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Regulation of inflammatory pathways in schizophrenia: A comparative study with bipolar disorder and healthy controls. Eur Psychiatry 2020; 47:50-59. [DOI: 10.1016/j.eurpsy.2017.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/19/2017] [Accepted: 09/26/2017] [Indexed: 12/20/2022] Open
Abstract
AbstractBackgroundImmune-inflammatory processes have been implicated in schizophrenia (SCH), but their specificity is not clear.Main aimTo identify potential differential intra-/intercellular biochemical pathways controlling immune-inflammatory response and their oxidative-nitrosative impact on SCH patients, compared with bipolar disorder (BD) patients and healthy controls (HC).MethodsCross-sectional, naturalistic study of a cohort of SCH patients (n=123) and their controls [BD (n=102) and HC (n=80)].Statistical analysisANCOVA (or Quade test) controlling for age and gender when comparing the three groups, and controlling for age, gender, length of illness, cigarettes per day, and body mass index (BMI) when comparing SCH and BD.ResultsPro-inflammatory biomarkers: Expression of COX-1 was statistically higher in SCH and BD than HC (P<0.0001; P<0.0001); NFκB and PGE2 were statistically higher in SCH compared with BD (P=0.001; P<0.0001) and HC (P=0.003; P<0.0001); NLRP3 was higher in BD than HC (P=0.005); and CPR showed a gradient among the three groups. Anti-inflammatory biomarkers: BD patients had lower PPARγ and higher 15d-PGJ2 levels than SCH (P=0.005; P=0.008) and HC (P=0.001; P=0.001). Differences between SCH and BD: previous markers of SCH (NFκB and PGE2) and BD (PPARγ and 15d-PGJ2) remained statistically significant and, interestingly, iNOS and COX-2 (pro-inflammatory biomarkers) levels were statistically higher in SCH than BD (P=0.019; P=0.040).ConclusionsThis study suggests a specific immune-inflammatory biomarker pattern for established SCH (NFκB, PGE2, iNOS, and COX-2) that differentiates it from BD and HC. In future, their pharmacological modulation may constitute a promising therapeutic target.
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Alamo C, García-Garcia P, Lopez-Muñoz F, Zaragozá C. Tianeptine, an atypical pharmacological approach to depression. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 12:170-186. [PMID: 30612921 DOI: 10.1016/j.rpsm.2018.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023]
Abstract
The introduction of the first antidepressants in the 50s of the 20th century radically changed the treatment of depression, while providing information on pathophysiological aspects of this disease. New antidepressants drugs (agomelatine, tianeptine, vortioxetine) are providing data that give rise to pathophysiological hypotheses of depression that differ from the classic monoaminergic theory. In this sense, tianeptina, an atypical drug by its mechanism of differential action, contributes to clarify that in depression there is more than monoamines. Thus, tianeptine does not modify the rate of extracellular serotonin, so it does not increase or decrease the reuptake of serotonin. Chronic administration of tianeptine does not alter the density or affinity of more than a hundred classical receptors related to depression. Recently, a weak action of tianeptine on Mu opioid receptors has been described that could explain the release of dopamine in the limbic system and its participation in the modulation of glutamatergic mechanisms. These mechanisms support the hypothesis of the possible mechanism of action of this antidepressant. Tianeptine is an antidepressant, with anxiolytic properties, that can improve somatic symptoms. Tianeptine as a glutamatergic modulator, among other mechanisms, allows us to approach depression from a different point of view than other antidepressants.
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Affiliation(s)
- Cecilio Alamo
- Departamento de Ciencias Biomédicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
| | - Pilar García-Garcia
- Departamento de Ciencias Biomédicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Francisco Lopez-Muñoz
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, España; Unidad de Neuropsicofarmacología, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, España
| | - Cristina Zaragozá
- Departamento de Ciencias Biomédicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España
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Llorca PM, Bobes J, Fleischhacker WW, Heres S, Moore N, Bent-Ennakhil N, Sapin C, Loze JY, Nylander AG, Patel MX. Baseline results from the European non-interventional Antipsychotic Long acTing injection in schizOphrenia (ALTO) study. Eur Psychiatry 2018; 52:85-94. [PMID: 29734130 DOI: 10.1016/j.eurpsy.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/06/2018] [Accepted: 04/07/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The Antipsychotic Long-acTing injection in schizOphrenia (ALTO) study was a non-interventional study across several European countries examining prescription of long-acting injectable (LAI) antipsychotics to identify sociodemographic and clinical characteristics of patients receiving and physicians prescribing LAIs. ALTO was also the first large-scale study in Europe to report on the use of both first- or second-generation antipsychotic (FGA- or SGA-) LAIs. METHODS Patients with schizophrenia receiving a FGA- or SGA-LAI were enrolled between June 2013 and July 2014 and categorized as incident or prevalent users. Assessments included measures of disease severity, functioning, insight, well-being, attitudes towards antipsychotics, and quality of life. RESULTS For the 572 patients, disease severity was generally mild-to-moderate and the majority were unemployed and/or socially withdrawn. 331/572 were prevalent LAI antipsychotic users; of whom 209 were prescribed FGA-LAI. Paliperidone was the most commonly prescribed SGA-LAI (56% of incident users, 21% of prevalent users). 337/572 (58.9%) were considered at risk of non-adherence. Prevalent LAI users had a tendency towards better insight levels (PANSS G12 item). Incident FGA-LAI users had more severe disease, poorer global functioning, lower quality of life, higher rates of non-adherence, and were more likely to have physician-reported lack of insight. CONCLUSIONS These results indicate a lower pattern of FGA-LAI usage, reserved by prescribers for seemingly more difficult-to-treat patients and those least likely to adhere to oral medication.
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Affiliation(s)
- Pierre-Michel Llorca
- University Hospital Center, EA 7280 University Clermont Auvergne, Clermont-Ferrand, France
| | - Julio Bobes
- Department of Psychiatry - CIBERSAM, University of Oviedo, Oviedo, Spain
| | - W Wolfgang Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry, Medical University Innsbruck, Innsbruck, Austria
| | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Munich Technical University, Munich, Germany
| | - Nicholas Moore
- Department of Pharmacology, University of Bordeaux, Bordeaux, France
| | | | | | - Jean-Yves Loze
- Otsuka Pharmaceutical Europe Ltd., Wexham, United Kingdom
| | | | - Maxine X Patel
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Kroeger CM, Garza C, Lynch CJ, Myers E, Rowe S, Schneeman BO, Sharma AM, Allison DB. Scientific rigor and credibility in the nutrition research landscape. Am J Clin Nutr 2018; 107:484-494. [PMID: 29566196 PMCID: PMC6248649 DOI: 10.1093/ajcn/nqx067] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 12/27/2022] Open
Abstract
Scientific progress depends on the quality and credibility of research methods. As discourse on rigor, transparency, and reproducibility joins the cacophony of nutrition information and misinformation in mass media, buttressing the real and perceived reliability of nutrition science is more important than ever. This broad topic was the focus of a 2016 plenary session, "Scientific Rigor and Competing Interests in the Nutrition Research Landscape." This article summarizes and expands on this session in an effort to increase understanding and dialogue with regard to factors that limit the real and perceived reliability of nutrition science and steps that can be taken to mitigate those factors. The end goal is to both earn and merit greater trust in nutrition science by both the scientific community and the general public. The authors offer suggestions in each of the domains of education and training, communications, research conduct, and procedures and policies to help achieve this goal. The authors emphasize the need for adequate funding to support these efforts toward greater rigor and transparency, which will be resource demanding and may require either increased research funding or the recognition that a greater proportion of research funding may need to be allocated to these tasks.
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Affiliation(s)
- Cynthia M Kroeger
- Department of Epidemiology and Biostatistics, Indiana University School of
Public Health-Bloomington, Bloomington, IN
| | | | - Christopher J Lynch
- National Institutes of Diabetes and Digestive and Kidney Diseases, NIH,
Bethesda, MD
| | | | | | | | | | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of
Public Health-Bloomington, Bloomington, IN
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Catalá-López F, Alonso-Arroyo A, Page MJ, Hutton B, Tabarés-Seisdedos R, Aleixandre-Benavent R. Mapping of global scientific research in comorbidity and multimorbidity: A cross-sectional analysis. PLoS One 2018; 13:e0189091. [PMID: 29298301 PMCID: PMC5751979 DOI: 10.1371/journal.pone.0189091] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/18/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The management of comorbidity and multimorbidity poses major challenges to health services around the world. Analysis of scientific research in comorbidity and multimorbidity is limited in the biomedical literature. This study aimed to map global scientific research in comorbidity and multimorbidity to understand the maturity and growth of the area during the past decades. METHODS AND FINDINGS This was a cross-sectional analysis of the Web of Science. Searches were run from inception until November 8, 2016. We included research articles or reviews with no restrictions by language or publication date. Data abstraction was done by one researcher. A process of standardization was conducted by two researchers to unify different terms and grammatical variants and to remove typographical, transcription, and/or indexing errors. All potential discrepancies were resolved via discussion. Descriptive analyses were conducted (including the number of papers, citations, signatures, most prolific authors, countries, journals and keywords). Network analyses of collaborations between countries and co-words were presented. During the period 1970-2016, 85994 papers (64.0% in 2010-2016) were published in 3500 journals. There was wide diversity in the specialty of the journals, with psychiatry (16558 papers; 19.3%), surgery (9570 papers; 11.1%), clinical neurology (9275 papers; 10.8%), and general and internal medicine (7622 papers; 8.9%) the most common. PLOS One (1223 papers; 1.4%), the Journal of Affective Disorders (1154 papers; 1.3%), the Journal of Clinical Psychiatry (727 papers; 0.8%), the Journal of the American Geriatrics Society (634 papers; 0.7%) and Obesity Surgery (588 papers; 0.7%) published the largest number of papers. 168 countries were involved in the production of papers. The global productivity ranking was headed by the United States (37624 papers), followed by the United Kingdom (7355 papers), Germany (6899 papers) and Canada (5706 papers). Twenty authors who published 100 or more papers were identified; the most prolific authors were affiliated with Harvard Medical School, State University of New York Upstate Medical University, National Taiwan Normal University and China Medical University. The 50 most cited papers ("citation classics" with at least 1000 citations) were published in 20 journals, led by JAMA Psychiatry (11 papers) and JAMA (10 papers). The most cited papers provided contributions focusing on methodological aspects (e.g. Charlson Comorbidity Index, Elixhauser Comorbidity Index, APACHE prognostic system), but also important studies on chronic diseases (e.g. epidemiology of mental disorders and its correlates by the U.S. National Comorbidity Survey, Fried's frailty phenotype or the management of obesity). CONCLUSIONS Ours is the first analysis of global scientific research in comorbidity and multimorbidity. Scientific production in the field is increasing worldwide with research leadership of Western countries, most notably, the United States.
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Affiliation(s)
- Ferrán Catalá-López
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
- Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Adolfo Alonso-Arroyo
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- Unidad de Información e Investigación Social y Sanitaria-UISYS, University of Valencia and Spanish National Research Council (CSIC), Valencia, Spain
| | - Matthew J. Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - Rafael Aleixandre-Benavent
- Unidad de Información e Investigación Social y Sanitaria-UISYS, University of Valencia and Spanish National Research Council (CSIC), Valencia, Spain
- Ingenio-Spanish National Research Council (CSIC) and Universitat Politécnica de Valencia (UPV), Valencia, Spain
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Muñoz-Negro JE, Cervilla JA. The comprehensive treatment of delusional disorder. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:221-223. [PMID: 28476504 DOI: 10.1016/j.rpsm.2017.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 01/10/2023]
Affiliation(s)
- José E Muñoz-Negro
- UGC de Salud Mental, Complejo Hospitalario Universitario de Granada, Servicio Andaluz de Salud, Granada, España.
| | - Jorge A Cervilla
- UGC de Salud Mental, Complejo Hospitalario Universitario de Granada, Servicio Andaluz de Salud, Granada, España; Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España
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Comparative study of pencil-and-paper and electronic formats of GHQ-12, WHO-5 and PHQ-9 questionnaires. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:160-167. [PMID: 28237432 DOI: 10.1016/j.rpsm.2016.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 12/11/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The increase in telemedicine in the mental health field has led to psychometric instruments changing from paper-and-pencil administration to an electronic format. A study is performed to determine if both formats are equivalent for well-known questionnaires such as GHQ-12, WHO-5, and PHQ-9. MATERIAL AND METHODS Forty-seven volunteers completed GHQ-12, WHO-5 and PHQ-9 questionnaires in paper-and-pencil format, and in the following 24h they completed their electronic versions via the web site www.memind.net. An electronic-Likert format was used by 24 participants, and 23 used an electronic-slider format. Internal consistency was measured by α-Cronbach index and omega coefficient, and test-retest was measured by the intraclass correlation coefficient (ICC). Agreement between individual items was compared using Weighted Kappa coefficients, and dimensional structure between formats using the Comparative Fit Index (CFI). RESULTS Internal consistency was higher than 0.8 for GHQ-12 and WHO-5. The ICC ranged between 0.655 for PHQ-9 paper-and-pencil/electronic-slider and 0.901 for GHQ-12 paper-and-pencil/electronic- slider. Agreement for individual items in paper-and-pencil and electronic-Likert versions was variable, ranging from low agreement in PHQ-1 (weighted κ=0.143; P=.384) to high agreement in PHQ-5 (weighted κ=0.769; P=.000). The CFI results showed an adequate equivalence between formats. CONCLUSIONS Except for the PHQ-9 electronic-Likert, questionnaires keep their structure in electronic formats. Discrepancies were found in items agreement. This study supports previous works indicating that the change from paper-and-pencil to electronic formats is not an immediate process, and needs a proper adaptation.
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Menchón JM, Bobes J, Saiz-Ruiz J. Obsessive-compulsive disorder: The usefulness of a pharmacological practice guideline. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 9:131-133. [PMID: 27368427 DOI: 10.1016/j.rpsm.2016.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Affiliation(s)
- José M Menchón
- Departamento de Psiquiatría, Hospital Universitario de Bellvitge-IDIBELL, Departamento de Ciencias Clínicas, Universidad de Barcelona. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), L'Hospitalet de Llobregat, Barcelona, España.
| | - Julio Bobes
- Departamento de Psiquiatría, Universidad de Oviedo, Hospital Universitario Central de Asturias, Centro de Investigación Biomédica en Red área de Salud Mental (CIBERSAM), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
| | - Jerónimo Saiz-Ruiz
- Departamento de Psiquiatría, Hospital Universitario Ramón y Cajal, CIBERSAM, IRYCIS. Universidad de Alcalá, Alcalá de Henares, Madrid, España
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