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Penadés R, Almodóvar-Payá C, García-Rizo C, Ruíz V, Catalán R, Valero S, Wykes T, Fatjó-Vilas M, Arias B. Changes in BDNF methylation patterns after cognitive remediation therapy in schizophrenia: A randomized and controlled trial. J Psychiatr Res 2024; 173:166-174. [PMID: 38537483 DOI: 10.1016/j.jpsychires.2024.03.014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
Although cognitive remediation therapy (CRT) produces cognitive benefits in schizophrenia, we do not yet understand whether molecular changes are associated with this cognitive improvement. A gene central to synaptic plasticity, the BDNF, has been proposed as one potential route. This study assesses whether BDNF methylation changes following CRT-produced cognitive improvement are detected. A randomized and controlled trial was performed with two groups (CRT, n = 40; TAU: Treatment as Usual, n = 20) on a sample of participants with schizophrenia. CRT was delivered by trained therapists using a web-based computerized program. Mixed Models, where the interaction of treatment (CRT, TAU) by time (T0: 0 weeks, T1: 16 weeks) was the main effect were used. Then, we tested the association between the treatment and methylation changes in three CpG islands of the BDNF gene. CRT group showed significant improvements in some cognitive domains. Between-groups differential changes in 5 CpG units over time were found, 4 in island 1 (CpG1.2, CpG1.7, CpG1.10, CpG1.17) and 1 in island 3 (CpG3.2). CRT group showed increases in methylation in CpG1.2, CpG1.7 and decreases in pG1.10, CpG1.17, and CpG3.2. Differences in the degree of methylation were associated with changes in Speed of Processing, Working Memory, and Verbal Learning within the CRT group. Those findings provide new data on the relationship between cognitive improvement and changes in peripheral methylation levels of BDNF gene, a key factor involved in neuroplasticity regulation. Trial Registration: NCT04278027.
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Affiliation(s)
- Rafael Penadés
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Barcelona, Spain; Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Carmen Almodóvar-Payá
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Barcelona, Spain; Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Victoria Ruíz
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Barcelona, Spain
| | - Rosa Catalán
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Barcelona, Spain; Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Sergi Valero
- ACE Alzheimer Center Barcelona, Barcelona, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London & Maudsley NHS Foundation Trust, London Hospital, London, United Kingdom
| | - Mar Fatjó-Vilas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Bárbara Arias
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
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Anmella G, Sanabra M, Primé-Tous M, Segú X, Solanes A, Ruíz V, Morilla I, Also Fontanet A, Sant E, Murgui S, Sans-Corrales M, Martínez-Aran A, Fico G, De Prisco M, Oliva V, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Aparicio-Nogué V, Martínez-Cerdá JF, Mas A, Carreras B, Blanch J, Radua J, Fullana MA, Cavero M, Vieta E, Hidalgo-Mazzei D. Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia. Rev Psiquiatr Salud Ment 2022:S1888-9891(22)00137-9. [PMID: 37758595 DOI: 10.1016/j.rpsm.2022.12.001] [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] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/17/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain. METHODS We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription. RESULTS Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD. CONCLUSIONS Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.
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Affiliation(s)
- Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Miriam Sanabra
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Aleix Solanes
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivette Morilla
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonieta Also Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Sandra Murgui
- CAP Comte Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Mireia Sans-Corrales
- CAP Comte Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Anabel Martínez-Aran
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Giovanna Fico
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Michele De Prisco
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Vincenzo Oliva
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Vicenç Aparicio-Nogué
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Ariadna Mas
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Bernat Carreras
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Blanch
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Abi Global Health, Spain; Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Barcelona, Spain; President of the European Association of Psychosomatic Medicine, Spain
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miquel A Fullana
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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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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Anmella G, Primé-Tous M, Segú X, Solanes A, Ruíz V, Martín-Villalba I, Morilla I, Also-Fontanet A, Sant E, Murgui S, Sans-Corrales M, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Martínez-Cerdá JF, Blanch J, Radua J, Fullana MÀ, Cavero M, Vieta E, Hidalgo-Mazzei D. PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols. Rev Psiquiatr Salud Ment (Engl Ed) 2021:S1888-9891(21)00051-3. [PMID: 33933665 DOI: 10.1016/j.rpsm.2021.04.003] [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] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND About 30-50% of Primary Care (PC) users in Spain suffer mental health problems, mostly mild to moderate anxious and depressive symptoms, which account for 2% of Spain's total Gross domestic product and 50% of the costs associated to all mental disorders. Mobile health tools have demonstrated to cost-effectively reduce anxious and depressive symptoms while machine learning (ML) techniques have shown to accurately detect severe cases. The main aim of this project is to develop a comprehensive ML digital support platform (PRESTO) to cost-effectively screen, assess, triage, and provide personalized treatments for anxious and depressive symptoms in PC. METHODS The project will be carried out in 3 complementary phases: First, a ML predictive severity model will be built based on all the cases referred to the PC mental health support programme during the last 5 years in Catalonia. Simultaneously, a smartphone app to monitor and deliver psychological interventions for anxiety and depressive symptoms will be developed and tested in a clinical trial. Finally, the ML models and the app will be integrated in a comprehensive decision-support platform (PRESTO) which will triage and assign to each patient a specific intervention based on individual personal and clinical characteristics. The effectiveness of PRESTO to reduce waiting times in receiving mental healthcare will be tested in a stepped-wedge cluster randomized controlled trial in 5 PC centres. DISCUSSION PRESTO will offer timely and personalized cost-effective mental health treatment to people with mild to moderate anxious and depressive symptoms. This will result in a reduction of the burden of mental health problems in PC and on society as a whole. TRIAL REGISTRATION The project and their clinical trials were registered in Clinical Trials.gov: NCT04559360 (September 2020).
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Affiliation(s)
- Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Aleix Solanes
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Inés Martín-Villalba
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Ivette Morilla
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonieta Also-Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Sandra Murgui
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Mireia Sans-Corrales
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Victor Vicens
- Chief Medical Officer and co-founder of Abi Global Health, Spain
| | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Jordi Blanch
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Chief Medical Officer and co-founder of Abi Global Health, Spain; Director of the Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Spain; President of the European Association of Psychosomatic Medicine, Spain
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miquel-Àngel Fullana
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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5
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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. Spanish validation of the Barcelona TEMPS-A questionnaire in patients with bipolar disorder and general population. J Affect Disord 2019; 249:199-207. [PMID: 30772748 DOI: 10.1016/j.jad.2019.02.037] [Citation(s) in RCA: 9] [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: 11/26/2018] [Revised: 01/16/2019] [Accepted: 02/11/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego (TEMPS-A) is a self-administered questionnaire intended to assess five affective temperaments: depressive, cyclothymic, hyperthymic, irritable and anxious. Our objective was to examine the psychometric properties of the TEMPS-A using a sample comprised by patients with bipolar disorder (BD) and healthy controls (HC) and to determine cut-off scores for each temperament. METHODS Five hundred and ninety-eight individuals (327 BD and 271 HC) completed the TEMPS-A. Cronbach's alpha was used to examine internal consistency reliability. Test-retest reliability and association between different temperamental scales were assessed using Spearman correlation. To confirm factor structure a confirmatory factor analysis (CFA) was carried out. Cut-off scores indicating the presence of dominant temperament were also calculated. RESULTS Internal consistency was optimal for all temperament subscales (α: 0.682- 0.893). The questionnaire demonstrated good test-retest reliability (ρ: 0.594-0.754). The strongest positive associations were found between cyclothymic and anxious and between depressive and anxious temperaments. Hyperthymic and depressive as well as hyperthymic and anxious temperaments showed a strong negative correlation. LIMITATIONS The HC sample was not matched with the BD group. There were some sociodemographic and clinical differences between groups that may impact on the obtained results. A portion of patients with BD was recruited from tertiary centers. CONCLUSIONS The Spanish version of the Barcelona TEMPS-A questionnaire presents a good internal consistency and their results are stable in clinical population. The performance of the Barcelona TEMPS-A is as good as the original scale.
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Affiliation(s)
- Esther Jiménez
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Del Mar Bonnín
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Brisa Solé
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jose Sánchez-Moreno
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Imma Torres
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Estela Salagre
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Cristina Varo
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Victoria Ruíz
- Institut Clínic de Neurociències, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Anna Giménez
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Antoni Benabarre
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Luís Gutiérrez-Rojas
- Psychiatry Service, Hospital Clínico San Cecilio, University of Granada, Granada, Spain
| | - Jorge Cervilla
- Psychiatry Service, Hospital Clínico San Cecilio, University of Granada, Granada, Spain
| | - Pilar 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 Paz 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
| | - Julio 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
| | - Benedikt 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
| | - Anabel Martínez-Arán
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Eduard Vieta
- Bipolar and Depression Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
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6
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Jiménez E, Solé B, Arias B, Mitjans M, Varo C, Reinares M, Bonnín CM, Salagre E, Ruíz V, Torres I, Tomioka Y, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Martínez-Arán A, Torrent C, Vieta E, Benabarre A. Characterizing decision-making and reward processing in bipolar disorder: A cluster analysis. Eur Neuropsychopharmacol 2018; 28:863-874. [PMID: 29807846 DOI: 10.1016/j.euroneuro.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/22/2018] [Accepted: 04/30/2018] [Indexed: 11/25/2022]
Abstract
The presence of abnormalities in emotional decision-making and reward processing among bipolar patients (BP) has been well rehearsed. These disturbances are not limited to acute phases and are common even during remission. In recent years, the existence of discrete cognitive profiles in this psychiatric population has been replicated. However, emotional decision making and reward processing domains have barely been studied. Therefore, our aim was to explore the existence of different profiles on the aforementioned cognitive dimensions in BP. The sample consisted of 126 euthymic BP. Main sociodemographic, clinical, functioning, and neurocognitive variables were gathered. A hierarchical-clustering technique was used to identify discrete neurocognitive profiles based on the performance in the Iowa Gambling Task. Afterward, the resulting clusters were compared using ANOVA or Chi-squared Test, as appropriate. Evidence for the existence of three different profiles was provided. Cluster 1 was mainly characterized by poor decision ability. Cluster 2 presented the lowest sensitivity to punishment. Finally, cluster 3 presented the best decision-making ability and the highest levels of punishment sensitivity. Comparison between the three clusters indicated that cluster 2 was the most functionally impaired group. The poorest outcomes in attention, executive function domains, and social cognition were also observed within the same group. In conclusion, similarly to that observed in "cold cognitive" domains, our results suggest the existence of three discrete cognitive profiles concerning emotional decision making and reward processing. Amongst all the indexes explored, low punishment sensitivity emerge as a potential correlate of poorer cognitive and functional outcomes in bipolar disorder.
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Affiliation(s)
- E Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - M Mitjans
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain; Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - C Varo
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnín
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Salagre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - I Torres
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Y Tomioka
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, 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
| | - P Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, 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
| | - A Martínez-Arán
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - A Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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7
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Penadés R, López-Vílchez I, Catalán R, Arias B, González-Rodríguez A, García-Rizo C, Masana G, Ruíz V, Mezquida G, Bernardo M. BDNF as a marker of response to cognitive remediation in patients with schizophrenia: A randomized and controlled trial. Schizophr Res 2018; 197:458-464. [PMID: 29274733 DOI: 10.1016/j.schres.2017.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 12/01/2017] [Accepted: 12/10/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is considered to be a putative biomarker for cognitive recovery in schizophrenia. However, current evidence is still scarce for pharmacological treatments, and the use of BDNF as a biomarker has only been tested once with cognitive remediation treatment (CRT). METHODS A randomized and controlled trial (NCT02341131) with 70 schizophrenia outpatients and 15 healthy volunteers was conducted. The participants with schizophrenia were randomly assigned to either CRT or the control group. All the participants were assessed in terms of cognition, quality of life, and their serum BDNF levels at both baseline and after the intervention. Additionally, comparisons of the effects of the different genotypes of the Val66Met polymorphism at the BDNF gene on the outcome variables were also performed. RESULTS The patients in the CRT group presented with improvements in both cognition and quality of life. However, no significant changes were detected in the serum levels of BDNF. Interestingly, we found a significant positive interaction effect between the serum BDNF levels and the different BDNF genotypes. The Val/Val group showed significantly higher serum levels after the CRT treatment. However, the interaction among the serum BDNF levels, the BDNF genotypes and the treatment condition was not statistically significant. CONCLUSIONS The replication of the previous finding of increased serum BDNF levels after cognitive remediation in clinically stable individuals with schizophrenia was not achieved. However, our data indicated that genetic variability may be mediating serum BDNF activity in the context of CRT.
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Affiliation(s)
- Rafael Penadés
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain.
| | - Irene López-Vílchez
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Hemotherapy and Hemostasis, Centre for Biomedical Diagnosis (CDB), Hospital Clínic, Barcelona, Spain
| | - Rosa Catalán
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Bárbara Arias
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Anthropology, Faculty of Biology and Biomedicine Institute, University of Barcelona, Spain
| | - Alexandre González-Rodríguez
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Clemente García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Guillem Masana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Victoria Ruíz
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
| | - Miquel Bernardo
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clinic, Barcelona, Spain
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8
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Jiménez E, Solé B, Arias B, Mitjans M, Varo C, Reinares M, Bonnín CDM, Ruíz V, Saiz PA, García-Portilla MP, Burón P, Bobes J, Amann BL, Martínez-Arán A, Torrent C, Vieta E, Benabarre A. Impact of childhood trauma on cognitive profile in bipolar disorder. Bipolar Disord 2017; 19:363-374. [PMID: 28691361 DOI: 10.1111/bdi.12514] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/31/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Bipolar Disorder (BD) is associated with cognitive impairment even during remission periods. Nonetheless, this impairment seems to adjust to different profiles of severity. Our aim was to examine the potential impact of childhood trauma (CT) on cognitive performance and, more specifically, on neurocognitive profile membership. METHODS Using a data-driven strategy, 113 euthymic bipolar patients were grouped according to their cognitive performance using a hierarchical clustering technique. Patients from the three resulting clusters, the so-called "low", "average", and "high performance" groups, were then compared in terms of main sociodemographic, clinical and functioning variables, including CT measures. One-way ANOVA, a chi-square test and partial correlations were used for this purpose, as appropriate. A multinomial logistic regression model was used to determine which variables contributed to neurocognitive clustering membership. RESULTS Patients from the three neurocognitive clusters differed in terms of sociodemographic, clinical, functioning and CT variables. Scores on the Childhood Trauma Questionnaire (CTQ), especially on the physical negligence subscale, were also associated with a poor cognitive performance. The multinomial regression model indicated that CTQ total scores and the estimated intelligence quotient (IQ) significantly contributed to differentiation among the three neurocognitive groups. CONCLUSIONS Our results confirmed that CT significantly impacts on cognitive performance during adulthood in BD. The data obtained suggest that a history of CT could act as a liability marker for cognitive impairment. A higher estimated IQ may act as a protective factor against cognitive decline in this group of patients.
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Affiliation(s)
- Esther Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Brisa Solé
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Bárbara Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - Marina Mitjans
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain.,Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Cristina Varo
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Del Mar Bonnín
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Victoria Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Pilar Alejandra Saiz
- 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 Paz 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
| | - Patricia Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain
| | - Julio 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
| | - Benedikt 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
| | - Anabel Martínez-Arán
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Antoni Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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9
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Jiménez E, Arias B, Mitjans M, Goikolea JM, Ruíz V, Brat M, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Oquendo MA, Vieta E, Benabarre A. Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder. Acta Psychiatr Scand 2016; 133:266-76. [PMID: 26726104 DOI: 10.1111/acps.12548] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our aim was to analyse sociodemographic and clinical differences between non-suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia-Suicide Severity Rating Scale (C-SRSS) criteria. Secondarily, we also investigated whether the C-SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB). METHOD A total of 215 euthymic bipolar out-patients were recruited. Semistructured interviews including the C-SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C-SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: 'patients with history of SI' and 'patients with history of SI and SB' according to whether they did or did not have a past actual suicide attempt respectively. RESULTS Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile. CONCLUSION Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.
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Affiliation(s)
- E Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Arias
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - M Mitjans
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - J M Goikolea
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - M Brat
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, 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
| | - P Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, 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
| | - M A Oquendo
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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10
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Jiménez E, Arias B, Mitjans M, Goikolea JM, Roda E, Ruíz V, Pérez A, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Vieta E, Benabarre A. Association between GSK3β gene and increased impulsivity in bipolar disorder. Eur Neuropsychopharmacol 2014; 24:510-8. [PMID: 24486183 DOI: 10.1016/j.euroneuro.2014.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/20/2013] [Accepted: 01/11/2014] [Indexed: 11/19/2022]
Abstract
Bipolar patients present increased levels of impulsivity even during remission periods. It is known that this dimensional trait negatively impacts on the course of illness and worsens their prognosis and outcome. Evidence from both basic and clinical researches supports that Lithium (Li) may decrease impulsivity. Owing to the fact that Li inhibits both glycogen synthetase kinase-3 (GSK3) isoenzimes, our aim was to analyze the potential impact of genetic variants located at the GSK3 α and β genes on impulsivity levels in a bipolar sample. Our sample consisted of 199 unrelated Caucasian bipolar outpatients who were recruited from the Bipolar Disorder Unit of the Hospital Clinic of Barcelona and from primary care settings from Oviedo. Four polymorphisms at the GSK3 α and β genes were genotyped in order to analyze the impact of genetic variability on impulsivity as measured by the BIS-11 scale. Single SNP analysis showed that patients carrying T and G alleles at the rs1732170-GSK3β and the rs334558-GSK3β, respectively, presented increased levels of attentional impulsivity compared to non-carriers. These results were also confirmed by haplotype analysis. Our results suggest that genetic variability at GSK3β gene is associated to increased impulsivity in bipolar patients.
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Affiliation(s)
- Esther Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Bárbara Arias
- Department of Animal Biology, Anthropology Section, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - Marina Mitjans
- Department of Animal Biology, Anthropology Section, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - Jose M Goikolea
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Esther Roda
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Victoria Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Ana Pérez
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Pilar 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 Paz 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
| | - Patricia Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain
| | - Julio 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
| | - Eduard Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Antoni Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Paéz A, Ruíz V, Ramírez T, Massó F, Salmón LE, Montaño LF. Transplacental IgG anti-Haemophilus influenzae type b transfer in Mexican mothers of a low socioeconomic level. J Infect Dis 1996; 173:1047-8. [PMID: 8603952 DOI: 10.1093/infdis/173.4.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Bissell RA, Pretto E, Angus DC, Shen B, Ruíz V, Ceciliano N, Sawyers R, Shurtleff D, Abrams J. Post-preparedness medical disaster response in Costa Rica. Prehosp Disaster Med 1994; 9:96-106. [PMID: 10155509 DOI: 10.1017/s1049023x00040991] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The 1991 earthquake in the Limón area of Costa Rica presented the opportunity to examine the effectiveness of a decade of disaster preparedness. HYPOTHESIS Costa Rica's concentrated work in disaster preparedness would result in significantly better management of the disaster response than was evident in earlier disasters in Guatemala and Nicaragua, where disaster preparedness largely was absent. METHODS Structured interviews with disaster responders in and outside of government, and with victims and victims' neighbors. Clinical and epidemiologic data were collected through provider agencies and the coroner's office. RESULTS Medical aspects of the disaster response were effective and well-managed through a network of clinic-based radio communications. Nonmedical aspects showed confusion resulting from: 1) poor government understanding of the roles and responsibilities of the central disaster coordinating agency; and 2) poor extension of disaster preparedness activities to the rural area that was affected by the earthquake. CONCLUSION To be effective, disaster preparedness activities need to include all levels of government and rural, as well as urban, populations.
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Affiliation(s)
- R A Bissell
- University of Maryland, National Study Center for Trauma and EMS 21201-1023, USA
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