treatment because of social isolation. The inclusion criteria were: home isolation, avoiding of social situations and relationships, for at least 6 months. Suicide risk was assessed by the item of the Severity of Psychiatric Illness, dividing in four groups (from absence to high suicide risk). Socio-demographic and clinical data were also analysed.ResultsMost cases (n = 132, 70.5%) had absence of suicide risk. They were predominantly young males in all groups. There were no statistically significant differences in sociodemographic or clinical variables. The mean age at onset of social isolation was lower in the high suicide risk group, having lower socially withdrawn period. This group had also lower rates of child abuse and suicide attempt history. The more frequent diagnosis in all groups was psychotic, affective and anxiety disorders. Those cases with mild and high suicide risk needed more frequently hospitalization.ConclusionsSocial isolated people attended by CRHT do not have high frequency of suicide risk. Cases with higher suicide risk are younger and have a shorter period of isolation. The absence of child abuse history or previous suicide attempts contrasts with previous suicidal behavior research. These data can be influenced by the characteristics of functioning of CRHT and the small sample size.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Singh D, Rocio Martinez W, Anand N, Pinkhasov A, Calixte R, Bulbena A, Coplan JD. The ALPIM (Anxiety, Laxity, Pain, Immune, and Mood) Syndrome in Adolescents and Young Adults: A Cohort Study. J Neuropsychiatry Clin Neurosci 2020; 31:239-245. [PMID: 30791805 DOI: 10.1176/appi.neuropsych.18080174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE ALPIM (anxiety, laxity, pain, immune, and mood) syndrome has been previously described in adults. The authors aimed to identify its occurrence in adolescents and confirm its existence in adults. Given the association of the disorder with somatic symptoms, separation anxiety disorder (SAD) was explored as an ALPIM comorbidity. METHODS Medical records of patients aged 11-34 with a diagnosis of depression or anxiety (panic disorder, SAD, social anxiety or generalized anxiety disorder) seen during a 1-year period were reviewed. Data were collected on the presence of ALPIM comorbidities. Analyses were conducted to detect their co-occurrence and evaluate possible predictors of the ALPIM syndrome. RESULTS Inclusion criteria were met by 185 patient charts. A significant association was observed between the ALPIM comorbidities with 20 study subjects (10.8%) meeting criteria for ALPIM syndrome (patients with one or more diagnoses from each ALPIM domain). Patients with SAD had increased odds of being diagnosed with ALPIM (odds ratio=7.14, 95% CI=2.48-20.54, p<0.001). Neither major depression nor generalized anxiety disorder was found to be predictive of ALPIM syndrome. There was no difference in the prevalence of ALPIM-related comorbidities between study subjects <18 years old compared with those ≥18 years old. CONCLUSIONS These findings reestablish the association of distinct psychiatric and nonpsychiatric conditions described as the ALPIM syndrome. Furthermore, the syndrome may present during adolescence. SAD may be an independent predictive factor for the occurrence of ALPIM syndrome. Patients with individual ALPIM comorbidities should be assessed for the syndrome, especially if they have a history of SAD.
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Affiliation(s)
- Deepan Singh
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Wendy Rocio Martinez
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Niyati Anand
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Aaron Pinkhasov
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Rose Calixte
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Antonio Bulbena
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
| | - Jeremy D Coplan
- The Department of Behavioral Health, NYU Winthrop Hospital, Mineola, New York (Singh, Pinkhasov); the Department of Psychiatry, Nassau University Medical Center, East Meadow, New York (Rocio Martinez); the Department of Psychology, College of Arts and Science, Stony Brook University, New York (Anand); the Department of Community Health and Social Medicine, CUNY School of Medicine, New York (Calixte); the Department of Psychiatry and Forensic Medicine, Universitat Autonoma Barcelona. Institute of Neuropsychiatry and Addictions, IMIM Parc de Salut Mar, Barcelona, Spain (Bulbena); and the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York (Coplan)
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Tribó MJ, Turroja M, Castaño-Vinyals G, Bulbena A, Ros E, García-Martínez P, Tausk F, Sagristà M, Pujol RM, Ferran M, Gallardo F. Patients with Moderate to Severe Psoriasis Associate with Higher Risk of Depression and Anxiety Symptoms: Results of a Multivariate Study of 300 Spanish Individuals with Psoriasis. Acta Derm Venereol 2019; 99:417-422. [PMID: 30628634 DOI: 10.2340/00015555-3114] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is a chronic skin disease associated with considerable physical and psychological comorbidities. Stress and emotional disturbances have been implicated in both triggering the onset and exacerbation of psoriasis. In order to determine the level of perceived stress and mood alterations in patients with psoriasis and their association with disease severity, 300 individuals completed diverse validated questionnaires assessing stress and psychological mood. Evaluation of perception of disease was also measured. A significant association between psoriasis severity and mood, emotional disturbances and an impact on assessments of the quality of life were observed. Particularly, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale and Hospital Anxiety and Depression Scale for Depression detected a significant risk for depression in relation to the disease severity. The association between depression features, anxiety and perceived stress with psoriasis severity is important and can influence the appropriate management of psoriasis.
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Bulbena-Cabre A, Duñó L, Almeda S, Batlle S, Camprodon-Rosanas E, Martín-Lopez LM, Bulbena A. Joint hypermobility is a marker for anxiety in children. Rev Psiquiatr Salud Ment (Engl Ed) 2019; 12:68-76. [PMID: 30926372 DOI: 10.1016/j.rpsm.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/12/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Joint hypermobility syndrome (JHS) has been found to be associated with anxiety disorders in clinical and nonclinical populations, but to date no studies have evaluated this association in children. The main goal of this study is to evaluate JHS along with anxiety, somatic and behavioral measures in children to clarify if JHS is associated with any of these variables in this age range. METHODS A sample of 160 children (74 girls and 86 boys) ranging from 5 to 17 o were recruited from a Child-Adolescent Mental Health clinic to participate in the study. All children underwent a diagnostic interview using the Mini International Neuropsychiatric Interview for Children and Adolescents. Instruments used include the Child Behavior Checklist (CBCL), the Screening Questionnaire to detect Hypermobility (SQ-CH) and the Children Manifested Anxiety Scale (CMAS-R). RESULTS The prevalence of JHS in this sample was 22%, and this was significantly higher in girls (31%) than in boys (14%) (χ2=6.83; P=.001). The JHS group scored significantly higher in the CMAS-R total anxiety (F=4.51; P=.035), CMAS-R Physiological anxiety (F=7.19; P=.008) and the CBCL somatic complaints (F=8.46; 0.004) and regression analyses showed that these 3 variables were predictors of JHS (χ2=36.77; P<.001; r2=0.22). The JHS group also scored higher in some behavioral measures. CONCLUSION Children with JHS have higher frequency of anxiety disorders and higher intensity of physiological anxiety, somatic complaints, and therefore, JHS might be used as marker for this anxiety phenotype in youngsters.
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Affiliation(s)
- Andrea Bulbena-Cabre
- Universidad Autónoma de Barcelona, Departamento de Psiquiatría y Medicina Forense (UAB), España; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, EE. UU.; Department of Psychiatry, New York Medical College, Nueva York, EE. UU.
| | - Lourdes Duñó
- Mar Health Park, Instituto de Neuropsiquiatría y Adicciones (INAD), Barcelona, España
| | - Sara Almeda
- Mar Health Park, Instituto de Neuropsiquiatría y Adicciones (INAD), Barcelona, España
| | - Santiago Batlle
- Mar Health Park, Instituto de Neuropsiquiatría y Adicciones (INAD), Barcelona, España
| | - Ester Camprodon-Rosanas
- Children and Adolescent Mental Health Research Group. Institut de Recerca Sant Joan de Déu Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain
| | - Luis Miguel Martín-Lopez
- Universidad Autónoma de Barcelona, Departamento de Psiquiatría y Medicina Forense (UAB), España; Mar Health Park, Instituto de Neuropsiquiatría y Adicciones (INAD), Barcelona, España; Centro de Investigación en red de Salud Mental (CIBERSAM), España
| | - Antonio Bulbena
- Universidad Autónoma de Barcelona, Departamento de Psiquiatría y Medicina Forense (UAB), España; Mar Health Park, Instituto de Neuropsiquiatría y Adicciones (INAD), Barcelona, España; Centro de Investigación en red de Salud Mental (CIBERSAM), España
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12
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Affiliation(s)
| | - Antonio Bulbena
- Distinguished Professor of Psychiatry,Chairman of the Department of Psychiatry and Forensic Medicine,Autonomous University of Barcelona,Spain.
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Cabrera A, Kolacz J, Pailhez G, Bulbena-Cabre A, Bulbena A, Porges SW. Assessing body awareness and autonomic reactivity: Factor structure and psychometric properties of the Body Perception Questionnaire-Short Form (BPQ-SF). Int J Methods Psychiatr Res 2018; 27:e1596. [PMID: 29193423 PMCID: PMC6877116 DOI: 10.1002/mpr.1596] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/01/2017] [Accepted: 10/04/2017] [Indexed: 01/29/2023] Open
Abstract
Body awareness and reactivity dysfunction are characteristic of a range of psychiatric disorders. Although the neural pathways communicating between the body and brain that contribute to these experiences involve the autonomic nervous system, few research tools for studying subjective bodily experiences have been informed by these neural circuits. This paper describes the factor structure, reliability, and convergent validity of the Body Awareness and Autonomic Reactivity subscales of the Body Perception Questionnaire-Short Form (BPQ-SF). Exploratory and confirmatory factor analyses were applied to data from three samples collected via the internet in Spain and the US and a college population in the US (combined n = 1320). Body awareness was described by a single factor. Autonomic reactivity reflected unique factors for organs above and below the diaphragm. Subscales showed strong reliability; converged with validation measures; and differed by age, sex, medication use, and self-reported psychiatric disorder. Post hoc analyses were used to create the 12-item Body Awareness Very Short Form. Results are discussed in relation to the distinct functions of supra- and sub-diaphragmatic autonomic pathways as proposed by the Polyvagal Theory and their potential dysfunction in psychiatric disorders.
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Affiliation(s)
- Ana Cabrera
- Institute of Neuropsychiatry and Addictions, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jacek Kolacz
- Kinsey Institute Traumatic Stress Research Consortium, Indiana University, Indiana, USA
| | - Guillem Pailhez
- Institute of Neuropsychiatry and Addictions, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Andrea Bulbena-Cabre
- Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.,Icahn School of Medicine at Mount Sinai, New York, USA
| | - Antonio Bulbena
- Institute of Neuropsychiatry and Addictions, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Stephen W Porges
- Kinsey Institute Traumatic Stress Research Consortium, Indiana University, Indiana, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, USA
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Baeza-Velasco C, Bourdon C, Montalescot L, de Cazotte C, Pailhez G, Bulbena A, Hamonet C. Low- and high-anxious hypermobile Ehlers-Danlos syndrome patients: comparison of psychosocial and health variables. Rheumatol Int 2018; 38:871-878. [PMID: 29497845 DOI: 10.1007/s00296-018-4003-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/26/2018] [Indexed: 12/19/2022]
Abstract
Despite the frequent co-ocurrence of hypermobile Ehler-Danlos syndrome (hEDS) and pathological anxiety, little is known about the psychosocial and health implications of such comorbidity. Our aim was to explore the association between high levels of anxiety and psychosocial (catastrophizing, kinesiophobia, somatosensory amplification, social support and functioning), health (pain, fatigue, BMI, tobacco/alcohol use, depression, diagnosis delay, general health), and sociodemographic factors in people with hEDS. In this cross-sectional study, 80 hEDS patients were divided into two groups according to self-reported anxiety levels: low and high. Psychosocial, sociodemographic and health variables were compared between the groups. Forty-one participants reported a high level of anxiety (51.2%). No differences were found in the sociodemographic variables between high-anxious and low-anxious patients. The percentage of participants with severe fatigue and high depressive symptomatology was significantly higher in the high-anxious group (80.5 vs 56.4; 26.8 vs 12.8%, respectively). High-anxious hEDS patients also showed significantly higher levels of pain catastrophizing, somatosensory amplification as well as a poorer social functioning and general health. Multivariate analyses showed that somatosensory amplification, pain catastrophizing and poor social functioning are variables that increase the probability of belonging to the high-anxious group. Despite limitations, this first study comparing high-anxious versus low-anxious hEDS patients with respect to health aspects, highlight the importance of considering the psychosocial factors (many susceptible to modification), to improve the adjustment to this chronic condition and provide support to those affected through a biopsychosocial approach.
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Affiliation(s)
- Carolina Baeza-Velasco
- Laboratory of Psychopathology and Health Processes, Institut de Psychologie, University Paris Descartes-Sorbonne Paris Cité, 71 Avenue Édouard Vaillant, 92100, Boulogne-Billancourt, France. .,INSERM U1061, Neuropsychiatry: Epidemiological and Clinical Research, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.
| | | | - Lucile Montalescot
- Laboratory of Psychopathology and Health Processes, Institut de Psychologie, University Paris Descartes-Sorbonne Paris Cité, 71 Avenue Édouard Vaillant, 92100, Boulogne-Billancourt, France
| | - Cécile de Cazotte
- Laboratory of Psychopathology and Health Processes, Institut de Psychologie, University Paris Descartes-Sorbonne Paris Cité, 71 Avenue Édouard Vaillant, 92100, Boulogne-Billancourt, France
| | - Guillem Pailhez
- Department of Psychiatry, Autonoma University of Barcelona, Barcelona, Spain
| | - Antonio Bulbena
- Department of Psychiatry, Autonoma University of Barcelona, Barcelona, Spain
| | - Claude Hamonet
- Department of Physical Medicine and Rehabilitation, Hôtel-Dieu Hospital, Paris, France.,University Paris-Est Créteil, Créteil, France
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Baeza-Velasco C, Bulbena A, Polanco-Carrasco R, Jaussaud R. Cognitive, emotional, and behavioral considerations for chronic pain management in the Ehlers–Danlos syndrome hypermobility-type: a narrative review. Disabil Rehabil 2018; 41:1110-1118. [DOI: 10.1080/09638288.2017.1419294] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Carolina Baeza-Velasco
- Laboratory of Psychopathology and Health Processes, University Paris Descartes - Sorbonne Paris Cité, Boulogne Billancourt, France
- Inserm U1061, La Colombière Hospital, Montpellier, France
| | - Antonio Bulbena
- Department of Psychiatry, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Medicine School, University of Lorraine, CHRU Nancy, Nancy, France
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Abstract
There is a growing concern in many countries over the low recruitment into psychiatry among medical graduates. This has led to studies that aim: (1) to study the attitudes of medical students towards psychiatry, (2) to determine factors that influence such attitudes, (3) to assess the possible causes of this low recruitment and (4) to try to change students’ views of psychiatry during their medical education to improve recruitment.
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Bulbena-Cabré A, Rojo C, Pailhez G, Buron Maso E, Martín-Lopez LM, Bulbena A. Joint hypermobility is also associated with anxiety disorders in the elderly population. Int J Geriatr Psychiatry 2018; 33:e113-e119. [PMID: 28543732 DOI: 10.1002/gps.4733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/05/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anxiety disorders (AD) are very prevalent in the elderly, tend to compromise quality of life, and generate substantial costs. Considering that the prevention and early detection of anxiety may be relevant to increase health gains in older adults, it would be of great interest to identify whether the joint hypermobility syndrome (JHS) is also related to anxiety disorders in this age range. METHODS Cross-sectional data was collected in a sample of 108 subjects in a rural town in Spain. Instruments included Spielberger STAI, a modified Wolpe Fear Survey Schedule, General health Questionnaire (GHQ)-28, and the anxiety and mood disorders section of the SCID, to assess past year prevalence of anxiety disorders. JHS was evaluated by trained examiners using the "Hospital del Mar criteria". RESULTS Among the 108 subjects (55% women, 45% men) over 60 years old, 21.3% meet criteria for JHS. These subjects scored significantly higher in both State (F = 5.53; p = 0.02) and Trait (F = 4.68; p = 0.03) anxiety and the GHQ 28 (F = 6.29; p = 0.01). Compared with non JHS subjects, they had more AD (34.8% vs. 11.8%; x2 = 6.90; p = 0.02) and mood disorders (30.4% vs. 10.6%; x2 = 5.65; p = 0.041) in the past year prevalence. A multiple logistic regression analysis showed that both JHS (β = 0.196; p = 0.04) and fears (β = 0.34; p = 0.001) are predictors of AD (r2 = 188; p = 0.001) in this population. CONCLUSIONS Joint hypermobility syndrome is associated with anxiety in the elderly population, and it may be used as a physical marker for AD among subjects within this age range. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Andrea Bulbena-Cabré
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,VA Bronx Health Care System, Mental Illness Research Education and Clinical Centers, New York, NY, USA.,Doctorate Program, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Conxita Rojo
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain
| | - Guillem Pailhez
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain.,Mar Health Park, Neuropsychiatry and Drug Addiction Institute (INAD), Barcelona, Spain
| | - Emma Buron Maso
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain.,Doctorate Program, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Luis Miguel Martín-Lopez
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain.,Mar Health Park, Neuropsychiatry and Drug Addiction Institute (INAD), Barcelona, Spain.,Centro de Investigación en red de Salud Mental, (CIBERSAM), Spain
| | - Antonio Bulbena
- Department of Psychiatry and Forensic Medicine (UAB), Autonomous University of Barcelona, Barcelona, Spain.,Mar Health Park, Neuropsychiatry and Drug Addiction Institute (INAD), Barcelona, Spain.,Centro de Investigación en red de Salud Mental, (CIBERSAM), Spain
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Bulbena-Cabré A, Bulbena A. Corrigendum: Psychiatric and psychological aspects in the Ehlers-Danlos syndromes. Am J Med Genet A 2017; 173:3241. [PMID: 28941053 DOI: 10.1002/ajmg.a.38488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/23/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Andrea Bulbena-Cabré
- Autonomous University of Barcelona, Department of Psychiatry and Forensic Medicine (UAB), Barcelona, Spain.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.,Mental Illness Research, Education, and Clinical Center, VA Bronx Health Care System, New York, New York.,Doctorate Program, Autonomous University of Barcelona, Barcelona, Spain
| | - Antonio Bulbena
- Autonomous University of Barcelona, Department of Psychiatry and Forensic Medicine (UAB), Barcelona, Spain.,Mar Health Park, Neuropsychiatry and Drug Addiction Institute (INAD), Barcelona, Spain.,Centro de Investigación en red de Salud Mental (CIBERSAM), Spain
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Calvo P, Pairet S, Vila M, Losada J, Bowen J, Cirac R, Bulbena A, Holloway A, Fatjó J. Dog assisted therapy for teenagers with emotional and behavioural issues: A multicentre study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionFurther research is still needed to demonstrate the benefits of animal-assisted therapy (AAT) for specific participant profiles, such as children with behavioural disorders.ObjectivesWe wanted to find out if AAT could be considered an efficient therapeutic strategy for the treatment of children with behavioural disorders.AimsWe wanted to study the effects of a preestablished AAT program on the behaviour of children with emotional and behavioural issues in 6 different reception centres for children under government guardianship.MethodsForty-five children (12 to 17 years old) with emotional and behavioural issues participated in a 14-session AAT program. Behavioural measures were those routinely scored as part of therapy; an observational report of 3 different problematic behaviours (such as impulsivity, lack of social skills or lack of personal recognition) was made twice a week for each child (with a score of frequency and intensity). A pre- and post-treatment “global behaviour score” was calculated for each child, as an average value of the 3 problematic behaviours measured during the month pre-treatment and the month post-treatment.ResultsThe 45 participants attended, on average, 72.8% of AAT sessions. Independent behaviour scores differed between the pre- and post-intervention evaluations (n = 135 behaviours) (Wilcoxon test; P < 0.0001). Based on the global behaviour score for each child (n = 45), significant change was found between pre- and post-intervention evaluations (Wilcoxon test; P = 0.0011).ConclusionsOur results suggest AAT could be a beneficial intervention for children with behavioural issues in terms of program adherence and behaviour improvement.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sánchez EP, Miranda JG, Romero VC, Moreno J, Palma A, Pale LA, Leon J, Bulbena A, Perez V. Describing the assistance, the basis for improvement. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionConsultation-liaison (CL) psychiatry is a branch of psychiatry that study and treat mental health of patients with other medical or surgical conditions. The assistance between hospitals and health services is heterogeneous.Aims and objectivesFor this reason, the objective of our research is to define the clinical characteristics from our CL service and check out the quality relationship with the applicant service, for improving future assistance.MethodsWe made a descriptive analysis of clinical variables from the patients who received assistance during 2 months by the CL service from the hospital del Mar, Barcelona. We got the frequencies and we used the Chi2 test for the comparison between variables: Diagnosis, appearance in the report and treatment in the report.ResultsTotal of the sample: 42 patients, 61.9% women. Mean age: 55.1 years. Psychiatric diagnosis was present before the assistance on 57.1% of the patients. The most frequent diagnosis was Adjustment Disorder (47.6%) and more than one diagnosis was made in the 14.3%. Near the half of the patients required only primary care assistance after the discharge from the hospital. In the 68.3% of the reports appeared information about CL assistance and the indicated treatment didn’t appear in all the reports. Statistically significant differences weren’t found in the comparisons.ConclusionsAdjustment Disorder is supposed to be the most common psychiatric diagnosis in our CL psychiatry service, as we found in the reviewed literature. The results reveal that relationships between services can be improved. More studies must be done for completing information in this issue.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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González C, Calvo P, Bowen J, Bulbena A, Cirac R, Holloway A, Fatjó J. Characteristics of 23 cases of animal hoarding in Catalonia (Spain). Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionAnimal hoarding is considered an under-reported problem, which affects the welfare of both people and animals. Few reports on animal hoarding are available in scientific literature, particularly outside North America.ObjectivesWe designed a study to analyse cases of animal hoarding in Catalonia.AimsWe wanted to expose the presence and consequences of this disorder in our area and to check for cross-cultural similarities with previous studies in other countries.MethodsData was obtained retrospectively from 23 case reports of animal hoarding in Catalonia collected by city councils and the Catalonian police from 1992 to 2015.ResultsThirty-three people (20 women and 13 men) and 1521 animals, mainly dogs and cats, were involved. Most cases (n = 13) involved a sole animal hoarder. Most cases (n = 14) were chronic (lasting longer than 5 years). Object hoarding co-morbidity was found in most cases (n = 17). All hoarders were over 40-years-old, with half of them aged over 65. Only in 4 cases was an intervention by the healthcare system reported. Most of the hoarders (9 out of 13) actively opposed animal removal. In more than 50% of cases, the hoarder's personal care, health and financial situation were precarious. No awareness of the impaired welfare of the animals was found in most cases.ConclusionsTo the author's knowledge, this is the first study on animal hoarding in Catalonia and one of the few available in Europe. Our results are aligned with previous research, adding evidence of cross-cultural common elements of animal hoarding.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pailhez G, Castaño J, Rosado S, Ballester MDM, Vendrell C, Canale F, Bulbena A. [Detecting and measuring functional and organic disease in general population: Development and validation of TOPYPS clinical scale]. Aten Primaria 2017; 49:570-575. [PMID: 28279506 PMCID: PMC6876013 DOI: 10.1016/j.aprim.2016.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/15/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To develop and validate the TOPYPS scale, an instrument designed to: (i)detect with a high degree of suspicion the most frequent functional pathologies according to standard diagnostic criteria, and (ii)to assess the physical health in the general population quickly, comprehensive and reliable. DESIGN Validation of a scale. LOCATION Primary Care Centre, Barcelona. PARTICIPANTS The scale was administered to 67 randomly selected adults. MEASUREMENTS TOPYPS scale was administered to 67 adults randomly selected from a primary care setting in Barcelona, Spain. TOPYPS has six sections based on body systems, each one scored according to the degree of interference in daily activity, type of treatment received, and prognostic of the reported illnesses in each section. Test-retest reliability completions were on two separate occasions one week apart. Validity was then tested by comparing the results with the clinical examination conducted by two different specialists in general practice (gold standard). RESULTS Repeatability (test-retest) and inter-rater agreement for each of the six sections and for the total score were satisfactory. Validity was acceptable both for content and construct, according to their correlation with the gold standard. CONCLUSIONS TOPYPS displayed good psychometrical properties. It is a suitable tool to detect and measure functional and organic diseases in general population.
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Affiliation(s)
- Guillem Pailhez
- Instituto de Neuropsiquiatría y Adicciones, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
| | - Juan Castaño
- Instituto de Neuropsiquiatría y Adicciones, Hospital del Mar, Barcelona, España
| | - Silvia Rosado
- Instituto de Neuropsiquiatría y Adicciones, Hospital del Mar, Barcelona, España
| | | | | | - Francisco Canale
- Departamento de Psiquiatría, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Antonio Bulbena
- Instituto de Neuropsiquiatría y Adicciones, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España
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Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, Francomano C. Pain management in the Ehlers-Danlos syndromes. Am J Med Genet 2017; 175:212-219. [DOI: 10.1002/ajmg.c.31554] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Bulbena A, Baeza-Velasco C, Bulbena-Cabré A, Pailhez G, Critchley H, Chopra P, Mallorquí-Bagué N, Frank C, Porges S. Psychiatric and psychological aspects in the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2017; 175:237-245. [PMID: 28186381 DOI: 10.1002/ajmg.c.31544] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
There is increasing amount of evidence pointing toward a high prevalence of psychiatric conditions among individuals with hypermobile type of Ehlers-Danlos syndrome (JHS/hEDS). A literature review confirms a strong association between anxiety disorders and JHSh/hEDS, and there is also limited but growing evidence that JHSh/hEDS is also associated with depression, eating, and neuro-developmental disorders as well as alcohol and tobacco misuse. The underlying mechanisms behind this association include genetic risks, autonomic nervous system dysfunction, increased exteroceptive and interoceptive mechanisms and decreased proprioception. Recent neuroimaging studies have also shown an increase response in emotion processing brain areas which could explain the high affective reactivity seen in JHS/hEDS. Management of these patients should include psychiatric and psychological approaches, not only to relieve the clinical conditions but also to improve abilities to cope through proper drug treatment, psychotherapy, and psychological rehabilitation adequately coupled with modern physiotherapy. A multidimensional approach to this "neuroconnective phenotype" should be implemented to ensure proper assessment and to guide for more specific treatments. Future lines of research should further explore the full dimension of the psychopathology associated with JHS/hEDS to define the nature of the relationship. © 2017 Wiley Periodicals, Inc.
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Galindo L, Bergé D, Murray GK, Mané A, Bulbena A, Pérez V, Vilarroya O. Default Mode Network Aberrant Connectivity Associated with Neurological Soft Signs in Schizophrenia Patients and Unaffected Relatives. Front Psychiatry 2017; 8:298. [PMID: 29375404 PMCID: PMC5767074 DOI: 10.3389/fpsyt.2017.00298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022] Open
Abstract
Brain connectivity and neurological soft signs (NSS) are reportedly abnormal in schizophrenia and unaffected relatives, suggesting they might be useful neurobiological markers of the illness. NSS are discrete sensorimotor impairments thought to correspond to deviant brain development. Although NSS support the hypothesis that schizophrenia involves disruption in functional circuits involving several hetero modal association areas, little is known about the relationship between NSS and brain connectivity. We explored functional connectivity abnormalities of the default mode network (DMN) related to NSS in schizophrenia. A cross-sectional study was performed with 27 patients diagnosed with schizophrenia, 23 unaffected relatives who were unrelated to the schizophrenia subjects included in the study, and 35 healthy controls. Subjects underwent magnetic resonance imaging scans including a functional resting-state acquisition and NSS evaluation. Seed-to-voxel and independent component analyses were used to study brain connectivity. NSS scores were significantly different between groups, ranging from a higher to lower scores for patients, unaffected relatives, and healthy controls, respectively (analysis of variance effect of group F = 56.51, p < 0.001). The connectivity analysis revealed significant hyperconnectivity in the fusiform gyrus, insular and dorsolateral prefrontal cortices, inferior and middle frontal gyri, middle and superior temporal gyri, and posterior cingulate cortex [minimum p-family wise error (FWE) < 0.05 for all clusters] in patients with schizophrenia as compared with in controls. Also, unaffected relatives showed hyperconnectivity in relation to controls in the supramarginal association and dorsal posterior cingulate cortices (p-FWE < 0.05 for all clusters) in patients with schizophrenia as compared with in controls. Also, unaffected relatives showed hyperconnectivity in relation to controls in the supramarginal association and dorsal posterior cingulate cortices (p-FWE = 0.001) and in the anterior prefrontal cortex (42 voxels, p-FWE = 0.047). A negative correlation was found between left caudate connectivity and NSS [p-FWE = 0.044, cluster size (k) = 110 voxels]. These findings support the theory of widespread abnormal connectivity in schizophrenia, reinforcing DMN hyperconnectivity and NSS as neurobiological markers of schizophrenia. The results also indicate the caudate nucleus as the gateway to the motor consequences of abnormal DMN connectivity.
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Affiliation(s)
- Liliana Galindo
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Daniel Bergé
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.,Institute of Behavioural and Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Anna Mané
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Bulbena
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Pérez
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Oscar Vilarroya
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Galindo L, Pastoriza F, Bergé D, Mané A, Picado M, Bulbena A, Robledo P, Pérez V, Vilarroya O, Cloninger CR. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives. PeerJ 2016; 4:e1651. [PMID: 27168955 PMCID: PMC4860298 DOI: 10.7717/peerj.1651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/12/2016] [Indexed: 11/26/2022] Open
Abstract
The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.
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Affiliation(s)
- Liliana Galindo
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Red de Trastornos Adictivos, RETIC, Spain
| | - Francisco Pastoriza
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Daniel Bergé
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Neuropharmacology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Mané
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Marisol Picado
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM) , Barcelona , Spain
| | - Antonio Bulbena
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Patricia Robledo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Neuropharmacology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Victor Pérez
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Oscar Vilarroya
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Claude Robert Cloninger
- Department of Psychiatry and Genetics, Washington University in St. Louis , Saint Louis, MO , United States
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Treen D, Batlle S, Mollà L, Forcadell E, Chamorro J, Bulbena A, Perez V. Are there glutamate abnormalities in subjects at high risk mental state for psychosis? A review of the evidence. Schizophr Res 2016; 171:166-75. [PMID: 26803691 DOI: 10.1016/j.schres.2016.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/29/2015] [Accepted: 01/01/2016] [Indexed: 02/07/2023]
Abstract
New approaches to underlying alterations in psychosis suggest increasing evidence of glutamatergic abnormalities in schizophrenia and an association between these abnormalities and certain core psychopathological alterations such as cognitive impairment and negative symptoms. Proton magnetic resonance spectroscopy ((1)H MRS) is an MR-based technique that enables investigators to study glutamate function by measuring in vivo glutamatergic indices in the brain. In this article we review the published studies of (1)H MRS in subjects with an at-risk mental state (ARMS) for psychosis. The primary aim was to investigate whether alterations in glutamate function are present before the illness develops in order to expand our understanding of glutamatergic abnormalities in prodromal phases. Three databases were consulted for this review. Titles and abstracts were examined to determine if they fulfilled the inclusion criteria. The reference lists of the included studies were also examined to identify additional trials. Eleven final studies were included in this review. Significant alterations in glutamate metabolites across different cerebral areas (frontal lobe, thalamus, and the associative striatum) in subjects with an ARMS for psychosis are reported in six of the trials. A longitudinal analysis in two of these trials confirmed an association between these abnormalities and worsening of symptoms and final transition to psychosis. Considering that five other studies found no significant differences across these same areas, we can conclude that more research is needed to confirm glutamatergic abnormalities in subjects with an ARMS for psychosis. However, future research must overcome the methodological limitations of existing studies to obtain reliable results.
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Affiliation(s)
- Devi Treen
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Santiago Batlle
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Laia Mollà
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Eduard Forcadell
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Jacobo Chamorro
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Antonio Bulbena
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Autonomous University of Barcelona UAB, Department of Psychiatry and Forensic Medicine, Bellaterra, Spain
| | - Victor Perez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Autonomous University of Barcelona UAB, Department of Psychiatry and Forensic Medicine, Bellaterra, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain
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Galindo L, Pastoriza F, Bergé D, Mané A, Roé N, Pujol N, Picado M, Bulbena A, Perez V, Vilarroya O. Abnormal connectivity in dorsolateral prefrontal cortex in schizophrenia patients and unaffected relatives. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectivesThe aim of this study is to explore connectivity of the left dorsolateral prefrontal cortex (LDLPC) by functional magnetic resonance imaging during resting state, in subjects affected by schizophrenia and unaffected relatives.MethodsWe recruited a group of 29 patients diagnosed with schizophrenia, who were treated with atypical antipsychotics, who are and were clinically stable in the last 6 months and had an illness duration range from 5 up to 15 years. We also recruited a group of 23 unaffected relatives, without history of other mental, neurological or somatic disease and a group of 37 healthy volunteers. No subject in any of the three groups met criteria for substance use disorders.All three groups were clinically evaluated, and a functional magnetic resonance during Resting State was performed.Functional images were reoriented to the first scan, normalized to the MNI EPI template and smoothed with an 8 mm Gaussian kernel, with SPM. The CONN-FMRI Toolbox v1.2 was used to create individual subject seed-to-voxel connectivity maps, to the corresponding seeds of the default mode network.ResultsFig. 1.ConclusionsOur results show a significant increase in connectivity between LDLPC and anterior prefrontal cortex, dorsolateral prefrontal cortex and somatosensory association areas, especially between patients and controls. It is noteworthy to mention that we found a significant decrease in connectivity between LDLPC and supramarginal gyrus, superior temporal gyrus and somatosensory association areas between unaffected relatives and controls.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pastoriza F, Galindo L, Mané A, Bergé D, Pujol N, Picado M, Bulbena A, Vilarroya O, Pérez V. Cortical and subcortical morphology deficits in cerebral gray matter in patients with schizophrenia and not affected siblings. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
ObjectiveExplore the basis of cortical morphometry in patients with schizophrenia and non-affected siblings by Magnetic Resonance Structural analyzing cortical thickness.MethodsTwenty-nine patients with schizophrenia treated with atypical antipsychotics and clinically stable in the last 6 months were recruited. Twenty-three not affected siblings of patients with schizophrenia and 37 healthy volunteers were recruited. Magnetic Resonance Structural was performed. FreeSurfer the brain imaging software package for analysis of Cortical Thickness is used. In the analysis of group differences in cortical thickness (CT) with the general linear model (GLM), the P-value was established in 0003 following the Bonferroni correction to control for multiple comparisons (seven regions of interest a priori in each hemisphere).ResultsSignificant differences in cortical thickness between patients and healthy controls. Differences between groups were calculated by general linear model (GLM) with age and sex as covairables (Table 1).ConclusionsIn applying the correction for multiple comparisons, differences in bilateral-lateral orbitofrontal, medial orbitofrontal-right and left temporal transverse frontal cortex are significant. Our study replicates previous findings and provides further evidence of abnormalities in the cerebral cortex, particularly in the frontal and temporal regions, being characteristic of schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.AcknowledgementsL. Galindo is a Rio-Hortega-fellowship-(ISC-III; CM14/00111).
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Coplan J, Singh D, Gopinath S, Mathew SJ, Bulbena A. A Novel Anxiety and Affective Spectrum Disorder of Mind and Body-The ALPIM (Anxiety-Laxity-Pain-Immune-Mood) Syndrome: A Preliminary Report. J Neuropsychiatry Clin Neurosci 2016; 27:93-103. [PMID: 25923849 DOI: 10.1176/appi.neuropsych.14060132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors describe a spectrum disorder comprising a core anxiety (A) disorder and four domains: joint laxity (L), chronic pain syndromes (P), immune disorders (I), and mood disorders (M)-dubbed the ALPIM syndrome. This study examined 76 consecutive outpatients with an anxiety disorder plus at least one somatic condition from three domains. More than 80% of the patients had panic attacks, fibromyalgia, and major depressive episodes. Associations were found between joint laxity and bipolar III, headache with bipolar II, and bipolar II with chronic fatigue syndrome. Significant relationships were demonstrated within and between domains, validating ALPIM as a syndrome.
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Affiliation(s)
- Jeremy Coplan
- From the Division of Neuropsychopharmacology, Dept. of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY (JC, SG); the Dept. of Psychiatry, Winthrop University Hospital, Mineola, NY (DS); the Michael E. Debakey VA Medical Center, Houston, TX (SJM); the Menninger Dept. of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX (SJM); and the Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain (AB)
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Sánchez R, Baillès E, Peri JM, Bastidas A, Pérez-Villa F, Bulbena A, Pintor L. Assessment of psychosocial factors and predictors of psychopathology in a sample of heart transplantation recipients: a prospective 12-month follow-up. Gen Hosp Psychiatry 2016; 38:59-64. [PMID: 26633863 DOI: 10.1016/j.genhosppsych.2015.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/02/2015] [Accepted: 10/03/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES In the last decades, researchers of heart transplantation (HT) programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The first objective of this study is the prospective description of changes in psychiatric and psychosocial factors in a sample of HT recipients through a 12-month follow-up. The second goal is to identify predictors of psychopathology 1 year after HT. METHODS Pretransplant baseline assessment consisted of clinical form; Hospital Anxiety and Depression Scale (HADS); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Structured Clinical Interview; Coping questionnaire (COPE); Five Factors Inventory Revised; Apgar-Family questionnaire and Multidimensional Health Locus of Control (MHLC). The assessment 1 year after HT consisted of HADS, COPE, Apgar-Family and MHLC. RESULTS The sample included 78 recipients. During the waiting list period, 32.1% of them had a psychiatric disorder; personality factors profile was similar to the general population, and they showed adaptive coping strategies. Some changes in psychosocial factors were observed at 12 months after the surgery: lower scores of anxiety and depression, less necessity of publicly venting of feelings and a trend to an internal locus of control. Neuroticism and Disengagement pre-HT were predictors of psychopathology in the follow-up assessment. CONCLUSIONS Pretransplant psychosocial screening is important and enables to find out markers of emotional distress like Neuroticism or Disengagement coping styles to identify patients who might benefit from psychiatric and psychological interventions. Successful HT involved some positive changes in psychosocial factors 12 months after the surgery beyond physical recovery.
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Affiliation(s)
- Roberto Sánchez
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
| | - Eva Baillès
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Josep Maria Peri
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Anna Bastidas
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Félix Pérez-Villa
- Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Antonio Bulbena
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Luis Pintor
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Abstract
BACKGROUND The olfactory function in panic disorder (PD) has been scarcely approached in the literature. The purpose of this paper is to study this question by focusing on the olfactory sensitivity (i.e. detection threshold), the reactivity to odors, and the odor awareness in patients suffering from PD. METHODS 41 patients with PD and 41 healthy controls performed Sniffin׳ Sticks Test (threshold subtest) and completed the Affective Impact of Odors scale (AIO), the Relational Scale of Olfaction (EROL) and the Odor Awareness Scale (OAS). Clinical symptoms rating scales were concurrently obtained. RESULTS PD patients showed lower olfactory detection thresholds (i.e. higher sensitivity) along with an enhanced reactivity to odors as well as a greater olfactory awareness compared to the healthy controls. The severity of PD was significantly associated with the olfactory questionnaires ratings, but not with the detection ability. Olfactory measures were intercorrelated in most cases. LIMITATIONS i) The results of the olfactory sensitivity are limited to one odorant (phenyl ethyl alcohol) and thus may not be generalizable to other odorants. ii) As comorbid Axis II disorders were not screened, it is not possible to exclude the influence of personality traits in our results. iii) The involvement of the medications in some olfactory outcomes cannot be ruled out. CONCLUSION The current findings highlight the importance of the olfactory function in PD as patients appeared to be highly sensitive, reactive and aware of odors. These results are discussed in the light of the common neural substrates involved in the olfactory processing and in the pathophysiology of PD, and also related to the clinical features of this disorder.
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Affiliation(s)
- Emma Burón
- Autonomous University of Barcelona, Department of Psychiatry and Forensic Medicine (UAB), Bellaterra, Spain.
| | - Antonio Bulbena
- Autonomous University of Barcelona, Department of Psychiatry and Forensic Medicine (UAB), Bellaterra, Spain; Mar Health Park, Neuropsychiatry and Drug Addiction Institute (INAD), Barcelona, Spain
| | - Andrea Bulbena-Cabré
- Autonomous University of Barcelona, Department of Psychiatry and Forensic Medicine (UAB), Bellaterra, Spain; Department of Psychiatry, Metropolitan Hospital Center, New York Medical College, New York, USA
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Galindo L, Pastoriza F, Guinart D, Roe N, Bergé D, Mané A, Bulbena A, Pérez V, Vilarroya O. Abnormal Conectivity in Medial Prefrontal Cortex in Schizophrenia Patients and Unaffected Relatives. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31946-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mallorquí-Bagué N, Bulbena A, Roé-Vellvé N, Hoekzema E, Carmona S, Barba-Müller E, Fauquet J, Pailhez G, Vilarroya O. Emotion processing in joint hypermobility: A potential link to the neural bases of anxiety and related somatic symptoms in collagen anomalies. Eur Psychiatry 2015; 30:454-8. [PMID: 25684692 DOI: 10.1016/j.eurpsy.2015.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/13/2015] [Accepted: 01/14/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Joint hypermobility syndrome (JHS) has repeatedly been associated with anxiety and anxiety disorders, fibromyalgia, irritable bowel syndrome and temporomandibular joint disorder. However, the neural underpinnings of these associations still remain unclear. This study explored brain responses to facial visual stimuli with emotional cues using fMRI techniques in general population with different ranges of hypermobility. METHODS Fifty-one non-clinical volunteers (33 women) completed state and trait anxiety questionnaire measures, were assessed with a clinical examination for hypermobility (Beighton system) and performed an emotional face processing paradigm during functional neuroimaging. RESULTS Trait anxiety scores did significantly correlate with both state anxiety and hypermobility scores. BOLD signals of the hippocampus did positively correlate with hypermobility scores for the crying faces versus neutral faces contrast in ROI analyses. No results were found for any of the other studied ROIs. Additionally, hypermobility scores were also associated with other key affective processing areas (i.e. the middle and anterior cingulate gyrus, fusiform gyrus, parahippocampal region, orbitofrontal cortex and cerebellum) in the whole brain analysis. CONCLUSIONS Hypermobility scores are associated with trait anxiety and higher brain responses to emotional faces in emotion processing brain areas (including hippocampus) described to be linked to anxiety and somatic symptoms. These findings increase our understanding of emotion processing in people bearing this heritable variant of collagen and the mechanisms through which vulnerability to anxiety and somatic symptoms arises in this population.
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Affiliation(s)
- N Mallorquí-Bagué
- Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Psychiatry, Psychology and Psychosomatics department, Institut Universitari Quirón Dexeus, Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain.
| | - A Bulbena
- Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Anxiety Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Roé-Vellvé
- Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain
| | - E Hoekzema
- Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - S Carmona
- Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud mental, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - E Barba-Müller
- Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain
| | - J Fauquet
- Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Department Psicobiologia i Metodologia de les Ciències de la Salut, Campus de la UAB, 08193 Bellaterra (Cerdanyola del Vallés), Barcelona, Spain
| | - G Pailhez
- Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Anxiety Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Vilarroya
- Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain
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Baeza-Velasco C, Pailhez G, Bulbena A, Baghdadli A. Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry. Gen Hosp Psychiatry 2015; 37:24-30. [PMID: 25459977 DOI: 10.1016/j.genhosppsych.2014.10.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 09/14/2014] [Accepted: 10/07/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The heritable disorders of connective tissue (HDCTs) are a group of genetic disorders affecting connective tissue matrix proteins. Fragility, laxity of tissues and joint hypermobility (JH) are commons features of HDCT for which the prognosis may range from benign to life threatening. JH and HDCTs, especially joint hypermobility syndrome, Ehlers-Danlos syndromes and Marfan syndrome, have been associated with psychiatric symptomatology. We explored the existing knowledge concerning this association in order to provide an overview of mental disorders linked to JH/HDCT, as well as the hypotheses proposed to explain such association. METHOD A comprehensive search of scientific online databases and references lists was conducted, encompassing publications based on quantitative and qualitative research, including case reports. RESULTS Psychiatric conditions in which there is some evidence of an association with JH/HDCT are anxiety disorders, depression, schizophrenia, neurodevelopmental disorders (autism, attention deficit/hyperactivity disorder, and developmental coordination disorder), eating disorders, personality disorders and substance use/misuse. CONCLUSION Despite the need of more research, the available data highlight the importance of examining psychiatric symptoms in those affected by JH/HDCT and the importance of providing interventions with a multidisciplinary approach. The relationship between JH/HDCT and mental disorders merits further attention in order to improve current knowledge and clarify a possible common etiology.
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Affiliation(s)
- Carolina Baeza-Velasco
- Department of Child and Adolescent Psychiatry, CHU Montpellier, France; Institut de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, France.
| | - Guillem Pailhez
- Anxiety Unit-Institut de Neuropsiquiatria i Addicions (INAD), Hospital del Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Antonio Bulbena
- Anxiety Unit-Institut de Neuropsiquiatria i Addicions (INAD), Hospital del Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Amaria Baghdadli
- Department of Child and Adolescent Psychiatry, CHU Montpellier, France; Laboratory Epsylon (EA 4556), University of Montpellier, France
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Pailhez G, Majó A, Córcoles D, Ginés JM, Arcega JM, Castaño J, Merino A, Bulbena A, Pérez V. Clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder in a psychiatric emergency service. Actas Esp Psiquiatr 2015; 43:8-15. [PMID: 25665975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 01/01/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION To analyze factors associated with clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder (AD) seeking care at a psychiatric emergency unit. METHOD A total of 5003 consecutive visits were reviewed over a three-year period at a psychiatric emergency service in a tertiary university hospital. Data collected included sociodemographic and clinical information as well as the Global Assessment of Functioning (GAF) and the Severity Psychiatric Illness (SPI) scale scores. RESULTS Of all the visits, 992 (19.8%) were diagnosed of AD. Of these, 19.6% required clinical observation and 72.2% were referred to a psychiatrist at discharge. Regression analysis showed that referral to psychiatry was associated with being male, native, psychiatric background, greater severity, lower global functioning, and behavioral disorders. Clinical observation (in a box) was associated with being female, greater severity, and psychotic or behavioral symptoms. Prescription of benzodiazepines was associated with anxiety, no history of addiction, and lower global functioning. Antidepressants were associated with being a native, anxiety with no history of addiction, and lower functioning. Antipsychotics were associated with being native, psychiatric background (not addiction), anxiety, and lower functioning. CONCLUSION Behavior, psychiatric background and illness severity were determinants of referral to a specialist. Besides these, psychotic symptoms and non-specific clinical symptoms were determinants of observation. Drug prescription in AD is less frequent if the main complaint is not anxiety and depends more on the level of functioning than on that of severity.
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Affiliation(s)
- Guillem Pailhez
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - Albert Majó
- Centre de Salut Mental Badalona 2 – Institut Municipal Serveis Personals. Badalona
| | - David Córcoles
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - José M Ginés
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - José M Arcega
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - Juan Castaño
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - Ana Merino
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - Antonio Bulbena
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
| | - Víctor Pérez
- Institut de Neuropsiquaitria i Addiccions – Hospital del Mar. Barcelona
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Mallorquí-Bagué N, Garfinkel SN, Engels M, Eccles JA, Pailhez G, Bulbena A, Critchley HD. Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility. Front Psychol 2014; 5:1162. [PMID: 25352818 PMCID: PMC4196473 DOI: 10.3389/fpsyg.2014.01162] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/24/2014] [Indexed: 12/23/2022] Open
Abstract
Objective: Anxiety is associated with increased physiological reactivity and also increased “interoceptive” sensitivity to such changes in internal bodily arousal. Joint hypermobility, an expression of a common variation in the connective tissue protein collagen, is increasingly recognized as a risk factor to anxiety and related disorders. This study explored the link between anxiety, interoceptive sensitivity and hypermobility in a sub-clinical population using neuroimaging and psychophysiological evaluation. Methods: Thirty-six healthy volunteers undertook interoceptive sensitivity tests, a clinical examination for hypermobility and completed validated questionnaire measures of state anxiety and body awareness tendency. Nineteen participants also performed an emotional processing paradigm during functional neuroimaging. Results: We confirmed a significant relationship between state anxiety score and joint hypermobility. Interoceptive sensitivity mediated the relationship between state anxiety and hypermobility. Hypermobile, compared to non-hypermobile, participants displayed heightened neural reactivity to sad and angry scenes within brain regions implicated in anxious feeling states, notably insular cortex. Conclusions: Our findings highlight the dependence of anxiety state on bodily context, and increase our understanding of the mechanisms through which vulnerability to anxiety disorders arises in people bearing a common variant of collagen.
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Affiliation(s)
- Núria Mallorquí-Bagué
- Psychiatry, Brighton and Sussex Medical School, University of Sussex Falmer, UK ; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autonoma de Barcelona Barcelona, Spain ; Department of Psychiatry, Psychology and Psychosomatics, Hospital Universitari Quirón Dexeus Barcelona, Spain
| | - Sarah N Garfinkel
- Psychiatry, Brighton and Sussex Medical School, University of Sussex Falmer, UK ; Mood and Anxiety Research in Sussex (MARS), Sussex Partnership NHS Foundation Trust Sussex, UK ; Sackler Centre for Consciousness Science, University of Sussex Falmer, UK
| | - Miriam Engels
- Psychiatry, Brighton and Sussex Medical School, University of Sussex Falmer, UK ; Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University Maastricht, Netherlands
| | - Jessica A Eccles
- Psychiatry, Brighton and Sussex Medical School, University of Sussex Falmer, UK ; Mood and Anxiety Research in Sussex (MARS), Sussex Partnership NHS Foundation Trust Sussex, UK
| | - Guillem Pailhez
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autonoma de Barcelona Barcelona, Spain ; Anxiety Unit, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Universitat Autònoma de Barcelona Barcelona, Spain ; Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Antonio Bulbena
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autonoma de Barcelona Barcelona, Spain ; Anxiety Unit, Institute of Neuropsychiatry and Addictions, Hospital del Mar, Universitat Autònoma de Barcelona Barcelona, Spain ; Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Hugo D Critchley
- Psychiatry, Brighton and Sussex Medical School, University of Sussex Falmer, UK ; Mood and Anxiety Research in Sussex (MARS), Sussex Partnership NHS Foundation Trust Sussex, UK ; Sackler Centre for Consciousness Science, University of Sussex Falmer, UK
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Moreno A, Duñó L, Hoekzema E, Picado M, Martín LM, Fauquet J, Vives-Gilabert Y, Bulbena A, Vilarroya O. Striatal volume deficits in children with ADHD who present a poor response to methylphenidate. Eur Child Adolesc Psychiatry 2014; 23:805-12. [PMID: 24395136 DOI: 10.1007/s00787-013-0510-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/22/2013] [Indexed: 11/30/2022]
Abstract
Methylphenidate (MPH) is the first choice of medical treatment for attention-deficit/hyperactivity disorder (ADHD). Its mechanism of action is to inhibit the reuptake of dopamine and noradrenaline mainly in the region of the striatum. It has been estimated that 10-30 % of patients with ADHD do not respond adequately to MPH. The aim of this study was to evaluate whether striatal differences exist between good and poor responders to MPH. The sample included 27 treatment-naïve children with ADHD between the ages of 6 and 14. MPH administration started 1 day after the MRI acquisition. After a month, psychiatrists established the good or poor response to treatment according to clinical criteria. MRI images were analyzed using a technique based on regions of interest applied specifically to the caudate and accumbens nuclei. Sixteen patients showed good response to MPH and 11 a poor one. Regions of interest analysis showed that good responders had a higher concentration of gray matter in the head of both caudate nuclei and the right nucleus accumbens. Furthermore, a significant correlation was found between caudate and accumbens nuclei volume and the Conners' Parent Rating Scale and Continuous Performance Test improvement. These results support the hypothesis of the involvement of the caudate and accumbens nuclei in MPH response and in ADHD pathophysiology.
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Affiliation(s)
- A Moreno
- Unitat de Recerca en Neurociència Cognitiva (Departament de Psiquiatria i Medicina Legal), Universitat Autònoma de Barcelona, Campus de Bellaterra, 08193, Barcelona, Spain,
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Pailhez G, Rosado S, Baeza-Velasco C, Bulbena A. Ectomorphic somatotype and joint hypermobility are linked in panic and agoraphobic patients: a case-control study. Int J Psychiatry Clin Pract 2014; 18:112-7. [PMID: 24527884 DOI: 10.3109/13651501.2014.894074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To test whether there is an association between somatotype measures, joint hypermobility (JH), and panic and/or agoraphobia (PA). METHOD Sociodemographic characteristics, somatotype, and JH status were assessed in 60 patients (30 men and 30 women) with PA and 60 non-clinical controls, matched by age and gender. RESULTS Patients and controls categorized by gender did not differ in terms of age, educational degree, marital status, or labour situation. There were significant differences between mean somatotype groups both in men and women. Men and women somatotype patients were significantly less endomorphic and more ectomorphic than controls. Hypermobility was significantly more frequent in both male and female patients. In the entire sample, 38.3% of patients and 13.3% of controls were categorized as ectomorphic (χ(2) = 8.5, p = 0.004). After adjusting for age and sex, ectomorphic somatotype was independently related to JH status [OR = 3.25, 95% CI 1.35-7.8, p = 0.008]. CONCLUSIONS Since PA may be associated with JH, it is suggested that the relationship found between panic and ectomorphic somatotype might be mediated through JH.
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Affiliation(s)
- Guillem Pailhez
- Anxiety Unit - Institut de Neuropsiquiatria i Addicions (INAD), Hospital del Mar , Barcelona , Spain
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Bulbena A, Mallorquí-Bagué N, Pailhez G, Rosado S, González I, Blanch-Rubió J, Carbonell J. Self-reported screening questionnaire for the assessment of Joint Hypermobility Syndrome (SQ-CH), a collagen condition, in Spanish population. Eur J Psychiat 2014. [DOI: 10.4321/s0213-61632014000100002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fullana MA, Cardoner N, Alonso P, Subirà M, López-Solà C, Pujol J, Segalàs C, Real E, Bossa M, Zacur E, Martínez-Zalacaín I, Bulbena A, Menchón JM, Olmos S, Soriano-Mas C. Brain regions related to fear extinction in obsessive-compulsive disorder and its relation to exposure therapy outcome: a morphometric study. Psychol Med 2014; 44:845-856. [PMID: 23773479 DOI: 10.1017/s0033291713001128] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The size of particular sub-regions within the ventromedial prefrontal cortex (vmPFC) has been associated with fear extinction in humans. Exposure therapy is a form of extinction learning widely used in the treatment of obsessive-compulsive disorder (OCD). Here we investigated the relationship between morphometric measurements of different sub-regions of the vmPFC and exposure therapy outcome in OCD. METHOD A total of 74 OCD patients and 86 healthy controls underwent magnetic resonance imaging (MRI). Cortical thickness and volumetric measurements were obtained for the rostral anterior cingulate cortex (rACC), the medial orbital frontal cortex and the subcallosal cortex. After MRI acquisition, patients were enrolled in an exposure therapy protocol, and we assessed the relationship between MRI-derived measurements and treatment outcome. Baseline between-group differences for such measurements were also assessed. RESULTS Compared with healthy controls, OCD patients showed a thinner left rACC (p = 0.008). Also, left rACC thickness was inversely associated with exposure therapy outcome (r - 0.32, p = 0.008), and this region was significantly thinner in OCD patients who responded to exposure therapy than in those who did not (p = 0.006). Analyses based on regional volumetry did not yield any significant results. CONCLUSIONS OCD patients showed cortical thickness reductions in the left rACC, and these alterations were related to exposure therapy outcome. The precise characterization of neuroimaging predictors of treatment response derived from the study of the brain areas involved in fear extinction may optimize exposure therapy planning in OCD and other anxiety disorders.
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Affiliation(s)
- M A Fullana
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - N Cardoner
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Subirà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - C López-Solà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - J Pujol
- CRC Mar, Hospital del Mar, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Bossa
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - E Zacur
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - A Bulbena
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - S Olmos
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
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Calvo P, Prats E, Blasco Cubedo M, Bulbena A, Fatjó J. The role of therapy dogs in the treatment of a phobia to dogs (cynophobia): A case report. J Vet Behav 2013. [DOI: 10.1016/j.jveb.2013.04.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hoekzema E, Carmona S, Ramos-Quiroga JA, Richarte Fernández V, Bosch R, Soliva JC, Rovira M, Bulbena A, Tobeña A, Casas M, Vilarroya O. An independent components and functional connectivity analysis of resting state fMRI data points to neural network dysregulation in adult ADHD. Hum Brain Mapp 2013; 35:1261-72. [PMID: 23417778 DOI: 10.1002/hbm.22250] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 10/01/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022] Open
Abstract
Spontaneous fluctuations can be measured in the brain that reflect dissociable functional networks oscillating at synchronized frequencies, such as the default mode network (DMN). In contrast to its diametrically opposed task-positive counterpart, the DMN predominantly signals during a state of rest, and inappropriate regulation of this network has been associated with inattention, a core characteristic of attention-deficit/hyperactivity disorder (ADHD). To examine whether abnormalities can be identified in the DMN component of patients with ADHD, we applied an independent components analysis to resting state functional magnetic resonance imaging data acquired from 22 male medication-naïve adults with ADHD and 23 neurotypical individuals. We observed a stronger coherence of the left dorsolateral prefrontal cortex (dlPFC) with the DMN component in patients with ADHD which correlated with measures of selective attention. The increased left dlPFC-DMN coherence also surfaced in a whole-brain replication analysis involving an independent sample of 9 medication-naïve adult patients and 9 controls. In addition, a post hoc seed-to-voxel functional connectivity analysis using the dlPFC as a seed region to further examine this region's suggested connectivity differences uncovered a higher temporal coherence with various other neural networks and confirmed a reduced anticorrelation with the DMN. These results point to a more diffuse connectivity between functional networks in patients with ADHD. Moreover, our findings suggest that state-inappropriate neural activity in ADHD is not confined to DMN intrusion during attention-demanding contexts, but also surfaces as an insufficient suppression of dlPFC signaling in relation to DMN activity during rest. Together with previous findings, these results point to a general dysfunction in the orthogonality of functional networks.
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Affiliation(s)
- Elseline Hoekzema
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
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Ginés J, Martín M, Alvaro P, García B, Arcega J, Nascimento M, Corcoles D, Bulbena A. 2347 – Consultation-liaison psychiatry and antipsychotics. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77188-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
BACKGROUND Olfaction and its relation to mental health is an area of growing interest. Brain areas linked to olfaction partially overlap with brain areas involved in psychiatric disorders; consequently, the study of olfactory function allows us to explore the integrity of these brain areas with a non-invasive and effective method. Accordingly, the aim of this paper is to review olfactory function in affective and anxiety disorders. METHODS For this purpose, an extensive literature review of English-language studies on olfactory function in patients with the aforementioned pathologies was performed using several online databases. A manual search of relevant journals and books as well as reference lists from selected papers was also performed. RESULTS The available data show that depressed patients are usually characterised by preserved olfactory function, except for detection threshold, where contrasting reports have been found. Bipolar disorder has been studied to a lesser extent, but the findings have shown a lack of impairment in most cases. Research on seasonal affective disorders is scant, and future studies are needed to make conclusions. Anxiety disorders have been scarcely approached, but the results note identification deficits in obsessive-compulsive and posttraumatic stress disorders. CONCLUSIONS Olfactory assessment appears to be a complementary, valuable research tool in the study of psychiatric disorders. However, further investigation is needed to improve our understanding of olfactory function in these disorders.
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Affiliation(s)
- Emma Burón
- Parc de Salut Mar, Institut de Neuropsiquiatria i Addiccions, Barcelona, Spain.
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Burón E, Bulbena A, Barrada JR, Pailhez G. EROL scale: a new behavioural olfactory measure and its relationship with anxiety and depression symptoms. Actas Esp Psiquiatr 2013; 41:2-9. [PMID: 23440530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 01/01/2013] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The main objective of this study was to develop and validate a new olfactory measure that assesses the influence of olfaction on several emotional, behavioural, and cognitive issues: The Relational Scale of Olfaction (EROL). A secondary objective was to explore the relationship between the olfactory function and the anxiety and depression symptoms by means of EROL and the Hospital Anxiety and Depression Scale (HADS). A positive relationship between anxiety symptoms and the olfactory function was hypothesized. Regarding depressive symptoms, a significant relationship with the olfactory scores was not expected. METHOD Psychometric properties of EROL scale and correlations between HADS and EROL were tested in a sample from the general population. RESULTS EROL showed an adequate level of test-retest reliability (ICC=.748) and good internal consistency (Cronbach’s alpha=.761). Convergent validity with other olfactory measures was satisfactory. A one-factor solution was found for the scale. HADS showed a significant relationship with EROL (r=.280, p<.01), but the analysis through dimensions revealed that only the anxiety subscale correlated significantly and moderately with the olfactory measure (r=.325, p<.001), whereas the correlation with the depression subscale was non-significant (r=.146, p>.05). CONCLUSIONS Given that EROL displayed good psychometrical properties, it appears as a suitable tool to assess the olfactory function in general population. The relationship between this olfactory scale and anxiety symptoms found in this study is an interesting issue that requires further research.
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Affiliation(s)
- Emma Burón
- Parc de Salut Mar, Institut de Neuropsiquiatria i Addiccions, Barcelona, Spain.
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Hoekzema E, Carmona S, Ramos-Quiroga JA, Richarte Fernández V, Picado M, Bosch R, Soliva JC, Rovira M, Vives Y, Bulbena A, Tobeña A, Casas M, Vilarroya O. Laminar thickness alterations in the fronto-parietal cortical mantle of patients with attention-deficit/hyperactivity disorder. PLoS One 2012; 7:e48286. [PMID: 23239964 PMCID: PMC3519773 DOI: 10.1371/journal.pone.0048286] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 09/24/2012] [Indexed: 11/18/2022] Open
Abstract
Although Attention-Deficit/Hyperactivity Disorder (ADHD) was initially regarded as a disorder exclusive to childhood, nowadays its prevalence in adulthood is well established. The development of novel techniques for quantifying the thickness of the cerebral mantle allows the further exploration of the neuroanatomical profiles underlying the child and adult form of the disorder. To examine the cortical mantle in children and adults with ADHD, we applied a vertex-wise analysis of cortical thickness to anatomical brain MRI scans acquired from children with (n = 43) and without ADHD (n = 41), as well as a group of adult neurotypical individuals (n = 31), adult patients with a history of stimulant treatment (n = 31) and medication-naïve adults with ADHD (n = 24). We observed several clusters of reduced laminar cortical thickness in ADHD patients in comparison to neurotypical individuals. These differences were primarily located in the dorsal attention network, including the bilateral inferior and superior parietal cortex and a section of the frontal cortex (centered on the superior frontal and precentral gyrus bilaterally). Further laminar thickness deficits were observed in the bilateral orbitofrontal cortex and medial occipital cortex. The deficits in the cortical surface were especially pronounced in the child sample, while adult patients showed a more typical laminar thickness across the cerebral mantle. These findings show that the neuroanatomical profile of ADHD, especially the childhood form of the disorder, involves robust alterations in the cortical mantle, which are most prominent in brain regions subserving attentional processing.
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Affiliation(s)
- Elseline Hoekzema
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain.
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Hoekzema E, Carmona S, Ramos-Quiroga JA, Canals C, Moreno A, Richarte Fernández V, Picado M, Bosch R, Duñó L, Soliva JC, Rovira M, Bulbena A, Tobeña A, Casas M, Vilarroya O. Stimulant drugs trigger transient volumetric changes in the human ventral striatum. Brain Struct Funct 2012. [PMID: 23184398 DOI: 10.1007/s00429-012-0481-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The ventral striatum (VStr) integrates mesolimbic dopaminergic and corticolimbic glutamatergic afferents and forms an essential component of the neural circuitry regulating impulsive behaviour. This structure represents a primary target of psychostimulant medication, the first-choice treatment for attention-deficit/hyperactivity disorder (ADHD), and is biochemically modified by these drugs in animals. However, the effects of stimulants on the human VStr remain to be determined. We acquired anatomical brain MRI scans from 23 never-medicated adult patients with ADHD, 31 adult patients with a history of stimulant treatment and 32 control subjects, and VStr volumes were determined using individual rater-blinded region of interest delineation on high-resolution neuroanatomical scans. Furthermore, we also extracted VStr volumes before and after methylphenidate treatment in a subsample of the medication-naïve adult patients as well as in 20 never-medicated children with ADHD. We observed smaller VStr volumes in adult patients with a history of stimulant treatment in comparison to never-medicated patients. Moreover, our longitudinal analyses uncovered a reduction of grey matter volume in the bilateral VStr in adult patients after exposure to methylphenidate, which was followed by volumetric recovery to control level. In children, the same pattern of VStr volume changes was observed after treatment with methylphenidate. These findings suggest that the altered VStr volumes previously observed in patients with ADHD may represent a transitory effect of stimulant exposure rather than an intrinsic feature of the disorder. More generally, these data show that stimulant drugs can render plastic volume changes in human VStr neuroanatomy.
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Affiliation(s)
- Elseline Hoekzema
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Campus Bellaterra, 08193, Barcelona, Spain,
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