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Maurel S, Sáez-Francàs N, Calvo N, Alegre-Martín J, Castro-Marrero J. Identifying mindfulness and acceptance as mediators between negative affect, functional disability and emotional distress in patients with fibromyalgia. Clin Exp Rheumatol 2021; 40:1102-1111. [DOI: 10.55563/clinexprheumatol/uzzejn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Sara Maurel
- Department of Neurosciences, University of the Basque Country, Leioa, Spain
| | | | - Natalia Calvo
- Department of Psychiatry, Biomedical Research Networking Center in Mental Health (CIBERSAM), Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | - José Alegre-Martín
- Division of Rheumatology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, and Rheumatology Research Unit, Vall d’Hebron Hospital Research Institute, Universitat Autònoma de Barcelona, Spain
| | - Jesús Castro-Marrero
- Rheumatology Research Unit, Vall d’Hebron Hospital Research Institute, Universitat Autònoma de Barcelona, Spain.
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Maurel S, Calvo N, Sáez-Francàs N, Alegre J, Castro-Marrero J. Association between psychological constructs and physical and emotional distress in individuals with fibromyalgia. Clin Exp Rheumatol 2021; 39 Suppl 130:13-19. [DOI: 10.55563/clinexprheumatol/p8kho6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/24/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Sara Maurel
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Natalia Calvo
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | | | - Jose Alegre
- Division of Rheumatology, Department of Internal Medicine, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | - Jesús Castro-Marrero
- Rheumatology Research Unit, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Spain.
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Hernández-Vara J, Sáez-Francàs N, Lorenzo-Bosquet C, Corominas-Roso M, Cuberas-Borròs G, Lucas-Del Pozo S, Carter S, Armengol-Bellapart M, Castell-Conesa J. BDNF levels and nigrostriatal degeneration in “drug naïve” Parkinson's disease patients. An “in vivo” study using I-123-FP-CIT SPECT. Parkinsonism Relat Disord 2020; 78:31-35. [DOI: 10.1016/j.parkreldis.2020.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 01/01/2023]
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Calvo N, Pueyo N, Gutiérrez F, Ferrer M, Castro-Marrero J, Alegre J, Casas M, Ramos Quiroga JA, Sáez-Francàs N. Dimensional Personality Assessment among a Chronic Fatigue Syndrome (CFS) sample with Personality Inventory for DSM-5 (PID-5). Actas Esp Psiquiatr 2018; 46:125-132. [PMID: 30079926] [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: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Personality Disorders (PD) are highly prevalent among Chronic Fatigue Syndrome (CFS) patients, but studies based on the DSM-5 are still scarce. Validated instruments have not yet been specifically used in CFS patients. Therefore, our aim was to analyze the differences in personality facets and domains profiles among CFS patients with and without a PD using the Personality Inventory for DSM-5 (PID-5). Additionally, we analyzed the ability of this instrument to predict PD in a sample of CFS patients. This instrument is validated for PDs, but not for CFS. METHODS All of the 84 CFS patients were evaluated through a clinical interview and underwent psychopathological evaluation with the SCID I and SCID II. Dimensional personality facets and domains were evaluated with the PID-5, according to DSM-5. RESULTS In our sample, 54 (64%) of the patients fulfilled the criteria of a PD. The most significant facets in CFS with PD in comparison to those patients without a PD were Separation Insecurity, Perseveration, Withdrawal, Depressivity, Rigid Perfectionism, Unusual Beliefs and Experiences. Negative Affectivity and Detachment were the two significant domains in CFS-PD patients. In the regression analyses, only Detachment and Rigid Perfectionism constituted a prognostic factor leading to high probability of an endorsed PD. Conclussion. According to these results, the PID-5 domains and facets could be adequate and useful to differentiate between PD and non-PD patients in clinical samples and suggest a more frequent dimensional personality profile in CFS patients.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain Psychiatry, Mental Health and Addictions Group. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain Grup TLP Barcelona, Spain
| | - Natalia Pueyo
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | - Marc Ferrer
- Psychiatry Department, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain Psychiatry, Mental Health and Addictions Group. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain Grup TLP Barcelona, Spain
| | - Jesús Castro-Marrero
- CFS/ME Unit, Vall d’Hebron University Hospital, Collserola Research Institute, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - José Alegre
- CFS/ME Unit, Vall d’Hebron University Hospital, Collserola Research Institute, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Miquel Casas
- Psychiatry Department, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain Psychiatry, Mental Health and Addictions Group. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain Grup TLP Barcelona, Spain
| | - Josep-Antoni Ramos Quiroga
- Psychiatry Department, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain Psychiatry, Mental Health and Addictions Group. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Castro-Marrero J, Zaragozá MC, González-Garcia S, Aliste L, Sáez-Francàs N, Romero O, Ferré A, Fernández de Sevilla T, Alegre J. Poor self-reported sleep quality and health-related quality of life in patients with chronic fatigue syndrome/myalgic encephalomyelitis. J Sleep Res 2018; 27:e12703. [PMID: 29770505 DOI: 10.1111/jsr.12703] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 12/22/2017] [Accepted: 03/23/2018] [Indexed: 11/28/2022]
Abstract
Non-restorative sleep is a hallmark symptom of chronic fatigue syndrome/myalgic encephalomyelitis. However, little is known about self-reported sleep disturbances in these subjects. This study aimed to assess the self-reported sleep quality and its impact on quality of life in a Spanish community-based chronic fatigue syndrome/myalgic encephalomyelitis cohort. A prospective cross-sectional cohort study was conducted in 1,455 Spanish chronic fatigue syndrome/myalgic encephalomyelitis patients. Sleep quality, fatigue, pain, functional capacity impairment, psychopathological status, anxiety/depression and health-related quality of life were assessed using validated subjective measures. The frequencies of muscular, cognitive, neurological, autonomic and immunological symptom clusters were above 80%. High scores were recorded for pain, fatigue, psychopathological status, anxiety/depression, and low scores for functional capacity and quality of life, all of which correlated significantly (all p < 0.01) with quality of sleep as measured by the Pittsburgh Sleep Quality Index. Multivariate regression analysis showed that after adjusting for age and gender, the pain intensity (odds ratio, 1.11; p <0.05), psychopathological status (odds ratio, 1.85; p < 0.001), fibromyalgia (odds ratio, 1.39; p < 0.05), severe autonomic dysfunction (odds ratio, 1.72; p < 0.05), poor functional capacity (odds ratio, 0.98; p < 0.05) and quality of life (odds ratio, 0.96; both p < 0.001) were significantly associated with poor sleep quality. These findings suggest that this large chronic fatigue syndrome/myalgic encephalomyelitis sample presents poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index, and that this poor sleep quality is associated with many aspects of quality of life.
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Affiliation(s)
- Jesús Castro-Marrero
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria C Zaragozá
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Clinical Research Department, Laboratorios Viñas, Barcelona, Spain
| | - Sergio González-Garcia
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luisa Aliste
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Odile Romero
- Sleep Unit, Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Alex Ferré
- Sleep Unit, Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Tomás Fernández de Sevilla
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Alegre
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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Calvo N, Sáez-Francàs N, Valero S, Castro-Marrero J, Alegre Martín J, Casas M. Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome. European Journal of Psychological Assessment 2017. [DOI: 10.1027/1015-5759/a000281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Spain
| | - Naia Sáez-Francàs
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
| | - Sergi Valero
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Institut Recerca Hospital Universitari Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Spain
| | - Jesús Castro-Marrero
- Chronic Fatigue Syndrome Research Unit, Institut de Recerca Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Spain
| | - José Alegre Martín
- Psychiatry Department, Hospital Sant Rafael, FIDMAG. Hospital Universitari Vall d'Hebron, CIBERSAM, Departament of Psychiatry, Uniercitat Autònoma Barcelona
- Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Casas
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Spain
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Castro-Marrero J, Sáez-Francàs N, Santillo D, Alegre J. Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome. Br J Pharmacol 2017; 174:345-369. [PMID: 28052319 DOI: 10.1111/bph.13702] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/25/2016] [Accepted: 12/14/2016] [Indexed: 01/10/2023] Open
Abstract
This review explores the current evidence on benefits and harms of therapeutic interventions in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and makes recommendations. CFS/ME is a complex, multi-system, chronic medical condition whose pathophysiology remains unknown. No established diagnostic tests exist nor are any FDA-approved drugs available for treatment. Because of the range of symptoms of CFS/ME, treatment approaches vary widely. Studies undertaken have heterogeneous designs and are limited by sample size, length of follow-up, applicability and methodological quality. The use of rintatolimod and rituximab as well as counselling, behavioural and rehabilitation therapy programs may be of benefit for CFS/ME, but the evidence of their effectiveness is still limited. Similarly, adaptive pacing appears to offer some benefits, but the results are debatable: so is the use of nutritional supplements, which may be of value to CFS/ME patients with biochemically proven deficiencies. To summarize, the recommended treatment strategies should include proper administration of nutritional supplements in CFS/ME patients with demonstrated deficiencies and personalized pacing programs to relieve symptoms and improve performance of daily activities, but a larger randomized controlled trial (RCT) evaluation is required to confirm these preliminary observations. At present, no firm conclusions can be drawn because the few RCTs undertaken to date have been small-scale, with a high risk of bias, and have used different case definitions. Further, RCTs are now urgently needed with rigorous experimental designs and appropriate data analysis, focusing particularly on the comparison of outcomes measures according to clinical presentation, patient characteristics, case criteria and degree of disability (i.e. severely ill ME cases or bedridden).
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Affiliation(s)
- Jesus Castro-Marrero
- CFS/ME Unit, Vall d'Hebron University Hospital, Collserola Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Dafna Santillo
- CFS/ME Unit, Vall d'Hebron University Hospital, Collserola Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose Alegre
- CFS/ME Unit, Vall d'Hebron University Hospital, Collserola Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
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Calvo N, Valero S, Sáez-Francàs N, Gutiérrez F, Casas M, Ferrer M. Borderline Personality Disorder and Personality Inventory for DSM-5 (PID-5): Dimensional personality assessment with DSM-5. Compr Psychiatry 2016; 70:105-11. [PMID: 27624429 DOI: 10.1016/j.comppsych.2016.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Borderline personality disorder (BPD) diagnosis has been considered highly controversial. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) proposes an alternative hybrid diagnostic model for personality disorders (PD), and the Personality Inventory for DSM-5 (PID-5) has adequate psychometric properties and has been widely used for the assessment of the dimensional component. METHODS Our aim was to analyze the utility of the personality traits presented in Section III of the DSM-5 for BPD diagnosis in an outpatient clinical sample, using the Spanish version of the PID-5. Two clinical samples were studied: BPD sample (n=84) and non-BPD sample (n=45). Between-sample differences in PID-5 scores were analyzed. RESULTS The BPD sample obtained significantly higher scores in most PID-5 trait facets and domains. Specifically and after regression logistic analyses, in BPD patients, the domains of Negative Affectivity and Disinhibition, and the trait facets of emotional lability, [lack of] restricted affectivity, and impulsivity were more significantly associated with BPD. CONCLUSIONS Although our findings are only partially consistent with the algorithm proposed by DSM-5, we consider that the combination of the PID-5 trait domains and facets could be useful for BPD dimensional diagnosis, and could further our understanding of BPD diagnosis complexity.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Sergi Valero
- Psychiatry Department, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Naia Sáez-Francàs
- Psychiatry Department, Sant Rafael Hospital, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Miguel Casas
- Psychiatry Department, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Ferrer
- Psychiatry Department, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sáez-Francàs N, Martí Andrés G, Ramírez N, de Fàbregues O, Álvarez-Sabín J, Casas M, Hernández-Vara J. Clinical and psychopathological factors associated with impulse control disorders in Parkinson's disease. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2015.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sáez-Francàs N, Calvo N, Alegre J, Castro-Marrero J, Ramírez N, Hernández-Vara J, Casas M. Childhood trauma in Chronic Fatigue Syndrome: focus on personality disorders and psychopathology. Compr Psychiatry 2015; 62:13-9. [PMID: 26343462 DOI: 10.1016/j.comppsych.2015.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/23/2014] [Revised: 06/01/2015] [Accepted: 06/13/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Personality Disorders (PDs) and childhood traumatic experiences have been considered risk factors for Chronic Fatigue Syndrome (CFS). However, the relationship between these factors and their associated psychopathological impact has not been explored in this population. This study was designed to evaluate the association between different childhood traumas and the presence and number of PDs and current psychopathology in a sample of CFS patients. MATERIAL AND METHODS For this purpose, 166 CFS patients were evaluated with the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Child Trauma Questionnaire. Other instruments were used to assess the associated psychopathology and the impact of fatigue. RESULTS Of the total sample, 55 (33.1%) presented childhood trauma, the most frequent of which were emotional neglect (21.7%) and emotional abuse (18.1%). Considering PD presence, 79 (47.6%) patients presented some PD. There were no differences in frequency of physical childhood trauma in patients with and without PD. However, patients with PD had more frequently experienced emotional childhood trauma (OR=2.18, p=0.034). Severity of childhood trauma was related to a higher number of PDs, more severe depressive symptoms (p=0.025) and suicide risk (p=0.001). Patients with PD and any childhood trauma presented more severe depressive and irritable symptoms and a higher suicide risk than those without any PD and non-childhood traumatic event. These patients' psychopathological symptoms were similar to those of patients with childhood trauma and without PD. CONCLUSIONS These results suggest that emotional childhood trauma but not physical childhood trauma is related to higher frequency of PD presence. More severe childhood emotional and physical traumas are related to a higher number of PDs and to more severe psychopathological symptoms.
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Affiliation(s)
- Naia Sáez-Francàs
- Servei de Psiquiatria, Hospital Sant Rafael, FIDMAG, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 107-117, 08035, Barcelona, Spain.
| | - Natalia Calvo
- Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain.
| | - José Alegre
- Servei de Medicina Interna, Hospital Universitari Vall d´Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain.
| | - Jesús Castro-Marrero
- Servei de Medicina Interna, Hospital Universitari Vall d´Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain.
| | - Nicolás Ramírez
- Servei de Psiquiatria, Hospital Sant Rafael, FIDMAG, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 107-117, 08035, Barcelona, Spain.
| | - Jorge Hernández-Vara
- Servei de Neurologia, Hospital Universitari Vall d´Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain.
| | - Miguel Casas
- Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain.
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Castro-Marrero J, Sáez-Francàs N, Segundo MJ, Calvo N, Faro M, Aliste L, Fernández de Sevilla T, Alegre J. Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome - A randomized, controlled, double-blind trial. Clin Nutr 2015. [PMID: 26212172 DOI: 10.1016/j.clnu.2015.07.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND & AIMS Chronic Fatigue Syndrome (CFS) is a complex condition, characterized by severe disabling fatigue with no known cause, no established diagnostic tests, and no universally effective treatment. Several studies have proposed symptomatic treatment with coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) supplementation. The primary endpoint was to assess the effect of CoQ10 plus NADH supplementation on age-predicted maximum heart rate (max HR) during a cycle ergometer test. Secondary measures included fatigue, pain and sleep. METHODS A proof-of-concept, 8-week, randomized, controlled, double-blind trial was conducted in 80 CFS patients assigned to receive either CoQ10 plus NADH supplementation or matching placebo twice daily. Maximum HR was evaluated at baseline and at end of the run-in period using an exercise test. Fatigue, pain and sleep were evaluated at baseline, and then reassessed at 4- and 8-weeks through self-reported questionnaires. RESULTS The CoQ10 plus NADH group showed a significant reduction in max HR during a cycle ergometer test at week 8 versus baseline (P = 0.022). Perception of fatigue also showed a decrease through all follow-up visits in active group versus placebo (P = 0.03). However, pain and sleep did not improve in the active group. Coenzyme Q10 plus NADH was generally safe and well tolerated. CONCLUSIONS Our results suggest that CoQ10 plus NADH supplementation for 8 weeks is safe and potentially effective in reducing max HR during a cycle ergometer test and also on fatigue in CFS. Further additional larger controlled trials are needed to confirm these findings. Clinical trial registrationThis trial was registered at clinicaltrials.gov as NCT02063126.
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Affiliation(s)
- Jesus Castro-Marrero
- CFS Clinical Unit, Vall d'Hebron University Hospital Research Institute, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain.
| | - Naia Sáez-Francàs
- Psychiatry Unit, Sant Rafael Hospital (FIDMAG), 08035, Barcelona, Spain; Psychiatry Department, Vall d'Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - María Jose Segundo
- Vitae Natural Nutrition, S.L., Sant Cugat del Vallès, 08172, Barcelona, Spain
| | - Natalia Calvo
- Psychiatry Department, Vall d'Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Mónica Faro
- CFS Clinical Unit, Vall d'Hebron University Hospital Research Institute, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Luisa Aliste
- CFS Clinical Unit, Vall d'Hebron University Hospital Research Institute, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Tomás Fernández de Sevilla
- CFS Clinical Unit, Vall d'Hebron University Hospital Research Institute, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Jose Alegre
- CFS Clinical Unit, Vall d'Hebron University Hospital Research Institute, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
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Sáez-Francàs N, Martí Andrés G, Ramírez N, de Fàbregues O, Álvarez-Sabín J, Casas M, Hernández-Vara J. [Clinical and psychopathological factors associated with impulse control disorders in Parkinson's disease]. Neurologia 2015; 31:231-8. [PMID: 26096669 DOI: 10.1016/j.nrl.2015.05.002] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/27/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Impulse control disorders (ICD) constitute a complication that may arise during the course of Parkinson's disease (PD). Several factors have been linked to the development of these disorders, and their associated severe functional impairment requires specific and multidisciplinary management. The objective of this study was to evaluate the frequency of ICDs and the clinical and psychopathological factors associated with the appearance of these disorders. METHODS Cross-sectional, descriptive, and analytical study of a sample of 115 PD patients evaluated to determine the presence of an ICD. Clinical scales were administered to assess disease severity, personality traits, and presence of psychiatric symptoms at the time of evaluation. RESULTS Of the 115 patients with PD, 27 (23.48%) displayed some form of ICD; hypersexuality, exhibited by 14 (12.2%), and binge eating, present in 12 (10.1%), were the most common types. Clinical factors associated with ICD were treatment with dopamine agonists (OR: 13.39), earlier age at disease onset (OR: 0.92), and higher score on the UPDRS-I subscale; psychopathological factors with a significant association were trait anxiety (OR: 1.05) and impulsivity (OR: 1.13). CONCLUSIONS ICDs are frequent in PD, and treatment with dopamine agonists is the most important risk factor for these disorders. High impulsivity and anxiety levels at time of evaluation, and younger age at disease onset, were also linked to increased risk. However, presence of these personality traits prior to evaluation did not increase risk of ICD.
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Affiliation(s)
- N Sáez-Francàs
- Servicio de Psiquiatría, Hospital Sant Rafael, FIDMAG, Hospital Universitari Vall d'Hebron, CIBERSAM. Departamento de Psiquiatría, Universitat Autònoma de Barcelona, Barcelona, España
| | - G Martí Andrés
- Servicio de Neurología, Hospital Universitari Vall d́Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | - N Ramírez
- Servicio de Psiquiatría, Hospital Sant Rafael, FIDMAG, Hospital Universitari Vall d'Hebron, CIBERSAM. Departamento de Psiquiatría, Universitat Autònoma de Barcelona, Barcelona, España
| | - O de Fàbregues
- Servicio de Neurología, Hospital Universitari Vall d́Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | - J Álvarez-Sabín
- Servicio de Neurología, Hospital Universitari Vall d́Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | - M Casas
- Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, CIBERSAM. Departamento de Psiquiatría, Universitat Autònoma de Barcelona, Barcelona, España
| | - J Hernández-Vara
- Servicio de Neurología, Hospital Universitari Vall d́Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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Castro-Marrero J, Cordero MD, Segundo MJ, Sáez-Francàs N, Calvo N, Román-Malo L, Aliste L, Fernández de Sevilla T, Alegre J. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal 2015; 22:679-85. [PMID: 25386668 PMCID: PMC4346380 DOI: 10.1089/ars.2014.6181] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Chronic fatigue syndrome (CFS) is a chronic and extremely debilitating illness characterized by prolonged fatigue and multiple symptoms with unknown cause, diagnostic test, or universally effective treatment. Inflammation, oxidative stress, mitochondrial dysfunction, and CoQ10 deficiency have been well documented in CFS. We conducted an 8-week, randomized, double-blind placebo-controlled trial to evaluate the benefits of oral CoQ10 (200 mg/day) plus NADH (20 mg/day) supplementation on fatigue and biochemical parameters in 73 Spanish CFS patients. This study was registered in ClinicalTrials.gov (NCT02063126). A significant improvement of fatigue showing a reduction in fatigue impact scale total score (p<0.05) was reported in treated group versus placebo. In addition, a recovery of the biochemical parameters was also reported. NAD+/NADH (p<0.001), CoQ10 (p<0.05), ATP (p<0.05), and citrate synthase (p<0.05) were significantly higher, and lipoperoxides (p<0.05) were significantly lower in blood mononuclear cells of the treated group. These observations lead to the hypothesis that the oral CoQ10 plus NADH supplementation could confer potential therapeutic benefits on fatigue and biochemical parameters in CFS. Larger sample trials are warranted to confirm these findings.
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Affiliation(s)
- Jesús Castro-Marrero
- 1 CFS Clinical Unit, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona , Barcelona, Spain
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Calvo N, Sáez-Francàs N, Valero S, Alegre J, Casas M. Comorbid personality disorders in chronic fatigue syndrome patients: a marker of psychopathological severity. Actas Esp Psiquiatr 2015; 43:58-65. [PMID: 25812543] [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: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION This study was designed to evaluate the presence of personality disorders (PDs) in Chronic Fatigue Syndrome (CFS) patients and to determine their influence on the severity of the associated psychopathology. METHODS 132 CFS patients were assessed using SCID-I, Personality Diagnostic Questionnaire-4+ (PDQ-4+) with its Clinical Significance Scale, and Fatigue Impact Scale. The Beck Depression Inventory, Buss-Durkee Hostility Inventory and the State-Trait Anxiety Inventory were also administered. RESULTS 48.5% patients presented PDs, being the most frequent the Obsessive-Compulsive and Avoidant ones. Patients with PDs had more depressive symptoms. Irritability, resentment, suspicion and guilt were the symptoms related with PDQ-4+ total score. CONCLUSIONS According to these results, PDs may be frequent in CFS patients. This comorbidity is associated with a complex clinical profile, secondary to more severe psychiatric symptoms.
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Affiliation(s)
- Natalia Calvo
- Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona Departamento de Psiquiatría y Medicina Legal. Universitat Autònoma de Barcelona
| | - Naia Sáez-Francàs
- Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona Departamento de Psiquiatría y Medicina Legal. Universitat Autònoma de Barcelona
| | - Sergi Valero
- Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona
| | - José Alegre
- Departamento de Medicina Interna. Hospital Universitari Vall d’Hebron. Departamento de Medicina Interna. Universitat Autònoma de Barcelona
| | - Miguel Casas
- Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona Departamento de Psiquiatría y Medicina Legal. Universitat Autònoma de Barcelona
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Sáez-Francàs N, Valero S, Calvo N, Gomà-I-Freixanet M, Alegre J, de Sevilla TF, Casas M. Chronic fatigue syndrome and personality: a case-control study using the Alternative Five Factor Model. Psychiatry Res 2014; 216:373-8. [PMID: 24630915 DOI: 10.1016/j.psychres.2014.02.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 01/08/2013] [Revised: 02/19/2014] [Accepted: 02/22/2014] [Indexed: 01/24/2023]
Abstract
Neuroticism is the personality dimension most frequently associated with chronic fatigue syndrome (CFS). Most studies have also shown that CFS patients are less extraverted than non-CFS patients, but results have been inconsistent, possibly because the facets of the extraversion dimension have not been separately analyzed. This study has the following aims: to assess the personality profile of adults with CFS using the Alternative Five-Factor Model (AFFM), which considers Activity and Sociability as two separate factors of Extraversion, and to test the discriminant validity of a measure of the AFFM, the Zuckerman-Kuhlman Personality Questionnaire, in differentiating CFS subjects from normal-range matched controls. The CFS sample consisted of 132 consecutive patients referred for persistent fatigue or pain to the Department of Medicine of a university hospital. These were compared with 132 matched normal population controls. Significantly lower levels of Activity and significantly higher levels of Neuroticism-Anxiety best discriminated CFS patients from controls. The results are consistent with existing data on the relationship between Neuroticism and CFS, and clarify the relationship between Extraversion and CFS by providing new data on the relationship of Activity to CFS.
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Affiliation(s)
- Naia Sáez-Francàs
- Department of Psychiatry, Hospital Universitari Vall d׳Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
| | - Sergi Valero
- Department of Psychiatry, Hospital Universitari Vall d׳Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain.
| | - Natalia Calvo
- Department of Psychiatry, Hospital Universitari Vall d׳Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
| | - Montserrat Gomà-I-Freixanet
- Department of Health Psychology, Universitat Autònoma de Barcelona, Edifici B, 08193 Bellaterra, Catalonia, Spain.
| | - José Alegre
- Department of Internal Medicine, Hospital Universitari Vall D´Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain.
| | - Tomás Fernández de Sevilla
- Department of Internal Medicine, Hospital Universitari Vall D´Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain.
| | - Miquel Casas
- Department of Psychiatry, Hospital Universitari Vall d׳Hebron, Passeig de la Vall d׳Hebron 119-129, 08035 Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
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Gomà-i-Freixanet M, Sáez-Francàs N, Valero S, Calvo N, Casas M. Personality profile of chronic fatigue syndrome patients and the alternative five factor model. Personality and Individual Differences 2014. [DOI: 10.1016/j.paid.2013.07.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Valero S, Sáez-Francàs N, Calvo N, Alegre J, Casas M. The role of neuroticism, perfectionism and depression in chronic fatigue syndrome. A structural equation modeling approach. Compr Psychiatry 2013; 54:1061-7. [PMID: 23759150 DOI: 10.1016/j.comppsych.2013.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 04/07/2013] [Accepted: 04/17/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Previous studies have reported consistent associations between Neuroticism, maladaptive perfectionism and depression with severity of fatigue in Chronic Fatigue Syndrome (CFS). Depression has been considered a mediator factor between maladaptive perfectionism and fatigue severity, but no studies have explored the role of neuroticism in a comparable theoretical framework. This study aims to examine for the first time, the role of neuroticism, maladaptive perfectionism and depression on the severity of CFS, analyzing several explanation models. METHODS A sample of 229 CFS patients were studied comparing four structural equation models, testing the role of mediation effect of depression severity in the association of Neuroticism and/or Maladaptive perfectionism on fatigue severity. RESULTS The model considering depression severity as mediator factor between Neuroticism and fatigue severity is the only one of the explored models where all the structural modeling indexes have fitted satisfactorily (Chi square=27.01, p=0.079; RMSE=0.047, CFI=0.994; SRMR=0.033). Neuroticism is associated with CFS by the mediation effect of depression severity. This personality variable constitutes a more consistent factor than maladaptive perfectionism in the conceptualization of CFS severity.
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Affiliation(s)
- Sergi Valero
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Catalonia, Spain.
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Sáez-Francàs N, Hernández-Vara J, Corominas Roso M, Alegre Martín J, Casas Brugué M. The association of apathy with central fatigue perception in patients with Parkinson's disease. Behav Neurosci 2013; 127:237-44. [DOI: 10.1037/a0031531] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sáez-Francàs N, Alegre J, Calvo N, Antonio Ramos-Quiroga J, Ruiz E, Hernández-Vara J, Casas M. Attention-deficit hyperactivity disorder in chronic fatigue syndrome patients. Psychiatry Res 2012; 200:748-53. [PMID: 22648008 DOI: 10.1016/j.psychres.2012.04.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [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: 10/17/2011] [Revised: 03/31/2012] [Accepted: 04/24/2012] [Indexed: 12/13/2022]
Abstract
Psychopathological disorders are frequent in chronic fatigue syndrome patients. The present study examines the presence of attention-deficit hyperactivity disorder (ADHD) in a sample of adult chronic fatigue syndrome (CFS) patients, and evaluates its clinical consequences in this population. CFS patients were assessed for childhood and adult ADHD by clinical interview and ADHD-specific scales. Psychopathological comorbidities were evaluated by clinical examination and questionnaires. Forty-seven of 158 CSF patients (29.7%) were diagnosed of childhood ADHD and in 33 (20.9%), the condition persisted into adulthood. CFS patients with adult ADHD had an earlier CSF onset, more severe anxiety and depression symptoms, and a higher risk of suicide than CFS patients without ADHD. Using lineal regression analysis, we found that depressive symptoms and ADHD severity were significant predictors of fatigue intensity. Consequently, ADHD may be common in CFS patients, and is associated with a more severe psychopathologic clinical profile.
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Affiliation(s)
- Naia Sáez-Francàs
- Psychiatry and Legal Medicine Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, CIBERSAM, Barcelona, Spain.
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Ramos-Quiroga JA, Bosch R, Richarte V, Valero S, Gómez-Barros N, Nogueira M, Palomar G, Corrales M, Sáez-Francàs N, Corominas M, Real A, Vidal R, Chalita PJ, Casas M. Criterion and concurrent validity of Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID) Spanish version. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rpsmen.2012.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ramos-Quiroga JA, Bosch R, Richarte V, Valero S, Gómez-Barros N, Nogueira M, Palomar G, Corrales M, Sáez-Francàs N, Corominas M, Real A, Vidal R, Chalita PJ, Casas M. Validez de criterio y concurrente de la versión española de la Conners Adult ADHD Diagnostic Interview for DSM-IV. Revista de Psiquiatría y Salud Mental 2012; 5:229-35. [DOI: 10.1016/j.rpsm.2012.05.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 03/25/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
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Corominas M, Ramos-Quiroga JA, Ferrer M, Sáez-Francàs N, Palomar G, Bosch R, Casas M. Cortisol responses in children and adults with attention deficit hyperactivity disorder (ADHD): a possible marker of inhibition deficits. ACTA ACUST UNITED AC 2012; 4:63-75. [PMID: 22576746 DOI: 10.1007/s12402-012-0075-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 04/24/2012] [Indexed: 11/28/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disease whose neurobiological background is not completely understood. It has been proposed that deficits of the inhibitory function with an underactive behavioral inhibition system (BIS) may be in the core of ADHD. In this regard, this review summarizes all studies that examine the involvement of cortisol in ADHD. Differences in cortisol responses from different ADHD subtypes, hyperactive/impulsive, inattentive, and combined, are analyzed. In addition, we examine the role of comorbidities as confounding factors in the study of cortisol in ADHD, including comorbid disruptive behavioral disorder (DBD), as well as anxiety and depressive disorders. Because ADHD is a neurodevelopmental condition and approximately half of the children enter adulthood with the disorder, we review cortisol studies in adults and children separately. Two diverse patterns of cortisol have been reported both in children and adults with ADHD. Blunted cortisol responses to stress are associated with comorbid DBD, whereas high cortisol responses are associated to comorbid anxiety disorders. Nevertheless, the inhibitory deficits in ADHD do not appear to be related directly to cortisol deficits in either children or adults. This review increases our understanding of the heterogeneity of ADHD and could help in determining new strategies for the treatment of these patients. Future studies including gender and a more systematic methodology to study the cortisol response are needed.
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Affiliation(s)
- M Corominas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron (UAB), Escola d'Infermeria building 5th floor, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain.
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López-Ortiz C, Sáez-Francàs N, Roncero C. [Sleep disorders and restless legs syndrome in an adult with Asperger's disorder, a case report]. Neurologia 2010; 25:393-394. [PMID: 20738960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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López-Ortiz C, Sáez-Francàs N, Roncero C. Sleep disorders and restless legs syndrome in an adult with Asperger's disorder, a case report. Neurología (English Edition) 2010. [DOI: 10.1016/s2173-5808(10)70072-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Roncero C, López-Ortiz C, Barral C, Sáez-Francàs N, Rovira M, Casas M. Tratamiento concomitante de litio y metadona en un paciente bipolar: a propósito de un caso. Adicciones 2009. [DOI: 10.20882/adicciones.244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Roncero C, López-Ortiz C, Barral C, Sáez-Francàs N, Rovira M, Casas M. [Concomitant lithium and methadone treatment in a bipolar patient: a case report]. Adicciones 2009; 21:167-172. [PMID: 19578734] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Dual diagnosis requires complex therapeutic approaches to adapt treatment to the dual nature of the problem. It is important to understand the drug effects and the drug interactions that may be observed during the integral treatment of these pathologies. Given the scarcity of data on the effects of lithium and methadone treatment, the aim of this clinical case report is to explain the interactions produced between methadone and lithium carbonate, in a female patient with medical multi-pathology, opioid-dependent and with comorbid bipolar disorder, who was treated with both drugs. The most common adverse effects for each drug are described. Drug interactions and temporal correspondence of the two drugs, as well as their dosages, are described through review of the retrospective chart and prospective follow-up of the patient. After one year of follow-up the patient had experienced no interactions in the concomitant lithium and methadone treatment. It should be noted that treatment of bipolar patients with dual diagnosis is complex, and should only be carried out by experts.
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Affiliation(s)
- Carlos Roncero
- CAS VAll d'Hebron, Servicio de Psiquiatría del Hospital Universitario Vall d'Hebrón, Barcelona
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