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Delahoy R, Bartholomeusz CF, Pemberton H, Alonso P, Pujol J, Cardoner N, Menchon JM, Soriano-Mas C, Harrison BJ. An examination of orbitofrontal sulcogyral morphology in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2019; 286:18-23. [PMID: 30852254 DOI: 10.1016/j.pscychresns.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/16/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/23/2022]
Abstract
Obsessive-compulsive disorder (OCD) has been consistently associated with structural and functional alteration of the orbitofrontal cortex (OFC) and its subcortical connections. In exploring these alterations, a neurodevelopmental basis to OCD has been suggested. While some studies have examined outcomes of early cortical maturation processes, such as global cortical thickness and gyrification, no work has specifically examined the OFC. Within the OFC, three types of sulcogyral patterns have been identified as a result of variance in cortical folding. The distribution of these patterns has been found to differ in patients of various neuropsychiatric disorders relative to the general population, however no study has yet investigated this distribution in individuals with OCD. Eighty OCD patients and 78 healthy controls were evaluated using magnetic resonance imaging, with identification of the sulcogyral pattern based on the method of Chiavaras and Petrides (2000). While gross changes in OFC sulcogyral patterning did not distinguish OCD patients from healthy controls, expression of both the Type II and Type III patterns was significantly associated with increased OCD illness severity. This finding indicates that early neurodevelopmental factors may influence illness severity.
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Affiliation(s)
- Rebekah Delahoy
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Cali F Bartholomeusz
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Hugh Pemberton
- Dementia Research Centre, Institute of Neurology, University College London, UK
| | - Pino Alonso
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL and CIBERSAM G-17, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar and CIBERSAM G-21, Barcelona, Spain
| | - Narcis Cardoner
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, CIBERSAM GCV16\SAM\1 and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - José M Menchon
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL and CIBERSAM G-17, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL and CIBERSAM G-17, Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia.
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Abstract
Gambling disorder (GD) has been reclassified recently into the "Substance-Related and Addictive Disorders" category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a landmark occurrence for a behavioral addiction. GD is characterized by recurrent, maladaptive gambling behavior that results in clinically significant distress. Although the number of randomized controlled trials assessing the effectiveness of pharmacological treatments is limited, some pharmacological treatments, notably opiate antagonists, have been employed in the treatment of GD. Patients with GD often present cognitive distortions and specific personality traits, making treatment more difficult. Cognitive behavioral therapy has become the most common psychological intervention for treating gambling problems, and it is effective in reducing gambling behavior. In this brief overview, we provide a report on the state of pharmacological and psychological treatments for gambling disorder. Risk factors and potential future lines of research are addressed.
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Affiliation(s)
- José M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
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Amor-Salamanca A, Menchon JM. Rate and characteristics of urgent hospitalisation in persons with profound intellectual disabilities compared with general population. J Intellect Disabil Res 2018; 62:179-186. [PMID: 29082562 DOI: 10.1111/jir.12436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 09/19/2017] [Accepted: 09/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Little is known about the hospitalisation rate of adults with severe/profound intellectual disability (PID) presenting at emergency services or about the appropriateness of hospital admissions in this population. Examining the possible differences in the patterns of hospitalisation between people with PID and those without intellectual disability (ID) may shed light on aspects of health and illness in these patients and may in turn make it possible to differentiate more clearly between mild-moderate ID and PID. METHODS After an evaluation of the emergency visits made by adults with PID and by people without ID, patients in both groups requiring one or more hospitalisations were subsequently followed up for 18 months. The appropriateness of the decision to hospitalise was assessed using the ambulatory care-sensitive conditions index. RESULTS There were no differences in the proportion of people with PID and controls admitted to hospital after their emergency visit. The median hospital stay was higher for PIDs: 7.5 vs. 4 days for controls. People with PID were admitted more than controls for respiratory reasons and somewhat less for other somatic causes unrelated to the nervous system. There were no admissions for psychiatric causes in the group with PID other than unspecified conduct disorders. There were no differences in other diagnostic groups. The rate of inappropriate admissions was similar in the two study groups. CONCLUSIONS In contrast to previous results reported for the group with ID as a whole, patients with PID consulting the emergency service were not admitted to hospital more frequently than the general population nor did they present a higher rate of inappropriate admissions. These results support the utility of maintaining two distinct groups of people with ID: mild-moderate and severe-profound.
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Affiliation(s)
- A Amor-Salamanca
- Department of Psychiatry, Fundación Vallparadís, Mutua Terrassa University Hospital, Barcelona, Spain
| | - J M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona. Cibersam, Barcelona, Spain
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Dell'Osso B, Benatti B, Rodriguez CI, Arici C, Palazzo C, Altamura AC, Hollander E, Fineberg N, Stein DJ, Nicolini H, Lanzagorta N, Marazziti D, Pallanti S, Van Ameringen M, Lochner C, Karamustafalioglu O, Hranov L, Figee M, Drummond L, Grant J, Denys D, Cath D, Menchon JM, Zohar J. Obsessive-compulsive disorder in the elderly: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). Eur Psychiatry 2017; 45:36-40. [PMID: 28728093 DOI: 10.1016/j.eurpsy.2017.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 04/30/2017] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD≥65years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample. METHODS Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age<vs≥65years, and then divided on the basis of the median age of the sample (age<vs≥42years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests). RESULTS G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P<.001), showing a significantly later age at onset (29.4±15.1 vs 18.7±9.2years, P<.001), a more frequent adult onset (75% vs 41.1%, P<.001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P<.05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P=.07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P<.05). CONCLUSIONS G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.
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Affiliation(s)
- B Dell'Osso
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, 94305 Stanford, CA, USA
| | - B Benatti
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - C I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, 94305 Stanford, CA, USA
| | - C Arici
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - C Palazzo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - A C Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - E Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, 10467 New York, USA
| | - N Fineberg
- Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, AL7 4HQ Welwyn Garden City, UK
| | - D J Stein
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, 7935 Cape Town, South Africa
| | - H Nicolini
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), 03100 Mexico City, Mexico; Carracci Medical Group, 03100 Mexico City, Mexico
| | - N Lanzagorta
- Carracci Medical Group, 03100 Mexico City, Mexico
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria, Università di Pisa, 56126 Pisa, Italy
| | - S Pallanti
- Department of Psychiatry, University of Florence, and Institute of Neurosciences, 50121 Florence, Italy
| | - M Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, ON L8S 4L8 Hamilton, Canada
| | - C Lochner
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, 7599 Stellenbosch, South Africa
| | - O Karamustafalioglu
- Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, 34371 Istanbul, Turkey
| | - L Hranov
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, 1797 Sofia, Bulgaria
| | - M Figee
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105 Amsterdam, Netherlands
| | - L Drummond
- National and Trustwide Services for OCD/BDD, SW London and St George's NHS Trust, SW17 7DJ London, UK
| | - J Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 60607 Chicago, USA
| | - D Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105 Amsterdam, Netherlands
| | - D Cath
- Department of Clinical and Health Psychology, Utrecht University, 3512 Utrecht, The Netherlands
| | - J M Menchon
- Psychiatry Unit at Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
| | - J Zohar
- Department of Psychiatry, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel
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Amor-Salamanca A, Menchon JM. Pain underreporting associated with profound intellectual disability in emergency departments. J Intellect Disabil Res 2017; 61:341-347. [PMID: 28054733 DOI: 10.1111/jir.12355] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability. METHODS Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge. The results were compared with data obtained from a control group of people with no ID who attended an ED for any reason during the same period. RESULTS Somatic complaints were the main reason for ED attendance among persons with PID (90% of consultations). These complaints were more often related to the central nervous system than was the case among non-ID patients (16 vs. 4.7%), whereas other kinds of non-central nervous system somatic complaint were less common among persons with PID (74 vs. 91%). A diagnosis implying physical pain was given less often to people with PID than to controls (3 vs. 20%). CONCLUSIONS The results suggest that persons with PID are less able to conceptualise and communicate information about their symptoms, especially as regards pain, and that this influences the diagnosis they are given when attending an ED. Professionals working in this environment need to be aware of this possibility so as not to underestimate or overlook such symptoms and the illnesses related to them.
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Affiliation(s)
- A Amor-Salamanca
- Fundación Vallparadís, Department of Psychiatry, Mutua Terrassa University Hospital, Spain
| | - J M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Spain
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Fineberg NA, Menchon JM, Zohar J, Veltman DJ. Compulsivity-A new trans-diagnostic research domain for the Roadmap for Mental Health Research in Europe (ROAMER) and Research Domain Criteria (RDoC) initiatives. Eur Neuropsychopharmacol 2016; 26:797-9. [PMID: 27235689 DOI: 10.1016/j.euroneuro.2016.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- N A Fineberg
- Highly Specialised Obsessive Compulsive Disorder and Body Dysmorphic Disorder Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Parkway, Welwyn Garden City, Hertfordshire, AL8 6HG, UK; University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - J M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - J Zohar
- Department of Psychiatry, Tel Aviv University, Israel
| | - D J Veltman
- Department of Psychiatry, VU University Amsterdam, Amsterdam, The Netherlands
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Fineberg NA, Baldwin DS, Menchon JM, Denys D, Grünblatt E, Pallanti S, Stein DJ, Zohar J. Manifesto for a European research network into obsessive-compulsive and related disorders. Eur Neuropsychopharmacol 2013; 23:561-8. [PMID: 22796228 DOI: 10.1016/j.euroneuro.2012.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 05/31/2012] [Accepted: 06/07/2012] [Indexed: 10/28/2022]
Abstract
Obsessive-compulsive and related disorders (O-CRDs) are highly disabling psychiatric illnesses of early-onset. They are responsible for considerable morbidity and socioeconomic burden. Existing treatments are usually only partially successful and there is an urgent need to understand the aetiological factors and neurobiological bases of the disorders in order to develop new and more effective strategies for prevention, early detection and effective treatment. Emerging data from the neurosciences supports the reconceptualisation of obsessive-compulsive disorder as a spectrum disorder, related to but different from the anxiety disorders and closely aligned with other less well understood psychiatric disorders characterised by compulsive acts such as body dysmorphic disorder, trichotillomania, skin-picking disorder, hoarding disorder; and possibly extending to tic disorders and other neurodevelopmental disorders such as autism. A new, O-CRDs research network, supported by the Networks Initiative of the European College of Neuropsychopharmacology and comprising leading figures in preclinical and clinical research, has been established. It aims to provide a European perspective on the current debate around internationally-accepted diagnostic criteria and treatment strategies for O-CRDs. Its objectives include; (1) identifying the key outstanding research questions that depend upon cross-centre collaborative investigation, (2) setting a research agenda that is likely to produce an impact on health-outcomes, and (3) strengthening existing projects and collaborative enterprises with these objectives in mind. This paper reviews some of these critical research priorities. By establishing shared multinational databases, collaborative research networks, multicentre studies and joint publications, it is hoped that progress will be achieved.
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Gilaberte I, Romera I, Perez-Sola V, Menchon JM, Schacht A. Different levels of lack of improvement at 4 weeks of escitalopram treatment as predictors of poor 8-week outcome in MDD. J Affect Disord 2013; 146:433-7. [PMID: 22921481 DOI: 10.1016/j.jad.2012.07.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Received: 06/15/2012] [Revised: 07/26/2012] [Accepted: 07/26/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Several post-hoc studies have shown that lack of early improvement reduces the chance of later response or remission. This post-hoc analysis evaluates different cut-off points of non-improvement at 4 weeks of escitalopram treatment to predict 8-week non-response and non-remission. METHOD This study consisted of MDD patients with an absence of improvement (<30% reduction in baseline score of the HAMD-17) at Week 4 of escitalopram treatment (10mg/day) that continued escitalopram treatment (10-20mg/day) for a further 4-week period (n=251). Predictive, sensitivity and specificity values for the several definitions of non-improvement (≤ 25%, ≤ 20% and ≤ 15% reduction in the HAMD-17 baseline total score) at 4 weeks were calculated. RESULTS Overall, 70.1% (176/251) of patients did not achieve response at Week 8 and 84.5% (212/251) did not achieve remission. The predictive value for non-response was high (71.4-74.3%) for all cut-off points of non-improvement tested. The respective values for non-remission were placed between 85.0% and 87.2%. LIMITATIONS This was a post-hoc subgroup analysis. The only drug assessed was escitalopram. CONCLUSIONS Our data indicate that an absence of improvement, <30% reduction in the HAMD-17, after 4 weeks of escitalopram treatment should prompt clinicians to consider a change in treatment strategy. Similar findings were previously reported for other antidepressants.
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Harrison BJ, Pujol J, Cardoner N, Deus J, Alonso P, López-Solà M, Contreras-Rodríguez O, Real E, Segalàs C, Blanco-Hinojo L, Menchon JM, Soriano-Mas C. Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder. Biol Psychiatry 2013. [PMID: 23200527 DOI: 10.1016/j.biopsych.2012.10.006] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [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: 11/26/2022]
Abstract
BACKGROUND Functional neuroimaging studies have provided consistent support for the idea that obsessive-compulsive disorder (OCD) is associated with disturbances of brain corticostriatal systems. However, in general, these studies have not sought to account for the disorder's prominent clinical heterogeneity. METHODS To address these concerns, we investigated the influence of major OCD symptom dimensions on brain corticostriatal functional systems in a large sample of OCD patients (n = 74) and control participants (n = 74) examined with resting-state functional magnetic resonance imaging. We employed a valid method for mapping ventral and dorsal striatal functional connectivity, which supported both standard group comparisons and linear regression analyses with patients' scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale. RESULTS Consistent with past findings, patients demonstrated a common connectivity alteration involving the ventral striatum and orbitofrontal cortex that predicted overall illness severity levels. This common alteration was independent of the effect of particular symptom dimensions. Instead, we observed distinct anatomical relationships between the severity of symptom dimensions and striatal functional connectivity. Aggression symptoms modulated connectivity between the ventral striatum, amygdala, and ventromedial frontal cortex, while sexual/religious symptoms had a specific influence on ventral striatal-insular connectivity. Hoarding modulated the strength of ventral and dorsal striatal connectivity with distributed frontal regions. CONCLUSIONS Taken together, these results suggest that pathophysiological changes among orbitofrontal-striatal regions may be common to all forms of OCD. They suggest that a further examination of certain dimensional relationships will also be relevant for advancing current neurobiological models of the disorder.
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Affiliation(s)
- Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia.
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Harrison BJ, Pujol J, Soriano-Mas C, Hernández-Ribas R, López-Solà M, Ortiz H, Alonso P, Deus J, Menchon JM, Real E, Segalàs C, Contreras-Rodríguez O, Blanco-Hinojo L, Cardoner N. Neural Correlates of Moral Sensitivity in Obsessive-Compulsive Disorder. ACTA ACUST UNITED AC 2012; 69:741-9. [DOI: 10.1001/archgenpsychiatry.2011.2165] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Segarra N, Bernardo M, Gutierrez F, Justicia A, Fernadez-Egea E, Allas M, Safont G, Contreras F, Gascon J, Soler-Insa PA, Menchon JM, Junque C, Keefe RSE. Spanish validation of the Brief Assessment in Cognition in Schizophrenia (BACS) in patients with schizophrenia and healthy controls. Eur Psychiatry 2011; 26:69-73. [PMID: 20435446 DOI: 10.1016/j.eurpsy.2009.11.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [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: 07/28/2009] [Revised: 11/01/2009] [Accepted: 11/02/2009] [Indexed: 10/19/2022] Open
Abstract
Neurocognitive impairment is a core feature of schizophrenia and is closely associated with functional outcome. The importance of cognitive assessment is broadly accepted today, and an easy-to-use, internationality validated cognitive assessment tool is needed by researchers and in daily clinical practice. The Brief Assessment of Cognition in Schizophrenia (BACS) has been validated in English, French, Japanese and Italian. It is as sensitive to cognitive dysfunction as a standard test battery, with the advantage of requiring less than 35minutes to complete. In our study, we tested the psychometric characteristics of a Spanish version of the BACS in 117 patients with schizophrenia-spectrum disorders and 36 healthy controls. All BACS cognitive subtests discriminated between patients and controls (P<.001), and the concurrent validity between the BACS and a traditional neuropsychological test battery was similar to that reported in other languages. We conclude that the BACS can facilitate the comparison of the cognitive performance of patients with schizophrenia in many different countries.
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Affiliation(s)
- N Segarra
- Schizophrenia Clinic Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic de, Barcelona, Spain
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Harrison BJ, Soriano-Mas C, Pujol J, Ortiz H, López-Solà M, Hernández-Ribas R, Deus J, Alonso P, Yücel M, Pantelis C, Menchon JM, Cardoner N. Altered corticostriatal functional connectivity in obsessive-compulsive disorder. ACTA ACUST UNITED AC 2009; 66:1189-200. [PMID: 19884607 DOI: 10.1001/archgenpsychiatry.2009.152] [Citation(s) in RCA: 439] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
CONTEXT Neurobiological models of obsessive-compulsive disorder (OCD) emphasize disturbances in the function and connectivity of brain corticostriatal networks, or "loops." Although neuroimaging studies of patients have supported this network model of OCD, very few have applied measurements that are sensitive to brain connectivity features. OBJECTIVE Using resting-state functional magnetic resonance imaging, we tested the hypothesis that OCD is associated with disturbances in the functional connectivity of primarily ventral corticostriatal regions, measured from coherent spontaneous fluctuations in the blood oxygenation level-dependent (BOLD) signal. DESIGN Case-control cross-sectional study. SETTING Hospital referral OCD unit and magnetic resonance imaging facility. PARTICIPANTS A total of 21 patients with OCD (10 men, 11 women) and 21 healthy control subjects matched for age, sex, and estimated intelligence. MAIN OUTCOME MEASURES Voxelwise statistical parametric maps testing the strength of functional connectivity of 4 striatal seed regions of interest (dorsal caudate nucleus, ventral caudate/nucleus accumbens, dorsal putamen, and ventral putamen) with remaining brain areas. RESULTS For both groups, there was a clear distinction in the pattern of cortical connectivity of dorsal and ventral striatal regions, consistent with the notion of segregated motor, associative, and limbic corticostriatal networks. Between groups, patients with OCD had significantly increased functional connectivity along a ventral corticostriatal axis, implicating the orbitofrontal cortex and surrounding areas. The specific strength of connectivity between the ventral caudate/nucleus accumbens and the anterior orbitofrontal cortex predicted patients' overall symptom severity (r(2) = 0.57; P < .001). Additionally, patients with OCD showed evidence of reduced functional connectivity of the dorsal striatum and lateral prefrontal cortex, and of the ventral striatum with the region of the midbrain ventral tegmental area. CONCLUSIONS This study directly supports the hypothesis that OCD is associated with functional alterations of brain corticostriatal networks. Specifically, our findings emphasize abnormal and heightened functional connectivity of ventrolimbic corticostriatal regions in patients with OCD.
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Affiliation(s)
- Ben J Harrison
- Institut d'Alta Tecnologia-Parc de Recerca Biomèdica de Barcelona, Centro Radiológico Computerizado Corporació Sanitària, Barcelona, Spain.
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Lopez-Sola M, Pujol J, Hernandez-Ribas R, Deus J, Harrison BJ, Ortiz H, Soriano C, Vallejo J, Menchon JM, Cardoner N. Dynamics of the right frontal cortex response to painful stimulation. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70292-7] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Alonso P, Menchon JM, Pifarre J, Mataix-Cols D, Torres L, Salgado P, Vallejo J. Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy. J Clin Psychiatry 2001; 62:535-40. [PMID: 11488364 DOI: 10.4088/jcp.v62n07a06] [Citation(s) in RCA: 141] [Impact Index Per Article: 6.1] [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: 10/19/2022]
Abstract
BACKGROUND The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. METHOD Sixty outpatients meeting DSM-II-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. RESULTS Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. CONCLUSION A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spite of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas short-term response to SRI treatment failed to achieve predictive value in the long-term course of OCD.
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Affiliation(s)
- P Alonso
- Department of Psychiatry, Hospital Principes de España, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona, Spain
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15
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Rosel P, Arranz B, Vallejo J, Alvarez P, Menchon JM, Palencia T, Navarro MA. Altered [3H]imipramine and 5-HT2 but not [3H]paroxetine binding sites in platelets from depressed patients. J Affect Disord 1999; 52:225-33. [PMID: 10357037 DOI: 10.1016/s0165-0327(98)00030-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 10/17/2022]
Abstract
BACKGROUND Serotonergic system alterations were studied in 51 depressed patients classified according to DSM-III-R criteria for major depression with melancholia compared to 31 healthy controls. METHOD [3H]Imipramine and [3H]paroxetine binding sites and the 5HT2 receptor were simultaneously determined in blood platelet membranes. RESULTS A significantly lower maximum binding in [3H]imipramine binding was observed in depressed patients compared to controls (1134+/-74 vs. 1712+/-106 fmol/mg protein, P<0.0001) without changes in the equilibrium dissociation constant (1.10+0.05 vs. 1.25-/+0.09 nM). [3H]Paroxetine binding did not differ between the two groups (Bmax, 1441+/-55 vs. 1280+/-81 fmol/mg protein; Kd, 0.060+/-0.002 vs. 0.062+/-0.002 nM). The K(d) value of 5HT2 binding was lower in depressed patients than controls (0.95+/-0.04 vs. 1.15+/-0.09 nM, P<0.039) without changes in maximum binding (140+/-11 vs. 127+/-14 fmol/mg protein). CONCLUSIONS Taken together, these results suggest that [3H]imipramine and 5HT2 receptors may be good biological markers for serotonergic dysfunction in depressive disorders.
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MESH Headings
- Adult
- Aged
- Antidepressive Agents, Second-Generation/blood
- Antidepressive Agents, Second-Generation/pharmacokinetics
- Antidepressive Agents, Second-Generation/therapeutic use
- Antidepressive Agents, Tricyclic/blood
- Antidepressive Agents, Tricyclic/pharmacokinetics
- Antidepressive Agents, Tricyclic/therapeutic use
- Binding Sites/drug effects
- Biomarkers
- Cell Membrane/metabolism
- Depressive Disorder, Major/blood
- Depressive Disorder, Major/drug therapy
- Depressive Disorder, Major/psychology
- Female
- Humans
- Imipramine/blood
- Imipramine/pharmacokinetics
- Imipramine/therapeutic use
- Male
- Middle Aged
- Paroxetine/blood
- Paroxetine/pharmacology
- Paroxetine/therapeutic use
- Receptors, Serotonin/blood
- Receptors, Serotonin/metabolism
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Affiliation(s)
- P Rosel
- Department of Biochemistry, Hospitalet de Llobregat, Barcelona, Spain
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16
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Rosel P, Arranz B, Vallejo J, Oros M, Crespo JM, Menchon JM, Navarro MA. Variations in [3H]imipramine and 5-HT2A but not [3H]paroxetine binding sites in suicide brains. Psychiatry Res 1998; 82:161-70. [PMID: 9754440 DOI: 10.1016/s0925-4927(98)00015-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [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: 11/21/2022]
Abstract
Both the [3H]imipramine and [3H]paroxetine binding sites and the 5-HT2A receptor were simultaneously determined in frontal cortex, cingulate cortex, hippocampus and amygdala from 17 control subjects and 17 depressed suicide victims. A significant decrease in the maximum binding (Bmax) of [3H]imipramine was observed in the hippocampus of suicide victims as compared to control subjects (160 +/- 25 vs. 328 +/- 52 fmol/mg protein; P = 0.007) without changes in the apparent affinity constant (Kd). Furthermore, a significant decrease in the number of 5-HT2A binding sites, together with a significantly lower Kd, was also observed in the hippocampus of suicides as compared to control subjects (129 +/- 18 vs. 225 +/- 32 fmol/mg protein; P = 0.02 and 0.91 +/- 0.07 vs. 1.38 +/- 0.08 nM, respectively; P = 0.006). [3H]Paroxetine binding did not display modifications between the two groups in either Bmax or Kd from any of the brain regions studied. When all four brain regions were taken together, a down-regulation was noted between presynaptic [3H]imipramine binding and the postsynaptic 5-HT2A receptor (r = -0.40; P = 0.0013) in the control group. This correlation did not appear in the suicide group. No correlation was observed between [3H]paroxetine binding and the 5-HT2A receptor in either control subjects or suicides. Taken together, these results suggest that the 5-HT uptake site measured with [3H]imipramine and the 5-HT2A receptors are reliable markers of serotonergic dysfunction.
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Affiliation(s)
- P Rosel
- Department of Clinical Chemistry, Hospital Princeps D'Espanya, Barcelona, Spain
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17
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Rosel P, Menchon JM, Oros M, Vallejo J, Cortadellas T, Arranz B, Alvarez P, Navarro MA. Regional distribution of specific high affinity binding sites for 3H-imipramine and 3H-paroxetine in human brain. J Neural Transm (Vienna) 1997; 104:89-96. [PMID: 9085196 DOI: 10.1007/bf01271297] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The binding of 3H-paroxetine and 3H-imipramine has been compared in 17 different regions of 12 human control brains. Our findings reveal that the regional distribution is similar for both radioligands and their bindings tend to be parallel in the brain. The highest binding site density was found in basal ganglia (hypothalamus Bmax 780 +/- 102 fmol/mg protein for 3H-imipramine binding and Bmax 515 approximately 83 for 3H-paroxetine binding). The lowest values were found in cortical areas (cingulate cortex 191 +/- 18.5 fmol/mg for 3H-imipramine binding and 88 +/- 7.5 fmol/mg for 3H-paroxetine binding). The Kd values for 3H-paroxetine binding to neuronal membranes were similar in all brain regions (mean +/- s.d. Kd 0.07 +/- 0.007 nM) and also for 3H-imipramine binding (mean +/- s.d. Kd 1.05 +/- 0.12 nM). As these values are the same as in platelet membrane, the results obtained indicate that both binding sites are identical in neuronal and in platelet membranes. These findings suggest that both ligands are good markers of the 5HT transporter. However, the higher affinity of 3H-paroxetine confirms that this compound is a better radioligand for the 5HT uptake site.
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Affiliation(s)
- P Rosel
- Hormone Unit, Hospital Princeps d'Espanya, Barcelona, Spain
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18
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Soria PR, Vallejo J, Oros M, Menchon JM, Cortadellas T, Navarro MA, Urretavizcaya M. Seasonal variability in blood platelet 3H-imipramine binding in healthy controls: age and gender effects. Biol Psychiatry 1996; 40:981-5. [PMID: 8915556 DOI: 10.1016/0006-3223(95)00593-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/03/2023]
Abstract
Binding of 3H-imipramine to blood platelet membranes was determined four times (once each season) in 26 healthy volunteers (11 men and 15 women), over the course of 1 year to determine possible seasonal variations. Blood platelets were obtained in April-May, July-August, October-November, and January-February. Significant seasonal variations in the maximum number of binding sites were found in women but not in men, with circannual peak in summer and a nadir in spring. The pattern of seasonal variations was not the same in men and women. The present results highlight the importance of monitoring for gender and season in binding studies. We found no significant correlation between 3H-imipramine binding parameters and age.
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Affiliation(s)
- P R Soria
- Hormone Unit, Hospital Princeps d'Espanya, Barcelona, Spain
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19
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Contreras F, Navarro MA, Menchon JM, Rosel P, Serrallonga J, Perez-Arnau F, Urretavizcaya M, Vallejo J. Growth hormone response to growth hormone releasing hormone in non-delusional and delusional depression and healthy controls. Psychol Med 1996; 26:301-307. [PMID: 8685286 DOI: 10.1017/s0033291700034693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/01/2023]
Abstract
Growth hormone (GH) responses to growth hormone releasing hormone (GHRH) of 53 in-patients meeting DSM-III-R criteria for major depressive episode with melancholia (24 non-delusional and 23 delusional depression) were compared with those of 19 healthy controls. No significant differences in basal GH were found between the control and either the non-delusional or the delusional groups. The whole group of depressed patients showed a significantly lower response than the control patients at all points of the GH response to GHRH curve as well as a lower area under curve. When the three groups (control, delusional, and non-delusional depressed) were compared, it was found that only the non-delusional depressed patients had a significantly lower area under curve and lower values at +60, +90 and +120 min than the controls. The only significant difference between the two groups of depressed patients was that the delusional group showed a delayed appearance of the maximum response peak and a more prolonged response.
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Affiliation(s)
- F Contreras
- Department of Psychiatry, Hospital de Bellvitge, School of Medicine, Barcelona, Spain
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20
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Rosel-Soria P, Vallejo J, Oros M, Serrallonga J, Menchon JM, Navarro MA. Changes in platelet 3-H-imipramine binding: influences of protein concentration of varying proportions of cytosol or intact platelets and displacing agents used. Biol Psychiatry 1995; 38:464-70. [PMID: 8672607 DOI: 10.1016/0006-3223(94)00380-l] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/01/2023]
Abstract
Platelet 3-H-imipramine binding exhibits considerable variation, both interindividually and between several groups. The aim of this study was to measure 3-H-imipramine binding, simultaneously in platelet membranes vs. intact platelets vs. cytosol or intracytosolic protein in order to determine their effect on Bmax and Kd values. 3-H-imipramine binding was carried out at different protein concentrations. Our results indicate that the affinity constant is heavily influenced by the presence of cytosol and intact platelets in membrane preparations. Finally, we demonstrate a negative correlation between Bmax and protein concentration. Only perfect analytical conditions will allow platelet 3-H-imipramine binding to be a biological marker for affective disorders.
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Affiliation(s)
- P Rosel-Soria
- Hormone Unit, Hospital Princeps d'Espanya, Barcelona, Spain
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21
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Vallejo J, Gasto C, Catalan R, Bulbena A, Menchon JM. Predictors of antidepressant treatment outcome in melancholia: psychosocial, clinical and biological indicators. J Affect Disord 1991; 21:151-62. [PMID: 1829739 DOI: 10.1016/0165-0327(91)90036-r] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [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: 12/29/2022]
Abstract
Predictive variables of response to imipramine and to phenelzine at 6 weeks and 6 months were studied in 116 patients suffering from major depression with melancholia (DSM-III). Several sociodemographic, clinical, and biological variables were studied. For imipramine-treated patients, high social support predicted a better response at 6 weeks, while development of hypomania during follow-up was associated with a better response at 6 weeks; absence of life events during the 6-month follow-up and initial non-suppression of dexamethasone predicted a better outcome at 6 months. For phenelzine-treated patients, development of hypomania during follow-up was associated with a better outcome at 6 months and absence of life events prior to the onset of the episode was associated with a worse outcome at 6 months.
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Affiliation(s)
- J Vallejo
- Department of Psychiatry, Hospital of Bellvitge School of Medicine, Barcelona, Spain
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