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González-Domenech PJ, Gurpegui M, González-Domenech CM, Gómez-González S, Rustarazo A, Ruiz-Nieto V, Carretero MD, Gutiérrez-Rojas L. Prader-Willi syndrome in a large sample from Spain: general features, obesity and regular use of psychotropic medication. J Intellect Disabil Res 2024; 68:446-463. [PMID: 38246690 DOI: 10.1111/jir.13123] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Prader-Willi syndrome (PWS), a genetically determined disorder, the most frequent cause of early onset obesity, is associated with physical and cognitive dysfunctions and behavioural disturbances; these disturbances are frequently treated with psychotropic medication. The aim of this cross-sectional study was to describe the characteristics of the first large national sample of persons with PWS in Spain and analyse the relationships of those characteristics with key demographic and clinical factors, particularly with obesity and the regular use of psychotropic medication. METHODS Participants were recruited among all members of the Spanish Prader-Willi Association who agreed to take part in the study and fulfilled its inclusion criteria. Family and patient demographic features, family size and birth order, intelligence quotient (IQ), anthropometric measures, lifestyle habits, behavioural disturbances (with the Aberrant Behavior Checklist) and clinical data, as well as use of psychotropic drugs and their side effects (with the UKU scale), were collected in genetically confirmed cases of PWS. Bivariate and logistic regression analyses were used for determining the associations of demographic and clinical factors with both obesity and the regular use of psychotropic medication. RESULTS The cohort included 177 participants (aged 6-48 years), that is, 90 (50.8%) males and 87 (49.2%) females. Behavioural disturbances were present in a range of 75% to 93% of participants; psychotropic medication was prescribed to 81 (45.8%) of them. Number of siblings showed a direct correlation with IQ, especially among males, and inappropriate speech was more intense in only-child females. Obesity was, in parallel, strongly associated with ascending age and with not being currently under growth hormone (GH) treatment. Participants taking any psychotropic medication were characterised by more frequent age ≥30 years, high level of hyperactivity and a psychiatric diagnosis. CONCLUSIONS Characterisation of persons with PWS in Spain confirms their physical and behavioural phenotype and supports the long-term application of GH therapy and the rational use of psychotropic medication.
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Affiliation(s)
- P J González-Domenech
- Multicentre CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain
- Department of Psychiatry, Universidad de Granada, Granada, Spain
| | - M Gurpegui
- Multicentre CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain
- Granada Centre for Psychiatric Studies, Granada, Spain
| | | | | | - A Rustarazo
- Asociación Española para el Síndrome de Prader-Willi, Madrid, Spain
| | - V Ruiz-Nieto
- Asociación Española para el Síndrome de Prader-Willi, Madrid, Spain
| | - M D Carretero
- Multicentre CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain
- Department of Psychiatry, Universidad de Granada, Granada, Spain
| | - L Gutiérrez-Rojas
- Multicentre CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain
- Department of Psychiatry, Universidad de Granada, Granada, Spain
- Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain
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de la Fuente-Tomás L, Arranz B, Sierra P, Sánchez-Autet M, García-Blanco A, Gutiérrez-Rojas L, Balanzá-Martínez V, Vidal-Rubio S, Vieta E, Jiménez E, Hernández C, Arrojo M, Gómez-Trigo J, Zapico-Merayo Y, Pelayo-Terán JM, Pérez-Solà V, Mur E, Cardoner N, González-Pinto A, Zorrilla I, Ruiz-Veguilla M, Catalán-Barragán R, Safont G, Martínez-Cao C, Sáiz P, Bobes J, García-Portilla MP. Spanish validation of the Empirically Developed Clinical Staging Model (EmDe-5) for patients with bipolar disorder. Rev Psiquiatr Salud Ment 2023:S1888-9891(21)00104-X. [PMID: 37965877 DOI: 10.1016/j.rpsm.2021.09.005] [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] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/26/2021] [Accepted: 09/28/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Bipolar disorder (BD) has been reconceptualised as a progressive disorder that develops from mild to severe presentations. An empirical staging model - the Empirically Developed Clinical Staging Model for BD (EmDe-5) - was developed in a previous study. This study aims to further validate that model using a larger and more representative Spanish sample. MATERIAL AND METHODS 183 BD outpatients were recruited at 11 sites in Spain. Assessment included clinical characteristics of the BD (number of hospitalisations, number of suicide attempts, comorbid personality disorders), physical health (BMI, metabolic syndrome, number of physical illnesses), cognition (SCIP), functioning (permanently disabled due to BD, FAST), and quality of life (SF-36). The CGI-S, VAS-S, and psychopharmacological treatment pattern were used as external validators. RESULTS Ten patients (51.5%) were classified as stage 1, 33 (18%) as stage 2, 93 (508%) as stage 3, 37 (202%) as stage 4, and 10 (55%) as stage 5. All profilers, other than number of suicide attempts (p=0.311) and comorbid personality disorder (p=0.061), exhibited worse scores from stage 1 to 5. As expected, VAS-S and CGI-S scores were worse in the later stages. Regarding treatment, early stages (1-2) were associated with the use of one to three drugs while late stages (4-5) were associated with four or more drugs (p=0.002). CONCLUSIONS We confirm the EmDe-5 staging model's construct validity. The ease of obtaining the profilers, together with the operational criteria provided to quantify them, will facilitate the use of the EmDe-5 staging model in daily clinical practice.
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Affiliation(s)
- Lorena de la Fuente-Tomás
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.
| | - Belén Arranz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Pilar Sierra
- La Fe University and Polytechnic Hospital, Valencia, and University of Valencia, Valencia, Spain
| | | | - Ana García-Blanco
- La Fe University and Polytechnic Hospital, Valencia, and University of Valencia, Valencia, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry and Psychiatry and Neurosciences Research Group (CTS-549), University of Granada, Granada, Spain
| | - Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Teaching Unit of Psychiatry, Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Hernández
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Manuel Arrojo
- Psychiatry Service, Complejo Hospitalario Universitario de Santiago, Spain
| | - Jesús Gómez-Trigo
- Psychiatry Service, Complejo Hospitalario Universitario de Santiago, Spain
| | - Yolanda Zapico-Merayo
- Servicio de Psiquiatría y Salud Mental. Hospital El Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y León (SACYL). Ponferrada (León), Spain
| | - Jose María Pelayo-Terán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Servicio de Psiquiatría y Salud Mental. Hospital El Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y León (SACYL). Ponferrada (León), Spain; Área de Medicina y Salud Pública, Departamento de Ciencias de la Salud, Universidad de León, León, Spain
| | - Victor Pérez-Solà
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Estanislao Mur
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Narcís Cardoner
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry UPV/EHU. BIOARABA, University Hospital Alava, País Vasco, Spain
| | - Iñaki Zorrilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry UPV/EHU. BIOARABA, University Hospital Alava, País Vasco, Spain
| | - Miguel Ruiz-Veguilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University Hospital Virgen del Rocío, Sevilla/ibis, University of Sevilla, Spain
| | | | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitari Mútua Terrassa, University of Barcelona, Integrative and Conscious Health Institute, Barcelona, Spain
| | - Clara Martínez-Cao
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Pilar Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Julio Bobes
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Maria Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
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Serrano Molina AM, Gómez-Sierra FJ, Fernández Ruiz J, Jiménez-Fernández S, González Domenech P, García-Jiménez J, Gutiérrez-Rojas L. Consequences of the COVID-19 pandemic on the mental health of medical students202. Actas Esp Psiquiatr 2023; 51:202-215. [PMID: 38117260 PMCID: PMC10803873] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 12/21/2023]
Abstract
Several studies have shown an increased prevalence of anxiety, depression and suicidal ideation in the general population in relation to the COVID-19 pandemic.
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Affiliation(s)
| | | | | | - Sara Jiménez-Fernández
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain Child and adolescent Mental Health Unit. Virgen de las Nieves University Hospital, Granada, Spain
| | - Pablo González Domenech
- Psychiatry Department, University of Granada, Granada, Spain. Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain
| | - Jesús García-Jiménez
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain 1 2 Child and adolescent Mental Health Unit. Virgen de las Nieves University Hospital, Granada, Spain
| | - Luis Gutiérrez-Rojas
- Psychiatry Department, University of Granada, Granada, Spain. Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain Child and adolescent Mental Health Unit. Virgen de las Nieves University Hospital, Granada, Spain
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Solis M, Valverde-Barea M, Gutiérrez-Rojas L, Romera I, Cruz-Bailén S, Jiménez-Fernández S. Suicidal Risk and Depression in Pregnant Women in Times of Pandemic. Matern Child Health J 2023:10.1007/s10995-023-03688-3. [PMID: 37289292 PMCID: PMC10248323 DOI: 10.1007/s10995-023-03688-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE Pregnancy is a risk period for the development of mental disorders. About 10% of pregnant women worldwide experience a mental disorder, mainly depression, and this percentage has been aggravated by the COVID-19 pandemic. This study aims to understand the impact of COVID-19 on the mental health of pregnant women. METHODS Three hundred and one pregnant women in the week 21.85 ± 9.9 were recruited through social media and pregnant women forums from September 2020 to December 2020. A multiple-choice questionnaire was administered to evaluate the sociodemographic characteristics of the women, the care provided, and different aspects related to COVID-19. A Beck Depression Inventory was also delivered. RESULTS Of the pregnant women 23.5% had seen or had considered seeing a mental health professional during pregnancy. Predictive models using multivariate logistic regression found that this fact was associated with an increased risk of depression (OR = 4.22; CI 95% 2.39-7.52; P < 0.001). Among women with moderate-severe depression, it was associated with an increased risk of having suicidal thoughts (OR = 4.99; CI 95% 1.11-27.9; P = 0.044) and age was found to be a protective variable (OR = 0.86; CI 95% 0.72-0.98; P = 0.053). CONCLUSIONS The COVID-19 pandemic represents a major mental health challenge for pregnant women. Despite the decrease in face-to-face visits, there are opportunities for health professionals to identify the existence of psycho-pathological alterations and suicidal ideation by asking the patient if she is seeing or considering seeing a mental health professional. Therefore, it is necessary to develop tools for early identification to ensure correct detection and care.
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Affiliation(s)
- Mirta Solis
- Child and Adolescent Mental Health Unit, Jaén Medical Center, Jaén, Spain
| | | | - Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.
- Psychiatry Service, Hospital Universitario San Cecilio, Granada, Spain.
| | - Inmaculada Romera
- Psychiatry Service, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Sheila Cruz-Bailén
- Child and Adolescent Mental Health Unit, Jaén Medical Center, Jaén, Spain
| | - Sara Jiménez-Fernández
- Child and Adolescent Mental Health Unit, Jaén Medical Center, Jaén, Spain
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
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García-Jiménez J, Gómez-Sierra FJ, Martínez-Hortelano A, Moreno-Merino P, Girela-Serrano B, Molero P, Gutiérrez-Rojas L. Cigarette smoking and risk of suicide in bipolar disorder: a systematic review. Front Psychiatry 2023; 14:1179733. [PMID: 37275988 PMCID: PMC10235444 DOI: 10.3389/fpsyt.2023.1179733] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
Objective Bipolar disorder (BD) is a highly prevalent, chronic and recurrent mental illness. The smoking rates in patients with BD are much higher than those of the general population, and BD is associated with an increased risk of suicide. An association between smoking and suicidal behavior has been found in the general population, this systematic review examines whether there is evidence of an association between smoking and suicide behavior in patients with BD. Method A database search was carried out in Medline, Embase, The Cochrane Library, Scopus, and Web of Science, updated until December 31st, 2021, according to the 2020 PRISMA guidelines. We identified prospective and retrospective studies that included patients diagnosed with BD types I, II, and not otherwise specified, and in which smoking and suicidal behavior were correlated. Articles that focused exclusively on other mental disorders were excluded. The Ottawa-Newcastle scale was used to assess the methodological quality of the included articles. Results Fifteen articles (n = 7,395) met all the inclusion criteria. In nine of these articles, the authors found an association between smoking and suicidal behavior in BD, while in the remaining six articles, this association was not found. A great deal of variability was observed between articles, particularly in the measurement of suicidal behavior and tobacco consumption. The risk of bias, as assessed by the NOS, was high for most of the included articles, except for two papers, whose risk was low. Conclusion It was not possible to establish a clear relationship between tobacco use and the risk of suicide in BD patients due to the heterogeneity of the articles included in this systematic review, which had different sample sizes and methodological issues. However, both conditions are highly prevalent and have a negative impact on the prognosis of BD. Therefore, a systematic approach is needed, based on accurate measurement of a patient's smoking habits and their risk of suicidal behavior, in order to establish an appropriate therapeutic plan. Additional information This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors and was registered on PROSPERO with the CRD42022301570 on January 21th 2022.
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Affiliation(s)
| | | | | | - Paula Moreno-Merino
- Mental Health Unit at Estepona, Virgen de la Victoria Hospital, Málaga, Spain
| | - Braulio Girela-Serrano
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Patricio Molero
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, San Cecilio University Hospital, Granada, Spain
- Psychiatry and Neuroscience Research Group (CTS-549), Neuroscience Institute, University of Granada, Granada, Spain
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Pedruzo B, Aymerich C, Pacho M, Herrero J, Laborda M, Bordenave M, Giuliano AJ, McCutcheon RA, Gutiérrez-Rojas L, McGuire P, Stone WS, Fusar-Poli P, González-Torres MÁ, Catalan A. Longitudinal change in neurocognitive functioning in children and adolescents at clinical high risk for psychosis: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02221-9. [PMID: 37199754 DOI: 10.1007/s00787-023-02221-9] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/29/2023] [Indexed: 05/19/2023]
Abstract
Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence.
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Affiliation(s)
- Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Jon Herrero
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Anthony J Giuliano
- Worcester Recovery Center and Hospital, Massachusetts Department of Mental Health, Boston, USA
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Paolo Fusar-Poli
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Miguel Ángel González-Torres
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Ana Catalan
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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Gutiérrez-Rojas L, de la Gándara Martín JJ, García Buey L, Uriz Otano JI, Mena Á, Roncero C. Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review. Gastroenterol Hepatol 2023; 46:382-396. [PMID: 35718017 DOI: 10.1016/j.gastrohep.2022.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Hepatitis C virus (HCV) infection is a global health problem that can results in cirrhosis, hepatocellular carcinoma and even death. HCV infection is 3-20-fold more prevalent among patients with versus without severe mental illness (SMI), such as major depressive disorder, personality disorder, bipolar disorder and schizophrenia. Treatment options for HCV were formerly based on pegylated interferon alpha, which is associated with neuropsychiatric adverse events, and this contributed to the exclusion of patients with SMI from HCV treatment, elimination programmes, and clinical trials. Moreover, the assumption of poor adherence, scant access to healthcare and the stigma and vulnerability of this population emerged as barriers and contributed to the low rates of treatment and efficacy. METHODS This paper reviews the literature published between December 2010 and December 2020 exploring the epidemiology of HCV in patients with SMI, and vice versa, the effect of HCV infection, barriers to the management of illness in these patients, and benefits of new therapeutic options with pangenotypic direct antiviral agents (DAAs). RESULTS The approval of DAAs has changed the paradigm of HCV infection treatment. DAAs have proven to be an equally efficacious and safe option that improves quality of life (QoL) in patients SMI. CONCLUSIONS Knowledge of the consequences of the HCV infection and the benefits of treatment with new pangenotypic DAAs among psychiatrists can increase screening, referral and treatment of HCV infection in patients with SMI.
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Affiliation(s)
| | | | - Luisa García Buey
- Gastroenterology Department, Liver Unit, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan I Uriz Otano
- Gastroenterology Department, Liver Unit, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Álvaro Mena
- Infectious Diseases Unit, Internal Medicine Service, Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Universidade da Coruña, Coruña, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex and Psychiatric Unit, School of Medicine, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
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Guerrero-Jiménez M, Ruiz M, Gutiérrez-Rojas L, Jiménez-Muñoz L, Baca-Garcia E, Porras-Segovia A. Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review. World J Psychiatry 2023; 13:182-190. [PMID: 37123096 PMCID: PMC10130960 DOI: 10.5498/wjp.v13.i4.182] [Citation(s) in RCA: 1] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/14/2023] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Physical exercise is an underutilized tool for the management of mental disorders. New technologies have made a breakthrough in health care, and one of its possible applications (apps) could be that of customizing exercise programs for special populations, such as patients with mental disorders. However, the app of the so-called e-health to mental health care is still limited.
AIM To know the efficacy of apps to promote physical activity in patients with mental disorders.
METHODS We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric illness. Following the selection process, 10 articles were included in the review.
RESULTS The most commonly used devices in this type of intervention are wearable devices and web platforms. Good results in terms of effectiveness and acceptability were obtained in most of the studies.
CONCLUSION Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.
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Affiliation(s)
| | - Marta Ruiz
- Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles 28933, Madrid, Spain
| | | | - Laura Jiménez-Muñoz
- Department of Psychiatry, Hospital Universitario Jiménez Díaz, Madrid 28040, Spain
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9
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Alvarez-Mon MA, García-Montero C, Fraile-Martinez O, Quintero J, Fernandez-Rojo S, Mora F, Gutiérrez-Rojas L, Molina-Ruiz RM, Lahera G, Álvarez-Mon M, Ortega MA. Current Opinions about the Use of Duloxetine: Results from a Survey Aimed at Psychiatrists. Brain Sci 2023; 13:brainsci13020333. [PMID: 36831876 PMCID: PMC9953910 DOI: 10.3390/brainsci13020333] [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: 01/16/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
Major depressive disorder (MDD) is a complex psychiatric disorder that, presented alone or with other comorbidities, requires different adjustments of antidepressant treatments. Some investigations have demonstrated that psychoactive drugs, such as serotonin and norepinephrine reuptake inhibitors (SNRIs), can exert more effective and faster antidepressant effects than other common medications used, such as serotonin selective reuptake inhibitors (SSRIs), although these differences are still controversial. During the last five years, the SNRI duloxetine has shown favorable results in clinical practice for the treatment of MDD, anxiety, and fibromyalgia. Through an online self-completed survey, in the present article, we collected information from 163 psychiatrists regarding the use of duloxetine and its comparison with other psychiatric drugs, concerning psychiatrists' knowledge and experience, as well as patients' preferences, symptoms, and well-being. We discussed and contrasted physicians' reports and the scientific literature, finding satisfactory concordances, and finally concluded that there is agreement regarding the use of duloxetine, not only due to its tolerability and effectiveness but also due to the wide variety of situations in which it can be used (e.g., somatic symptoms in fibromyalgia, diabetes) as it relieves neuropathic pain as well.
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Affiliation(s)
- M. A. Alvarez-Mon
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Correspondence:
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Javier Quintero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
- Department of Legal Medicine and Psychiatry, Complutense University, 28040 Madrid, Spain
| | - Sonia Fernandez-Rojo
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Fernando Mora
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
- Department of Legal Medicine and Psychiatry, Complutense University, 28040 Madrid, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, 18016 Granada, Spain
- Psychiatry Service, San Cecilio University Hospital, 18016 Granada, Spain
| | - Rosa M. Molina-Ruiz
- Department of Psychiatry and Mental Health, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry, University Hospital Príncipe de Asturias, 28805 Alcalá de Henares, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), 28029 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Príncipe de Asturias, CIBEREHD, 28806 Alcalá de Henares, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
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10
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Bodoano Sánchez I, Mata Agudo A, Guerrero-Jiménez M, Girela Serrano B, Álvarez Gil P, Carrillo de Albornoz Calahorro CM, Gutiérrez-Rojas L. Treatment of post-psychotic depression in first-episode psychosis. A systematic review. Nord J Psychiatry 2023; 77:109-117. [PMID: 35507756 DOI: 10.1080/08039488.2022.2067225] [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: 10/18/2022]
Abstract
BACKGROUND Post-psychotic depression (PPD) after a FEP (first-episode psychosis) differs from other depressive symptoms in chronic schizophrenia in its aetiology, symptomatology, and prognostic implications. The objective was to search if any pharmacological or non-pharmacological interventions have proven to be effective on depressive symptoms after a FEP. METHODS for this systematic review we systematically searched and screened PubMed for articles published from August 1975 to October 15, 2020, with the terms: treatment AND first-episode psychosis OR post-psychotic OR post-schizophrenic AND depression. RESULTS we identified 139 articles of which 20 met the inclusion criteria. These interventions were then categorized into four subgroups (antipsychotics, antidepressants, psychological and miscellaneous). LIMITATIONS this review has several limitations. The reviewed studies were heterogeneous as to assessments, interventions, and samples; furthermore, only one study had PPD in FEP as its primary outcome. CONCLUSIONS to our knowledge, this is the first review of PPD in a FEP's treatment. PPD continues to be a diagnostic and therapeutic challenge. The available evidence for the use of treatment whether pharmacological or non-pharmacological is limited. However, certain approaches such as online therapy and treatment with n-3 polyunsaturated fatty acids (PUFA) show promising results. It could be of interest for future studies to focus not only on the treatment of PPD but also on the diagnostic heterogeneity of the sample and the adaptation of the content of the intervention to the individual.
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Affiliation(s)
| | - Alba Mata Agudo
- Psychiatry Service, Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Paula Álvarez Gil
- Psychiatry Service, Virgen de las Nieves University Hospital, Granada, Spain
| | | | - Luis Gutiérrez-Rojas
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Psychiatry Service, San Cecilio University Hospital, Granada, Spain.,Psychiatry Department, University of Granada, Granada, Spain
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11
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Villanueva V, Artal J, Cabeza-Alvarez CI, Campos D, Castillo A, Flórez G, Franco-Martin M, García-Portilla MP, Giráldez BG, Gotor F, Gutiérrez-Rojas L, Albanell AM, Paniagua G, Pintor L, Poza JJ, Rubio-Granero T, Toledo M, Tortosa-Conesa D, Rodríguez-Uranga J, Bobes J. Proposed Recommendations for the Management of Depression in Adults with Epilepsy: An Expert Consensus. Neurol Ther 2023; 12:479-503. [PMID: 36692706 PMCID: PMC10043101 DOI: 10.1007/s40120-023-00437-0] [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] [Received: 11/30/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Experts agree that there is a need for protocols to guide health professionals on how to best manage psychiatric comorbidities in patients with epilepsy (PWE). We aimed to develop practical recommendations for key issues in the management of depression in PWE. METHODS This was a qualitative study conducted in four steps: (1) development of a questionnaire on the management of depression in PWE to be answered; (2) literature review and, if evidence from guidelines/consensus or systematic reviews was available, drafting initial recommendations; (3) a nominal group methodology for reviewing initial recommendations and formulating new recommendations on those issues without available evidence; and (4) drafting and approving the final recommendations. A scientific committee (one neurologist and one psychiatrist) was responsible for the development of the project and its scientific integrity. The scientific committee selected a panel of experts (nine neurologists and nine psychiatrists with experience in this field) to be involved in the nominal group meetings and to formulate final recommendations. RESULTS Fifteen recommendations were formulated. Four on the screening and diagnosis: screening and diagnosis of depression, evaluation of the risk of suicide, and diagnosis of depression secondary to epilepsy; nine on the management of depression: referral to a psychiatrist, selection of the antiseizure medication, change of antiseizure medication, antidepressant treatment initiation, selection of antidepressant, use of antidepressants during pregnancy, use of psychotherapy, antidepressant treatment duration, and discontinuation of antidepressant treatment; two on the follow-up: duration of the follow-up under usual conditions, and follow-up of patients at risk of suicide. CONCLUSION We provide recommendations based on expert opinion consensus to help healthcare professionals assess depression in PWE. The detection and treatment of major depressive disorders are key factors in improving epilepsy outcomes and avoiding suicide risk.
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Affiliation(s)
- Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - Jesús Artal
- Psychiatry Department, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008, Santander, Spain.
| | | | - Dulce Campos
- Neurology Department, University Clinical Hospital of Valladolid, Valladolid, Spain
| | - Ascensión Castillo
- Neurology Department, Consorcio Hospital General Universitario Valencia, Valencia, Spain
| | - Gerardo Flórez
- Psychiatry Department, Addiction Treatment Unit, Orense, Spain
| | - Manuel Franco-Martin
- Psychiatry Department, Zamora Hospital (Complejo Asistencial de Zamora), Zamora, Spain
| | - María Paz García-Portilla
- Psychiatry Department, University of Oviedo, ISPA, CIBERSAM, INEUROPA, and Mental Health Services of Principality of Asturias, Oviedo, Spain
| | - Beatriz G Giráldez
- Neurology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Francisco Gotor
- Psychiatry Department, School of Medicine, University Hospital Virgen del Rocio, Seville, Spain
| | | | | | - Gonzalo Paniagua
- Psychiatry Department, University of Oviedo, Oviedo, Spain.,Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Luis Pintor
- Psychiatry Department, Hospital Clínico of Barcelona, Barcelona, Spain
| | - Juan José Poza
- Neurology Department, Hospital Universitario Donostia, Donostia, Spain
| | - Teresa Rubio-Granero
- Psychiatry Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Manuel Toledo
- Epilepsy Unit, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Diego Tortosa-Conesa
- Neurology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Julio Bobes
- Medicine-Psychiatry, Universidad de Oviedo, Oviedo, Spain
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12
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Gutiérrez-Rojas L, Alvarez-Mon MA, Andreu-Bernabeu Á, Capitán L, de Las Cuevas C, Gómez JC, Grande I, Hidalgo-Mazzei D, Mateos R, Moreno-Gea P, De Vicente-Muñoz T, Ferre F. Telepsychiatry: The future is already present. Span J Psychiatry Ment Health 2023; 16:51-57. [PMID: 37689522 DOI: 10.1016/j.rpsm.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/20/2022] [Revised: 08/02/2022] [Accepted: 09/02/2022] [Indexed: 09/11/2023]
Abstract
This review paper analyzes the state of knowledge on Telepsychiatry (TP) after the crisis caused by COVID and the resulting need to use new modalities of care. Six essential aspects of TP are addressed: patient's and mental health staff satisfaction, diagnostic reliability, effectiveness of TP interventions, cost-effectiveness in terms of opportunity cost (or efficiency), legal aspects inherent to confidentiality and privacy in particular and the attitude of professionals toward TP. Satisfaction with TP is acceptable among both patients and professionals, the latter being the most reluctant. Diagnostic reliability has been demonstrated, but requires further studies to confirm this reliability in different diagnoses and healthcare settings. The efficacy of TP treatments is not inferior to face-to-face care, as has been proven in specific psychotherapies. Finally, it should be noted that the attitude of the psychiatrist is the most decisive element that limits or facilitates the implementation of TP.
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Affiliation(s)
- Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain.
| | - Miguel A Alvarez-Mon
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Luis Capitán
- Psychiatry Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Carlos de Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, Instituto Universitario de Neurociencia (IUNE) de la Universidad de La Laguna
| | | | - Iria Grande
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Raimundo Mateos
- University of Santiago de Compostela, Department of Psyhciatry and CHUS University Hospital, Psychogeriatric Unit, Santiago de Compostela, Spain
| | | | | | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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13
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de Las Cuevas C, Gutiérrez-Rojas L, Alvarez-Mon MA, Andreu-Bernabeu Á, Capitán L, Gómez JC, Grande I, Hidalgo-Mazzei D, Mateos R, Moreno-Gea P, De Vicente-Muñoz T, Ferre F. Evaluating the Effect of a Telepsychiatry Educational Program on the Awareness, Knowledge, Attitude, and Skills of Telepsychiatry Among Spanish Psychiatrists during COVID-19 Pandemic. Telemed J E Health 2023; 29:102-108. [PMID: 35549720 DOI: 10.1089/tmj.2022.0051] [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] [Indexed: 01/12/2023] Open
Abstract
Introduction: The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers' unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude, and skills (AKAS) of telepsychiatry among psychiatrists. Methods: The study used a pre-post-test design to compare AKAS of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The telemedicine AKAS questionnaire adapted to telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. Results: Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37%, and inadequate in 2%. With respect to attitudes toward telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention significantly improved psychiatrists' awareness, knowledge and attitudes toward telepsychiatry although not their skills. Conclusions: Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a health care alternative.
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Affiliation(s)
- Carlos de Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry and Instituto Universitario de Neurociencia (IUNE), University of La Laguna, Canary Islands, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, Hospital Universitario San Cecilio, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
| | - Miguel A Alvarez-Mon
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Luis Capitán
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Juan Carlos Gómez
- Global Head of Medical Science, Shionogi & Co, London, United Kingdom
| | - Iria Grande
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Raimundo Mateos
- Psychogeriatric Unit, Department of Psychiatry, University of Santiago de Compostela, CHUS University Hospital, Santiago de Compostela, Spain
| | | | | | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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14
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Cruz S, Gutiérrez-Rojas L, González-Domenech P, Díaz-Atienza F, Martínez-Ortega JM, Jiménez-Fernández S. Deep brain stimulation in obsessive-compulsive disorder: Results from meta-analysis. Psychiatry Res 2022; 317:114869. [PMID: 36240634 DOI: 10.1016/j.psychres.2022.114869] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 02/08/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 01/04/2023]
Abstract
The aim of this work is to investigate the effectiveness of Deep Brain Stimulation (DBS) in patients with severe Obsessive Compulsive Disorder (OCD) who are resistant to pharmacological treatments, focusing on obsessive compulsive, depressive and anxiety symptoms as well as global function. A systematic review and meta-analysis including 25 studies (without language restrictions) from between 2003 and 2020 was performed. A total of 303 patients were evaluated twice (before and after DBS). After DBS treatment OCD patients with resistance to pharmacological treatments showed a significant improvement of obsessive-compulsive symptoms (25 studies; SMD=2.39; 95% CI, 1.91 to 2.87; P<0.0001), depression (9 studies; SMD= 1.19; 95%CI, 0.84 to 1.54; P<0.0001), anxiety (5 studies; SMD=1.00; 95%CI, 0.32 to 1.69; P=0.004) and functionality (7 studies; SMD=-3.51; 95%CI, -5.00 to -2.02; P=0.005) measured by the standardized scales: Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and Global Assessment of Function (GAF). Publication bias were discarded by using funnel plot. The main conclusions of this meta-analysis highlight the statistically significant effectiveness of DBS in patients with severe OCD who are resistant to conventional pharmacological treatments, underlying its role in global functioning apart from obsessive-compulsive symptoms.
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Affiliation(s)
- Sheila Cruz
- Child and Adolescent Mental Health Service, Jaén University Hospital Complex, Jaén, Spain
| | - Luis Gutiérrez-Rojas
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain; Psychiatry Service, Hospital San Cecilio, Granada, Spain.
| | | | - Francisco Díaz-Atienza
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain; Child and Adolescent Mental Health Service, Granada Virgen de las Nieves University Hospital, Granada, Spain
| | - José M Martínez-Ortega
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain
| | - Sara Jiménez-Fernández
- Child and Adolescent Mental Health Service, Jaén University Hospital Complex, Jaén, Spain; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain
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15
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Jiménez E, Bonnín CDM, Solé B, Sánchez-Moreno J, Reinares M, Torrent C, Torres I, Salagre E, Varo C, Ruíz V, Giménez A, Benabarre A, Gutiérrez-Rojas L, Cervilla J, Sáiz PA, García-Portilla MP, Bobes J, Amann BL, Martínez-Arán A, Vieta E. Corrigendum to "Spanish validation of the Barcelona TEMPS-A questionnaire in patients with bipolar disorder and general population" [J. Affect. Disord. 249 (2019) 199-207 (Apr 15)]. J Affect Disord 2022; 316:280. [PMID: 35985967 DOI: 10.1016/j.jad.2022.08.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- E Jiménez
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C D M Bonnín
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J Sánchez-Moreno
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - I Torres
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Salagre
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Varo
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Ruíz
- Institut Clínic de Neurociències, Hospital Clinic, Barcelona, Catalonia, Spain
| | - A Giménez
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Benabarre
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - L Gutiérrez-Rojas
- Psychiatry Service, Hospital Clínico San Cecilio, University of Granada, Granada, Spain
| | - J Cervilla
- Psychiatry Service, Hospital Clínico San Cecilio, University of Granada, Granada, Spain
| | - P A Sáiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M P García-Portilla
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - J Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - B L Amann
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Fòrum Research Unit, Parc de Salut Mar Hospital del Mar, IMIM, Autonomous University of Barcelona, CIBERSAM, Barcelona, Spain
| | - A Martínez-Arán
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - E Vieta
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
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16
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Jiménez-Fernández S, Gurpegui M, Garrote-Rojas D, Gutiérrez-Rojas L, Carretero MD, Correll CU. Oxidative stress parameters and antioxidants in adults with unipolar or bipolar depression versus healthy controls: Systematic review and meta-analysis. J Affect Disord 2022; 314:211-221. [PMID: 35868596 DOI: 10.1016/j.jad.2022.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 08/24/2021] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND To study differences in oxidative stress markers and antioxidants among patients with bipolar depression (BPD) and unipolar depression (UPD). METHODS Data sources. Electronic MEDLINE/PubMed/Cochrane Library/Scopus/TripDatabase database search until 30/06/2021. STUDY SELECTION Included were articles comparing antioxidant or oxidative stress markers between adults with BPD or UPD and healthy controls (HCs). DATA EXTRACTION Two authors extracted data independently. Random effects meta-analysis, calculating standardized mean differences for results from ≥3 studies. RESULTS Oxidative stress markers reported in 40 studies -1 published repeatedly- (UPD, studies = 30 n = 3072; their HCs, n = 2856; BPD, studies = 11 n = 393; their HCs, n = 540; with 1 study reporting on both UPD and BPD) included thiobarbituric acid reactive substances (TBARS), antioxidant uric acid and antioxidant-enhancing enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione-peroxidase (GPX). Compared with HCs, UPD and BPD were associated with significantly higher levels of TBARS, without differences between UPD and BPD (P = 0.11). Compared with HCs, UPD and BPD did not differ regarding the activity of the CAT (P = 0.28), SOD (P = 0.87) and GPX (P = 0.25) enzymes. However, uric acid levels were significantly higher vs HCs in BPD than in UPD among adult patients (P = 0.004). Results were heterogenous, which, for some parameters, decreased after stratification by the blood source (serum, plasma red blood cells, whole blood). LIMITATIONS The main limitations are the small number of studies/participants in the BPD subgroup, and heterogeneity of the results. SUMMATIONS Both BPD and UPD may be associated with an impaired oxidative stress balance, with significantly higher uric acid levels vs. HCs in UPD than in BPD.
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Affiliation(s)
- Sara Jiménez-Fernández
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Child and Adolescent Mental Health Unit, Jaén University Hospital, Jaén, Spain.
| | - Manuel Gurpegui
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
| | | | - Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - María D Carretero
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
| | - Christoph U Correll
- Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
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17
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Jiménez-Fernández S, Gurpegui M, de Leon J, Gutiérrez-Rojas L. Clozapine for the treatment of pediatric encephalopathy associated with nonketotic hyperglycinemia. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:287-289. [PMID: 36513404 DOI: 10.1016/j.rpsmen.2022.10.001] [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] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/15/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Sara Jiménez-Fernández
- Child and Adolescent Mental Health Unit, Jaén University Hospital, Jaén, Spain; CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain.
| | - Manuel Gurpegui
- CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain; Granada Center for Psychiatric Studies, Granada, Spain
| | - Jose de Leon
- Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA; Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, Spain
| | - Luis Gutiérrez-Rojas
- CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
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18
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Benavente-Fernández A, Gutiérrez-Rojas L, Torres-Parejo Ú, Parejo Morón AI, Fernández Ontiveros S, Vinuesa García D, González-Domenech P, Laínez Ramos-Bossini AJ. Psychological Impact and Risk of Suicide in Hospitalized COVID-19 Patients, During the Initial Stage of the Pandemic: A Cross-Sectional Study. J Patient Saf 2022; 18:499-506. [PMID: 35041358 PMCID: PMC9328938 DOI: 10.1097/pts.0000000000000974] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to assess the psychological impact and risk of suicide in patients hospitalized for COVID-19. METHODS A cross-sectional study was conducted on a representative sample of patients hospitalized for COVID-19 at the "San Cecilio" University Hospital (Granada, Spain) between March and May 2020. Sociodemographic and clinical variables were collected. All participants were evaluated using the Gijon's Social-Familial Evaluation Scale to assess social problems, the Impact of Event Scale-6 and the Hospital Anxiety-Depression Scale to assess psychological impact, the Columbia Suicide Severity and Beck Hopelessness scales to assess risk of suicide, and the List of Threatening Experiences questionnaire to control for confounding bias. RESULTS Thirty-six COVID-19 patients were evaluated. Of them, 33.3% had a significant psychological impact; 13.9% showed symptoms of anxiety, 13.9% showed symptoms of depression, and 47.2% showed symptoms of anxiety-depression. Moderate and severe risk of suicide were found in 75% and 2.8% of the patients, respectively. Suicidal ideation was observed in 16.7% and suicide behaviors in 5.6% of the patients. Psychological impact was associated with previous psychological treatment, a greater degree of functional dependency, and increased social-familial risk. In addition, the risk of suicide was mainly associated with active treatment of a psychiatric illness and active smoking. No significant correlation was found between psychological impact and risk of suicide. CONCLUSIONS Psychological impact and risk of suicide were significant in patients admitted for COVID-19. Although the risk of suicide was not associated with increased psychological impact, both should be assessed, especially in patients at higher risk based on significantly associated factors.
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Affiliation(s)
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry
- CTS-549 Research Group, Institute of Neurosciences, University of Granada
- Psychiatry Service, San Cecilio University Hospital
| | | | | | | | | | - Pablo González-Domenech
- Department of Psychiatry
- CTS-549 Research Group, Institute of Neurosciences, University of Granada
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19
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Ortega MA, Fraile-Martínez Ó, García-Montero C, Alvarez-Mon MA, Lahera G, Monserrat J, Llavero-Valero M, Gutiérrez-Rojas L, Molina R, Rodríguez-Jimenez R, Quintero J, De Mon MA. Biological Role of Nutrients, Food and Dietary Patterns in the Prevention and Clinical Management of Major Depressive Disorder. Nutrients 2022; 14:nu14153099. [PMID: 35956276 PMCID: PMC9370795 DOI: 10.3390/nu14153099] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 07/11/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 02/06/2023] Open
Abstract
Major Depressive Disorder (MDD) is a growing disabling condition affecting around 280 million people worldwide. This complex entity is the result of the interplay between biological, psychological, and sociocultural factors, and compelling evidence suggests that MDD can be considered a disease that occurs as a consequence of an evolutionary mismatch and unhealthy lifestyle habits. In this context, diet is one of the core pillars of health, influencing multiple biological processes in the brain and the entire body. It seems that there is a bidirectional relationship between MDD and malnutrition, and depressed individuals often lack certain critical nutrients along with an aberrant dietary pattern. Thus, dietary interventions are one of the most promising tools to explore in the field of MDD, as there are a specific group of nutrients (i.e., omega 3, vitamins, polyphenols, and caffeine), foods (fish, nuts, seeds fruits, vegetables, coffee/tea, and fermented products) or dietary supplements (such as S-adenosylmethionine, acetyl carnitine, creatine, amino acids, etc.), which are being currently studied. Likewise, the entire nutritional context and the dietary pattern seem to be another potential area of study, and some strategies such as the Mediterranean diet have demonstrated some relevant benefits in patients with MDD; although, further efforts are still needed. In the present work, we will explore the state-of-the-art diet in the prevention and clinical support of MDD, focusing on the biological properties of its main nutrients, foods, and dietary patterns and their possible implications for these patients.
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Affiliation(s)
- Miguel A. Ortega
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28805 Alcalá de Henares, Spain
- Correspondence:
| | - Óscar Fraile-Martínez
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (M.L.-V.); (J.Q.)
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (M.L.-V.); (J.Q.)
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Maria Llavero-Valero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (M.L.-V.); (J.Q.)
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neuroscience, University of Granada, 18071 Granada, Spain;
- Psychiatry Service, San Cecilio University Hospital, 18016 Granada, Spain
| | - Rosa Molina
- Department of Psychiatry and Mental, Health San Carlos University Hospital (HCSC), 28034 Madrid, Spain;
- Research Biomedical Fundation of HCSC Hospital, 28034 Madrid, Spain
- Department of Psychology, Comillas University, Cantoblanco, 28015 Madrid, Spain
| | - Roberto Rodríguez-Jimenez
- Department of Legal Medicine, Psychiatry, and Pathology, Complutense University (UCM), 28040 Madrid, Spain;
- Institute for Health Research 12 de Octubre Hospital, (imas12)/CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health), 28041 Madrid, Spain
| | - Javier Quintero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (M.L.-V.); (J.Q.)
- Department of Legal Medicine, Psychiatry, and Pathology, Complutense University (UCM), 28040 Madrid, Spain;
| | - Melchor Alvarez De Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (Ó.F.-M.); (C.G.-M.); (M.A.A.-M.); (G.L.); (J.M.); (M.A.D.M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain
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20
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Calvo-Rivera MP, Navarrete-Páez MI, Bodoano I, Gutiérrez-Rojas L. Comorbidity Between Anorexia Nervosa and Depressive Disorder: A Narrative Review. Psychiatry Investig 2022; 19:155-163. [PMID: 35330562 PMCID: PMC8958208 DOI: 10.30773/pi.2021.0188] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Anorexia nervosa (AN) is a disorder with a significantly high prevalence. Affective disorders, including depressive disorder (DD), often coexist with this eating disorder (ED). In this review we will focus on its prevalence, associated vulnerability factors, clinical manifestations, possible etiological factors and its prognosis. METHODS A bibliographic search was carried out in the PubMed database selecting those articles that approached the subject of comorbidity between AN and DD. The search was limited to articles published from January 1990 to December 2021. RESULTS Of the 1891 abstracts reviewed, 33 studies met inclusion criteria. The prevalence of this comorbidity was extremely variable between studies, which exposed their heterogeneity. As to symptomatology this comorbidity presents itself with more severity, greater expression of psychological traits and greater cognitive impairment. Certain personality traits are postulated as vulnerability factors. Genetic factors such as neurochemicals seem to be involved in its pathogenesis. CONCLUSION The comorbidity between DD and ED have important influence in its symptomatic expression, severity and prognosis. Some of the analyzed studies provide consistent data, but there are others that are contradictory. It would be necessary to increase the number of studies and use a unified methodology.
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Affiliation(s)
| | | | - Isabel Bodoano
- Psychiatry Service, Hospital Virgen de las Nieves, Granada, Spain
| | - Luis Gutiérrez-Rojas
- Psychiatry Service, Hospital Universitario San Cecilio, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
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21
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Girela-Serrano BM, Guerrero-Jiménez M, Spiers ADV, Gutiérrez-Rojas L. Obesity and overweight among children and adolescents with bipolar disorder from the general population: A review of the scientific literature and a meta-analysis. Early Interv Psychiatry 2022; 16:113-125. [PMID: 33735937 DOI: 10.1111/eip.13137] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/09/2020] [Revised: 02/05/2021] [Accepted: 03/06/2021] [Indexed: 11/27/2022]
Abstract
There is substantial evidence of the high prevalence of obesity (OB) and overweight (OW) and their association with increased medical and psychiatric burden among adults with bipolar disorder (BD). However, little is known regarding its prevalence among young people with BD, other than the risk from psychotropic medication, which has been the focus of research in this population. We present a systematic review and meta-analysis of the literature on prevalence and correlates of OB and OW children and adolescents with BD using a different perspective than impact of medication. Four studies met inclusion criteria. The prevalence of OB in children and adolescents with BD was 15% (95% CI 11-20%). We observed a higher prevalence of OB in comparison to the general population. Different studies found significant associations between OB, OW, and BD in young populations including non-Caucasian race, physical abuse, suicide attempts, self-injurious behaviours, psychotropic medication, and psychiatric hospitalizations.
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Affiliation(s)
| | - Margarita Guerrero-Jiménez
- Department of Psychiatry, University of Granada, Granada, Spain.,Virgen de las Nieves University Hospital, Granada, Spain
| | - Alexander D V Spiers
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,San Cecilio University Hospital, Granada, Spain
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22
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Guerrero-Jiménez M, Carrillo de Albornoz Calahorro CM, Girela-Serrano B, Bodoano Sánchez I, Gutiérrez-Rojas L. Post-Psychotic Depression: An Updated Review of the Term and Clinical Implications. Psychopathology 2022; 55:82-92. [PMID: 35220306 DOI: 10.1159/000520985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/01/2021] [Accepted: 11/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Post-psychotic depression (PPD) is an important and frequent clinical phenomenon featuring controversial complexity in its nosological and aetiopathogenic cataloguing. OBJECTIVES The main objective of this research was to review the published literature on PPD. The second objective was to indicate its clinical importance, either comorbid or as an entity of its own. To answer these questions, a historical review of the term is made and a search about the clinical, evolutionary, predisposal, and prognostic variables that characterize the PPD. METHODS The international recommendations were followed according to the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses (PRISMA). The databases used were Web of Science and PubMed, with the deadline for the inclusion of articles in November 2019. The MeSH used were the following: "post" AND "psych *" AND "psich" AND "depr." RESULTS The search resulted in 64 articles. Only 19 of these met the pre-specified inclusion criteria and were finally included in the review. One article found that reading this literature was added due to its relevance. Despite its high prevalence (around 30%), there is little research about the term PPD. Nevertheless, results show data to improve the description of the syndrome, revealing differential characteristics from other depressive symptoms in chronic psychosis due to its clinical implications. CONCLUSIONS Coinciding with the latest classification manuals that do not include the term, there appears to be an abandonment of its use despite its high prevalence. Data suggest that PPD is a nosological entity different from a secondary effect to antipsychotics, the negative symptoms of psychosis, and other clinical disorders that combine psychotic and depressive symptoms such as bipolar disorder, schizoaffective disorder, or depression with psychotic symptoms. PPD also has differential characteristics concerning further depressive symptoms, especially important clinical implications such as higher suicide risk and poorer quality of life.
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Affiliation(s)
| | | | - Braulio Girela-Serrano
- Division of Psychiatry, Department of Brain Sciences, Imperial College, London, United Kingdom
| | | | - Luis Gutiérrez-Rojas
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain
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23
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Gutiérrez-Rojas L, Sánchez-Alonso S, García Dorado M, López Rengel PM. Impact of 3-Monthly Long-Acting Injectable Paliperidone Palmitate in Schizophrenia: A Retrospective, Real-World Analysis of Population-Based Health Records in Spain. CNS Drugs 2022; 36:517-527. [PMID: 35460508 PMCID: PMC9095535 DOI: 10.1007/s40263-022-00917-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment of schizophrenia requires long-term medication to prevent relapse. Treatment nonadherence may increase the risk of relapse, leading to increased hospitalizations and emergency room (ER) visits. Long-acting injectables (LAIs) such as paliperidone palmitate have improved treatment adherence and therefore symptoms. However, real-world studies comparing 3-monthly LAI formulations with other LAIs and oral antipsychotics (OAs) are scarce. OBJECTIVE The objective of this study was to investigate and evaluate the clinical effectiveness of paliperidone palmitate LAI monthly (PP1M; Xeplion®) and 3-monthly (PP3M; Trevicta®) formulations compared with the monthly LAI aripiprazole (AM; Abilify Maintena®) and OAs in Spain. METHODS This was a retrospective, observational study including 2275 adult patients with schizophrenia in a Spanish population. Data from hospital, primary care, and pharmacy dispensation electronic medical records were obtained between January 2017 and February 2018. The main outcomes included psychiatric hospitalizations and ER visit rates, days on treatment, and treatment persistence. RESULTS Patients receiving PP3M had a significantly lower mean hospitalization rate (0.00046 ± standard deviation [SD] 0.00181; p < 0.0001) than other treatment groups. Kaplan-Meier curves revealed that 92.0 and 88.4% of patients receiving PP3M remained hospitalization free by 12 and 18 months, respectively. All treatment groups had at least a twofold significantly higher risk of psychiatric hospitalizations compared with those receiving PP3M or OAs, and the hospitalization risk among the PP3M group was significantly lower (hazard ratio [HR] 0.46; 95% confidence interval [CI] 0.31-0.67). The risk of ER visits was significantly lower with both PP3M and PP1M than with OAs, and lowest with PP3M (HR 0.462 [95% CI 0.29-0.62] and HR 0.833 [95% CI 0.59-0.97], respectively). Time until treatment switch with PP3M was high, with more than 86.5% of patients remaining on treatment at 18 months. CONCLUSIONS PP3M was more effective than OAs and monthly LAIs in improving clinical outcomes for patients with schizophrenia in a real-world setting in Spain.
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Affiliation(s)
| | - Sergio Sánchez-Alonso
- Department of Psychiatry, Jimenez Diaz Foundation University Hospital, Madrid, Spain
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24
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Porras-Segovia A, Peñuelas-Calvo I, Nobile B, Gutiérrez-Rojas L. Editorial: Interventions based on new technologies for the management of mood disorders. Front Psychiatry 2022; 13:1099947. [PMID: 36569613 PMCID: PMC9768544 DOI: 10.3389/fpsyt.2022.1099947] [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: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Alejandro Porras-Segovia
- Mental Health Research Group, Health Research Institute Foundation Jimenez Diaz (IIS-FJD), Madrid, Spain.,Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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25
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De Diego-Adeliño J, Crespo JM, Mora F, Neyra A, Iborra P, Gutiérrez-Rojas L, Salonia SF. Vortioxetine in major depressive disorder: from mechanisms of action to clinical studies. An updated review. Expert Opin Drug Saf 2021; 21:673-690. [PMID: 34964415 DOI: 10.1080/14740338.2022.2019705] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Vortioxetine is a multimodal-acting antidepressant that provides improvements on cognitive function aside from antidepressants and anxiolytic effects. Vortioxetine has been found to be one of the most effective and best tolerated options for major depressive disorder (MDD) in head-to-head trials. AREAS COVERED The present review intends to gather the most relevant and pragmatic data of vortioxetine in MDD, specially focusing on new studies that emerged between 2015 and 2020. EXPERT OPINION Vortioxetine is the first antidepressant that has shown improvements both in depression and cognitive symptoms, due to the unique multimodal mechanism of action that combine the 5-HT reuptake inhibition with modulations of other key pre- and post-synaptic 5-HT receptors (agonism of 5-HT1A receptor, partial agonism of 5-HT1B receptor, and antagonism of 5-HT3, 5-HT1D and 5-HT7 receptors). This new mechanism of action can explain the dose-dependent effect and can be responsible for its effects on cognitive functioning and improved tolerability profile. Potential analgesic and anti-inflammatory properties observed in preclinical studies as well as interesting efficacy and tolerability results of clinical studies with specific target groups render it a promising therapeutic option for patients with MDD and concomitant conditions (as menopause symptoms, pain, inflammation, apathy, sleep and/or metabolic abnormalities).
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Affiliation(s)
- Javier De Diego-Adeliño
- Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut d'Investigació Biomèdica Sant Pau (Iib-sant Pau), Universitat Autònoma de Barcelona (Uab), Centro de Investigación Biomédica En Red de Salud Mental (Cibersam), Spain
| | - José Manuel Crespo
- Department of Psychiatry, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Fernando Mora
- Department of Psychiatry, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Adrián Neyra
- Department of Psychiatry, Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Pedro Iborra
- Department of Psychiatry, San Juan University Hospital, Alicante, Spain
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26
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Jiménez-Fernández S, Gurpegui M, Garrote-Rojas D, Gutiérrez-Rojas L, Carretero MD, Correll CU. Oxidative stress parameters and antioxidants in patients with bipolar disorder: Results from a meta-analysis comparing patients, including stratification by polarity and euthymic status, with healthy controls. Bipolar Disord 2021; 23:117-129. [PMID: 32780547 DOI: 10.1111/bdi.12980] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 05/01/2020] [Revised: 07/12/2020] [Accepted: 08/07/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate oxidative stress markers and antioxidants in bipolar disorder (BD). METHODS Electronic MEDLINE/PubMed/Cochrane-Library/Scopus/TripDatabase search until 06/30/2019 for studies comparing antioxidant or oxidative stress markers between BD and healthy controls (HCs). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated for ≥3 studies. RESULTS Forty-four studies (n = 3,767: BD = 1,979; HCs = 1,788) reported on oxidative stress markers malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS), and total nitrites; antioxidants glutathione (GSH), uric acid, and zinc; or antioxidantenhancing enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and GSH-transferase (GST). Compared with HCs, BD was associated with higher GST (P = .01), CAT (P = .02), nitrites (P < .0001), TBARS (P < .0001), MDA (P = .01), uric acid (P < .0001), and lower GSH (P = .006), without differences in SOD, GPX, and zinc. Compared to HCs, levels were higher in BD-mania for TBARS (P < .0001) and uric acid (P < .0001); in BD-depression for TBARS (P = .02); and BD-euthymia for uric acid (P = .03). Uric acid levels were higher in BD-mania vs BD-depression (P = .002), but not vs BD euthymia. TBARS did not differ between BD-mania and BD-depression. Medication-free BD-mania patients had higher SOD (P = .02) and lower GPX (P < .0001) than HCs. After treatment, BD did not differ from HCs regarding SOD and GPX. CONCLUSIONS Beyond a single biomarker of oxidative stress, the combination of several parameters appears to be more informative for BD in general and taking into account illness polarity. BD is associated with an imbalance in oxidative stress with some phase-specificity for uric acid and TBARS and possible treatment benefits for SOD and GPX. Future studies should take into account confounding factors that can modify oxidative stress status and simultaneously measure oxidative stress markers and antioxidants including different blood sources.
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Affiliation(s)
- Sara Jiménez-Fernández
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.,Child and Adolescent Mental Health Unit, Jaén Medical Center, Jaén, Spain
| | - Manuel Gurpegui
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
| | | | - Luis Gutiérrez-Rojas
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | | | - Christoph U Correll
- Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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Gutiérrez-Rojas L, Porras-Segovia A, Dunne H, Andrade-González N, Cervilla JA. Prevalence and correlates of major depressive disorder: a systematic review. ACTA ACUST UNITED AC 2020; 42:657-672. [PMID: 32756809 DOI: 10.1590/1516-4446-2020-0650] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 03/03/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. METHODS A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. RESULTS Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. CONCLUSIONS MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
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Affiliation(s)
- Luis Gutiérrez-Rojas
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | | | - Henry Dunne
- Brighton and Sussex University Hospital, Brighton, UK
| | - Nelson Andrade-González
- Grupo de Investigación en Procesos Relacionales y Psicoterapia, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jorge A Cervilla
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Jiménez-Muñoz L, Gutiérrez-Rojas L, Porras-Segovia A, Courtet P, Baca-García E. Mobile applications for the management of chronic physical conditions: A systematic review. Intern Med J 2020; 52:21-29. [PMID: 33012045 DOI: 10.1111/imj.15081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/31/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic physical conditions (CPCs) decrease the quality of life of millions of people. In the absence of curative treatments, maintaining healthy lifestyle habits is one of the main pillars in their clinical management. Mobile-based interventions may help patients take care of their health and follow medical recommendations. The purpose of this review is to summarize the latest evidence about mobile phone applications (apps) for the management of CPC. METHODS We performed a systematic search of the PubMed and EMBASE databases to identify articles that explored apps for the management of CPCs, testing the apps empirically, and providing clear outputs on effectiveness and/or feasibility. 3528 articles were identified in the initial search. Following screening and selection process, 20 articles were finally included in the review. RESULTS Mobile apps for CPC are very heterogeneous. The condition with the greater number of apps available was diabetes, followed by cardiovascular diseases. Results of feasibility were generally positive, with high rates of study completion and user engagement. Some studies used incentives, monetary of otherwise. Some of the apps have been tested in randomized clinical trials showing effectiveness in improving symptoms and/or controlling analytical parameters. CONCLUSIONS Mobile apps are promising tools for the management of CPCs. Some apps have been sufficiently tested to propose their implementation in clinical practice. However, several barriers exist that can slow down the routine use of new technologies in healthcare settings. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Laura Jiménez-Muñoz
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, Jimenez Diaz Foundation Health Research Institute (IIS), Madrid, Spain.,Madrid Autonomous University, Madrid, Spain
| | | | - Alejandro Porras-Segovia
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, Jimenez Diaz Foundation Health Research Institute (IIS), Madrid, Spain
| | - Philippe Courtet
- University of Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Enrique Baca-García
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, Jimenez Diaz Foundation Health Research Institute (IIS), Madrid, Spain.,Psychiatry Department, University of Granada, Spain.,CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, Madrid, Spain.,Universidad Católica del Maule, Talca, Chile.,Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Deparment of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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Gutiérrez-Rojas L, Porras-Segovia A, Dunne H, Andrade-González N, Cervilla JA. Prevalence and correlates of major depressive disorder: a systematic review. Braz J Psychiatry 2020; 42. [PMID: 32756809 PMCID: PMC7678895 DOI: 10.1590/1516-4446-2019-0650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. METHODS A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. RESULTS Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. CONCLUSIONS MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
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Affiliation(s)
- Luis Gutiérrez-Rojas
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain,Correspondence: Luis Gutiérrez-Rojas, Department of Psychiatry, School of Medicine, Torre A, planta 9 E-18071, Granada, Spain. E-mail:
| | | | - Henry Dunne
- Brighton and Sussex University Hospital, Brighton, UK
| | - Nelson Andrade-González
- Grupo de Investigación en Procesos Relacionales y Psicoterapia, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jorge A. Cervilla
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Blasco BV, García-Jiménez J, Bodoano I, Gutiérrez-Rojas L. Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review. Psychiatry Investig 2020; 17:715-724. [PMID: 32777922 PMCID: PMC7449839 DOI: 10.30773/pi.2020.0099] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 03/15/2020] [Accepted: 05/09/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Depression and obesity are two conditions with great impact over global health. This is mainly due to their high prevalence and the morbidity and mortality associated to both. The main aim of the present systematic review is to study the association between obesity and depression and the prognostic implications derived from it. METHODS A literature review was performed in the PUBMED database. 18 articles were found (9 cross-sectional studies, 6 longitudinal studies and 3 clinical trials), which were reviewed by critical reading after which a summary of the main conclusions was written. RESULTS These selected articles confirmed that there is indeed a link between depression and obesity, although there are doubts as to the significance of this relationship. Depression is a risk factor for obesity, especially atypical depression and in African-American adolescent males. Obesity is a risk factor for depression, especially in women and for recurrent depressive disorder. The comorbidity between obesity and depression is a risk factor for a bad prognosis illness. CONCLUSION The relationship between both disorders has been analysed in scientific literature, obtaining significant associations but also contradictory results. The most current data demonstrates that there is a relationship between both entities, although there is no unanimity when it comes to establishing the meaning of this association.
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Affiliation(s)
| | | | - Isabel Bodoano
- Psychiatry Service, Virgen de las Nieves Hospital, Granada, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.,Psychiatry Service, San Cecilio University Hospital, Granada, Spain
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31
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González-Domenech PJ, Díaz Atienza F, García Pablos C, Fernández Soto ML, Martínez-Ortega JM, Gutiérrez-Rojas L. Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial. J Autism Dev Disord 2020; 50:935-948. [PMID: 31813108 DOI: 10.1007/s10803-019-04333-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.
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Affiliation(s)
- Pablo José González-Domenech
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
| | - Francisco Díaz Atienza
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain
| | - Carlos García Pablos
- Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain. .,Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain. .,CTS-549 Research Group, Institute of Neuroscience, Granada, Spain.
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Abstract
PURPOSE OF REVIEW To summarize the latest evidence about mobile phone applications for the management of depression. RECENT FINDINGS Depression apps are very heterogeneous, given the absence of standards for their development, description, and evaluation. Randomized clinical trials show the effectiveness of some of these applications in reducing depressive symptoms. Attrition is an important issue whose evaluation is limited by the frequent use of incentives in the studies. The number of mobile applications for depression far exceeds the number of studies evaluating their efficacy and feasibility. Despite the limitations of the digital market, there are a small number of apps that have demonstrated sufficient effectiveness and tolerability to think of short-term clinical use. However, there are still barriers at different levels that may delay the implementation of these interventions in daily clinical practice.
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Affiliation(s)
- Alejandro Porras-Segovia
- Department of Psychiatry, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles, Spain.
| | - Isaac Díaz-Oliván
- Department of Psychiatry, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles, Spain.,Madrid Autonomous University, Madrid, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, Universidad de Granada, Granada, Spain.,Unidad de Hospitalización del Hospital Campus de la Salud, Complejo Hospitalario de Granada, Granada, Spain
| | - Henry Dunne
- Brighton & Sussex University Hospital, Brighton, UK
| | - Manon Moreno
- Department of Psychiatry, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles, Spain
| | - Enrique Baca-García
- Department of Psychiatry, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles, Spain.,Madrid Autonomous University, Madrid, Spain.,CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, Madrid, Spain.,Universidad Catolica del Maule, Talca, Chile.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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Cano-Ruiz P, Sanmartin-Salinas P, Gómez-Peinado A, Calero-Mora C, Gutiérrez-Rojas L. Diagnostic stability in bipolar disorder: a systematic review. Actas Esp Psiquiatr 2020; 48:28-35. [PMID: 32297649] [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: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Stability of a diagnosis over time represents the best evidence to validate psychiatric diagnoses and helps to predict the course of a disorder. The diagnosis of bipolar disorder shows large variability over time and only a few numbers of investigations have evaluated the impact of the diagnostic stability vs the change. MATERIAL AND METHODS A systematic review was made through a literature search in Pubmed, Medline and Web of Science of the articles published in the last 10 years (2008- 2018). We used the following key words; "stability diagnosis", AND "bipolar disorders", AND "mood disorders". We selected those studies conducted in patients who presented affective and/or psychotic clinic where the stability of the diagnosis was studied over time. RESULTS The initial search showed a total of 140 articles, 13 of which met inclusion criteria. In this review we have found that, compared to other mental disorders, Bipolar Disorder has in its favor a greater construct validity and longterm stability. CONCLUSIONS Initial phases of Bipolar Disorder constitute a real diagnostic and therapeutic challenge. Despite this, it is considered, added to schizophrenia as one of the most stable diagnostic categories (60% of patients who receive this initial diagnosis remain it during time). The absence of reliable and valid instruments for diagnosis is considered as a limitation so it would be convenient that in the next classifications of mental disorders they continue striving so that the nosological entities have greater construct validity possible.
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Affiliation(s)
| | - Patricia Sanmartin-Salinas
- Department of Biology, Biochemical and Molecular Biology, University of Alcalá, Alcalá de Henares, Madrid, Spain
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Andrade-González N, Hernández-Gómez A, Álvarez-Sesmero S, Gutiérrez-Rojas L, Vieta E, Reinares M, Lahera G. The influence of the working alliance on the treatment and outcomes of patients with bipolar disorder: A systematic review. J Affect Disord 2020; 260:263-271. [PMID: 31521862 DOI: 10.1016/j.jad.2019.09.014] [Citation(s) in RCA: 7] [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: 04/26/2019] [Revised: 07/22/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The working alliance plays an essential role in the treatment of patients with different diseases. However, this variable has received little attention in patients with bipolar disorder. Therefore, this systematic review aimed to examine the working alliance's influence on these patients' treatment outcomes, analyze its role in the adherence to pharmacotherapy, and identify the variables that are related to a good working alliance. METHODS PubMed, PsycINFO, and Web of Science databases were searched until January 5, 2018 using a predetermined search strategy. Then, a formal process of study selection and data extraction was conducted. RESULTS Seven articles fulfilled the inclusion criteria and they included a total of 3,985 patients with bipolar disorder type I and II. Although the working alliance's ability to predict the duration and presence of manic and depressive symptoms is unclear, a good working alliance facilitates the adherence to pharmacological treatment. In addition, good social support for patients is associated with a strong working alliance. LIMITATIONS The selected studies used different definitions and measures of the working alliance and adherence, and most used self-reports to assess the working alliance. Furthermore, the relationships found among the variables were correlational. CONCLUSIONS The working alliance can play an important role in adjunctive psychological therapies and in pharmacological and somatic treatments for patients with bipolar disorder. However, the number of studies on working alliance in bipolar disorder is rather limited and there is methodological heterogeneity between the studies.
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Affiliation(s)
- Nelson Andrade-González
- Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | | | | | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Guillermo Lahera
- Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain; IRyCIS, CIBERSAM, Madrid, Spain.
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García-Jiménez J, Gutiérrez-Rojas L, Jiménez-Fernández S, González-Domenech PJ, Carretero MD, Gurpegui M. Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder. Front Psychiatry 2020; 11:584501. [PMID: 33304285 PMCID: PMC7701086 DOI: 10.3389/fpsyt.2020.584501] [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: 07/17/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: The aim of this study is to determine the prevalence of three possible diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their association with important socio-demographic, clinical and course-of-illness variables. Methods: A retrospective and naturalistic study on 108 BD outpatients, who were classified according to the PP, polarity of the first episode and early age at onset (≤ 20 years) [vs. late (>20 years)] and were characterized by their demographics, clinical data, functionality and social support, among others features. After bivariate analyses, those variables showing certain association (P value < 0.25) with the three dependent variables were entered in logistic regression backward selection procedures to identify the variables independently associated with the PP, polarity of the first episode and early age at onset. Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26% with type II. Around 70% had depressive PP, onset with a depressive episode and onset after age 20. Depressive PP was independently associated with depressive onset, higher score on the CGI severity scale and work disability. Onset with depressive episode was associated with type II BD, longer diagnostic delay and higher score on family disability. Early age at onset (≤ 20 years) was associate with younger age, longer diagnostic delay, presence of ever psychotic symptoms, current use of antipsychotic drugs and higher social support score. Conclusions: The results of this study show that BD patients with depressive PP, onset with depression and early age at onset may represent greater severity, because they are frequently associated with variables that worsen the prognosis. Our findings match up with the conclusions of two systematic reviews and we also include a disability factor (at family and work) that has not been previously reported. This work contributes to the use of polarity and age at onset in BD patients, as it can become a useful instrument in the prognostic and therapeutic applications.
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Affiliation(s)
- Jesús García-Jiménez
- Southern Mental Health Clinical Management Unit, Santa Ana Hospital, Motril, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Granada Mental Health Clinical Management Unit, Hospital Clínico San Cecilio, Granada, Spain
| | - Sara Jiménez-Fernández
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Child and Adolescent Mental Health Service, Jaén University Hospital Complex, Jaén, Spain
| | - Pablo José González-Domenech
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain
| | | | - Manuel Gurpegui
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain
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González-Pinto A, Balanzá-Martínez V, Benabarre Hernández A, Gutiérrez-Rojas L, Montes JM, de Dios Perrino C, Pérez Sola V, Montejo González ÁL, Giménez Palomo A, Crespo JM. Expert consensus on information sheet proposals for patients under treatment with lithium. Rev Psiquiatr Salud Ment (Engl Ed) 2019; 14:27-39. [PMID: 31882351 DOI: 10.1016/j.rpsm.2019.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/25/2019] [Accepted: 11/05/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Lithium is one of the first therapeutic options for bipolar disorder, which is characterized by recurrent mood swings that strongly reduce quality of life. Our purpose was to achieve professional consensus criteria to define the contents of an information sheet for patients with bipolar disorder that are starting treatment with lithium. MATERIAL AND METHODS A modified Delphi method in two rounds was used. The Scientific Committee-made up by nine psychiatrists-created a 20-item questionnaire about the information that must be given to the patient treated with lithium and selected a panel of ambulatory and hospital psychiatric experts to agree on this information. Panelists scored each item based on a Likert scale of 9 points and could add comments in a confidential manner. It was considered consensus in agreement when median scores were within the range of [7-9] and in disagreement within the range of [1-3]. RESULTS A high level of consensus was reached. In the first round, there was agreement on 17 out of 20 items and, after the second round, there was disagreement on just one item containing information about the discovery of lithium. Finally, said item was modified in the Patient's Information Sheet based on the comments suggested by the panelists. CONCLUSIONS This study allowed to create an information sheet for patients with bipolar disorder under treatment with lithium, with information agreed upon by a group of experts from different health care settings.
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Affiliation(s)
- Ana González-Pinto
- Hospital Universitario de Alava, EHU, BIOARABA, CIBERSAM, Vitoria, España.
| | - Vicent Balanzá-Martínez
- Unidad de Salud Mental de Catarroja, Departament de Medicina, Universitat de València, CIBERSAM, València, España
| | - Antoni Benabarre Hernández
- Unidad de Trastornos Bipolares, Servicio de Psiquiatría, Institut Clínic de Neurociències, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Barcelona, España
| | - Luis Gutiérrez-Rojas
- Unidad de Hospitalización de Salud Mental, Hospital Clínico San Cecilio, Granada, España
| | - José Manuel Montes
- Hospital Universitario Ramón y Cajal, Universidad de Alcalá, CIBERSAM, IRYCIS, Madrid, España
| | - Consuelo de Dios Perrino
- Servicio de Psiquiatría, Hospital Universitario La Paz, Instituto de Investigación Idipaz, CIBERSAM, Madrid, España
| | - Víctor Pérez Sola
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, CIBERSAM, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Psiquiatria, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ángel Luis Montejo González
- Universidad de Salamanca, Área de Neurociencias, Instituto de Investigación Biomédica de Salamanca (IBSAL), Servicio de Psiquiatría, Hospital Universitario de Salamanca, Salamanca, España
| | | | - José Manuel Crespo
- Servicio de Psiquiatría, Hospital Universitari de Bellvitge-ICS, IDIBELL, CIBERSAM, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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Martínez-Ortega JM, Nogueras P, Muñoz-Negro JE, Gutiérrez-Rojas L, González-Domenech P, Gurpegui M. Quality of life, anxiety and depressive symptoms in patients with psoriasis: A case-control study. J Psychosom Res 2019; 124:109780. [PMID: 31443809 DOI: 10.1016/j.jpsychores.2019.109780] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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] [Received: 05/28/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To compare quality of life (QoL), anxiety and depressive symptoms, alcohol consumption and other correlates between patients with psoriasis and controls; and to identify features of psoriasis associated with lower levels of QoL. METHOD Case-control study including 70 subjects with moderate-severe psoriasis and 140 controls without psoriasis. All participants answered the Short Form Health Survey (SF-36), with physical and mental component scores of quality of life, and the Hospital Anxiety and Depression Scale (HADS). Among subjects with psoriasis, the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were used, respectively, to measure the severity of psoriasis and the impact of psoriasis on the specific quality of life. RESULTS Compared to controls, patients with psoriasis showed higher HADS depression score and alcohol consumption, and lower QoL. Among subjects with psoriasis, multivariate analysis showed: 1) poorer physical QoL was associated with older age, articular lesions and anxious symptoms, whereas poorer mental QoL was associated with younger age, female sex, genital lesions and depressive symptoms; 2) the higher the severity of psoriasis, the lower the level of QoL and the higher the levels of anxious or depressive symptoms; and 3) female sex and articular or genital location of lesions are linked with higher HADS scores. CONCLUSION Higher scores in anxiety and depression and lower QoL is common in psoriasis, especially among women and those with genital or articular lesions. Dermatologists should give special attention to this subgroup of persons with psoriasis in order to prevent future psychopathology.
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Affiliation(s)
- José M Martínez-Ortega
- Department of Psychiatry, University of Granada, Granada, Spain; CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
| | - Paloma Nogueras
- Dermatology Service, Virgen de la Nieves University Hospital, Granada, Spain
| | - José E Muñoz-Negro
- Department of Psychiatry, University of Granada, Granada, Spain; UGC Salud Mental, San Cecilio University Hospital and ibs Granada, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain; CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; UGC Salud Mental, San Cecilio University Hospital and ibs Granada, Spain.
| | | | - Manuel Gurpegui
- Department of Psychiatry, University of Granada, Granada, Spain; CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
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Arango C, Baeza I, Bernardo M, Cañas F, de Dios C, Díaz-Marsá M, García-Portilla MP, Gutiérrez-Rojas L, Olivares JM, Rico-Villademoros F, Rodríguez-Jiménez R, Sánchez-Morla EM, Segarra R, Crespo-Facorro B. Long-acting injectable antipsychotics for the treatment of schizophrenia in Spain. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.rpsmen.2018.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sarramea F, Jaén-Moreno MJ, Feu N, Redondo-Écija J, Balanzá-Martínez V, Gutiérrez-Rojas L, García-Portilla MP. Preparar la cesación tabáquica en el trastorno mental grave: diagnóstico precoz y oportunidades de prevención. Revista de Psiquiatría y Salud Mental 2019; 12:133-134. [DOI: 10.1016/j.rpsm.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 08/28/2018] [Indexed: 02/02/2023]
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Sarramea F, Jaen-Moreno MJ, Balanzá-Martínez V, Osuna MI, Alcalá JÁ, Montiel FJ, Gómez C, Sánchez MD, Rico AB, Redondo-Écija J, Gil S, Valdivia F, Caballero-Villarraso J, Gutiérrez-Rojas L. Setting the stage to quit smoking in Bipolar Disorder patients: brief advice in clinical practice. Adicciones 2019; 31:136-146. [PMID: 30059580 DOI: 10.20882/adicciones.1006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Tobacco consumption is the main preventable factor of mortality in smokers with bipolar disorder (BD), and any possible solutions are often blocked by prejudices over desire, and the possibilities and risks for these patients in giving up tobacco consumption. Adults with BD were recruited at 8 Mental Health Centres. Smokers were evaluated before and after a brief intervention based on the 3 A's and classified into a 'Stage of Change' (SOC) and their 'Readiness to Change' (RTC). A multiple linear regression was used to analyze the progression in their RTC and the independent effect of different variables (pharmacological treatment, history of psychotic symptoms, current anxiety symptoms, willingness, self-perceived capacity to quit smoking and subjective perception of cognitive functioning). Of 212 stable patients diagnosed with BD, current smokers (n=101; 47.6%) were included in the intervention phase, and 80.2% completed it. At baseline, 75.2% were considering the idea of giving up smoking and, after the brief intervention, 30.9% of the patients progressed in their SOC. A significant increase in the level of RTC was observed (53.3 vs 59.3, P=0.019). Perception of cognitive performance (β=-0.35;P=0.002), the degree of willing to quit (β=0.32;P=0.008), self-perceived capacity to quit tobacco smoking (β=-0.30;P=0.012), the patient's age (β=-0.72;P=0.004), the age of onset of smoking (β=0.48;P=0.022) and years as a smoker (β=0.48;P=0.025) were all factors that significantly influenced the chances of improving after the short intervention. Smokers with BD consider the idea of quitting and a brief intervention developed in the every day mental health care setting improves the level of readiness. The neurocognitive dysfunction associated with BD may limit patients' readiness to quit smoking.
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Ramón-Jarne FJ, Jurado D, Jiménez-Fernández S, Gutiérrez-Rojas L, Martínez-Ortega JM, Gurpegui M. Disordered eating behaviors among Christian and Muslim adolescents in Ceuta, a multicultural town. Psychiatry Res 2019; 272:182-189. [PMID: 30583261 DOI: 10.1016/j.psychres.2018.12.089] [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] [Received: 06/16/2018] [Revised: 12/14/2018] [Indexed: 10/27/2022]
Abstract
Studies on disordered eating behaviors (DEB) in multicultural populations with multiple religious/cultural affiliations are needed in order to clarify the relationship between cultural background and DEB. Therefore, we compared the presence of DEB among Christian and Muslim adolescents who share their school environment, controlling for the effect of body mass index, demographic variables and lifestyle habits. A sample of 493 girls and boys (339 Christian, 138 Muslim) whose mean (±SD) age was 14.8 (±1.7) years completed self-reporting questionnaires and underwent measurements of anthropometric data. Religious/cultural affiliation was defined by self-identification. The dependent variable, DEB was assessed by means of the Eating Disorders Inventory (EDI-2). Muslim girls and boys score higher than Christians on EDI-2 total scores, especially on the perfectionism subscale. Bivariate and multivariate analyses were used to determine the characteristics associated with DEB, which were detected in 24% of participants (19% of Christians and in 35% of Muslims). Among girls, DEB were directly associated with overweight or obesity, the presence of frequent quarrels with parents, academic failure and spending more than 3 h a day watching screen images. Among boys, DEB were directly associated with overweight or obesity and Muslim background; and inversely associated with age and socioeconomic status.
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Affiliation(s)
- F Javier Ramón-Jarne
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Ceuta School of Nursing and Ceuta Military Hospital, Ceuta, Spain
| | - Dolores Jurado
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Spain
| | - Sara Jiménez-Fernández
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Child and Adolescent Mental Health Unit, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Luis Gutiérrez-Rojas
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - José M Martínez-Ortega
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain
| | - Manuel Gurpegui
- CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Department of Psychiatry, University of Granada, Granada, Spain.
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Jaén-Moreno MJ, Feu N, Redondo-Écija J, Montiel FJ, Gómez C, Del Pozo GI, Alcalá JÁ, Gutiérrez-Rojas L, Balanzá-Martinez V, Chauca GM, Carrión L, Osuna MI, Sánchez MD, Caro I, Ayora M, Valdivia F, López MS, Poyato JM, Sarramea F. Smoking cessation opportunities in severe mental illness (tobacco intensive motivational and estimate risk - TIMER-): study protocol for a randomized controlled trial. Trials 2019; 20:47. [PMID: 30642365 PMCID: PMC6332915 DOI: 10.1186/s13063-018-3139-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/08/2018] [Accepted: 12/15/2018] [Indexed: 01/19/2023] Open
Abstract
Background There is an increased risk of premature death in people with severe mental illness (SMI). Respiratory disorders and cardiovascular disease are leading causes of increased mortality rates in these patients, and tobacco consumption remains the most preventable risk factor involved. Developing new tools to motivate patients towards cessation of smoking is a high priority. Information on the motivational value of giving the lung age and prevention opportunities is unknown in this high-risk population. Methods/design This article describes in detail a protocol developed to evaluate an intensive motivational tool, based on the individual risks of pulmonary damage and prevention opportunities. It is designed as a randomized, 12-month, follow-up, multicenter study. A minimum of 204 smokers will be included, aged 40 years and older, all of whom are patients diagnosed with either schizophrenia or bipolar disorder (BD). Chronic obstructive pulmonary disease (COPD) will be evaluated using spirometry, and the diagnosis will then be validated by a pneumologist and the lung age estimated. Based on this value, a motivational message about prevention will be issued for the intervention group, which will be reinforced by individualized text messages over a period of 3 months. The efficacy of the method and the pulmonary damage variables will be evaluated: smoking cessation at the end of follow-up will be confirmed by cooximetry, and the COPD diagnosis and the severity of the staging for disease will be assessed. Discussion In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provide patients with SMI with a better chance of quitting smoking. Trial registration ClinicalTrials.gov, ID: NCT03583203. Registered on 11 July 2018. Trial status: recruitment.
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Affiliation(s)
- María José Jaén-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Departamento de Ciencias Sociosanitarias, Radiología y Medicina Física, Universidad de Córdoba, Córdoba, Spain
| | - Nuria Feu
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Justa Redondo-Écija
- Unidad de Drogas y Adicciones, Instituto Provincial de Bienestar Social, Diputación de Córdoba, Córdoba, Spain
| | | | - Cristina Gómez
- Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, Córdoba, Spain
| | - Gloria I Del Pozo
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Jose Ángel Alcalá
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Luis Gutiérrez-Rojas
- Grupo de Investigación Psiquiatría y Neurociencias (CTS-549), Instituto de Neurociencias, Universidad de Granada, Granada, Spain
| | - Vicente Balanzá-Martinez
- Área de Psiquiatría y Psicología Médica. Departamento de Medicina, Servicio de Psiquiatría, Universidad de Valencia, CIBERSAM, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Geli Marie Chauca
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Laura Carrión
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Maria Isabel Osuna
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - María Dolores Sánchez
- Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, Córdoba, Spain
| | - Inmaculada Caro
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Miriam Ayora
- Unidad de Psiquiatría del niño y del adolescente, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Francisca Valdivia
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - María Soledad López
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Jose Manuel Poyato
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Fernando Sarramea
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. .,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006, Oviedo, Spain.
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García-Jiménez J, Álvarez-Fernández M, Aguado-Bailón L, Gutiérrez-Rojas L. Factores asociados a la polaridad predominante en el trastorno bipolar: una revisión sistemática. Revista de Psiquiatría y Salud Mental 2019; 12:52-62. [DOI: 10.1016/j.rpsm.2017.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/19/2017] [Accepted: 06/14/2017] [Indexed: 01/25/2023]
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Sarramea Crespo F, Jaén-Moreno MJ, Gutiérrez-Rojas L, Balanzá-Martínez V, García-Alvarez L, Saiz Martínez PA, Garcia-Portilla MP, Guler I, Bobes J. "Readiness to Change" Predicts Efficacy of Reduction among Smokers with Severe Mental Illness. Eur Addict Res 2019; 25:256-262. [PMID: 31163435 DOI: 10.1159/000500450] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 04/05/2019] [Indexed: 11/19/2022]
Abstract
AIMS Smoking cessation in subjects with a severe mental illness (SMI) is a challenging but attainable goal. Furthermore, the identification of variables involved in the quitting process is a highly relevant factor in clinical practice. This study aimed to analyze the influence of smokers' motivation in smoking reduction and cessation and select the most suitable way of measuring motivation. METHODS This is a secondary analysis of a 9-month, multicenter trial examining a Multicomponent Smoking Cessation Program in 82 adult outpatients with SMI. At the end of the preparation stage, the smokers' motivational level was evaluated with the University of Rhode Island Change Assessment Scale. This allowed us to rate subjects using a continuous measure ("Readiness to Change," RTC) and group them in "Stages of Change" (SOC). Regression analyses were carried out to identify predictors of the efficacy outcomes: a reduction in at least 50% of the cigarettes smoked per day (CPD), a reduction in the expired carbon monoxide (CO), and complete abstinence from smoking. RESULTS We studied differences in measurements of motivational levels independently (RTC and SOC) for patients who had a reduction in at least 50% of the CPD and for patients who achieved complete abstinence from smoking. However, these differences did not reach statistical significance during the follow-up study with a logistic mixed-effects model. In a linear mixed-effects model, the reduction of expired CO was significantly associated with RTC, at the end of the active treatment phase and during follow-up (β: -1.51; SD 0.82; p < 0.01). CONCLUSION The motivation level achieved in the preparation phase predicted the reduction of expired CO over a given period when calculated by a continuous measure (RTC).
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Affiliation(s)
- Fernando Sarramea Crespo
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain, .,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain, .,Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain,
| | - Maria José Jaén-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Departamento de Ciencias Sociosanitarias, Radiología y Medicina Física, Universidad de Córdoba, Córdoba, Spain
| | - Luis Gutiérrez-Rojas
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | | | - Pilar Alejandra Saiz Martínez
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Maria Paz Garcia-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Ipek Guler
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
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Arango C, Baeza I, Bernardo M, Cañas F, de Dios C, Díaz-Marsá M, García-Portilla MP, Gutiérrez-Rojas L, Olivares JM, Rico-Villademoros F, Rodríguez-Jiménez R, Sánchez-Morla EM, Segarra R, Crespo-Facorro B. Long-acting injectable antipsychotics for the treatment of schizophrenia in Spain. Rev Psiquiatr Salud Ment (Engl Ed) 2018; 12:92-105. [PMID: 29954707 DOI: 10.1016/j.rpsm.2018.03.006] [Citation(s) in RCA: 8] [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: 12/22/2017] [Revised: 03/08/2018] [Accepted: 03/27/2018] [Indexed: 12/18/2022]
Abstract
Antipsychotics are an essential component in the treatment of schizophrenia. Long-acting injectable formulations (LAI) arose to improve adherence with the associated potential of reducing the risk of relapse. The objective of this article is to analyze the use of LAI antipsychotics in Spain, which is similar to other European countries but with a predominance of the use of second generation LAI, to discuss the possible causes of prescribing differences with respect to other countries (including organizational aspects, attitudes of psychiatrists, patients and family members, and clinical practice guidelines), and to discuss their use in acute psychiatric units, first episode, and in children and adolescents. In our view, while it is necessary to increase existing evidence regarding the advantages of LAI antipsychotics and the differentiation between LAI antipsychotics currently available, their use will likely continue to grow driven by clinical experience.
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Affiliation(s)
- Celso Arango
- Hospital General Universitario Gregorio Marañón, IiSGM, Facultad de Medicina Universidad Complutense, CIBERSAM, Madrid, España.
| | - Inmaculada Baeza
- Hospital Clinic i Universitari de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IDIBAPS, Universitat de Barcelona
| | - Miquel Bernardo
- Hospital Clinic i Universitari de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IDIBAPS, Universitat de Barcelona
| | - Fernando Cañas
- Hospital «Dr. R. Lafora», Universidad Francisco de Vitoria, Madrid, España
| | | | - Marina Díaz-Marsá
- Hospital Clínico de San Carlos, Universidad Complutense, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universidad de Oviedo, Oviedo, España
| | | | | | | | - Roberto Rodríguez-Jiménez
- Instituto de Investigación Hospital 12 de Octubre (imas12) Madrid, Universidad Complutense de Madrid (UCM), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
| | - Eva María Sánchez-Morla
- Instituto de Investigación Hospital 12 de Octubre (imas12) Madrid, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
| | - Rafael Segarra
- Hospital Universitario Cruces, Biocruces, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bilbao, España
| | - Benedicto Crespo-Facorro
- Universidad de Cantabria, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, España
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López-Díaz Á, Fernández-González JL, Luján-Jiménez JE, Galiano-Rus S, Gutiérrez-Rojas L. Use of repeated intravenous ketamine therapy in treatment-resistant bipolar depression with suicidal behaviour: a case report from Spain. Ther Adv Psychopharmacol 2017; 7:137-140. [PMID: 28540033 PMCID: PMC5433615 DOI: 10.1177/2045125316675578] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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] [Indexed: 12/28/2022] Open
Abstract
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour. After repeated intravenous ketamine infusions without remarkable side effects, the patient experienced a complete clinical recovery during the 4 weeks following hospital discharge. Unfortunately, depressive symptoms reappeared in the 5th week, and the patient was finally readmitted to hospital as a result of a suicide attempt.
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Affiliation(s)
- Álvaro López-Díaz
- Hospital San Juan de la Cruz, Mental Health Inpatient Unit, Úbeda, Jaén, Spain
| | | | | | - Sara Galiano-Rus
- Hospital San Juan de la Cruz, Mental Health Inpatient Unit, Úbeda, Jaén, Spain
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47
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Martínez-Ortega JM, Franco S, Rodríguez-Fernández JM, Gutiérrez-Rojas L, Wang S, Gurpegui M. Temporal sequencing of nicotine dependence and major depressive disorder: A U.S. national study. Psychiatry Res 2017; 250:264-269. [PMID: 28183022 DOI: 10.1016/j.psychres.2017.01.087] [Citation(s) in RCA: 6] [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] [Received: 08/10/2016] [Revised: 01/21/2017] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
Major Depressive Disorder (MDD) and Nicotine dependence (ND) often co-occur. However, little attention has been given to the temporal order between the two disorders. We compared the sociodemographic and clinical characteristics of individuals whose onset of ND preceded (ND-prior) or followed the onset of MDD (MDD-prior). Binary logistic regression models were computed to compare ND-prior (n=546) and MDD-prior (n=801) individuals from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n=43,093). We found that MDD-prior were more likely to have a history of suicide attempts and a family history of both depression and antisocial behavior, to have had psychiatric hospitalization, and to have an earlier age of onset of the first depressive episode; but a later age of onset for both daily smoking and ND. On average, MDD-prior individuals showed a significantly longer transition time from daily smoking to ND (15.6±0.6 vs. 6.9±0.4 years, P<0.001). In contrast, ND-prior subjects had a significantly greater proportion of withdrawal symptoms, and of lifetime alcohol use or alcohol use disorder. We conclude that the phenomenology and course of ND and MDD vary significantly, depending on which disorder had earlier onset.
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Affiliation(s)
- José M Martínez-Ortega
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA; Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Psychiatry Service, San Cecilio University Hospital, Granada, Spain.
| | - Silvia Franco
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - Jorge M Rodríguez-Fernández
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - Shuai Wang
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
| | - Manuel Gurpegui
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA; Psychiatry Service, San Cecilio University Hospital, Granada, Spain
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García-Jiménez J, Porras-Segovia A, García-López R, Muñoz-Negro J, Gutiérrez-Rojas L. Late-onset bipolar illness: Literature review and case report. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.384] [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: 11/25/2022] Open
Abstract
IntroductionLate-onset bipolar-illness (LOBI) diagnosis comprises those patients whose first mania episode occurs aged 60 or older. Traditionally, it has been considered as a secondary disorder, accompanying other conditions such as dementia. While this is true for some cases, LOBI is a wider concept, which has its own features and also includes other entities.ObjectivesTo describe the main features of LOBI.MethodsCritical review of the literature and description of the case of a 72-year-old woman diagnosed with LOBI.ResultsWhile only 6–8% of all new cases of bipolar disorder (BD) occur in people older than 60, recent research suggests an increase of first episodes in this age group. LOBI is less associated with family history compared to early onset BD and seems to occur more frequently in women.LOBI presents with better premorbid functioning and atypical psychopathology as compared to early onset. Also, there is a higher prevalence of mixed episodes and a higher frequency of episodes per year, with a great risk of suicide. LOBI patients have more cognitive impairment and higher rates of comorbid psychiatric disorders.These patients show some specific neuroimaging signs, including subcortical hyperintensities.Quetiapine and valproate have proved useful, but the pharmacokinetic and pharmacodynamic characteristics of older patients must be taken into account.ConclusionThe reported case identifies similarities between LOBI and classical BD. However, both this case and the literature review reveal that LOBI has specific features that differentiate it from classical BD. Further research is needed to characterise the condition and improve its management.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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García López R, Gota Garcés J, García Jiménez J, Muñoz Negro J, Gutiérrez-Rojas L. A case for considering differences between organic and psychogenic amnesia. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1187] [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
IntroductionMedical record, general examination, laboratory findings, neuropsychological interview and multidisciplinary consideration are essential to establish differencial diagnosis and correct approach in amnesic episodes.AimTo describe differences between organic and psychogenic anterograde amnesia.MethodsSingle case report and literature review.ResultsA 51-year-old man with only diagnosis of DM I, single, a good relationship with his family, without any personal or familiar psychiatric or neurological history, came to the hospital emergency department brought by his sisters referring disorientation, acute memory loss and mood changes, prevailing indifference to the situation for the last three days. After general exploration, including psychopatological examination and higher brain functions study, we arrived to the conclusion that the patient suffered from anterograde short-term severe amnesia as the only symptom, with evident conservation of autobiographic memory. The family referred as a possible stressor factor his mother's recent transfer to a different city, which had caused constant repeated questions about her location. Given the questionable presentation and trigger we shared the case with the neurologist, who ordered an array of tests to rule out any organic cause (LP, CT, MRI…), obtaining as a final result a diagnosis of limbic encephalitis, treated and effectively solved in two weeks with high-dose glucocorticoids.ConclusionCertain features of the symptoms exploration in amnesic episodes such as reiterative questioning about a specific topic, a non-modified autobiography or the absence of a clear traumatic precipitant factor, are essential for a correct approach and may lead the clinic to an organic evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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García-Jiménez J, Porras-Segovia A, Gota-Garcés J, Muñoz-Negro J, Gutiérrez-Rojas L. Epidemiological and Clinical Variables Related with the Predominant Polarity on Bipolar Disorder: A Systematic Review. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1899] [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
IntroductionType I and type II classification of bipolar disorder (BD) may not provide useful information to the clinician regarding epidemiological and clinical correlates.New classifications have recently been proposed, such as the Predominant Polarity (PP) classification, which is based on the tendency of the patient to relapse in the manic (Manic Predominant Polarity [MPP]) or the depressive (Depressive Predominant Polarity [DPP]) poles along the course of the disease.ObjectivesTo explore the epidemiological and clinical correlates of PP.MethodsWe performed a search of the PubMed and Web of Science databases up to June 1st 2016, using the keywords “bipolar disorder”, “polarity” and “predominant polarity”.ResultsThe initial search identified 1598 articles. Only 17 articles met inclusion criteria. Factors associated with MPP are manic onset, history of drug abuse and a better response to atypical antipsychotics and mood stabilizers. Meanwhile DPP is associated with depressive onset, more relapses, longer acute episodes, and a higher risk of suicide. Moreover, delay until diagnosis, mixed episodes and comorbid anxiety disorders are more prevalent in DPP patients, whose treatment often involves quetiapine and lamotrigine.LimitationsFew prospective studies. Variability of results.ConclusionsPP classification may be useful for the clinical management of BD. Further research in this field is needed. Future research should use standardized definitions and more comparable methods.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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