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Llorca-Bofí V, Madero S, Amoretti S, Cuesta MJ, Moreno C, González-Pinto A, Bergé D, Rodriguez-Jimenez R, Roldán A, García-León MÁ, Ibáñez A, Usall J, Contreras F, Mezquida G, García-Rizo C, Berrocoso E, Bernardo M, Bioque M. Inflammatory blood cells and ratios at remission for psychosis relapse prediction: A three-year follow-up of a cohort of first episodes of schizophrenia. Schizophr Res 2024; 267:24-31. [PMID: 38513331 DOI: 10.1016/j.schres.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND The clinical course following a first episode of schizophrenia (FES) is often characterized by recurrent relapses, resulting in unfavorable clinical and functional outcomes. Inflammatory dysregulation has been implicated in relapse risk; however, the predictive value of inflammatory blood cells in clinically remitted patients after a FES has not been previously explored. METHODS In this study, we closely monitored 111 patients in remission after a FES until relapse or a three-year follow-up endpoint. The participants were recruited from the multicenter 2EPS Project. Data on inflammatory blood cells and ratios were collected at baseline and at the time of relapse or after three years of follow-up. RESULTS Monocyte counts (OR = 1.91; 95 % CI = 1.07-3.18; p = 0.009) and basophil counts (OR = 1.09; 95 % CI = 1.01-1.12; p = 0.005) at baseline were associated with an increased risk of relapse, while the platelet-lymphocyte ratio (OR = 0.98; 95 % CI = 0.97-0.99; p = 0.019) was identified as a protective factor. However, after adjusting for cannabis and tobacco use during the follow-up, only monocyte counts (OR = 1.73; 95 % CI = 1.03-2.29; p = 0.027) and basophil counts (OR = 1.08; 95 % CI = 1.01-1.14; p = 0.008) remained statistically significant. ROC curve analysis indicated that the optimal cut-off values for discriminating relapsers were 0.52 × 10^9/L (AUC: 0.66) for monocytes and 0.025 × 10^9/L (AUC: 0.75) for basophils. When considering baseline inflammatory levels, no significant differences were observed in the inflammatory biomarkers at the endpoint between relapsers and non-relapsers. CONCLUSION This study provides evidence that higher monocyte and basophil counts measured at remission after a FES are associated with an increased risk of relapse during a three-year follow-up period.
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Affiliation(s)
- Vicent Llorca-Bofí
- Department of Medicine, University of Barcelona, Barcelona, Spain; Department of Psychiatry, Santa Maria University Hospital Lleida, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Santiago Madero
- Department of Medicine, University of Barcelona, Barcelona, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Spain; University of Barcelona, Spain.
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Ana González-Pinto
- Bioaraba, Alava University Hospital, UPV/EHU, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Dani Bergé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Roberto Rodriguez-Jimenez
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Alexandra Roldán
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, IIB-SANT PAU, Barcelona, Spain; CIBERSAM, ISCIII, Spain.
| | - María Ángeles García-León
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
| | - Angela Ibáñez
- Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Judith Usall
- Research Institute Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
| | - Fernando Contreras
- Psychiatric Service, Bellvitge Universitari Hospital, IDIBELL, CIBERSAM, Spain.
| | - Gisela Mezquida
- University of Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic of Barcelona, Neuroscience Institute, Spain; Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Spain.
| | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.
| | - Esther Berrocoso
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain.
| | - Miquel Bioque
- Department of Medicine, University of Barcelona, Barcelona, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Spain.
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2
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Baeza I, de la Serna E, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Díaz-Caneja CM, Corripio I, Valli I, Puig O, Mané A, Bioque M, Ayora M, Bernardo M, Castro-Fornieles J. Prodromal symptoms and the duration of untreated psychosis in first episode of psychosis patients: what differences are there between early vs. adult onset and between schizophrenia vs. bipolar disorder? Eur Child Adolesc Psychiatry 2024; 33:799-810. [PMID: 37027026 PMCID: PMC10894175 DOI: 10.1007/s00787-023-02196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
To assess the role of age (early onset psychosis-EOP < 18 years vs. adult onset psychosis-AOP) and diagnosis (schizophrenia spectrum disorders-SSD vs. bipolar disorders-BD) on the duration of untreated psychosis (DUP) and prodromal symptoms in a sample of patients with a first episode of psychosis. 331 patients with a first episode of psychosis (7-35 years old) were recruited and 174 (52.6%) diagnosed with SSD or BD at one-year follow-up through a multicenter longitudinal study. The Symptom Onset in Schizophrenia (SOS) inventory, the Positive and Negative Syndrome Scale and the structured clinical interviews for DSM-IV diagnoses were administered. Generalized linear models compared the main effects and group interaction. 273 AOP (25.2 ± 5.1 years; 66.5% male) and 58 EOP patients (15.5 ± 1.8 years; 70.7% male) were included. EOP patients had significantly more prodromal symptoms with a higher frequency of trouble with thinking, avolition and hallucinations than AOP patients, and significantly different median DUP (91 [33-177] vs. 58 [21-140] days; Z = - 2.006, p = 0.045). This was also significantly longer in SSD vs. BD patients (90 [31-155] vs. 30 [7-66] days; Z = - 2.916, p = 0.004) who, moreover had different profiles of prodromal symptoms. When assessing the interaction between age at onset (EOP/AOP) and type of diagnosis (SSD/BD), avolition was significantly higher (Wald statistic = 3.945; p = 0.047), in AOP patients with SSD compared to AOP BD patients (p = 0.004). Awareness of differences in length of DUP and prodromal symptoms in EOP vs. AOP and SSD vs. BD patients could help improve the early detection of psychosis among minors.
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Affiliation(s)
- Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain.
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain.
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
| | - Gisela Mezquida
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Psychiatry, Psychiatric Genetics Unit, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine and Psychiatry, Hospital Clínico Universitario and Instituto de Investigación Sanitaria (IIS) Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, EHU, Vitoria, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Puig
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Anna Mané
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Spain
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miriam Ayora
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, Madrid, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
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3
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Hidalgo-Figueroa M, Salazar A, Romero-López-Alberca C, MacDowell KS, García-Bueno B, Bioque M, Bernardo M, Parellada M, González-Pinto A, García Portilla MP, Lobo A, Rodriguez-Jimenez R, Berrocoso E, Leza JC. The Influence of Oxytocin and Prolactin During a First Episode of Psychosis: The Implication of Sex Differences, Clinical Features, and Cognitive Performance. Int J Neuropsychopharmacol 2022; 25:666-677. [PMID: 35353882 PMCID: PMC9380712 DOI: 10.1093/ijnp/pyac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Approximately 3% of the population suffers a first episode of psychosis (FEP), and a high percentage of these patients subsequently relapse. Because the clinical course following a FEP is hard to predict, it is of interest to identify cognitive and biological markers that will help improve the diagnosis, treatment, and outcome of such events and to define new therapeutic targets. Here we analyzed the plasma oxytocin and prolactin levels during an FEP, assessing their correlation with clinical and cognitive features. METHODS The oxytocin and prolactin in plasma was measured in 120 FEP patients and 106 healthy controls, all of whom were subjected to a clinical and neuropsychological assessment. Most patients were under antipsychotics. Statistical analyses aimed to identify factors associated with the FEP and to search for associations between the variables. This study is preliminary and exploratory because the P-values were not corrected for multiple comparisons. RESULTS FEP patients had less oxytocin, more prolactin, and a poor premorbid IQ, and they performed worse in sustained attention. Male patients with higher prolactin levels experienced more severe psychotic symptoms and required higher doses of antipsychotics. Low oxytocin was associated with poor sustained attention in women, whereas low oxytocin and high prolactin in men correlated with better performance in sustained attention. CONCLUSION Low oxytocin, high prolactin, and poor premorbid IQ and sustained attention are factors associated with an FEP, representing potential therapeutic targets in these patients. These biological factors and cognitive domains might play an important role during a FEP, which could help us to develop new strategies that improve the outcomes of this disorder and that should perhaps be gender specific.
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Affiliation(s)
| | | | - Cristina Romero-López-Alberca
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain,Personality, Evaluation and Psychological Treatment Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain
| | - Karina S MacDowell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Borja García-Bueno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, EHU, Vitoria-Gasteiz, Spain
| | - María Paz García Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Medicine and Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12)/Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Esther Berrocoso
- Correspondence: Esther Berrocoso, PhD, Neuropsychopharmacology Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cádiz, 11510 Cádiz, Spain ()
| | - Juan C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | | | - CIBERSAM
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
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4
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Bernardo M, Amoretti S, Cuesta MJ, Parellada M, Mezquida G, González-Pinto A, Bergé D, Lobo A, Aguilar EJ, Usall J, Corripio I, Bobes J, Rodríguez-Jiménez R, Sarró S, Contreras F, Ibáñez Á, Gutiérrez M, Micó JA. The prevention of relapses in first episodes of schizophrenia: The 2EPs Project, background, rationale and study design. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:164-176. [PMID: 34456031 DOI: 10.1016/j.rpsmen.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022]
Abstract
Up to 80% of first-episode psychosis patients suffer a relapse within five years of the remission. Relapse should be an important focus of prevention given the potential harm to the patient and family. It threatens to disrupt their psychosocial recovery, increases the risk of resistance to treatment and has been associated with greater direct and indirect costs for society. Based on a previous project entitled "Genotype-phenotype and environment. Application to a predictive model in first psychotic episodes" (PEPs Project), the project "Clinical and neurobiological determinants of second episodes of schizophrenia. Longitudinal study of first episode of psychosis" was designed, also known as the 2EPs Project. It aimed to identify and characterize those factors that predict a relapse within the years immediately following a first episode. This project has focused on following the clinical course, with neuropsychological assessments, biological and neuroanatomical measures, genetic adherence and physical health monitoring in order to compare a subgroup of patients with a second episode to another group of patients which remains in remission. The main objective of the present article is to describe the rationale of the 2EPs Project, explaining the measurement approach adopted and providing an overview of the selected clinical and functional measures. 2EPs Project is a multicenter, coordinated, naturalistic, longitudinal follow-up study over three years in a Spanish sample of patients in remission after a first-psychotic episode of schizophrenia. It is closely monitoring the clinical course of the cases recruited to compare the subgroup of patients with a second episode to that which remains in remission. The sample is composed of 223 subjects recruited from 15 clinical centres in Spain with experience of the preceding PEPs Study project, albeit 2EPs being an expanded version with new basic groups in biological research. From the total sample recruited, 63 patients presented a relapse (44%). 2EPs arose to characterize first episodes in an exhaustive, novel and multimodal way, thus contributing towards the development of a predictive model of relapse. Identifying the characteristics of patients who relapse could improve early detection and intervention.
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Affiliation(s)
- Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel Jesús Cuesta
- Departamento de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Daniel Bergé
- Department of Neurosciences and Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza. Instituto de Investigación Aragón, CIBERSAM, Zaragoza, Spain
| | - Eduardo J Aguilar
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Santa Creu and Sant Pau Hospital; Autonomous University of Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), CIBERSAM, Oviedo, Asturias, Spain
| | - Roberto Rodríguez-Jiménez
- Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), CIBERSAM, Madrid, Spain
| | - Salvador Sarró
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ángela Ibáñez
- Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, CIBERSAM, Madrid, Spain
| | - Miguel Gutiérrez
- Department of Psychiatry, Hospital Santiago Apóstol, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Juan Antonio Micó
- Grupo de Investigación en Neuropsicofarmacología y Psicobiología, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, CIBERSAM, Cádiz, Spain
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5
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Bernardo M, Amoretti S, Cuesta MJ, Parellada M, Mezquida G, González-Pinto A, Bergé D, Lobo A, Aguilar EJ, Usall J, Corripio I, Bobes J, Rodríguez-Jiménez R, Sarró S, Contreras F, Ibáñez Á, Gutiérrez M, Micó JA. The prevention of relapses in first episodes of schizophrenia: The 2EPs Project, background, rationale and study design. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020. [PMID: 33020032 DOI: 10.1016/j.rpsm.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Up to 80% of first-episode psychosis patients suffer a relapse within five years of the remission. Relapse should be an important focus of prevention given the potential harm to the patient and family. It threatens to disrupt their psychosocial recovery, increases the risk of resistance to treatment and has been associated with greater direct and indirect costs for society. Based on a previous project entitled "Genotype-phenotype and environment. Application to a predictive model in first psychotic episodes" (PEPs Project), the project "Clinical and neurobiological determinants of second episodes of schizophrenia. Longitudinal study of first episode of psychosis" was designed, also known as the 2EPs Project. It aimed to identify and characterize those factors that predict a relapse within the years immediately following a first episode. This project has focused on following the clinical course, with neuropsychological assessments, biological and neuroanatomical measures, genetic adherence and physical health monitoring in order to compare a subgroup of patients with a second episode to another group of patients which remains in remission. The main objective of the present article is to describe the rationale of the 2EPs Project, explaining the measurement approach adopted and providing an overview of the selected clinical and functional measures. 2EPs Project is a multicenter, coordinated, naturalistic, longitudinal follow-up study over three years in a Spanish sample of patients in remission after a first-psychotic episode of schizophrenia. It is closely monitoring the clinical course of the cases recruited to compare the subgroup of patients with a second episode to that which remains in remission. The sample is composed of 223 subjects recruited from 15 clinical centres in Spain with experience of the preceding PEPs Study project, albeit 2EPs being an expanded version with new basic groups in biological research. From the total sample recruited, 63 patients presented a relapse (44%). 2EPs arose to characterize first episodes in an exhaustive, novel and multimodal way, thus contributing towards the development of a predictive model of relapse. Identifying the characteristics of patients who relapse could improve early detection and intervention.
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Affiliation(s)
- Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel Jesús Cuesta
- Departamento de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | | | - Ana González-Pinto
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Daniel Bergé
- Department of Neurosciences and Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza. Instituto de Investigación Aragón, CIBERSAM, Zaragoza, Spain
| | - Eduardo J Aguilar
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Santa Creu and Sant Pau Hospital; Autonomous University of Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), CIBERSAM, Oviedo, Asturias, Spain
| | - Roberto Rodríguez-Jiménez
- Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), CIBERSAM, Madrid, Spain
| | - Salvador Sarró
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ángela Ibáñez
- Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, CIBERSAM, Madrid, Spain
| | - Miguel Gutiérrez
- Department of Psychiatry, Hospital Santiago Apóstol, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Juan Antonio Micó
- Grupo de Investigación en Neuropsicofarmacología y Psicobiología, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, CIBERSAM, Cádiz, Spain
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6
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Mas S, Boloc D, Rodríguez N, Mezquida G, Amoretti S, Cuesta MJ, González-Peñas J, García-Alcón A, Lobo A, González-Pinto A, Corripio I, Vieta E, Castro-Fornieles J, Mané A, Saiz-Ruiz J, Gassó P, Bioque M, Bernardo M. Examining Gene-Environment Interactions Using Aggregate Scores in a First-Episode Psychosis Cohort. Schizophr Bull 2020; 46:1019-1025. [PMID: 32083289 PMCID: PMC7342095 DOI: 10.1093/schbul/sbaa012] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Gene-environment (GxE) interactions have been related to psychosis spectrum disorders, involving multiple common genetic variants in multiple genes with very small effect sizes, and several environmental factors that constitute a dense network of exposures named the exposome. Here, we aimed to analyze GxE in a cohort of 310 first-episode psychotic (FEP) and 236 healthy controls, by using aggregate scores estimated in large populations such as the polygenic risk score for schizophrenia and (PRS-SCZ) and the Maudsley environmental risk score (ERS). In contrast to previous findings, in our study, the PRS-SCZ did not discriminate cases from controls, but the ERS score explained a similar percentage of the variance as in other studies using similar approaches. Our study supports a positive additive interaction, indicating synergy between genetic susceptibility to schizophrenia (PRS-SCZ dichotomized according to the highest quartile distribution of the control population) and the exposome (ERS > 75% of the controls). This additive interaction showed genetic and environmental dose dependence. Our study shows that the use of aggregate scores derived from large and powered studies instead of statistics derived from specific sample characteristics is a powerful tool for the study of the effects of GxE on the risk of psychotic spectrum disorders. In conclusion, by using a genetic risk score and an ERS we have provided further evidence for the role of GxE in psychosis.
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Affiliation(s)
- Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain,To whom correspondence should be addressed; Department of Clinical Foundations, University of Barcelona, IDIBAPS, CIBERSAM, Casanova 143, E-08036 Barcelona, Spain; tel: 0034934024526, fax: 003493403, e-mail:
| | - Daniel Boloc
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Javier González-Peñas
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM). Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Alicia García-Alcón
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM). Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Zaragoza University, Spain. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza. Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain,BIOARABA Health Research Institute, Vitoria, Spain,University of the Basque Country, Vitoria, Spain
| | - Iluminada Corripio
- Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - Eduard Vieta
- Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain,Hospital Clínic de Barcelona, Barcelona, Spain,Department of Medicine, University of Barcelona; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Autonomous University of Barcelona (UAB). Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jeronimo Saiz-Ruiz
- Universidad de Alcalá, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain
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7
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Mas S, Gassó P, Rodríguez N, Cabrera B, Mezquida G, Lobo A, González-Pinto A, Parellada M, Corripio I, Vieta E, Castro-Fornieles J, Bobes J, Usall J, Saiz-Ruiz J, Contreras F, Parellada E, Bernardo M, Bioque M, Diaz‐Caneja CM, González‐Peñas J, Solis AA, Rebella M, González‐Ortega I, Besga A, SanJuan J, Nacher J, Morro L, Montserrat C, Jimenez E, Costa SGD, Baeza I, de la Serna E, Rivas S, Diaz C, Saiz PA, Garcia‐Álvarez L, Fraile MG, Rabadán AZ, Torio I, Rodríguez‐Jimenez R, Butjosa A, Pardo M, Sarró S, Pomarol‐Clotet E, Cuadrado AI, Cuesta MJ. Personalized medicine begins with the phenotype: identifying antipsychotic response phenotypes in a first-episode psychosis cohort. Acta Psychiatr Scand 2020; 141:541-552. [PMID: 31746462 DOI: 10.1111/acps.13131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/16/2019] [Accepted: 11/17/2019] [Indexed: 12/29/2022]
Abstract
AIMS Here, we present a clustering strategy to identify phenotypes of antipsychotic (AP) response by using longitudinal data from patients presenting first-episode psychosis (FEP). METHOD One hundred and ninety FEP with complete data were selected from the PEPs project. The efficacy was assessed using total PANSS, and adverse effects using total UKU, during one-year follow-up. We used the Klm3D method to cluster longitudinal data. RESULTS We identified four clusters: cluster A, drug not toxic and beneficial; cluster B, drug beneficial but toxic; cluster C, drug neither toxic nor beneficial; and cluster D, drug toxic and not beneficial. These groups significantly differ in baseline demographics, clinical, and neuropsychological characteristics (PAS, total PANSS, DUP, insight, pIQ, age of onset, cocaine use and family history of mental illness). CONCLUSIONS The results presented here allow the identification of phenotypes of AP response that differ in well-known simple and classic clinical variables opening the door to clinical prediction and application of personalized medicine.
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Affiliation(s)
- S Mas
- Pharmacology Unit, Department of Clinical Foundations, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - P Gassó
- Pharmacology Unit, Department of Clinical Foundations, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - N Rodríguez
- Fundació Clinic per la Recerca Biomédica (FCRB), Barcelona, Spain
| | - B Cabrera
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - G Mezquida
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Barcelona, Spain.,Fundació Clínic per la Recerca Biomèdica (FCRB), Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - A Lobo
- Department of Medicine and Psychiatry, University of Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - A González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain.,BIOARABA Health Research Institute, Vitoria, Spain.,University of the Basque Country, Vitoria, Spain
| | - M Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - I Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Servicio de Psiquiatría, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB-SANT PAU), Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Hospital Clínic de Barcelona, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - J Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - J Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Área de Psiquiatría, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - J Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - J Saiz-Ruiz
- Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - F Contreras
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Psychiatric Service, Bellvitge University Hospital, Hospitalet del Llobregat, Spain.,University of Barcelona, Barcelona, Spain
| | - E Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain
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8
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Una década del proyecto de primeros episodios psicóticos (PEPs): avanzando hacia una psiquiatría de precisión. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 12:135-140. [DOI: 10.1016/j.rpsm.2019.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/22/2019] [Indexed: 12/24/2022]
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9
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Salagre E, Arango C, Artigas F, Ayuso-Mateos JL, Bernardo M, Castro-Fornieles J, Bobes J, Desco M, Fañanás L, González-Pinto A, Haro JM, Leza JC, Mckenna PJ, Meana JJ, Menchón JM, Micó JA, Palomo T, Pazos Á, Pérez V, Saiz-Ruiz J, Sanjuán J, Tabarés-Seisdedos R, Crespo-Facorro B, Casas M, Vilella E, Palao D, Olivares JM, Rodriguez-Jimenez R, Vieta E. CIBERSAM: Ten years of collaborative translational research in mental disorders. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 12:1-8. [PMID: 30416047 DOI: 10.1016/j.rpsm.2018.10.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Estela Salagre
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Celso Arango
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Francesc Artigas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Neuroquímica y Neurofarmacología, Institut d'Investigacions Biomèdiques de Barcelona IIBB-CSIC, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, España
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Unidad Esquizofrenia Clínic, Institut Clínic de Neurociencias, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología Infantil y Juvenil, Institut Clínic de Neurociencias, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, España
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Asturias, España
| | - Manuel Desco
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, España
| | - Lourdes Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Secció Zoologia i Antropologia Biològica, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, España
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital Universitario Araba, Instituto de Investigación Sanitaria Bioaraba; Universidad del País Vasco, Vitoria, España
| | - Josep María Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, España
| | - Juan Carlos Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Farmacología, Facultad de Medicina, Universidad Complutense de Madrid, Instituto Universitario de Investigación en Neuroquímica UCM, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, España
| | - Peter J Mckenna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, España
| | - José Javier Meana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Farmacología, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Barakaldo, Bizkaia, España
| | - José Manuel Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Departamento de Ciencias Clínicas, Universitat de Barcelona, Barcelona, España
| | - Juan Antonio Micó
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Grupo de Investigación en Neuropsicofarmacología y Psicobiología,, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Tomás Palomo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital 12 de Octubre, Madrid, España
| | - Ángel Pazos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Fisiología y Farmacología, Facultad de Medicina, Universidad de Cantabria, Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC-SODERCAN, Santander, Cantabria, España
| | - Víctor Pérez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Universitat Autònoma de Barcelona, Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, España
| | - Jerónimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España
| | - Julio Sanjuán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; INCLIVA, Universidad de Valencia, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Rafael Tabarés-Seisdedos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Medicina, INCLIVA, Universidad de Valencia, Valencia, España
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, España
| | - Miquel Casas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España
| | - Elisabet Vilella
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Tarragona, España
| | - Diego Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servei de Salut Mental, Parc Taulí Hospital Universitari, Institut de Recerca i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - Jose Manuel Olivares
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Unidad de Psiquiatría, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Instituto Biomédico Galicia Sur, Vigo, Pontevedra, España
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, España
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
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Detection of early psychotic symptoms: Validation of the Spanish version of the "Symptom Onset in Schizophrenia (SOS) inventory". Psychiatry Res 2018; 261:68-72. [PMID: 29287238 DOI: 10.1016/j.psychres.2017.12.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 01/16/2023]
Abstract
The period of subclinical signs that precedes the onset of psychosis is referred to as the prodrome or high-risk mental state. The "Symptom Onset in Schizophrenia (SOS) inventory" is an instrument to characterize and date the initial symptoms of a psychotic illness. The present study aims to provide reliability and validity data for clinical and research use of the Spanish version of the SOS. Thirty-six participants with a first-episode of psychosis meeting DSM-IV criteria for schizophrenia/schizoaffective/schizophreniform disorder were administered the translated SOS and other clinical assessments. The internal validity, intrarater and interrater reliability were studied. We found strong interrater reliability. To detect the presence/absence of prodromal symptoms, Kappa coefficients ranged between 0.8 and 0.7. Similarly, the raters obtained an excellent level of agreement regarding the onset of each symptom and the duration of symptoms until first treatment (intraclass correlation coefficients between 0.9 and 1.0). Cronbach's alpha was 0.9-1.0 for all the items. The interrater reliability and concurrent validity were also excellent in both cases. This study provides robust psychometric properties of the Spanish version of the SOS. The translated version is adequate in terms of good internal validity, intrarater and interrater reliability, and is as time-efficient as the original version.
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Evolution of metabolic risk factors over a two-year period in a cohort of first episodes of psychosis. Schizophr Res 2018; 193:188-196. [PMID: 28663026 DOI: 10.1016/j.schres.2017.06.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 02/04/2023]
Abstract
Patients with a first episode of psychosis (FEP) display a broad range of metabolic risk factors related to the development of diverse medical comorbidities. Initial stages of these disorders are essential in understanding the increased vulnerability of developing cardiometabolic disturbances, associated with a reduced life expectancy. This study aimed to evaluate the metabolic profile of a cohort of patients with a FEP and its evolution during a two year follow-up, as well as the factors that influence the changes in their metabolic status. 16 participating centers from the PEPs Project recruited 335 subjects with a FEP and 253 matched healthy controls, aged 9-35years. We investigated a set of anthropometric measures, vital signs and laboratory data obtained from each participant over two years in a prospective, naturalistic study. From the beginning of the study the FEP group showed differences in the metabolic profile compared to the control group, together with a progressive worsening in the major part of the analyzed variables during the follow-up period, with higher rates of obesity and metabolic syndrome. Certain risk factors were related to determinate clinical variables such as male gender, the presence of affective symptoms or an early onset or to treatment variables such as the use of antipsychotic polypharmacy, antidepressants or mood stabilizers. Our results highlight the extremely high risk of patients at early phases of schizophrenia and other psychotic disorders of developing cardiovascular comorbidity and the fast worsening of the metabolic profile during the first two years.
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12
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Mezquida G, Cabrera B, Bioque M, Amoretti S, Lobo A, González-Pinto A, Espliego A, Corripio I, Vieta E, Castro-Fornieles J, Bergé D, Escartí MJ, Ibañez Á, Penadés R, Sánchez-Torres AM, Bernardo M. The course of negative symptoms in first-episode schizophrenia and its predictors: A prospective two-year follow-up study. Schizophr Res 2017; 189:84-90. [PMID: 28185786 DOI: 10.1016/j.schres.2017.01.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to investigate the course of negative symptoms and its stability over a two-year period following a first-episode schizophrenia (FES) and the possible predictors of higher severity in this symptomatology after this period. METHODS In this longitudinal two-year prospective follow-up study we included 268 patients with a FES, according to DSM-IV. Analysis of variance was conducted in patients who completed the full follow-up to study changes in negative symptoms over three visits. Regression analyses were conducted to show correlates and potential predictors of negative symptoms at two-year follow-up. RESULTS There was a significant effect for time in negative symptomatology, which was less severe at one-year follow-up after a FES and remained stable up to two years (Time 1>Time 2>Time 3); F(2,151)=20.45, p<0.001. Poorer premorbid adjustment (p=0.01) and higher negative symptoms at baseline (p<0.001) made a significant contribution to the changes in the negative symptoms severity at two-years after a FES (R2=0.21, p<0.001). CONCLUSIONS We found a reduction in the negative symptomatology at one-year after a FES. This change remained stable at two-year. Our results suggested that the presence of this symptomatology early in the course of the illness, together with a poorer premorbid adjustment, predict more severe negative symptoms at mid-term outcome.
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Affiliation(s)
- Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Antonio Lobo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Araba University Hospital, Bioaraba Research Institute, Spain; University of the Basque Country (UPV-EHU), Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Psychology, Clinical Institute for the Neurosciences (ICN), Hospital Clinic of Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
| | - Josefina Castro-Fornieles
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM) - UAB, Neurosciences, Psychiatry, Barcelona, Spain
| | - Maria J Escartí
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Valencia Clinic Hospital, Valencia, Spain
| | - Ángela Ibañez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Rafael Penadés
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain.
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13
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Bernardo M, Bioque M, Cabrera B, Lobo A, González-Pinto A, Pina L, Corripio I, Sanjuán J, Mané A, Castro-Fornieles J, Vieta E, Arango C, Mezquida G, Gassó P, Parellada M, Saiz-Ruiz J, Cuesta MJ, Mas S. Modelling gene-environment interaction in first episodes of psychosis. Schizophr Res 2017; 189:181-189. [PMID: 28179063 DOI: 10.1016/j.schres.2017.01.058] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Recent research demonstrates the heterogeneous etiology of psychotic disorders, where gen-environment (GxE) interaction plays a key role. Large genetic studies have linked many genetic variants with schizophrenia, but each variant is only associated with a small effect and the GxE interaction contribution has not been evaluated. METHODS The PEPs Project was designed to carefully collect a large amount of genetic and environmental exposure data of 335 FEP patients and 253 matched healthy controls.780single-nucleotide polymorphisms (from 159 candidate genes)and 16 environmental variables previously reported as the main psychosis non-genetic risk factors were analyzed together using entropy-based measures of information gain. RESULTS Our analyses identified an interaction between nine SNPs and the exposition to the environmental risk factors of psychosis, showing a clear enrichment of genes linked to serotonin neurotransmission and neurodevelopmental processes. CONCLUSIONS This study has allowed the identification of several GxE-environment interactions involved in the risk of presenting a FEP. Our results highlight the importance of serotonin neurotransmission interacting with certain environmental stimuli. The serotoninergic system may be playing a key role in the regulatory network of stress and other systems implicated in the emergence and development of psychotic disorders.
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Affiliation(s)
- Miguel Bernardo
- Barcelona Clínic SchizophreniaUnit, Hospital Clínic de Barcelona, CIBERSAM, Spain; Universitat de Barcelona, IDIBAPS, Barcelona, Spain.
| | - Miquel Bioque
- Barcelona Clínic SchizophreniaUnit, Hospital Clínic de Barcelona, CIBERSAM, Spain
| | - Bibiana Cabrera
- Barcelona Clínic SchizophreniaUnit, Hospital Clínic de Barcelona, CIBERSAM, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Spain
| | - Laura Pina
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Spain
| | - Anna Mané
- Department of Psychiatry, Hospital del Mar, Barcelona, IMIM, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain
| | - Eduard Vieta
- Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Gisela Mezquida
- Barcelona Clínic SchizophreniaUnit, Hospital Clínic de Barcelona, CIBERSAM, Spain
| | - Patricia Gassó
- Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institutd'InvestigacionsBiomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Jerónimo Saiz-Ruiz
- Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, CIBERSAM, Madrid, Spain
| | - Manuel J Cuesta
- Psychiatric Department, Complejo Hospitalario de Navarra, Pamplona (Spain), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain
| | - Sergi Mas
- Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institutd'InvestigacionsBiomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
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Cuando la asistencia no sigue a la evidencia: el caso de la falta de programas de intervención temprana en psicosis en España. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:78-86. [DOI: 10.1016/j.rpsm.2017.01.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 11/11/2016] [Accepted: 01/03/2017] [Indexed: 12/14/2022]
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Crespo-Facorro B, Bernardo M, Argimon JM, Arrojo M, Bravo-Ortiz MF, Cabrera-Cifuentes A, Carretero-Román J, Franco-Martín MA, García-Portilla P, Haro JM, Olivares JM, Penadés R, del Pino-Montes J, Sanjuán J, Arango C. Eficacia, eficiencia y efectividad en el tratamiento multidimensional de la esquizofrenia: proyecto Rethinking. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:4-20. [DOI: 10.1016/j.rpsm.2016.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/29/2016] [Accepted: 09/20/2016] [Indexed: 01/20/2023]
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16
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Cabrera B, Bioque M, Penadés R, González-Pinto A, Parellada M, Bobes J, Lobo A, García-Bueno B, Leza JC, Bernardo M. Cognition and psychopathology in first-episode psychosis: are they related to inflammation? Psychol Med 2016; 46:2133-2144. [PMID: 27055381 DOI: 10.1017/s0033291716000659] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cognitive deficits are present from the onset of psychosis and are considered a core feature of the disorder. Increasing evidence suggests that cognitive function is associated with inflammatory processes. This study evaluated the association between cognition and inflammatory biomarkers in first-episode psychosis (FEP), in order to identify cognitive phenotypes from inflammatory expression profiles. METHOD A case-control study of 92 FEP patients and 80 matched controls was used. Neurocognitive assessment, including verbal ability, sustained attention, verbal memory, working memory and executive function, was performed. The expression of pro- and anti-inflammatory mediators of the main intracellular inflammatory pathway was measured in peripheral blood mononuclear cells and plasma. RESULTS FEP patients performed worse in all cognitive domains compared to controls and had higher expression of pro-inflammatory mediators and lower expression of anti-inflammatory mediators. In the FEP group, cognition and psychopathology were associated with inflammation. Hierarchical regression analysis showed that association between the anti-inflammatory prostaglandin 15d-PGJ2 and sustained attention on one hand, and COX-2 expression and executive function on the other, were statistically significant. CONCLUSIONS Our study provides evidence for an association between anti-inflammatory biomarkers and cognition in FEP. The identification of a subgroup of patients based on these measures could be useful to guide treatment programmes by providing tools to select a personalized treatment approach, but longitudinal studies are needed before. In the future, establishment of biomarkers linked to cognition would be useful to monitor the course of cognitive impairment, but substantially more data will be required. Determination of IκBα, the inhibitory protein of the pro-inflammatory transcription factor NFκB, could be useful in early phases to assess clinical severity.
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Affiliation(s)
- B Cabrera
- Barcelona Clinic Schizophrenia Unit,Neuroscience Institute,Hospital Clinic of Barcelona,Spain
| | - M Bioque
- Barcelona Clinic Schizophrenia Unit,Neuroscience Institute,Hospital Clinic of Barcelona,Spain
| | - R Penadés
- Barcelona Clinic Schizophrenia Unit,Neuroscience Institute,Hospital Clinic of Barcelona,Spain
| | - A González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - M Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - J Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - A Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - B García-Bueno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - J C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit,Neuroscience Institute,Hospital Clinic of Barcelona,Spain
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17
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Bernardo M, Bioque M. Three-month paliperidone palmitate - a new treatment option for schizophrenia. Expert Rev Clin Pharmacol 2016; 9:899-904. [DOI: 10.1080/17512433.2016.1191945] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain
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18
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Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Janssen J, Arango C. Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies. Schizophr Res 2016; 173:132-139. [PMID: 25556081 DOI: 10.1016/j.schres.2014.12.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies on longitudinal brain volume changes in patients with early-onset psychosis (EOP) are particularly valuable for understanding the neurobiological basis of brain abnormalities associated with psychosis. However, findings have not been consistent across studies in this population. We aimed to conduct a meta-analysis on progressive brain volume changes in children and adolescents with EOP. METHODS A systematic literature search of magnetic resonance imaging (MRI) studies comparing longitudinal brain volume changes in children and adolescents with EOP and healthy controls was conducted. The annualized rates of relative change in brain volume by region of interest (ROI) were used as raw data for the meta-analysis. The effect of age, sex, duration of illness, and specific diagnosis on volume change was also evaluated. RESULTS Five original studies with 156 EOP patients (mean age at baseline MRI in the five studies ranged from 13.3 to 16.6years, 67.31% males) and 163 age- and sex-matched healthy controls, with a mean duration of follow-up of 2.46years (range 2.02-3.40), were included. Frontal gray matter (GM) was the only region in which significant differences in volume change over time were found between patients and controls (Hedges' g -0.435, 95% confidence interval (CI): -0.678 to -0.193, p<0.001). Younger age at baseline MRI was associated with greater loss of temporal GM volume over time in patients as compared with controls (p=0.005). Within patients, a diagnosis of schizophrenia was related to greater occipital GM volume loss over time (p=0.001). CONCLUSIONS Compared with healthy individuals, EOP patients show greater progressive frontal GM loss over the first few years after illness onset. Age at baseline MRI and diagnosis of schizophrenia appear to be significant moderators of particular specific brain volume changes.
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Affiliation(s)
- David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
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19
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Bioque M, Llerena A, Cabrera B, Mezquida G, Lobo A, González-Pinto A, Díaz-Caneja CM, Corripio I, Aguilar EJ, Bulbena A, Castro-Fornieles J, Vieta E, Lafuente A, Mas S, Parellada M, Saiz-Ruiz J, Cuesta MJ, Bernardo M. A Pharmacovigilance Study in First Episode of Psychosis: Psychopharmacological Interventions and Safety Profiles in the PEPs Project. Int J Neuropsychopharmacol 2016; 19:pyv121. [PMID: 26506856 PMCID: PMC4851267 DOI: 10.1093/ijnp/pyv121] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 09/15/2015] [Accepted: 10/23/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. METHODS Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period. RESULTS The majority of first episode of psychosis patients received a second-generation antipsychotic (96.3%), orally (95%), and in adjusted doses according to the product specifications (87.2%). A total of 24% were receiving an antipsychotic polytherapy pattern at baseline, frequently associated with lower or higher doses of antipsychotics than the recommended ones. Eight patients were taking clozapine, all in monotherapy. Males received higher doses of antipsychotic (P=.043). A total of 5.2% of the patients were being treated with long-acting injectable antipsychotics; 12.2% of the patients received anticholinergic drugs, 12.2% antidepressants, and 13.7% mood stabilizers, while almost 40% received benzodiazepines; and 35.52% reported at least one adverse drug reaction during the pharmacovigilance period, more frequently associated with higher antipsychotic doses and antipsychotic polytherapy (85.2% vs 45.5%, P<.001). CONCLUSIONS These data indicate that the overall pharmacologic prescription for treating a first episode of psychosis in Spain follows the clinical practice guideline recommendations, and, together with security issues, support future research of determinate pharmacological strategies for the treatment of early phases of psychosis, such as the role of clozapine, long-acting injectable antipsychotics, antipsychotic combination, and the use of benzodiazepines.
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Affiliation(s)
- Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Adrián Llerena
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Bibiana Cabrera
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Gisela Mezquida
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Antonio Lobo
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Ana González-Pinto
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Covadonga M Díaz-Caneja
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Iluminada Corripio
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Eduardo J Aguilar
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Antoni Bulbena
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Josefina Castro-Fornieles
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Eduard Vieta
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Amàlia Lafuente
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Sergi Mas
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Mara Parellada
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Jerónimo Saiz-Ruiz
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Manuel J Cuesta
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo)
| | - Miguel Bernardo
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain (Drs Bioque, Cabrera, Mezquida, and Bernardo); CICAB-CAIBER Centro de Investigación Clínica, Hospital Universitario, Servicio Extremeño de Salud SES, Facultad de Medicina Universidad de Extremadura, CIBERSAM, Badajoz, Spain (Dr Llerena); Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain (Dr Lobo); Department of Psychiatry, Hospital Universitario de Alava, CIBERSAM, University of the Basque Country, Vitoria, Spain (Dr González-Pinto); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain (Drs Díaz-Caneja and Parellada); Department of Psychiatry, Hospital de Sant Pau, CIBERSAM, Barcelona, Spain (Dr Corripio); Clinic Hospital Valencia, INCLIVA, CIBERSAM, Valencia University, Valencia, Spain (Dr Aguilar); Department of Psychiatry, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (Dr Bulbena); Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Spain (Dr Castro-Fornieles); Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain (Dr Vieta); Department of Pathological Anatomy, Pharmacology and Microbiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain (Drs Lafuente and Mas); Hospital Ramon y Cajal, Universidad de Alcala, IRYCIS, CIBERSAM, Madrid, Spain (Dr Saiz-Ruiz); Servicio de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (Dr Cuesta); Universitat de Barcelona, IDIBAPS, Barcelona, Spain (Dr Bernardo).
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Síntomas básicos en la esquizofrenia, su estudio clínico y relevancia en investigación. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 9:111-22. [DOI: 10.1016/j.rpsm.2015.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 12/26/2022]
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