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Muñoz-Manchado LI, Perez-Revuelta JI, Banerjee A, Galindo-Guarin L, Bernardo M, González-Saiz F, Villagrán-Moreno JM, Fernández-Egea E. Influence of time to clozapine prescription on the clinical outcome. Schizophr Res 2023:S0920-9964(23)00339-0. [PMID: 37805277 DOI: 10.1016/j.schres.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/24/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND This study investigates whether early clozapine use is associated with improved responses in different clinical domains, including positive and negative symptoms, functioning, and well-being. METHODS Data from 254 clozapine-treated patients at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) were analysed. Among them, 231 (90.9 %) had a diagnosis of schizophrenia, 21 (8.3 %) schizoaffective disorder, and 2 (0.8 %) had other diagnoses. The International Classification of Diseases-Mortality and Morbidity Statistics criteria (ICD-10) were employed (World Health Organization, 1992). The cohort was assessed using the positive and negative syndrome scale (PANSS), the Brief Negative Symptom Scale (BNSS), Global Assessment of Functioning Scale (GAF), and the short version of Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). Logistic regression models (for positive and negative symptom remission) and linear regression (for functioning and well-being) were utilized to assess the influence of time to clozapine initiation (TCI), age at the first episode of psychosis (AFE), duration of clozapine treatment (DCT), and gender. RESULTS Early clozapine treatment (within the first three years after the first episode of psychosis) was associated with increased negative symptom remission (exp (B) = 0.38; p = 0.02) and higher functioning scores (β = -0.12, p = 0.046). However, no effect of time to clozapine initiation was found on positive symptom remission rates or well-being scores. CONCLUSIONS Initiating clozapine treatment within the first 3 years of the first episode of psychosis may lead to reduced severity of negative symptoms and improved functioning in clozapine-treated patients. The time to clozapine initiation did not influence its effect on positive symptom remission rates.
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Affiliation(s)
- Leticia I Muñoz-Manchado
- Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom; Unidad de Gestión clínica de Salud Mental, Área de Gestión Sanitaria Norte de Cádiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder Research Group, Department of Neuroscience, University of Cádiz, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - Jose I Perez-Revuelta
- Unidad de Gestión clínica de Salud Mental, Área de Gestión Sanitaria Norte de Cádiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder Research Group, Department of Neuroscience, University of Cádiz, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - Arka Banerjee
- St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
| | - Liliana Galindo-Guarin
- Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
| | - Miguel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 170, Villarroel St., 8037 Barcelona, Spain.
| | - Francisco González-Saiz
- Unidad de Gestión clínica de Salud Mental, Área de Gestión Sanitaria Norte de Cádiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder Research Group, Department of Neuroscience, University of Cádiz, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - J M Villagrán-Moreno
- Unidad de Gestión clínica de Salud Mental, Área de Gestión Sanitaria Norte de Cádiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder Research Group, Department of Neuroscience, University of Cádiz, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Emilio Fernández-Egea
- Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
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Bernardo M, Fernández-Egea E. CONSENSUS BY THE COLLECTIVE OF PSYCHIATRISTS FOR THE CLOZAPINE UPDATE. Actas Esp Psiquiatr 2023; 51:141-144. [PMID: 37489558 PMCID: PMC10803841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 07/26/2023]
Abstract
Treatment-resistant schizophrenia affects one in three patients with schizophrenia, constituting the most severe group of the disease spectrum.
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Affiliation(s)
- Miquel Bernardo
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Institute of Neurosciences (UBNeuro), Barcelona Clínic Schizophrenia Unit (BCSU), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Center for Biomedical Research in the Mental Health Network (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Emilio Fernández-Egea
- Cambridge Psychosis Centre. Cambridgeshire and Peterborough NHS Foundation Trust. Cambridge, UK Department of Psychiatry. The University of Cambridge. UK
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Toll A, Blanco-Hinojo L, Bergé D, Duran X, Canosa I, Legido T, Marmol F, Pérez-Solà V, Fernández-Egea E, Mané A. Multidimensional predictors of negative symptoms in antipsychotic-naive first-episode psychosis. J Psychiatry Neurosci 2022; 47:E21-E31. [PMID: 35046133 PMCID: PMC8789336 DOI: 10.1503/jpn.210138] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/15/2021] [Accepted: 11/01/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Despite a large body of schizophrenia research, we still have no reliable predictors to guide treatment from illness onset. The present study aimed to identify baseline clinical or neurobiological factors - including peripheral brain-derived neurotrophic factor (BDNF) levels and amygdala or hippocampal relative volumes - that could predict negative symptomatology and persistent negative symptoms in first-episode psychosis after 1 year of follow-up. METHODS We recruited 50 drug-naive patients with first-episode psychosis and 50 age- and sex-matched healthy controls to study brain volumes. We performed univariate and multiple and logistic regression analyses to determine the association between baseline clinical and neurobiological variables, score on the PANSS negative subscale and persistent negative symptoms after 1 year of follow-up. RESULTS Low baseline serum BDNF levels (p = 0.011), decreased left amygdala relative volume (p = 0.001) and more severe negative symptomatology (p = 0.021) predicted the severity of negative symptoms at 1 year, as measured by the PANSS negative subscale. Low baseline serum BDNF levels (p = 0.012) and decreased left amygdala relative volume (p = 0.010) predicted persistent negative symptoms at 1 year. LIMITATIONS We were unable to assess negative symptoms and their dimensions with next-generation scales, which were not available when the study was initiated. CONCLUSION This study shows that a set of variables at baseline, including low BDNF levels, smaller left amygdala relative volume and score on the PANSS negative subscale are significant predictors of outcomes in first-episode psychosis. These findings might offer an initial step for tailoring treatments in first-episode psychosis.
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Affiliation(s)
| | - Laura Blanco-Hinojo
- From the Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain (Toll, Bergé, Canosa, Legido, Pérez-Solà, Mané); the Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Toll, Bergé, Duran, Canosa, Legido, Pérez-Solà, Mané); the Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain (Toll, Blanco-Hinojo, Bergé, Canosa, Pérez-Solà, Mané); the Department of Psychiatry and Forensic Medicine, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Toll); the MRI Research Unit, Department of Radiology, Parc de Salut Mar, Barcelona, Spain (Blanco-Hinojo); the Pharmacology Unit, Department of Clinical Fundamentals, Faculty of Medicine, Barcelona University, Barcelona, Spain (Marmol); and the Department of Psychiatry and Behavioral and Clinical Neuroscience Institute, University of Cambridge, United Kingdom (Fernández-Egea)
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Martínez-Cao C, García-Álvarez L, Bobes-Bascarán T, de la Fuente-Tomás L, Fernández-Egea E, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz-Martínez PA, García-Portilla MP, Bobes J. Validation of a European Spanish adaptation of the Apathy Evaluation Scale-self-rated version (AES-S) in patients with schizophrenia. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:22-28. [PMID: 35256069 DOI: 10.1016/j.rpsmen.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/16/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Apathy is a negative symptom of schizophrenia and is associated with poor real world functioning. Therefore, it is important to have validated psychometric instruments to assess this symptom. This is the first study to validate the Spanish adaptation of the self-rated version of the Apathy Assessment Scale (AES-S) in patients with schizophrenia. MATERIALS AND METHODS Naturalistic, cross-sectional, validation study in 104 patients with schizophrenia evaluated using the following scales: Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP), Clinical Assessment Interview for Negative Symptoms (CAINS), Self-report of Negative Symptoms (SNS), Motivation and Pleasure Scale-Self-Report (MAP-SR), Calgary Depression Scale for Schizophrenia (CDSS), and Apathy Evaluation Scale-self-rated version (AES-S). RESULTS Reliability: Internal consistency (Cronbach's alpha) was 0.908. Convergent validity: The Pearson correlation coefficient between AES-S and CAINS-MAP total scores was -0.483 (p<0.001). For SNS, total and avolition subscale scores were -0.803 and -0.639 (p<0.001), respectively. With the MAP-SR, the correlation coefficient was -0.727 (p<0.001). Divergent validity: The Pearson correlation coefficient between AES-S and PSP total scores was 0.504 (p<0.001). Furthermore, with the CDSS, the correlation coefficient was -0.431 (p<0.001). Discriminant validity: The AES-S discriminated between different levels of illness severity according to CGI-S scores. Factor analysis: A three-component solution explained 57.32% of the variance. Pearson correlations between coefficients were 1-2=0.265, 1-3=0.464, and 2-3=0.060. CONCLUSION The Spanish AES-S is a reliable and valid instrument for assessing apathy in Spanish patients with schizophrenia. It seems to be appropriate for use in everyday clinical practice as a means of monitoring apathy in these patients.
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Affiliation(s)
| | | | | | | | | | - Ángela Velasco
- Dpto. Psiquiatría, CIBERSAM, Universidad de Oviedo, Oviedo, Spain
| | | | | | | | | | | | - Julio Bobes
- Dpto. Psiquiatría, CIBERSAM, ISPA, Universidad de Oviedo, Oviedo, Spain
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Fernández-Egea E. Waiting for Godot or the use of biomarkers in clinical practice. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:123-124. [PMID: 34456029 DOI: 10.1016/j.rpsmen.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Emilio Fernández-Egea
- University of Cambridge, Addenbrooke's Hospital, Psychiatry, Cambridgeshire and Peterborough N, Cambridge, United Kingdom.
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Affiliation(s)
- Emilio Fernández-Egea
- University of Cambridge, Addenbrooke's Hospital, Psychiatry, Cambridgeshire and Peterborough N, Cambridge, United Kingdom.
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7
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Nombela C, Fernández-Egea E, Giné E, Worbe Y, Del Río-Hortega Bereciartu J, de Castro F. Women Neuroscientist Disciples of Pío del Río-Hortega: the Cajal School Spreads in Europe and South America. Front Neuroanat 2021; 15:666938. [PMID: 34040507 PMCID: PMC8143187 DOI: 10.3389/fnana.2021.666938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/26/2021] [Indexed: 11/15/2022] Open
Abstract
Pio del Rio-Hortega was not only the discoverer of the microglia and oligodendroglia but also possibly the most prolific mentor of all Santiago Ramon y Cajal’s disciples (Nobel awardee in Physiology or Medicine 1906 and considered as the father of modern Neuroscience). Among Río-Hortega’s mentees, three exceptional women are frequently forgotten, chronologically: Pio’s niece Asunción Amo del Río who worked with Río-Hortega at Madrid, Paris, and Oxford; the distinguished British neuropathologist Dorothy Russell who also worked with Don Pío at Oxford; and Amanda Pellegrino de Iraldi, the last mentee in his career. Our present work analyzes the figures of these three women who were in contact and collaborated with Don Pío del Río-Hortega, describing the influences received and the impact on their careers and the History of Neuroscience. The present work completes the contribution of women neuroscientists who worked with Cajal and his main disciples of the Spanish Neurological School both in Spain (previous work) and in other countries (present work).
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Affiliation(s)
- Cristina Nombela
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Emilio Fernández-Egea
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Elena Giné
- Departamento de Biología Celular, Universidad Complutense de Madrid, Madrid, España
| | - Yulia Worbe
- Department of Neurophysiology, Saint-Antoine Hospital, Sorbonne Université, Paris, France
| | - Juan Del Río-Hortega Bereciartu
- Departamento de Pediatría, Inmunología, Obstetricia-Ginecología, Nutrición-Bromatología, Psiquiatría e Historia de la Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Fernando de Castro
- Instituto Cajal-CSIC, Spanish Research Council/Consejo Superior de Investigaciones Científicas-CSIC, Madrid, Spain
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Martínez-Cao C, García-Álvarez L, Bobes-Bascarán T, de la Fuente-Tomás L, Fernández-Egea E, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz-Martínez PA, García-Portilla MP, Bobes J. Validation of a European Spanish adaptation of the Apathy Evaluation Scale-self-rated version (AES-S) in patients with schizophrenia. Rev Psiquiatr Salud Ment (Engl Ed) 2020; 15:S1888-9891(20)30033-1. [PMID: 32507728 DOI: 10.1016/j.rpsm.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Apathy is a negative symptom of schizophrenia and is associated with poor real world functioning. Therefore, it is important to have validated psychometric instruments to assess this symptom. This is the first study to validate the Spanish adaptation of the self-rated version of the Apathy Assessment Scale (AES-S) in patients with schizophrenia. MATERIALS AND METHODS Naturalistic, cross-sectional, validation study in 104 patients with schizophrenia evaluated using the following scales: Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP), Clinical Assessment Interview for Negative Symptoms (CAINS), Self-report of Negative Symptoms (SNS), Motivation and Pleasure Scale-Self-Report (MAP-SR), Calgary Depression Scale for Schizophrenia (CDSS), and Apathy Evaluation Scale-self-rated version (AES-S). RESULTS Reliability: Internal consistency (Cronbach's alpha) was 0.908. Convergent validity: The Pearson correlation coefficient between AES-S and CAINS-MAP total scores was -0.483 (p<0.001). For SNS, total and avolition subscale scores were -0.803 and -0.639 (p<0.001), respectively. With the MAP-SR, the correlation coefficient was -0.727 (p<0.001). Divergent validity: The Pearson correlation coefficient between AES-S and PSP total scores was 0.504 (p<0.001). Furthermore, with the CDSS, the correlation coefficient was -0.431 (p<0.001). Discriminant validity: The AES-S discriminated between different levels of illness severity according to CGI-S scores. Factor analysis: A three-component solution explained 57.32% of the variance. Pearson correlations between coefficients were 1-2=0.265, 1-3=0.464, and 2-3=0.060. CONCLUSION The Spanish AES-S is a reliable and valid instrument for assessing apathy in Spanish patients with schizophrenia. It seems to be appropriate for use in everyday clinical practice as a means of monitoring apathy in these patients.
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Affiliation(s)
| | | | | | | | | | - Ángela Velasco
- Dpto. Psiquiatría, CIBERSAM, Universidad de Oviedo, Oviedo, Spain
| | | | | | | | | | | | - Julio Bobes
- Dpto. Psiquiatría, CIBERSAM, ISPA, Universidad de Oviedo, Oviedo, Spain
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Dal Santo F, Jarratt-Barnham I, González-Blanco L, García-Portilla MP, Bobes J, Fernández-Egea E. Longitudinal effects of clozapine concentration and clozapine to N-desmethylclozapine ratio on cognition: A mediation model. Eur Neuropsychopharmacol 2020; 33:158-163. [PMID: 32057590 DOI: 10.1016/j.euroneuro.2020.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/08/2020] [Accepted: 01/26/2020] [Indexed: 11/20/2022]
Abstract
Previous cross-sectional studies have found clozapine to N-desmethylclozapine (CLZ:NDMC) ratio to be negatively correlated with cognition in clozapine-treated patients with schizophrenia. However, no work has examined the association between CLZ:NDMC ratio and cognition using a within-subjects design. Here, we investigate the longitudinal effects of changes in the clozapine load and the CLZ:NDMC ratio on cognition whilst controlling for a range of independent factors. We analyzed data from a cohort of seventeen clozapine-treated patients who have been repeatedly assessed with the Brief Assessment of Cognition for Schizophrenia (BACS). The Positive symptoms sub-score of the Clinical Global Impression for Schizophrenia (CGI-P) was used to assess severity of psychosis. Blood samples were collected to measure the plasmatic levels of clozapine (CLZ) and of N-desmethylclozapine, allowing calculation of the CLZ:NDMC ratio. Our analyses included bivariate and partial correlations, along with a mediation model analysis. We found that both plasmatic levels of CLZ and the CLZ:NDMC ratio were negatively correlated with cognitive performance, and that these associations were independent of changes in both daily clozapine dose and severity of psychotic symptoms. Mediation analyses further revealed the association between CLZ concentration and cognition to be partially mediated by changes in the CLZ:NDMC ratio. This is the first longitudinal analysis of the influence of CLZ concentration and CLZ:NDMC ratio on cognition. Our findings suggest that reduction of CLZ concentration and the CLZ:NDMC ratio might favorably affect cognition. Thus, the CLZ:NDMC ratio may represent a promising target for novel therapeutic strategies aiming to ameliorate cognitive impairment in clozapine-treated patients.
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Affiliation(s)
- Francesco Dal Santo
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Isaac Jarratt-Barnham
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Leticia González-Blanco
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - María Paz García-Portilla
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Julio Bobes
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Emilio Fernández-Egea
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, 128 Tenison Road, CB1 2DP Cambridge, UK.
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Mezquida G, Fernández-Egea E, Treen D, Mané A, Bergé D, Savulich G, García-Álvarez L, García-Portilla MP, Bobes J, Bernardo M, García-Rizo C. Difficulties in delivery and depressive symptomatology in schizophrenia. Rev Psiquiatr Salud Ment (Engl Ed) 2020; 14:66-68. [PMID: 32061577 DOI: 10.1016/j.rpsm.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/18/2019] [Accepted: 12/05/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Gisela Mezquida
- Unidad de Esquizofrenia, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España.
| | - Emilio Fernández-Egea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, Reino Unido; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, Reino Unido
| | - Devi Treen
- Instituto de Neuropsiquiatría y Adicciones, Hospital del Mar, Barcelona, España
| | - Anna Mané
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Instituto Hospital del Mar de Investigación Médica (IMIM)-Universidad Autónoma de Barcelona, Neurociencias, Psiquiatría, Barcelona, España
| | - Daniel Bergé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Instituto de Neuropsiquiatría y Adicciones, Parc de Salut Mar, Instituto Hospital del Mar de Investigación Médica (IMIM), Barcelona, España
| | - George Savulich
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, Reino Unido
| | | | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España
| | - Miguel Bernardo
- Unidad de Esquizofrenia, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España
| | - Clemente García-Rizo
- Unidad de Esquizofrenia, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España
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Garcia-Portilla MP, Garcia-Alvarez L, Mané A, Garcia-Rizo C, Sugranyes G, Bergé D, Bernardo M, Fernández-Egea E, Bobes J. The negative syndrome of schizophrenia: three -underlying components are better than two. Schizophr Res 2015; 166:115-8. [PMID: 26044112 DOI: 10.1016/j.schres.2015.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 04/24/2015] [Accepted: 05/04/2015] [Indexed: 11/19/2022]
Abstract
AIMS To analyse the underlying structure of the negative syndrome of schizophrenia as it is represented in the Brief Negative Symptom Scale. METHODS Cross-sectional, multicentre study, employing data from 190 evaluations. STATISTICS Exploratory factor analysis using the principal component analysis method. RESULTS The three-component solution explained 77.4% of the total variance. Pearson correlation coefficients between components were: 1-2=-0.494, 1-3=-0.117, and 2-3=0.179. CONCLUSION Our solution favours a three-component structure of the negative syndrome, consisting of: external world (anhedonia and asociality), inner world (avolition and blunted affect), and alogia, with the latter only marginally related to the two former components.
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Affiliation(s)
- Maria Paz Garcia-Portilla
- Department of Psychiatry, University of Oviedo, Spain; Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain.
| | | | - Anna Mané
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain; Institut de Neuropsiquiatria i Adiccions, Parc de Salut Mar, Barcelona, Spain; Fundació IMIM, Barcelona, Spain
| | - Clemente Garcia-Rizo
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain; Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatric Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Bergé
- Institut de Neuropsiquiatria i Adiccions, Parc de Salut Mar, Barcelona, Spain; Fundació IMIM, Barcelona, Spain
| | - Miguel Bernardo
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain; Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Fernández-Egea
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Spain; Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain
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Horga G, Fernández-Egea E, Mané A, Font M, Schatz KC, Falcon C, Lomeña F, Bernardo M, Parellada E. Brain metabolism during hallucination-like auditory stimulation in schizophrenia. PLoS One 2014; 9:e84987. [PMID: 24416328 PMCID: PMC3885666 DOI: 10.1371/journal.pone.0084987] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 11/25/2013] [Indexed: 11/19/2022] Open
Abstract
Auditory verbal hallucinations (AVH) in schizophrenia are typically characterized by rich emotional content. Despite the prominent role of emotion in regulating normal perception, the neural interface between emotion-processing regions such as the amygdala and auditory regions involved in perception remains relatively unexplored in AVH. Here, we studied brain metabolism using FDG-PET in 9 remitted patients with schizophrenia that previously reported severe AVH during an acute psychotic episode and 8 matched healthy controls. Participants were scanned twice: (1) at rest and (2) during the perception of aversive auditory stimuli mimicking the content of AVH. Compared to controls, remitted patients showed an exaggerated response to the AVH-like stimuli in limbic and paralimbic regions, including the left amygdala. Furthermore, patients displayed abnormally strong connections between the amygdala and auditory regions of the cortex and thalamus, along with abnormally weak connections between the amygdala and medial prefrontal cortex. These results suggest that abnormal modulation of the auditory cortex by limbic-thalamic structures might be involved in the pathophysiology of AVH and may potentially account for the emotional features that characterize hallucinatory percepts in schizophrenia.
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Affiliation(s)
- Guillermo Horga
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, United States of America
- Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- * E-mail:
| | - Emilio Fernández-Egea
- Department of Psychiatry, University of Cambridge, Cambridge, and the Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon, United Kingdom
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna Mané
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Centre Forum, Barcelona, Spain
| | - Mireia Font
- Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Kelly C. Schatz
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, United States of America
| | | | - Francisco Lomeña
- Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d′Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miguel Bernardo
- Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d′Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eduard Parellada
- Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d′Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Horga G, Parellada E, Lomeña F, Fernández-Egea E, Mané A, Font M, Falcón C, Konova AB, Pavia J, Ros D, Bernardo M. Differential brain glucose metabolic patterns in antipsychotic-naïve first-episode schizophrenia with and without auditory verbal hallucinations. J Psychiatry Neurosci 2011; 36:312-21. [PMID: 21266125 PMCID: PMC3163647 DOI: 10.1503/jpn.100085] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are a core symptom of schizophrenia. Previous reports on neural activity patterns associated with AVHs are inconsistent, arguably owing to the lack of an adequate control group (i.e., patients with similar characteristics but without AVHs) and neglect of the potential confounding effects of medication. METHODS The current study was conducted in a homogeneous group of patients with schizophrenia to assess whether the presence or absence of AVHs was associated with differential regional cerebral glucose metabolic patterns. We investigated differences between patients with commenting AVHs and patients without AVHs among a group of dextral antipsychotic-naive inpatients with acute first-episode schizophrenia examined with [(18)F]fluoro-deoxyglucose positron emission tomography (FDG-PET) at rest. Univariate and multivariate approaches were used to establish between-group differences. RESULTS We included 9 patients with AVHs and 7 patients without AVHs in this study. Patients experiencing AVHs during FDG uptake had significantly higher metabolic rates in the left superior and middle temporal cortices, bilateral superior medial frontal cortex and left caudate nucleus (cluster level p < 0.005, family wise error-corrected, and bootstrap ratio > 3.3, respectively). Additionally, the multivariate method identified hippocampal-parahippocampal, cerebellar and parietal relative hypoactivity during AVHs in both hemispheres (bootstrap ratio < -3.3). LIMITATIONS The FDG-PET imaging technique does not provide information regarding the temporal course of neural activity. The limited sample size may have increased the risk of false-negative findings. CONCLUSION Our results indicate that AVHs in patients with schizophrenia may be mediated by an alteration of neural pathways responsible for normal language function. Our findings also point to the potential role of the dominant caudate nucleus and the parahippocampal gyri in the pathophysiology of AVHs. We discuss the relevance of phenomenology-based grouping in the study of AVHs.
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Affiliation(s)
- Guillermo Horga
- Clinic Schizophrenia Program, Psychiatry Department, Hospital Clinic of Barcelona, Barcelona, Spain.
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Ahuir M, Bernardo M, de la Serna E, Ochoa S, Carlson J, Escartín G, Gutiérrez-Zotes A, Valero J, Salamero M, Cañizares S, Fernández-Egea E, Cañete J, Gallo P. Adaptación y validación española de la Escala Pronóstica para la Esquizofrenia de Strauss y Carpenter. Revista de Psiquiatría y Salud Mental 2009; 2:150-9. [DOI: 10.1016/s1888-9891(09)73233-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 10/30/2009] [Indexed: 11/17/2022]
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Cardinal RN, Shah DN, Edwards CJ, Hughes GRV, Fernández-Egea E. Psychosis and catatonia as a first presentation of antiphospholipid syndrome. Br J Psychiatry 2009; 195:272. [PMID: 19721128 DOI: 10.1192/bjp.195.3.272] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Bernardo M, Fernández-Egea E, Torras A, Gutiérrez F, Ahuir M, Arango C. [Adaptation and validation into Spanish of Schedule for the Deficit Syndrome]. Med Clin (Barc) 2007; 129:91-3. [PMID: 17594858 DOI: 10.1157/13107363] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Schizophrenia is a high prevalent disorder associated with huge economic and sanitary costs. Negative symptoms represent the main prognostic factors, thus to identify them is important to design effective guidelines of treatment. The Schedule for the Deficit Syndrome (SDS) is the only validated method to evaluate those symptoms as primary and stable. We propose its adaptation and validation into Spanish. PATIENTS AND METHOD Patients diagnosed of schizophrenia attended at 2 different hospitals were evaluated with SDS (Spanish version) and PANSS (Positive and Negative Symptom Scale). Stable patients were reevaluated 6 months later. One rater acted as gold standard while two 2 raters, naïve to SDS, evaluated patients too. RESULTS Twenty-one patients were evaluated (15 men). Raters agreed ranged from kappa = 0.79 to kappa = 0.89 with gold standard and kappa = 0.90 between them. Kappa ranged from 0.60-0.70 for severity criteria and 0.78-0.90 for primary criteria. Temporal stability at 6 months between raters was kappa = 0.72 and 0.87. We also evaluated interclass correlation index and homogeneity of construct. CONCLUSIONS After a brief training with the Spanish version of SDS, is fast and feasible to categorize patients into deficit or non-deficit forms of schizophrenia.
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Affiliation(s)
- Miguel Bernardo
- Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic, Barcelona, España.
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Gómez-Gil E, Fernández-Egea E, Trilla A, Almela M. Relevancia de la serología luética sistemática en pacientes ingresados por enfermedad psiquiátrica aguda. Med Clin (Barc) 2007; 129:77. [PMID: 17588367 DOI: 10.1157/13106941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Fernández-Egea E, Ferrer del Alamo A, Torrebadell Burriel M, Carrió Ybáñez A. [Velo-cardio-facial syndrome at the psychiatry consulting-liaison service in a general hospital]. Actas Esp Psiquiatr 2006; 34:67-8. [PMID: 16525908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Psychotic syndromes secondary to genomic disorders have low prevalence and may easily go unnoticed in the daily clinical practice. The velo-cardio-facial syndrome or DiGeorge syndrome (VCFS/DGS) is the genomic disorder most frequently associated to an interstitial deletion of the 22q11 region, with an incidence of one per every 4,000 newborns. Clinical manifestations constitute a constellation of cardiac, facial, urogenital and psychiatric disorders, among which schizophrenia or schizophreniform disorder stand out with an incidence of about 30% over the lifetime. In the following, we present the case of a 21 year old female patient who was admitted to the hematology service of our hospital due to pancytopenia secondary to metimazole, who had non-specified psychiatric background and who received antipsychotic treatment.
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Affiliation(s)
- E Fernández-Egea
- Servicio de Psiquiatría, Institut de Neurociències, Hospital Clínic, Barcelona.
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Baillès E, Pintor L, Torres X, Fernández-Egea E, de Pablo J, Arroyo S. [Psychiatric disease in patients with psychogenic non-epileptic seizures referred from an epilepsy unit in a general hospital]. Actas Esp Psiquiatr 2004; 32:76-81. [PMID: 15042467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION We evaluate psychiatric disease associated with psychogenic non-epileptic seizures (PNES) and study the role played by previous traumatic experiences, dissociative episodes and personality disorders. METHOD After diagnosing PNES in our epilepsy unit, we obtained a sample of 46 patients and carried out a structured psychiatric interview (SCID) following DSM-III-R criteria. We looked for previous dissociative episodes and prepared a questionnaire for traumatic experiences and basic clinical data. RESULTS The most frequent psychiatric disorders were depression, anxiety and somatoform disorders. Personality disorders were found in 16 patients (34.78%), dissociative episodes in 17 (36.95%), and previous traumatic experiences in 14 (30.43%). No statistically significant differences were found in regards to PNES, with respect to presence or absence of previous traumatic experiences, dissociative episodes, and personality disorders. CONCLUSIONS As in previous studies, our research project confirms the co-existence of PNES with other mental disorders, and although we do find a higher frequency of seizures, the role played by traumatic experiences and dissociative disorders in CNEP remains unclear.
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Affiliation(s)
- E Baillès
- Instituto Clínico de Psiquitatría y Psicología, Hospital Clínic de Barcelona.
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20
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Parellada E, Lomeña F, Catafau AM, Bernardo M, Font M, Fernández-Egea E, Pavía J, Gutierrez F. Lack of sex differences in striatal dopamine D2 receptor binding in drug-naive schizophrenic patients: an IBZM-SPECT study. Psychiatry Res 2004; 130:79-84. [PMID: 14972370 DOI: 10.1016/j.pscychresns.2003.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2002] [Revised: 04/24/2003] [Accepted: 05/25/2003] [Indexed: 11/20/2022]
Abstract
Differences in antipsychotic treatment response, clinical course and outcome of schizophrenia could be related to gender-related cerebral differences in anatomy and function. The aim of the study was to assess sex differences in the striatal dopamine D2 receptor binding in 15 drug-naive schizophrenic patients (seven males, eight females) using (123)I-IBZM single photon emission computed tomography. Basal ganglia/frontal cortex (BG/FC) uptake ratios were obtained. No significant differences were found in global, left and right BG/FC ratios or laterality indices between males and females. No correlation was found between BG/FC ratios and age, duration of illness or scores on symptom rating scales. Our data indicate a lack of sex differences in striatal D2 receptor binding in drug-naive schizophrenic patients and do not support previous reports of left lateralized striatal asymmetry in male schizophrenic patients.
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Affiliation(s)
- Eduard Parellada
- Department of Psychiatry, Hospital ClínicVillarroel 170, Universitat de Barcelona, E-08036 Barcelona, Spain.
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Gómez-Gil E, Vidal A, Panés J, Jaén J, Peri JM, Fernández-Egea E, Piqué JM. [Relationship between patient's subjective stress perception and the course of inflammatory bowel disease]. Gastroenterol Hepatol 2003; 26:411-6. [PMID: 12887854 DOI: 10.1016/s0210-5705(03)70382-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Studies examining the relationship between stress secondary to adverse life events (ALE) and inflammatory bowel disease (IBD) have produced controversial data. The aim of this study was to explore the subjective perception of this relationship in IBD patients. PATIENTS AND METHODS Seventy consecutive patients suffering from IBD (40 Crohn's disease, 30 ulcerative colitis) were assessed using a self-rating questionnaire related to demographic variables, clinical characteristics, subjective perception of the influence of ALE on the course of IBD, psychiatric background, and the HAD scale. The results of this scale were compared with a group of 25 relatives. RESULTS Forty-two patients (60%) perceived that there was relationship between ALE and the onset of their disease, forty-nine (70%) between ALE and the increasing IBD symptoms severity, and fifty-one patients (72.9%) with disease activity. Sixteen of the patients (22.9%) had been visited by a psychiatrist during relapses of IBD. Twenty-five patients (42.4%) reached a score of 11 or higher on the depression or anxiety subscales of the HAD, indicating a probable psychological disorder. CONCLUSIONS IBD patients perceive a strong relationship between ALE and the course of IBD. We have found a high prevalence of anxiety and depression symptoms in these patients. If this observation is confirmed with objective measurements, it will be important to consider psychiatric intervention for these patients.
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Affiliation(s)
- E Gómez-Gil
- Institut Clínic de Psiquiatria i Psicologia. Hospital Clínic. Barcelona. España.
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Font M, Parellada E, Fernández-Egea E, Bernardo M, Lomeña F. [Functional neuroimaging of auditory hallucinations in schizophrenia]. Actas Esp Psiquiatr 2003; 31:3-9. [PMID: 12590366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The neurobiological bases underlying the generation of auditory hallucinations, a distressing and paradigmatic symptom of schizophrenia, are still unknown in spite of in-depth phenomenological descriptions. This work aims to make a critical review of the latest published literature in recent years, focusing on functional neuroimaging studies (PET, SPECT, fMRI) of auditory hallucinations. Thus, the studies are classified according to whether they are sensory activation, trait and state. The two main hypotheses proposed to explain the phenomenon, external speech vs. subvocal or inner speech, are also explained. Finally, the latest unitary theory as well as the limitations the studies published are commented on. The need to continue investigating in this field, that is still underdeveloped, is posed in order to understand better the etiopathogenesis of auditory hallucinations in schizophrenia.
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Affiliation(s)
- M Font
- Instituto Clínico de Psiquiatría y Psicología, Hospital Clínico y Universitario de Barcelona, España
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Fernández-Egea E, Gómez Gil E, Corbella Santomà B, Salamero Baró M, Blanch Andreu J, Valdés Miyar M. [Serological testing and prevalence of human immunodeficiency, hepatitis B and C viruses infections amongst acute psychiatric inpatients]. Med Clin (Barc) 2002; 119:690-2. [PMID: 12459106 DOI: 10.1016/s0025-7753(02)73543-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The request for serological tests for HIV, HBV and HCV is usual amongst acute psychiatric inpatients. Nevertheless, the seroprevalence and the repercussion of a positive result have been scarcely studied. PATIENTS AND METHOD Serological requests for these viruses were retrospectively analyzed in a sample of 332 psychiatric inpatients. RESULTS Serological tests were requested by 65.3% patients. The prevalence of any seropositivity was 7.3%: 1.4% were infected by HIV-I, 3.2% had been in contact with HBV but none had an active infection, and 5.1% were infected by HCV. The presence of a positive result did not change the psychiatric therapeutic approach in any case. CONCLUSIONS The low prevalence of seropositivity suggests that such tests should be performed selectively in patients who present risk factors or atypical psychiatric symptoms.
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Gómez-Gil E, Trilla A, Corbella B, Fernández-Egea E, Luburich P, de Pablo J, Ferrer Raldúa J, Valdés M. Lack of clinical relevance of routine chest radiography in acute psychiatric admissions. Gen Hosp Psychiatry 2002; 24:110-3. [PMID: 11869746 DOI: 10.1016/s0163-8343(01)00179-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To make clinically relevant recommendations for chest X-ray testing in acute psychiatric admissions, this study examined the current practice of this screening test in patients admitted to a University Hospital. The records of the 332 first consecutive admissions to the psychiatric ward were assessed. In 200 patients (60%) a chest X-ray was requested. The X-ray film was normal in 81.5% of patients. The remaining subjects presented abnormalities: nonrelevant in twenty-seven (13.5% of the total), and relevant in eleven (5.5%). Since all these relevant abnormalities were already known, in no cases was the test followed by changes in therapy or by additional diagnostic procedures. In almost all cases this screening test was of no practical value. Our findings challenge the systematic indication of chest X-ray in acute psychiatric patients, and suggest that the number of tests performed and the cost of medical care could be reduced by a more efficient use of past medical history and physical examination criteria, without compromising the quality of patient care.
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Affiliation(s)
- Esther Gómez-Gil
- Psychiatry and Clinical Psychology Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
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