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Brain-derived neurotrophic factor (BDNF) is involved in neurogenesis and in the protection against oxidative damage and neuronal apoptosis. After exercise, there is an increased expression of this myokine, especially in skeletal muscle and brain. Low BDNF levels have been described in neurodegenerative diseases. Alcoholics show both muscle atrophy and brain atrophy. Thus, this study was performed in order to analyze serum BDNF levels among alcoholics and their associations with brain atrophy and muscle strength.
Serum BDNF values were determined to 82 male alcoholics and 27 age-matched controls, and compared with handgrip strength, with the presence of brain atrophy, assessed by computed tomography, and with the intensity of alcoholism and liver function derangement.
BDNF levels and handgrip strength were significantly lower among patients. Handgrip strength was correlated with BDNF values, both in the whole population and in alcoholics, especially in patients over 59 years of age. BDNF was poorly related to liver dysfunction but showed no relationship with brain atrophy or age.
Chronic alcoholics show decreased BDNF serum levels that are related to muscle function impairment rather than to age, brain atrophy, liver dysfunction, or the amount of ethanol consumed.
The following commentary on Jang and Choi’s chapter Issues and New Directions in Personality Disorder (PD) Genetics (This Volume) echoes their call to harness advances in PD assessment rather than rely on politically derived "top down" nosologies. We first discuss how recent work in the joint hierarchical structure of PD traits and psychopathology, as well as, personality dynamics (i.e., how personality manifests in different situations) likely offer fruitful avenues for exploring the more nuanced role of genetics in the development and maintenance of PD. Second, we highlight the need to better understand the role of environment in PD genetics and discuss emerging models (e.g., common pathway model). Third, we stress the need for more research and larger samples in order to arrive at stronger conclusions. Fourth, we consider how advances in gene-environment research can help to determine targets for PD prevention and treatment.
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Depersonalization (DP) is a common and complex clinical phenomenon in neurology and psychiatry. It is defined as an experience in which the individual feels a sense of unreality and detachment from him/herself. Prevalence and clinical correlates of dissociative symptoms in general, and DP in particular have been associated to panic disorder (Hunter et al., 2004). Moreover, DP has been associated with certain personality traits, specifically “harm-avoidant” temperament dimension, immature defenses, and overconnection and disconnection cognitive schemata (Simeon et al., 2002).
To investigate the prevalence of DP syndrome in panic disorder and its relationship with personality.
One-hundred-four consecutive adult patients with panic disorder were assessed with the Semi- Structured Clinical Interview for DSM-IV-Axis I and II. All participants were evaluated with the Cambridge Depersonalization Scale (Sierra and Berrios, 2000) and the Cloninger Temperament and Character Inventory. The severity of panic disorder was measured with the Panic and Agoraphobia Scale.
Seventeen patients (16.3%) had a DP syndrome. There were not socio-demographic differences between both groups with and without DP syndrome. Patients with DP syndrome showed a higher score in “self-transcendence” character dimension (p< .001), higher prevalence of personality disorders (p=.007) and greater severity of panic disorder (p=.007). A logistic regression analysis showed that severity of panic disorder (p=.031) and higher “self-transcendence” personality dimension (p=.019) predicts DP syndrome in panic disorder patients. The Hosmer-Lemeshow test showed the goodness-of-fit of the model.
The study confirms the association of DP syndrome with panic disorder and their relationship with “self-transcendence” personality dimension.
Interest in the premorbid personality of schizophrenic patients is well established in the psychiatric literature. The relationship between personality disorders and acute phase proteins (APP) in schizophrenia is not well known.
Investigating the relationship among acute phase proteins and personality disorders in schizophrenic patients in a sample of adult schizophrenic patients under psychiatric treatment in a general hospital health setting.
Material and Methods:
37 adult paranoid schizophrenics undergoing treatment in the University Hospital of the Canary Islands with DSM-IV diagnosis of paranoid schizophrenia are included. Years from onset 9.20 s.d. 6.29, age at onset 19.75 s.d. 4.73. The record of personality disorders as a secondary diagnosis in the medical chart was taking into account. A blood sample as routine standard analysis was carried out in each patient.
In 21 patients (56.7%) a personality disorder, mainly with paranoid and schizotypal traits, was registered. The percentage of each personality disorder is as follows, Schizotypal (16.2%), Paranoid (13.5%), Schizoid (2.7%), Paranoid and Schizotypal (24.3%). The results point to no significant correlation according to APP (C3, C4, alpha2-macroglobulin, alpha1-glicoprotein, ceruloplasmin) in the different diagnostic groups.
Discussion and conclusions:
In our study there is no evidence to support a significant correlation among APP and the different personality disorders in our sample of schizophrenics in spite of a positive correlation of APP and some psychopathology dimensions that has been communicated earlier elsewhere. In order to set some possible specificity of acute phase proteins and other clinical features in schizophrenia further research is required.
Pregnancy and postpartum both imply high risk for developing psychiatric disorders in women.
To study the relationship between life events (LE) and social support degree (SS) during pregnancy and depressive symptoms in early postpartum period.
A cross-sectional study of 309 consecutive Spanish women, evaluated the second day postpartum. They were all over 18 years old and have signed the informed consent. We excluded: illiteracy, cognitive impairment or severe medical illness, psychiatric disorders during pregnancy and decease of the newborn. We collected socio-demographic and obstetrical data, as well as family and personal psychiatric history, the Edinburgh Postnatal Depression Scale (EPDS), LE (Saint Paul Ramsey) and SS (DUKE-UNK).
Mean age (SD) was 31.6 (4.7). Most of women were married, had intermediated or high level of education. Sixty-one percent were primiparous. Twenty-six percent had family history and 22% had personal psychiatric history. Mean (SD) of LE was 0.95 (0.89) and of SS was 53.1 (7.6). The prevalence of depressive symptoms according to EPDS scores was 18%. This subgroup of depressed women had more psychiatric family history (p=0.046), less LE (p< 0.001) and more SS during pregnancy (p=0.048). Logistic regression analysis showed that SS was the only significant variable (OR=1.085; 95%CI=0.997-0.994; p=0.001). LE did not achieve statistical significance (OR=1.085; 95%CI=0.997-1.180; p=0.059).
Low social support degree during pregnancy is associated with depressive symptoms during immediate postpartum.
This study has been done in part with grants Instituto Carlos III: G03/184, FIS: PI04178; 05/2565.
To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers
Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.
Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression.
Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.
There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver’ws work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.
Social isolation is a factor associated to mortality and morbidity in general population.
This symptom has been considered as prodrome in ‘high-risk mental states’ for a possible development of psychosis. Social isolation is a frequent problem in psychotic patients visited by mobile crisis unit (EMSE).
To describe the differences between psychotic patients with social isolation with patients without it.
A descriptive observational and cross-linked study in patients with diagnostic of psychotic disorder visited by EMSE from 2004 to 2010. The sample was divided in two groups; present and absence of social isolation as the main problem. We evaluated demographic and clinical variables including the aggressive behaviour and violence scale (AVAT) and positive and negative syndrome scale (PANSS).
N: 662 subjects (61.3% men; mean age 44+-16 years) with psychotic disorder. 15.1% present social isolation like the main problem against 84.9% who present others main problems: delusion/hallucination (44.7%), behaviour disturbance (18.1%) and agitation/aggressivity (14%).
Patients with social isolation are mostly men (72%, p < 0.05), live with family (79.4%, p < 0.05), are less aggressive (AVAT 2.77 p < 0.05) than psychotic patients that are not isolated. The punctuation in subscale negative syndrome of PANSS is higher (26.19 versus 20.25, p0.001).
This study concludes that patients with psychotic disorder and social isolation are mainly men and they have less aggressivity and predominantly negative syndrome. These results are important to improve the multidisciplinary therapeutic approach.
Fibromyalgia and ADHD share some clinical features, and a reduced dopamine function has been proposed for both disorders. Here we found, in a large sample of fibromyalgia female patients, a higher frequency of childhood ADHD antecedent when compared with healthy women. Our data suggest that Fibromyalgia and ADHD have some common etiopathological mechanism.
Dhat syndrome is a widely recognized clinical condition from the Indian subcontinent characterized by a preoccupation with semen loss in urine and other symptoms such as fatigue or depressed mood. This condition has been considered to be a culture-bound syndrome, and may be considered to be a culturally manifestation of depression or anxiety.
The purpose of this paper was to perform a systematic review of published literature on Dhat syndrome.
A review of the literature on Dhat syndrome until July 2008, without any language restriction was conducted by a search of the MEDLINE and PsycLIT indexing services using the following key words:Dhat syndrome, semen loss anxiety and loss of semen syndrome. Inclusion criteria were any case-control or cross-over study.
Twenty-three studies were identified, of which 10 met the inclusion criteria. There were 8 cross-over and 2 case-control studies. The reviewed studies included a total number of 680 cases and 93 controls. Patients included in these studies were mostly unmarried, young males (25.4 years old;18-45 years) from a poor socio-economic status. Majority of the studies involved patients from the Indian subcontinent. Some studies reported concomitant depressive symptoms (50%), anxiety (40%), fatigue (30%) and sexual problems (40%). Only 4 studies reported information about treatment (psychotherapy and pharmacotherapy).
There was a high degree of heterogeneity among the studies reviewed. In conclusion, Dhat syndrome appears to be commonly associated with depression, anxiety and somatic symptoms. More studies are warranted related to the various treatment approaches for this condition.
To assess antipsychotic medication in the treatment of schizophrenia, based on trial drop-out rates.
The studies included were randomised controlled trials that compared any of the four clinically best-established atypical antipsychotics (quetiapine, olanzapine, risperidone or clozapine) against either of two typical antipsychotics regarded as the gold standard (haloperidol or chlorpromazine).
Meta-analysis indicated less risk of all-cause patient withdrawal from atypical medication trials where dosage was flexible, in both the short, relative risk (RR) 0.70 (95% CI 0.64–0.76), P < 0.00001, and long term, RR 0.72 (0.65–0.80), P < 0.00001. Similar results were observed for withdrawal due to adverse events, RR: 0.54 (0.41–0.72), P < 0.0001. Nevertheless, the favourable effects of atypical medication disappeared in trials relying on fixed dosage.
We detected a significant positive effect in terms of the outcome of treatment discontinuation for atypical versus typical medication, though only where the use of flexible rather than fixed doses (closer to an experimental control situation) was possible.
Terms such as mark, affront or bad name are usually employed in habitual dictionaries to describe the concept of stigma. Related to the area of mental health, this concept includes also the presence of false myths and negative evaluations towards the mental patient. The consecuence of that are prejudiced behaviours that demage the life of the stigmatized patient. Due to the significant repercussion of this fact, evaluate the level of mental stigmatization become fundamental.
To evaluate the presence of behavioural discrimination among the general public from Madrid city against people with mental health problems.
Material and Methods
This RIBS scale (Reported and Intended Behaviour Scale) was used to evaluate the previously cited discrimination. Different sociodemographic variables were also included to be able to establish the possible Association between them and the scale reults. 100 participants from general population from Madrid completed this questionnaire. A descriptive and analytical analysis were carried out using the statistics programme spss v. 21.
Results and Conclusions
In line with the results from previous studies, this analysis shows a high rate of behavioural discrimination against people with mental health problems. This situation may be a negative condition to the access of mental patients to mental health services. Besides, it may affect in a deleterious way to many others vital areas of the patient. Theese results reinforce the need of encourage anti-stigma programmes.
Sexuality and emotional life are rarely focus on attention in people suffering from severe long-term mental diseases like schizophrenia and bipolar disorder.
53 patients and 47 matched controls were studied using a new questionnaire (SEXSAM Scale) measuring relevance of sexual and emotional relationships in patients’ daily life. A specific Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SALSEX Montejo 2001-2008), Sexual Activity Assessment Scale modified from Kinsey (Montejo 2006) and the HONOS Scale measuring bio-psychosocial functioning were also applied.
Sexuality (physic and emotional) was scored as high valuable and the main motivation for sexual activity was looking for love and fondness in both groups. No differences were found in the value of more affective behaviours such as kissing, caressing, hugging or massaging. Global satisfaction in sexual and emotional life was significantly superior in control group and linked to the higher frequency of sexual relations. Many patients suffered for sexual dysfunction related to the treatment use and many of then were dissatisfied with their sexual life. Just a few numbers of patients had regular sexual intercourses. Patients describe an improvement in the self-perception of mood, appetite, sleep, anxiety level, humour sense and self-esteem when they have sexual relations. Predominant sexual activity for patients was masturbation. Prostitution use was higher in patient group. All these findings are negatively influencing personal satisfaction and quality of life.
Relevance of sexual and emotional life in patients is as high as in normal population. These patients are more concerned about affection and companionship than about physical pleasure.
There is a lack of accurate screening tools for suicide risk in the patients presenting to emergency departments. The Personality and Life Event (PLE) Scale, a set of the 27 most discriminative items from a collection of questionnaires usually employed in the assessment of suicidal behavior, demostrated an elevated accuracy, sensibility, and specificity in classifying suicide attempters.
To validate the self-administered PLE Scale.
Material and methods:
In order to examine its psychometric properties, the PLE scale was administered to 59 suicide attempters, 48 psychiatric controls, and 69 medical patients attending the Puerta de Hierro emergency department. To examine its reliability, we used: 1) Cronbach's coefficient α to evaluate the internal consistency; 2) test-retest reliability to assess if the scale is stable over time. Interrater reliability is not relevant as the PLE is a self-report. To assess its construct validity, we used some of Beck's Suicide Intent Scale (SIS). All analyses were carried out using SPSS v.20 (Macintosh).
The most frequent criteria for suicide attempters were item 4 (‘I often feel empty inside’; 88.1%) and 20 (‘I act on impulse’; 79,7%). Mean (± SD) of the PLE Scale in suicide attempters, psychiatric controls, and medical controls was 74.49 (± 32.44), 57.19 (± 29.63), and 17.48 (± 21.15), respectively. The PLE had an acceptable internal consistency (Cronbach's alpha =0,674).
Our preliminary findings support the reliability, construct validity, and ussefulness of the PLE to identify suicide attempters to those attending to emergency departments.
There is an increasing demand for treatment for dependence on different psychiatric medication like benzodiazepines. The goal is to determine the user's profile that is attended in a mental health center.
We obtained a sample of 30 users, divided into two groups: A) main drug benzodiazepines, B) primary drug others.
Sociodemographic, psychiatric and drug use variables are collected, making a descriptive retrospective analysis, using means for quantitative variables and proportions for categorical variables.
Group A is composed mainly of women (63.6%) of average age 46 years, and the group B of males (75%) with slightly higher average age (48 years). In group A and B the average level of education is primary/secondary education. Overall, they do not work and are single, having more pensioners and separated in group B.
In both groups, more than half have a history of affective disorders, often followed by anxiety disorders, with higher prevalence in group A (54.6% vs 36.8%), and personality disorders (77.3% and 75%).
In reference to group B, the primary drug of abuse is mostly alcohol. In general there is higher prevalence of nicotine dependence.
The profile of group A is a middle-aged woman who presents comorbidity with affective and personality disorders. The profile of group B is a middle-aged man, alcohol dependent, with earlier onset of use and with personality disorder.
Cognitive deficits are known to be present in psychotic patients even before psychosis has been diagnosed. Those deficits show poor response to antipsychotics and seem to be responssible of functional impairment.
Several trials point out cognitive remediation interventions may improve these neuropsychological deficits and therefore functioning.
Our aim is to evaluate if a computerized cognitive remediation program (Rehacom®) improves cognition, and therefore insight, functioning and quality of life in early stages of psychosis.
A randomized open label prospective study comparing 21 first psychotic outpatients doing RehaCom with 21 first psychotic patients doing non specific computer work. All 42 patients have done 24 one hour sessions, twice a week during 12 consecutive weeks. The trial was conducted between january 1st and december 31st, 2013. All patients were evaluated using the Matrics Cognitive Consensus Battery (MCCB), the Scale Unawarness of Mental Disorders (SUMD), the Global Assessment of Functioning (GAF) and the Quality of Life Scale (QLS) at basal time, 6 and 12 months later.
Basal differences between groups were analized using Chi2 and U-Man Whitney. STATA v.11 was used for the analysis.
MCCB total score were 32, 34 and 38 at basal time, midtime and endpoint. All patients show neuropsicological improvement after a year but no statistical differences were found between groups. Education was associated with better scores after cognitive remediation, The RehaCom group did show better scores in insight (p<0.041) but not in functioning or quality of life.
Substance-dependent patients(SDP) have more personality disorders(PD) than general population; and they present more frequent and severe levels of depression and anxiety.
To study cluster C personality disorders in SDP.
We included a clinical sample of 822(621 males) SDP according to the DSM-IV-TR criteria seeking treatment in the Outpatient Drug Clinic Vall d’Hebron in Barcelona, Spain.
The assessment process consisted of three interview sessions conducted by trained psychiatrists and psychologists using SCID I and II, BDI, STAI-R/S. Exclusion criteria were:intoxication at baseline examination, severe somatic disease at baseline examination and low language proficiency.
39.2% of the sample presented at least one PD and 9.55% presented a cluster C PD. Of them the found prevalence were Avoidant(44.9%), Dependt(11.5%), Obssessive-compulsive(37.2%), comorbidity (6.4%). The addiction prevalences that Cluster C PD patients show were: dependent of alcohol 9.4%, benzodiazepines 18.5%, opioids 6.1%, cocaine 9.7 and cannabis 12.3%.
70.5% of the PD cluster C group were men, however differences according to the cluster C PD were found, being higher the proportion of men in Obsessive-compulsive PD (85.7%) and fewer in Dependent PD patients (33.7%)(χ2 =12.19, p = .007).
Cluster C PD patients presented more depressive symptoms and showed higher scores in anxiety-trait than patient with Cluster A or B PD, being this difference statistically significant.
There is a high rate of cluster C personality disorders among addicted patients. Higher levels of anxiety depression are detected in these patients. Clinicians should be check systematically this symptoms and traits in addicted patients.
Although asthma has been one of the most investigated topics in psychosomatics, studies and papers on psychopathology in asthma are fairly scarce and of diverse meaning. Furthermore, psychopathology acoording to sex in asthma is not a common research topic.
Aim This study aims at analyzing psychopathology sex differences in asthmatics.
The psychopathology profile in a sample of 84 adult asthmatics in a hospital outpatient facility, mean age 34.62 (s.d.12.78), 36 male / 48 female, is studied. The Symptom Checklist-90-R (SCL-90-R) Self-Report Questionnaire was administered.
The symptomatic profile is characterized by higher scores in women, with a main elevation in the dimensions of Somatization (1.92), Depression (1.66), Obsession-Compulsion (1.62) and Anxiety (1.44) whereas lower scores are recorded in men, with a profile dominated by Hostility (1.70), Anxiety (1.68), Interpersonal Sensitivity (1.58) and Depression (1.44). These scores mainly contribute to the psychopathology pattern according to sex.
The possible clinical implications of the observed psychopathology sex differences should be taken into account in the management of these patients.