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A research initiative was launched during the initial coronavirus disease (COVID-19) outbreak by 3 New York metropolitan area institutions. Collaborators recruited community members and patients from previous research studies to examine COVID-19 experiences and mental health symptoms through self-report surveys. The current report descriptively presents findings from the initial survey characterized by both community and clinical cohorts, and discusses challenges encountered with rapid implementation. The clinical cohort exhibited higher rates of symptoms of mental health difficulties (depression, anxiety, and posttraumatic stress disorder [PTSD]) as compared to the community cohort. COVID-19 positivity rates were similar among both groups and lower than the national average. While both groups reported low rates of job loss, community members reported higher rates of financial difficulty resulting from the pandemic. Findings indicate the need for further collaborative research on the mental health impact of COVID-19.
Documenting neotectonic instabilities and determining the style and time of deformation in the vast and difficult to access central Amazonia region is challenging. We focus on these issues by investigating a large area of the Negro River drainage basin, applying morphostructural analysis based on synthetic aperture radar data. The digital elevation models of the C-band Shuttle Radar Topography Mission and the L-band Protection System of Amazonia were used as the database. We also used subsurface magnetic information from the Earth Magnetic Anomaly Grid global model to validate the morphostructures. The results revealed NW-oriented morphostructural lineaments bounding multiple depositional valley fills. These were extensively fragmented to form regularly distributed en échelon rectangular blocks commonly offset horizontally by several kilometers. Strike-slip faults and oblique, either normal or reverse, faults are present. These structures were reactivated along the main NE- and SW-oriented regional structural trends due to N-S-oriented horizontal compression and E-W-oriented horizontal extension in the late Pleistocene and Holocene. The extensive neotectonic faulting results from the interplay of plate motion and Andean uplifting since the late Pleistocene, combined with local stresses.
ABSTRACT IMPACT: The proposed research study will provide critical pilot data on the effect of using the prebiotic (HAMS-AB) on the gut microbiome profile, Beta-cell function and immune markers in humans with T1D. OBJECTIVES/GOALS: The overall objective of this study is to assess how the prebiotic high amylose maize starch that has been acetylated and butyrylated (HAMS-AB) impacts the gut microbiome profile, short chain fatty acid (SCFA) production, glycemia, Beta-cell function/health and immune responses in newly diagnosed youth with type 1 diabetes (T1D). METHODS/STUDY POPULATION: We are performing a pilot randomized cross-over trial. We plan to recruit 12 newly-diagnosed T1D youth with residual Beta-cell function between 12-16 years of age. We will profile the gut microbiome using metagenomics, measure stool SCFA levels using mass spectrometry, assess glycemia using continuous glucose monitoring, assess insulin production using mixed meal tolerance testing, assess Beta-cell stress using proinsulin/C-peptide levels, and test immune responses by examining cytokine levels and frequency, phenotype and function of T cell markers in peripheral blood. RESULTS/ANTICIPATED RESULTS: Thus far, we have enrolled 3 participants, 1 has completed the study. Baseline assessments indicate that we have technical feasibility of performing the above studies and measurements. Recruitment and enrollment are ongoing. We hypothesize that the use of HAMS-AB in newly diagnosed youth with T1D will (i) improve the gut microbiome profile, (ii) increase SCFA production, (iii) improve overall glycemia and Beta-cell function and (iv) modulate the immune system and mitigate autoimmunity. DISCUSSION/SIGNIFICANCE OF FINDINGS: Given the failure to develop a cure for T1D despite multiple completed intervention studies and the unknown long-term effects of immune-modulatory therapy on those at risk for or those diagnosed with T1D, prebiotics such as HAMS-AB may offer a simple, safe, yet inexpensive and tolerated dietary alternative approach to mitigating disease.
This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention.
A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group—studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)—or to the active control group, who followed the 5 A’s intervention.
The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group.
In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A’s intervention.
To use Internet search data to compare duration of compliance for various diets.
Using a passive surveillance digital epidemiological approach, we estimated the average duration of diet compliance by examining monthly Internet searches for recipes related to popular diets. We fit a mathematical model to these data to estimate the time spent on a diet by new January dieters (NJD) and to estimate the percentage of dieters dropping out during the American winter holiday season between Thanksgiving and the end of December.
Internet searches in the USA for recipes related to popular diets over a 15-year period from 2004 to 2019.
Individuals in the USA performing Internet searches for recipes related to popular diets.
All diets exhibited significant seasonality in recipe-related Internet searches, with sharp spikes every January followed by a decline in the number of searches and a further decline in the winter holiday season. The Paleo diet had the longest average compliance times among NJD (5.32 ± 0.68 weeks) and the lowest dropout during the winter holiday season (only 14 ± 3 % dropping out in December). The South Beach diet had the shortest compliance time among NJD (3.12 ± 0.64 weeks) and the highest dropout during the holiday season (33 ± 7 % dropping out in December).
The current study is the first of its kind to use passive surveillance data to compare the duration of adherence with different diets and underscores the potential usefulness of digital epidemiological approaches to understanding health behaviours.
Methane (CH4) is a greenhouse gas (GHG) produced and released by eructation to the atmosphere in large volumes by ruminants. Enteric CH4 contributes significantly to global GHG emissions arising from animal agriculture. It has been contended that tropical grasses produce higher emissions of enteric CH4 than temperate grasses, when they are fed to ruminants. A number of experiments have been performed in respiration chambers and head-boxes to assess the enteric CH4 mitigation potential of foliage and pods of tropical plants, as well as nitrates (NO3−) and vegetable oils in practical rations for cattle. On the basis of individual determinations of enteric CH4 carried out in respiration chambers, the average CH4 yield for cattle fed low-quality tropical grasses (>70% ration DM) was 17.0 g CH4/kg DM intake. Results showed that when foliage and ground pods of tropical trees and shrubs were incorporated in cattle rations, methane yield (g CH4/kg DM intake) was decreased by 10% to 25%, depending on plant species and level of intake of the ration. Incorporation of nitrates and vegetable oils in the ration decreased enteric CH4 yield by ∼6% to ∼20%, respectively. Condensed tannins, saponins and starch contained in foliages, pods and seeds of tropical trees and shrubs, as well as nitrates and vegetable oils, can be fed to cattle to mitigate enteric CH4 emissions under smallholder conditions. Strategies for enteric CH4 mitigation in cattle grazing low-quality tropical forages can effectively increase productivity while decreasing enteric CH4 emissions in absolute terms and per unit of product (e.g. meat, milk), thus reducing the contribution of ruminants to GHG emissions and therefore to climate change.
OBJECTIVES/GOALS: Type 1 diabetes (T1D) results from the autoimmune destruction of insulin-producing β-cells. Emerging data suggest that differences in intestinal microbiota might be critically involved both in autoimmunity and in glucose homeostasis. The prebiotic high amylose maize starch (HAMS) alters the gut microbiome profile and metabolites positively by increasing production of beneficial short chain fatty acids (SCFAs) that have significant anti-inflammatory effects. HAMS also improves glycemia, insulin sensitivity and secretion in healthy non-diabetic adults. Further, an acetylated and butyrylated form of HAMS (HAMS-AB) that increases beneficial SCFA production, namely acetate and butyrate, has been safe and effective in disease prevention in mouse T1D models. The objective of the proposed study is to assess the effect of administering a prebiotic, such as HAMS-AB, on the gut microbiome profile, SCFA production, glycemia and β-cell function in humans with T1D. METHODS/STUDY POPULATION: We hypothesize that administration of HAMS-AB will (i) improve the gut microbiome profile in humans with T1D, (ii) increase SCFA production, and (iii) improve β-cell health, β-cell function and overall glycemia. We propose a pilot randomized controlled cross-over trial of HAMS-AB in 12 youth with newly-diagnosed T1D. We will use state-of-the-art markers to profile the gut microbiome (using 16S rRNA sequencing), measure stool SCFA levels (using gas chromatography), asses β-cell stress/death (by measuring proinsulin to C-peptide ratios) and glycemia (assessed by continuous glucose monitoring and HbA1c measurements). RESULTS/ANTICIPATED RESULTS: We expect that the use of HAMS-AB in newly diagnosed youth with type 1 diabetes will alter the gut microbiome profile (thus increasing the number of fermenters and SCFA levels), β-cell function and glycemia in humans with T1D. DISCUSSION/SIGNIFICANCE OF IMPACT: Given the unknown long-term effects of immune-modulatory therapy on those at risk for or those diagnosed with T1D, the use of a prebiotic such as HAMS-AB offers a simple, safe, yet inexpensive and tolerated dietary alternative approach to mitigating disease.
Functional magnetic resonance imaging (fMRI) is a neuroimaging technique increasingly used for both patient care and clinical research. This techniche provides a space-time high-resolution able to detect small changes in regional brain activation.Ojbectives: the aim of this study was to compare patterns of regional brain activation in patients with eating disorders (ED) and healthy volunteers during emotional stimulation.
Materials and methods
A group of 13 young female ED outpatients was selected using DSM-IV criteria and 13 young healthy female volunteers with no significant differences in sociodemographic or environmental data. fMRI was used to examine the neural responses after visual stimulation with neutral and fearful images, taken from the IAPS (International Affective Picture System) and selected a region of interest (ROI) aproach to examine the function of the amygdala in emotional processing.Data processing and higher level analysis were carried out using FSL (fMRI's Software Library).
ED patients showed significantly greater rigth amygdala activation to the fearful images versus neutral images than healthy control subjects (p < 0.02)
A higher right amygdala response to processing of fearful stimuli was observed in ED patients compared to healthy volunteers. This emotional dysregulation in the affective response to unpleasant stimuli would correlate with a maladaptative response and therefore justify disruptive behaviours in this patients.
Diffusion tensor imaging (DTI) is a relatively new imaging technique that is being increasingly used in different types of psychiatric patologies to characterize white matter microstructural organization in this kind of disorders. In the present study we use DTI to explore the structure of the white matter of borderline personality disorder (BPD) patients, using a novel voxel-based approach, tract-based spatial statistics (TBSS), to analyze the data.
Methods and materials
DTI was performed in a 1.5T MRI unit in 9 young male patients with a DSM-IV defined BPD and 14 healthy male control subjects (no significant age difference between groups).Voxel wise analysis was performed using TBSS (diffusion toolbox of FSL- functional MRI Software Library) to localize regions of white matter showing significant changes of fractional anisotropy (FA). Additional high resolution three dimensional datasets were also acquired and normalised white matter volume was estimated with SIENAX (part of FSL).
The TBSS analysis revealed a statistically significant decrease in FA at the anterior part of the body and the genu of the corpus callosum and frontal white matter. This finding is consistent with previously reported findings of subtle prefrontal white matter abnormalities in BPD.
Significant white matter tract alterations in patients with BPD where observed in frontal regions involved in emotional, behavioural and cognitive regulation, and these abnormalities may be linked to key aspects of psychopatology in these patients.
A study of N-acetyl-aspartate (NAA) can provide data of interest about cortical alterations in psychotic illnesses. Although a decreased NAA level in the cerebral cortex is a replicated finding in chronic schizophrenia, the data are less consistent for bipolar disease. On the other hand, it is likely that NAA values in schizophrenia may differ in men and women.
We used proton magnetic resonance spectroscopy (1H MRS) to examine NAA levels in the prefrontal cortex in two groups of male patients, one with schizophrenia (n = 11) and the other with bipolar disorder (n = 13) of similar duration, and compared them to a sample of healthy control males (n = 10). Additionally, we compared the degree of structural deviations from normal volumes of gray matter (GM) and cerebrospinal fluid (CSF) in the dorsolateral prefrontal cortex.
Compared to controls, schizophrenia and bipolar patients presented decreased NAA to creatine ratios, while only the schizophrenia group showed an increase in CSF in the dorsolateral prefrontal region. There were no differences in choline to creatine ratios among the groups.
These data suggest that the decrease in NAA in the prefrontal region may be similar in schizophrenia and bipolar disorder, at least in the chronic state. However, cortical CSF may be markedly increased in schizophrenia patients.
Excessive cortical cerebrospinal fluid (CSF) has been acknowledged as a possible marker of a gray matter loss. This excess in schizophrenia is found predominantly in the prefrontal and temporal regions. We hypothesized that the poorer global outcome and treatment response in males with schizophrenia are related to a greater cortical volume loss as compared to females.
Subjects and methods
In order to test this hypothesis we have used magnetic resonance imaging (MRI) to study the cortical (prefrontal, temporal, and hemispheric) CSF values in a group of 85 patients with schizophrenia, of whom 56 were males and 29, females. We calculated the residual values of CSF in the patients based on the data pertaining to 45 control subjects and linear regression, from which the normal effects of age and intracranial volume were discounted. These residual scores constitute a quantitative measurement of the excess of CSF due to the disease.
Males, but not females, presented a trend-level significant excess of left prefrontal CSF. The prefrontal and temporal residual values were significantly associated with illness duration in males, but not in females.
These results conform to the worse outcome and the higher severity of structural abnormalities generally found in schizophrenia in male subjects.
Our data support the hypothesis of accelerated prefrontal cortical loss in males, but not in females with schizophrenia.
Despite the use of antipsychotics as monotherapy is considered to be the standard treatment for schizophrenia and other psychotic disorders, many studies prove that antipsychotic polypharmacy (AP) is more frequent than expected in accordance to the experts' guidelines.
To analyze the prescription of long-acting risperidone (LAR) for schizophrenic patients discharged after being admitted in our BHU and its relationship with the AP.
Material and methods:
This retrospective study reviews the antipsychotics prescribed to those discharged patients diagnosed as schizophrenic who were admitted in our BHU during 2005. A total of 209 patients are included. The data are analyzed in relation to the prescription of antipsychotics for discharged patients on LAR and the antipsychotic combinations for those patients discharged on another antipsychotic regime, both as a complementary treatment and to cover the LAR therapeutic window.
57 patients (27%) were discharged on LAR. 42% were treated with benzodiazepines, 56% with anticholinergics and 16% with mood stabilizers. 79% of patients treated with LAR were discharged with another antipsychotic in combination: oral risperidone (58%), followed by amisulpiride (18%). Similar dosages were used in patients discharged only on LAR and those used in patients prescribed with more than one antipsychotic (p>0.05).
LAR could be an efficient strategy both to enable the treatment compliance and to achieve a monotherapy treatment. Despite LAR is frequently combined with another antipsychotic, in most cases oral risperidone is used, consequently avoiding the use of two antipsychotics of different kind in the same patient.
Until a patient is diagnosed of schizophrenia often receives another diagnoses. Reasons can be multiple: difficulty for the differential diagnosis in prodromical phases, comorbidity with other psychiatric disorders, abuse of substances, behaviour disorders, etc.
The aim of this study is to analyze the diagnosis that received in the first admission a sample of schizophrenia diagnosed patients.
Patients and Methods
Health histories of schizophrenia diagnosed patients who entered the Brief Hospitalization Unit of Dr R. Lafora Hospital in 2005 are analyzed. A total number of 162 patients is obtained. The diagnosis that received in the first entrance to our hospital is extracted from the health history.
A 64,4% of the patients with diagnosis of schizophrenia in 2005 were diagnosed of schizophrenia in their first entrance. Another 8,6% were diagnosed of psychotic nonspecified disorder. A 7,4% did not receive psychiatric diagnosis. 6,4% brief psychotic episode. A 3,1% psychotic disorder induced by substances. A 2,5% schizoaffective disorder. A 0,6% bipolar disorder. And a 6,2% received other diagnoses.
The data of our study indicated that a 28,2% of the schizophrenia diagnosed patients received another diagnosis previously (a 7,4% did not receive diagnosis to the discharge). Of the previously data, a 21,4% received diagnoses of psychotic disorders different from schizophrenia. This must probably response to temporary criteria for the diagnosis of schizophrenia (brief psychotic episode) prodromical forms (psychotic nonspecified disorder) and to substances use (psychotic disorder induced by substances) that make difficult the diagnosis in the early phases of the disease.
Use of antipsychotic drugs in monotherapy is considered the standard treatment for schizophrenia and other psychotic disorders. Nevertheless, exist numerous studies that show as the polypharmacy with antipsyhotics (PA) is much more frequent than it would be expected attending to experts recommendations.
The objective is to compare the prescription habits, in reference to the PA as well as to other psychotropic drugs, of 8 psychiatrists of a Psychiatric Hospitalization Unit.
Material and methods:
Review of the psychotropic drugs prescribed as maintenance treatment in schizophrenia patients (n=200) at outcome in 2005.
55,5% of 200 studied patients were registered with PA. This frequency oscillates between 78% and the 33,3% based on the psychiatrist. The patients received an average of 3,06 (DS 1,26) of psychotropic drugs; rank between 2,69 (DS 1,10) and 3,38 (DS 0,52) in relation to the psychiatrist. As maintenance treatment at outcome, it was prescribed an average of 1.61 (DS 0.65) of antipsychotics, rank 1.33 (DS 0,49) – 2,00 (DS 0.7). 33,2% patients received anticholinergics (17,1%-100% according to psychiatrist). Benzodiazepines were prescribed to 62,2% of patients (17,1%-100%). Mood stabilizer in the 16,7% of the cases (8%-41%). It is observed that those psychiatrists who use more PA use less benzodiazepines and anticholinergics.
PA extended practice in spite of therapeutic guides recommendations. Although differences between the psychiatrists from the study are observed, most of the patients have 3 psychotropic drugs as maintenance treatment at outcome: 1 or 2 antipsychotics, benzodiazepines and anticholinergic drugs.
There is a subpopulation of schizophrenic patients sometimes referred to as “revolving door” patients due to the frequency of readmissions in psychiatric units. Substance abuse and noncompliance with medication are the most important factors related to frequency of hospitalization. It has been related also with the number of previous admissions.
To describe the profile of the “revolving door” schizophrenic patient.
This retrospective study examines demographic and diagnostic features of the patients who met criteria for schizophrenia and have been admitted in our brief hospitalization unit during 2005. 209 adult patients were included. We compared the data of patients with only one admission (n=132) with those who have been admitted two or more times (n=77) in the period of study.
We detected a significative difference between the two groups in the number of previous hospitalizations. The group with one admission during 2005 had 3.75 previous hospitalizations (SD 5.34) vs. 6.37 previous hospitalizations (SD 5.75) for the group with two or more admissions during 2005 (p<0.01). No differences were found between the two groups about gender, age, the subtype of schizophrenia, substance abuse, the presence of another psychiatric illness, or the length of the stay.
Our study shows that the number of previous readmissions could be used as a main predictor of the risk of rehospitalization. This fact supports the results of other studies. However, we have not found the substance abuse as a predictor of earlier readmission, as other studies do.
Compliance is essential to achieve the best results in serious mental illness like schizophrenia.
It was expected that the use of second-generation oral antipsychotics with less extrapyramidal side effect profile would improve the compliance, but the results do not support these expectations except in the case of risperidone long-acting injection.
The aim of this study is to assess the degree of compliance in outpatients who were started treatment with RLAI while they were hospitalized for an acute psychotic episode in psychiatric unit.
A retrospective study was conducted by reviewing medical records of hospitalized patients for psychotic episodes over the past 5 years in three hospitals in Mallorca (Balearic Islands, Spain) -Hospital de Manacor, Hospital son Llatzer and Hospital de Inca). Due to computerization of medical records, we knew the degree of compliance with treatment and outcome in outpatient clinics. We designed a case report data (CRD) to assess specific variables in our study that was completed for each patient.
The mean duration of treatment in patients who continue with RLAI was 38.8 months. Overall. 69.5% continued with the treatment after 5 years. The patients who continued treatment were rehospitalazed 20% less than the ones who discontinued.
The compliance with RLAI in outpatients was high even in patients with substances abuse. The patients who remain on treatment from hospital discharge have less readmissions. The most common dosis of RLAI is 50 mg. Lack of insight was the most frequent cause of discontinuation.
One of the problems of many studies and clinical trials is that don’t reflect the patient's opinion about the medication that they receive and their satisfaction.
Objetive and aims
The aim of this study was to assess the degree of outpatients satisfaction with antipsychotic treatment in four outpatients clinics in Mallorca. The adherence rates was estimated from information provided by the patients and their psychiatrists.
A cross.-sectional and descriptive study was conducted during one month, from May to June 2010, by administering several questionnaires to outpatients with psychotic disorders. It was designed a case report data which recorded the following variables: age, gender, diagnosis (schizophreniform, schizophrenia, schizoaffective disorder, delusional, psychotic disorder not otherwise specified), time since diagnosis, substance use, number of antipsychotic drugs, type of antipsychotic (oral and / or im), number of doses per day and number of tablets, via of administration (buttocks or deltoid). The psychometric instruments used were: the Morisky-Green test, Haynes-Sacket test, the MSQ (Medication Satisfaction Questionnaire) and CGI (Clinical Global Impression).
The sample was of 92 patients with a mean age of 42.1 years (SD 12.2): 57.6% male and the most frequent diagnosis was schizophrenia in 65.2%. The duration of treatment from diagnosis was more than 5 years in 66.3%.
The patients on maintenance monotherapy with RLAI showed better adherence rates and more insight, evaluated by their psychiatrits.
78% of patients receiving antipsychotic medication injections were satisfied with the treatment.
Patients with RLAI administrating in deltoid were satisfied in 65.7%.
Poor insight has been associated to positive and negative symptoms in schizophrenia. However, the impact of antipsychotic treatment on insight in delusional disorder (DD) has not well defined.
Our purpose was to investigate the impact of long-acting atypical antipsychotics (PPLAI, RLAI) on insight in DD patients.
We conducted a prospective and observational study by including 60 consecutive cases of DD outpatients, which were followed up for at least 6 months. Outcome variables: Scores in the first three items of the SUMD for Insight, PANSS for psychopathology, HRSD-17 for depression and PSP for functionality. The sample was divided into two groups according to the treatment received: oral or long-acting atypical antipsychotics (RLAI or PPLAI). T and Chi-square tests were used. Insight differences between both groups were investigated by applying Analysis of Covariance.
At baseline, DD patients treated with long-acting injectable antipsychotics had higher scores in awareness of social consequences. Although no statistically significant differences were found, after 6 months of treatment, patients receiving long-acting injectable antipsychotics showed a tendency of improvement of awareness of illness, awareness of the effects of medication and awareness of social consequences. Statistically significant treatment group*PANSS total score interactions were found for awareness for social consequences. After controlling for SUMD baseline and PANSS total scores, DD patients treated with long-acting antipsychotics showed an improvement of awareness of the effects of medications and social consequences.
Patients receiving long-acting injectable antipsychotics showed an improvement in psychotic symptoms and insight dimensions.
Recent meta-analysis in schizophrenia report that patients treated with long-acting injectable antipsychotics (LAI) show a significant improvement in hallucinations. However, little evidence supports their efficacy in non-prominent hallucinations in delusional disorder (DD) patients.
To examine treatment effectiveness of LAI antipsychotics (PPLAI and RLAI) with other oral antipsychotics in DD with non-prominent hallucinations.
A prospective and observational study was carried out by including 60 consecutive cases of DD outpatients, as part of the DEVCODEL Study. All patients were followed up for at least 6 months. Outcome variables: Scores in PANSS, HRSD-17 items, PSP for functionality, and C-SSRS for suicide. To investigate whether differences between treatment groups were biased by confounding variables, scores in assessment scales at 6 months served as dependent variables, and hallucinatory and treatment groups were included as between-subject factors when analysis of covariance (ANCOVA) was applied.
24(40%) patients had non-prominent hallucinations. Although not statistically significant, when uncorrected for influencing factors, DD patients receiving PPLAI or RLAI (n=27;45.5%) were less frequently treated with antidepressants (32%vs.68%) and showed lower suicidality (44.4%vs.55.6%). Patients treated with PPLAI or RLAI had lower scores in psychotic symptoms and suicidal ideation intensity, and higher functionality. After adjustment, patients with non-prominent hallucinations receiving PPLAI or RLAI showed a tendency of improvement in functionality, lower scores in PANSS positive (p=0.003) and negative (p=0.047) subscales, and suicidal ideation severity (p<0.001) compared to those treated with oral antipsychotics.
Non-prominent hallucinatory patients treated with PPLAI or RLAI showed a significant improvement in psychopathology and suicidal ideation.
Oestrogens may be a protective factor in psychosis. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD).
To evaluate gynaecological variables and psychopathology in women with DD.
To investigate the relationship between age of menarche and onset, and psychopathology in DD.
Forty-five outpatients with DD (DSM-IV-TR) were recruited at the Hospital Clinic of Barcelona, from 2008 to 2012. Twenty-five females underwent a demographic and gynaecological questionnaire. HRSD-17 for depression, PANSS for psychopathology, PSP for functionality and C-SSRS for suicide were assessed. The sample was divided into two groups according to the age of menarche: 12 years or less and more than 12.
Mean age of menarche (SD) was 12.6(1.4) years, mean age of menopause 49.1(3.15), mean age at onset of DD was 49.9(12.58). 33.3% of the sample did not receive gynaecological service in the last 3 years. The group with the earliest age of menarche was older [67.33(11.67) vs.56(9.6); p=0.026], presented an earlier age of menopause [46.80(2.84) vs.50.71(2.29) p=0.018] and latest onset of DD (53.50(14.32) vs.47.44(11.5); p=NS], than those with later age of menarche. No differences were found regarding psychopathology, suicidal behaviour or functionality.
Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. A low compliance rate in gynaecological service use was found. An earlier age of menarche was associated to an earlier age of onset of DD.