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Aranda S, Jiménez E, Canales-Rodríguez EJ, Verdolini N, Alonso S, Sepúlveda E, Julià A, Marsal S, Bobes J, Sáiz PA, García-Portilla P, Menchón JM, Crespo JM, González-Pinto A, Pérez V, Arango C, Sierra P, Sanjuán J, Pomarol-Clotet E, Vieta E, Vilella E. Processing speed mediates the relationship between DDR1 and psychosocial functioning in euthymic patients with bipolar disorder presenting psychotic symptoms. Mol Psychiatry 2024:10.1038/s41380-024-02480-1. [PMID: 38374360 DOI: 10.1038/s41380-024-02480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
The DDR1 locus is associated with the diagnosis of schizophrenia and with processing speed in patients with schizophrenia and first-episode psychosis. Here, we investigated whether DDR1 variants are associated with bipolar disorder (BD) features. First, we performed a case‒control association study comparing DDR1 variants between patients with BD and healthy controls. Second, we performed linear regression analyses to assess the associations of DDR1 variants with neurocognitive domains and psychosocial functioning. Third, we conducted a mediation analysis to explore whether neurocognitive impairment mediated the association between DDR1 variants and psychosocial functioning in patients with BD. Finally, we studied the association between DDR1 variants and white matter microstructure. We did not find any statistically significant associations in the case‒control association study; however, we found that the combined genotypes rs1264323AA-rs2267641AC/CC were associated with worse neurocognitive performance in patients with BD with psychotic symptoms. In addition, the combined genotypes rs1264323AA-rs2267641AC/CC were associated with worse psychosocial functioning through processing speed. We did not find correlations between white matter microstructure abnormalities and the neurocognitive domains associated with the combined genotypes rs1264323AA-rs2267641AC/CC. Overall, the results suggest that DDR1 may be a marker of worse neurocognitive performance and psychosocial functioning in patients with BD, specifically those with psychotic symptoms.
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Affiliation(s)
- Selena Aranda
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Jiménez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
- Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Erick J Canales-Rodríguez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Spain
- Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Norma Verdolini
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Spain
| | - Silvia Alonso
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Esteban Sepúlveda
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Julio Bobes
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- nstituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
| | - Pilar A Sáiz
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- nstituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
| | - Paz García-Portilla
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- nstituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
| | - Jose M Menchón
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - José M Crespo
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
- Araba University Hospital, Bioaraba Research Institute, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Víctor Pérez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Hospital de Mar. Mental Health Institute, Barcelona, Spain
- Neurosciences Research Unit, Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Celso Arango
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Institute of Psychiatry and Mental Health, Madrid, Spain
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Pilar Sierra
- La Fe University and Polytechnic Hospital, Valencia, Spain
- Department of Psychiatry, School of Medicine, University of Valencia, Valencia, Spain
| | - Julio Sanjuán
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Valencia, Valencia, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Elisabet Vilella
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain.
- Hospital Universitari Institut Pere Mata, Reus, Spain.
- Universitat Rovira i Virgili, Reus, Spain.
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)-Instituto de Salud Carlos III, Madrid, Spain.
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Zorrilla I, Lopez-Zurbano S, Alberich S, Barbero I, Lopez-Pena P, García-Corres E, Chart Pascual JP, Crespo JM, de Dios C, Balanzá-Martínez V, Gonzalez-Pinto A. Lithium levels and lifestyle in patients with bipolar disorder: a new tool for self-management. Int J Bipolar Disord 2023; 11:11. [PMID: 36929031 PMCID: PMC10020397 DOI: 10.1186/s40345-023-00291-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/23/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Patients should get actively involved in the management of their illness. The aim of this study was to assess the influence of lifestyle factors, including sleep, diet, and physical activity, on lithium levels in patients with bipolar disorder. METHODS A multicenter study was performed. In total, 157 lithium measurements were done biweekly in a sample of 65 patients (35 women) over 6 weeks. Lifestyle, based on total sleep hours and physical activity, was assessed by actigraphy. Diet was evaluated using the Mediterranean Lifestyle Index (Medlife). RESULTS 35.4% of patients had a normal weight. The mean Medlife score was 14.5 (± 2.5) (moderate-good adherence to Mediterranean diet). BMI, daily dose of lithium and intensity of physical activity had a combined effect on lithium levels, after adjustment for other variables. Patients who practiced intense physical exercise, who took lower doses and had a higher BMI exhibited lower levels of lithium. CONCLUSIONS Higher physical activity and BMI contribute to lower lithium levels. Patients should be made aware of these relationships to improve their perception of control and self-management. Lifestyle-based interventions contribute to establishing a more personalized medicine.
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Affiliation(s)
- I Zorrilla
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - S Lopez-Zurbano
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - S Alberich
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - I Barbero
- University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - P Lopez-Pena
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - E García-Corres
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - J P Chart Pascual
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain.,Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain.,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - J M Crespo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain.,Departament of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-Idibell, Barcelona, Spain.,Departament of Clinical Sciences, University of Barcelona, Bellvitge Campus, L´Hospitalet de Llobregat, Barcelona, Spain
| | - C de Dios
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain.,Psychiatric Department, University Hospital La Paz, IdiPAZ, Madrid, Spain
| | - V Balanzá-Martínez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - A Gonzalez-Pinto
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain. .,Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain. .,University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. .,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain.
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3
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Castiglione JI, Crespo JM, Lecchini L, Silveira FO, Luis MB, Cotti N, Simison CJ, Aguirre F, Piedrabuena MA, Alonso RN, Azcona CL, Sosa PS, Maldonado E, Barroso F. Bilateral facial palsy with paresthesias, variant of Guillain-Barré syndrome following COVID-19 vaccine: A case series of 9 patients. Neuromuscul Disord 2022; 32:572-574. [PMID: 35644722 PMCID: PMC9090822 DOI: 10.1016/j.nmd.2022.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 04/24/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022]
Abstract
Several cases of Guillain-Barré Syndrome (GBS) associated with COVID-19 vaccination have been reported, including the rare subtype known as Bilateral Facial Palsy with paresthesias (BFP). To date, it is not known whether a causal relationship may exist between the two. We report 9 cases of BFP in patients vaccinated against COVID-19 in the previous month. Nerve conduction studies revealed demyelinating polyneuropathy in 4 patients, and 5 presented bilateral, focal facial nerve involvement, exclusively. Ganglioside antibody panel was positive in 4 patients (anti-GM1=2, anti-GD1a=1 and anti-sulfatide=1). Seven patients received intravenous immunoglobulin treatment, one plasma exchange, and one patient died from sudden cardiac arrest following arrhythmia before treatment could be administered. Rates of BFP following COVID-19 vaccination, did not differ from those reported in previous series. Epidemiological studies are essential to determine whether a causal relationship may exist between this rare form of GBS and COVID-19 vaccination.
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Affiliation(s)
- J I Castiglione
- Neurology Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, Buenos Aires 1428, Argentina.
| | - J M Crespo
- Neurology Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, Buenos Aires 1428, Argentina; Hospital Nacional Alejandro Posadas, Argentina; Hospital Italiano de Buenos Aires, Argentina; Sanatorio Güemes, Argentina
| | - L Lecchini
- Hospital Nacional Alejandro Posadas, Argentina
| | | | | | - N Cotti
- Sanatorio de los Arcos, Argentina
| | | | - F Aguirre
- Hospital J.M. Ramos Mejía, Argentina
| | | | | | - C L Azcona
- Hospital Italiano de Buenos Aires, Argentina
| | - P S Sosa
- Hospital Italiano de Buenos Aires, Argentina
| | - E Maldonado
- Hospital Nacional Alejandro Posadas, Argentina
| | - F Barroso
- Neurology Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, Buenos Aires 1428, Argentina
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4
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Salvat-Pujol N, Labad J, Urretavizcaya M, de Arriba-Arnau A, Segalàs C, Real E, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Menchón JM, Soria V. Childhood maltreatment interacts with hypothalamic-pituitary-adrenal axis negative feedback and major depression: effects on cognitive performance. Eur J Psychotraumatol 2021; 12:1857955. [PMID: 33796230 PMCID: PMC7968873 DOI: 10.1080/20008198.2020.1857955] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Childhood maltreatment (CM) is associated with impaired hypothalamic-pituitary-adrenal (HPA) axis negative feedback and cognitive dysfunction, resembling those abnormalities linked to major depressive disorder (MDD). Objectives: We aimed to assess the potential modulating effects of MDD diagnosis or HPA axis function in the association between different types of CM and cognitive performance in adulthood. Methods: Sixty-eight MDD patients and 87 healthy controls were recruited. CM was assessed with the Childhood Trauma Questionnaire. We obtained three latent variables for neuropsychological performance (verbal memory, visual memory and executive function/processing speed) after running a confirmatory factor analysis with cognitive tests applied. Dexamethasone suppression test ratio (DSTR) was performed using dexamethasone 0.25 mg. Results: Different types of CM had different effects on cognition, modulated by MDD diagnosis and HPA axis function. Individuals with physical maltreatment and MDD presented with enhanced cognition in certain domains. The DSTR differentially modulated the association between visual memory and physical neglect or sexual abuse. Conclusions: HPA axis-related neurobiological mechanisms leading to cognitive impairment might differ depending upon the type of CM. Our results suggest a need for early assessment and intervention on cognition and resilience mechanisms in individuals exposed to CM to minimize its deleterious and lasting effects.
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Affiliation(s)
- Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Sabadell, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí (I3PT), Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
| | - Mikel Urretavizcaya
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Cinto Segalàs
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Eva Real
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Alex Ferrer
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Sabadell, Spain
| | - José M Crespo
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - Carles Soriano-Mas
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - José M Menchón
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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5
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Ferrer A, Labad J, Salvat-Pujol N, Monreal JA, Urretavizcaya M, Crespo JM, Menchón JM, Palao D, Soria V. Hypothalamic-pituitary-adrenal axis-related genes and cognition in major mood disorders and schizophrenia: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109929. [PMID: 32197928 DOI: 10.1016/j.pnpbp.2020.109929] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 08/12/2019] [Revised: 03/01/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Hypothalamic-pituitary-adrenal (HPA) axis dysregulation and cognitive deficits are two well-characterized endophenotypes present in different serious mental illnesses (SMIs), including major depressive disorder, bipolar disorder and schizophrenia. Our aim was to study the influence of genetic and epigenetic variations in HPA axis-related genes on cognitive performance in clinical samples, including patients with major mood disorders and schizophrenia. A systematic search was performed using PubMed (Medline), PsycINFO and Scopus databases. The systematic review identified 12 studies dealing with HPA-related genes and cognition in samples including patients with SMIs, focusing on single nucleotide polymorphism (SNP) variants, while no studies analysing epigenetic variations were found. The results suggest different and specific effects on the cognitive performance of SNP variants in the HPA axis-related genes studied, as well as interactions with traumatic experiences. There was high heterogeneity in the studied samples, genes analysed, and cognitive tasks evaluated. The relationship between HPA-related genes and cognition in SMIs is still largely unknown, and further studies including larger samples and epigenetic variations are needed.
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Affiliation(s)
- Alex Ferrer
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Neus Salvat-Pujol
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - José A Monreal
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Mikel Urretavizcaya
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - José M Crespo
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - José M Menchón
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Diego Palao
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Virginia Soria
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.
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6
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Haro S, Bohórquez J, Lara M, Garcia-Robledo E, González CJ, Crespo JM, Papaspyrou S, Corzo A. Diel patterns of microphytobenthic primary production in intertidal sediments: the role of photoperiod on the vertical migration circadian rhythm. Sci Rep 2019; 9:13376. [PMID: 31527648 PMCID: PMC6746711 DOI: 10.1038/s41598-019-49971-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/01/2019] [Indexed: 02/08/2023] Open
Abstract
Diel primary production patterns of intertidal microphytobenthos (MPB) have been attributed to short-term physiological changes in the photosynthetic apparatus or to diel changes in the photoautotrophic biomass in the sediment photic layer due to vertical migration. Diel changes in primary production and vertical migration are entrained by external factors like photoperiod and tides. However, the role of photoperiod and tides has not been experimentally separated to date. Here, we performed laboratory experiments with sediment cores kept in immersion, in the absence of tides, with photoperiod or under continuous light. Measurements of net production, made with O2 microsensors, and of spectral reflectance at the sediment surface showed that, in intertidal sediments, the photoperiod signal was the major driver of the diel patterns of net primary production and sediment oxygen availability through the vertical migration of the MPB photoautotrophic biomass. Vertical migration was controlled by an endogenous circadian rhythm entrained by photoperiod in the absence of tides. The pattern progressively disappeared after 3 days in continuous light but was immediately reset by photoperiod. Even though a potential contribution of a subjective in situ tidal signal cannot be completely discarded, Fourier and cross spectral analysis of temporal patterns indicated that the photosynthetic circadian rhythm was mainly characterized by light/dark migratory cycles.
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Affiliation(s)
- S Haro
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain. .,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain.
| | - J Bohórquez
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain.,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain
| | - M Lara
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain.,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain
| | - E Garcia-Robledo
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain.,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain
| | - C J González
- Division of Naval Support and Oceanography, Marine Hydrographic Institute, Spanish Navy, Cadiz, Spain
| | - J M Crespo
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain
| | - S Papaspyrou
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain.,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain
| | - A Corzo
- Department of Biology, University of Cádiz, Puerto Real, 11510, Spain.,Instituto Universitario de Investigación Marina (INMAR), Universidad de Cádiz, Campus de Excelencia Internacional del Mar (CEIMAR). Campus Universitario de Puerto Real, Puerto Real (Cádiz), 11510, Spain
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7
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Ferrer A, Costas J, Labad J, Salvat-Pujol N, Segalàs C, Urretavizcaya M, Real E, de Arriba-Arnau A, Alonso P, Crespo JM, Barrachina M, Soriano-Mas C, Carracedo Á, Menchón JM, Soria V. FKBP5 polymorphisms and hypothalamic-pituitary-adrenal axis negative feedback in major depression and obsessive-compulsive disorder. J Psychiatr Res 2018; 104:227-234. [PMID: 30107269 DOI: 10.1016/j.jpsychires.2018.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 05/06/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022]
Abstract
Major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) have both been linked to abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. Polymorphisms in the genes involved in HPA axis activity, such as FKBP5, and their interactions with childhood trauma have been associated with stress-related mental disorders. Our goal was to study the role of FKBP5 genetic variants in HPA axis negative feedback regulation as a possible risk factor for different mental disorders such as MDD and OCD, while controlling for childhood trauma, anxiety and depressive symptoms. The sample included 266 participants divided into three groups: 1) MDD (n = 89 [n = 73 melancholic; n = 3 atypical]), 2) OCD (n = 51; 39% with comorbid MDD [n = 13 melancholic; n = 7 atypical]) and 3) healthy controls (n = 126). Childhood trauma, trait anxiety and depressive symptoms were assessed. HPA negative feedback was analyzed using the dexamethasone suppression test ratio (DSTR) after administration of 0.25 mg of dexamethasone. Twelve SNPs in the FKBP5 gene were selected for genotyping. Multiple linear regressions, after adjusting for the covariates considered, showed a reduced DSTR in individuals with the rs9470079-A variant that was significant after correction for multiple testing. Childhood trauma did not moderate the association between the rs9470079 and DSTR. Our results support the evidence that FKBP5 genetic variation could lead to abnormal HPA axis negative feedback independent of diagnosis. Therefore, this association can be identified as a transdiagnostic feature, offering an interesting opportunity to identify patients with higher stress vulnerability. Further studies focusing on the influence of FKBP5 on measurable biological endophenotypes are needed.
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Affiliation(s)
- Alex Ferrer
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Javier Costas
- Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain
| | - Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Neus Salvat-Pujol
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Mikel Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - José M Crespo
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Marta Barrachina
- Neuropathology Group, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Ángel Carracedo
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado - Instituto Carlos III, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Carlos III Health Institute, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
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8
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Sanchez-Moreno J, Bonnin CM, González-Pinto A, Amann BL, Solé B, Balanzá-Martinez V, Arango C, Jiménez E, Tabarés-Seisdedos R, Garcia-Portilla MP, Ibáñez A, Crespo JM, Ayuso-Mateos JL, Martinez-Aran A, Torrent C, Vieta E. Factors associated with poor functional outcome in bipolar disorder: sociodemographic, clinical, and neurocognitive variables. Acta Psychiatr Scand 2018; 138:145-154. [PMID: 29726004 DOI: 10.1111/acps.12894] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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] [Accepted: 04/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The current investigation aimed at studying the sociodemographic, clinical, and neuropsychological variables related to functional outcome in a sample of euthymic patients with bipolar disorder(BD) presenting moderate-severe levels of functional impairment. METHODS Two-hundred and thirty-nine participants with BD disorders and with Functioning Assessment Short Test(FAST) scores equal or above 18 were administered a clinical and diagnostic interview, and the administration of mood measure scales and a comprehensive neuropsychological battery. Analyses involved preliminary Pearson bivariate correlations to identify sociodemographic and clinical variables associated with the FAST total score. Regarding neuropsychological variables, a principal component analysis (PCA) was performed to group the variables in orthogonal factors. Finally, a hierarchical multiple regression was run. RESULTS The best fitting model for the variables associated with functioning was a linear combination of gender, age, estimated IQ, Hamilton Depression Rating Scale (HAM-D), number of previous manic episodes, Factor 1 and Factor 2 extracted from the PCA. The model, including all these previous variables, explained up to 29.4% of the observed variance. CONCLUSIONS Male gender, older age, lower premorbid IQ, subdepressive symptoms, higher number of manic episodes, and lower performance in verbal memory, working memory, verbal fluency, and processing speed were associated with lower functioning in patients with BD.
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Affiliation(s)
- J Sanchez-Moreno
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - C M Bonnin
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - A González-Pinto
- Álava University Hospital, CIBERSAM, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - B L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, Parc de Salut Mar, CIBERSAM, Autonomous University of Barcelona, Barcelona, Spain
| | - B Solé
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - V Balanzá-Martinez
- Department of Medicine, CIBERSAM, INCLIVA, University of Valencia, Valencia, Spain.,Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - C Arango
- Child and Adolescent Psychiatry Department, Hospital Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - E Jiménez
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - R Tabarés-Seisdedos
- Department of Medicine, CIBERSAM, INCLIVA, University of Valencia, Valencia, Spain
| | - M P Garcia-Portilla
- Department of Psychiatry, School of Medicine, CIBERSAM Instituto de Neurociencias del Principado de Asturias, INEUROPA, Servicio de Salud del Principado de Asturias (SESPA), University of Oviedo, Oviedo, Spain
| | - A Ibáñez
- Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERSAM, Universidad de Alcalá, Madrid, Spain
| | - J M Crespo
- Department of Psychiatry, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, University Hospital of Bellvitge, Barcelona, Spain
| | - J L Ayuso-Mateos
- Department of Psychiatry, IIS-IP, CIBERSAM, Universidad Autónoma de Madrid, Madrid, Spain
| | - A Martinez-Aran
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Torrent
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - E Vieta
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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9
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Labad J, Soria V, Salvat-Pujol N, Segalàs C, Real E, Urretavizcaya M, de Arriba-Arnau A, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Alonso P, Menchón JM. Hypothalamic-pituitary-adrenal axis activity in the comorbidity between obsessive-compulsive disorder and major depression. Psychoneuroendocrinology 2018; 93:20-28. [PMID: 29684711 DOI: 10.1016/j.psyneuen.2018.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 06/05/2017] [Revised: 03/04/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) is the most common psychiatric comorbidity in patients with obsessive-compulsive disorder (OCD). Hypothalamic-pituitary-adrenal (HPA) axis abnormalities have been described in both disorders and might play a role in the association between them. We aimed to study the role of HPA axis activity in the comorbidity between OCD and MDD, while controlling for psychopathological dimensions such as anxiety and depressive symptoms. We studied 324 participants belonging to four diagnostic groups: 1) MDD (n = 101), 2) OCD with comorbid MDD (n = 33), 3) OCD without MDD (n = 52), and 4) healthy subjects (n = 138). State anxiety, trait anxiety and depressive symptoms were assessed. Three HPA axis measures were analyzed in saliva: cortisol awakening response (CAR), diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope]; [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.), and dexamethasone suppression test ratio after 0.25 mg of dexamethasone (DSTR). Multiple linear regression analyses were conducted to explore the contribution of clinical diagnosis and symptom dimensions to each HPA axis measure. A more flattened FTP diurnal cortisol slope was observed for OCD patients with comorbid MDD. Regarding the CAR and DSTR, a significant interaction was found between trait anxiety and OCD, as OCD patients with greater trait anxiety showed an increased CAR and reduced cortisol suppression after dexamethasone administration. Our results suggest that trait anxiety plays an important role in the relationship between HPA axis measures and OCD/MDD comorbidity.
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Affiliation(s)
- Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
| | - Neus Salvat-Pujol
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Cinto Segalàs
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Eva Real
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Urretavizcaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Alex Ferrer
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - José M Crespo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Pino Alonso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - José M Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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10
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Salvat-Pujol N, Labad J, Urretavizcaya M, de Arriba-Arnau A, Segalàs C, Real E, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Menchón JM, Soria V. Hypothalamic-pituitary-adrenal axis activity and cognition in major depression: The role of remission status. Psychoneuroendocrinology 2017; 76:38-48. [PMID: 27883963 DOI: 10.1016/j.psyneuen.2016.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 07/10/2016] [Revised: 11/04/2016] [Accepted: 11/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Neuropsychological deficits and hypothalamic-pituitary-adrenal (HPA) axis dysfunction have been described in major depressive disorder (MDD). We conducted an exploratory study to investigate the role of remission status in the relationship between HPA axis and cognition in MDD. METHODS Ninety-seven MDD patients (44 remitted, 53 non-remitted) and 97 healthy controls (HC) were evaluated. We measured verbal and visual memory, working memory, processing speed, attention, and executive function. Three HPA axis measures were assessed: cortisol awakening response (CAR), diurnal cortisol slope, and cortisol suppression ratio with 0.25mg of dexamethasone (DSTR). Multiple linear regression analyses were performed to study the relationship between cortisol measures and cognition while controlling for potential confounders. We conducted an overall analysis in all participants to compare both MDD-remitted and MDD non-remitted groups with respect to HC. Another analysis including MDD patients only was used to explore a moderating effect by remission status. RESULTS MDD patients showed poorer cognitive performance compared with HC, without significant differences between remitters and non-remitters. Cortisol measures did not differ between remitters and non-remitters. Although most HPA axis measures were not associated with cognitive dysfunction, we found significant associations between cognitive performance in MDD-remitters and cortisol measures for visual memory, processing speed and executive function. A significant moderating effect for remission status was found between cortisol diurnal slope (but neither CAR nor DSTR) and performance in processing speed or executive function. CONCLUSIONS Remission status in MDD appears to moderate the association between some cognitive domains (processing speed and executive function) and HPA axis activity.
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Affiliation(s)
- Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Javier Labad
- Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Mikel Urretavizcaya
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Cinto Segalàs
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Eva Real
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Alex Ferrer
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - José M Crespo
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - José M Menchón
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
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11
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Albacete A, Bosque C, Custal N, Crespo JM, Gilabert E, Albiach A, Menchón JM, Contreras F. Emotional intelligence in non-psychotic first-degree relatives of people with schizophrenia. Schizophr Res 2016; 175:103-108. [PMID: 27177808 DOI: 10.1016/j.schres.2016.04.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 10/23/2015] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Subtle social cognitive deficits in unaffected relatives of schizophrenia patients have received increasing attention over the last few years, supporting their potential endophenotypic role for this disorder. The current study assessed non-psychotic first-degree relatives' performance on a multidimensional measure of emotional intelligence (EI): the Mayer-Salovey-Caruso Emotional Intelligence Test 2.0 (MSCEIT). Endorsed by the National Institute of Mental Health, the MSCEIT is a valid and reliable instrument for detecting emotion-processing deficits among schizophrenia patients and people high in schizotypy. METHOD Thirty-seven first-degree relatives, 37 schizophrenia outpatients and 37 healthy controls completed the MSCEIT, which comprises eight subscales aimed to assess the four branches of EI: Identifying, Facilitating, Understanding and Managing Emotions. Potential associations with cognitive function and schizotypy levels, measured with the Schizotypal Personality Questionnaire-Brief, were further evaluated. RESULTS Relatives had significantly lower MSCEIT total scores than controls and also significantly lower scores on the Identifying emotions branch. Nevertheless, schizophrenia patients still had the poorest global EI performance. The strongest positive correlations were found in relatives and controls with measures of executive function, processing speed and general intelligence. A higher level of schizotypy correlated significantly with lower MSCEIT scores among controls, but not among relatives. CONCLUSIONS Contrary to expectations in the general population, the current study observed subtle EI impairment in non-psychotic first-degree relatives of schizophrenia patients. These findings support the hypothesis that these EI deficiencies may be potential endophenotypes located between the clinical phenotype and the genetic predisposition for schizophrenia.
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Affiliation(s)
- Auria Albacete
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Clara Bosque
- Polyvalent Mental Health Unit, Benito Menni CASM, L'Hospitalet de Llobregat, Spain; Fundació per a la Investigació i Docència María Angustias Giménez, Germanes Hospitalàries, Barcelona, Spain
| | - Nuria Custal
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
| | - José M Crespo
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red en Salud Mental), Carlos III Health Institute, Spain
| | - Ester Gilabert
- Mental Health Unit L'Hospitalet, SAP Delta Llobregat, AP Costa de Ponent, L'Hospitalet de Llobregat, Spain
| | - Angela Albiach
- Mental Health Unit L'Hospitalet, SAP Delta Llobregat, AP Costa de Ponent, L'Hospitalet de Llobregat, Spain
| | - José M Menchón
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red en Salud Mental), Carlos III Health Institute, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red en Salud Mental), Carlos III Health Institute, Spain.
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Soria V, Vives M, Martínez-Amorós È, Gálvez V, Monzón S, Crespo JM, Gili M, Menchón JM, Roca M, Parker G, Urretavizcaya M. The CORE system for sub-typing melancholic depression: Adaptation and psychometric properties of the Spanish version. Psychiatry Res 2016; 239:179-83. [PMID: 27010187 DOI: 10.1016/j.psychres.2016.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/09/2015] [Revised: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 11/18/2022]
Abstract
We report the development procedure for a Spanish version of the CORE measure for subtyping melancholic depression and its psychometric properties. The sample comprised two subsets of depressive patients: 117 in-patients clinically assessed after admission and before discharge; and 34 in- and out-patients who were video-recorded, with each recording being rated by independent raters and re-rated six months later. The internal consistency of the Spanish version of the CORE was high, with Cronbach's alpha coefficient of 0.93 for the total CORE score. High intra-class correlation coefficient for the total score (0.96) and the three subscales (around 0.8) indicate high inter-rater reliability. Baseline and six-month ratings of video-recordings showed high test-retest reliability. Regarding construct validity, the correlation between the CORE and the Newcastle endogeneity scale scores was 0.64. A ROC curve generated an optimal cut-off of 10 to predict the definition of endogeneity/melancholia based on the Newcastle score >=6 and the DSM-IV-TR definition of melancholia. The comparison between the CORE scores at admission and at discharge revealed large differences, indicating demonstrable sensitivity to change. The Spanish version of the CORE system is a reliable and valid instrument for sub-typing depression in terms of melancholic versus non-melancholic sub-types.
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Affiliation(s)
- Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
| | - Margalida Vives
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Èrika Martínez-Amorós
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Verònica Gálvez
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia
| | - Saray Monzón
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - José M Crespo
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Margalida Gili
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Miquel Roca
- Institut Universitari d' Investigació en Ciències de la Salut (IUNICS), Red de Actividades Preventivas y de Promoción de la Salud (Rediapp), Hospital Joan March, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia
| | - Mikel Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital, IDIBELL, CIBERSAM, Department of Clinical Sciences, University of Barcelona, Barcelona, Spain.
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13
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Bonnin CM, Torrent C, Arango C, Amann BL, Solé B, González-Pinto A, Crespo JM, Tabarés-Seisdedos R, Reinares M, Ayuso-Mateos JL, García-Portilla MP, Ibañez Á, Salamero M, Vieta E, Martinez-Aran A. Functional remediation in bipolar disorder: 1-year follow-up of neurocognitive and functional outcome. Br J Psychiatry 2016; 208:87-93. [PMID: 26541692 DOI: 10.1192/bjp.bp.114.162123] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [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] [Received: 07/24/2014] [Accepted: 01/25/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few randomised clinical trials have examined the efficacy of an intervention aimed at improving psychosocial functioning in bipolar disorder. AIMS To examine changes in psychosocial functioning in a group that has been enrolled in a functional remediation programme 1 year after baseline. METHOD This was a multicentre, randomised, rater-masked clinical trial comparing three patient groups: functional remediation, psychoeducation and treatment as usual over 1-year follow-up. The primary outcome was change in psychosocial functioning measured by means of the Functioning Assessment Short Test (FAST). Group×time effects for overall psychosocial functioning were examined using repeated-measures ANOVA (trial registration NCT01370668). RESULTS There was a significant group×time interaction for overall psychosocial functioning, favouring patients in the functional remediation group (F = 3.071, d.f. = 2, P = 0.049). CONCLUSIONS Improvement in psychosocial functioning is maintained after 1-year follow-up in patients with bipolar disorder receiving functional remediation.
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Affiliation(s)
- C M Bonnin
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Arango
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B L Amann
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A González-Pinto
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J M Crespo
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - R Tabarés-Seisdedos
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J L Ayuso-Mateos
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M P García-Portilla
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Á Ibañez
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Salamero
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martinez-Aran
- Caterina del Mar Bonnin, PhD, Carla Torrent, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Celso Arango, MD, PhD, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid; Benedikt L. Amann, MD, PhD, FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona; Brisa Solé, PsyD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Ana González-Pinto, MD, PhD, Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria; Jose Manuel Crespo, MD, PhD, Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona; Rafael Tabarés-Seisdedos, MD, PhD, Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia; Maria Reinares, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia; Jose Luis Ayuso-Mateos, MD, PhD, Department of Psychiatry, Autonomous University of Madrid, Research Institute of the Hospital de la Princesa, CIBERSAM, Madrid; M. Paz García-Portilla, MD, PhD, Department of Psychiatry, University of Oviedo, CIBERSAM; Ángela Ibañez, MD, PhD, Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid; Manel Salamero, MD, PhD, Eduard Vieta, MD, PhD, Institute of Neurosciences, University of Barcelona, Hospital Clinic i Provincial, Catalonia; Anabel Martinez-Aran, PhD, Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Bonnin CM, Reinares M, Martínez-Arán A, Balanzá-Martínez V, Sole B, Torrent C, Tabarés-Seisdedos R, García-Portilla MP, Ibáñez A, Amann BL, Arango C, Ayuso-Mateos JL, Crespo JM, González-Pinto A, Colom F, Vieta E. Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory. Psychol Med 2016; 46:291-301. [PMID: 26387583 DOI: 10.1017/s0033291715001713] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND Functional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients. METHOD A total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants' neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients. RESULTS Patients receiving functional remediation (n = 56) showed an improvement on delayed free recall when compared with the TAU (n = 63) and psychoeducation (n = 69) groups as shown by the group × time interaction at 6-month follow-up [F 2,158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU (p = 0.04), but not with psychoeducation (p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome (F 2,158 = 4.26, df = 2, p = 0.016). CONCLUSIONS Functional remediation is effective at improving verbal memory and psychosocial functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.
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Affiliation(s)
- C M Bonnin
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | - M Reinares
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | - A Martínez-Arán
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | | | - B Sole
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | - C Torrent
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | | | | | - A Ibáñez
- Department of Psychiatry,Ramon y Cajal University Hospital, University of Alcala,IRYCIS,CIBERSAM,Madrid,Spain
| | - B L Amann
- FIDMAG Hermanas Hospitalarias Research Foundation,CIBERSAM,Barcelona,Spain
| | - C Arango
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense,IiSGM,CIBERSAM,Madrid,Spain
| | - J L Ayuso-Mateos
- Department of Psychiatry,Universidad Autonoma de Madrid,IIS-IP,CIBERSAM,Madrid,Spain
| | - J M Crespo
- Department of Psychiatry,University Hospital of Bellvitge,Bellvitge Biomedical Research Institute (IDIBELL),CIBERSAM,Barcelona,Spain
| | - A González-Pinto
- Álava University Hospital,CIBERSAM,University of the Basque Country,Kronikgune,Vitoria,Spain
| | - F Colom
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
| | - E Vieta
- Bipolar Disorders Unit,Hospital Clinic,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona, Catalonia,Spain
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15
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Popovic D, Benabarre A, Crespo JM, Goikolea JM, González-Pinto A, Gutiérrez-Rojas L, Montes JM, Vieta E. Risk factors for suicide in schizophrenia: systematic review and clinical recommendations. Acta Psychiatr Scand 2014; 130:418-26. [PMID: 25230813 DOI: 10.1111/acps.12332] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [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] [Accepted: 08/14/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To identify risk factors associated with suicide of patients with schizophrenia and provide clinical recommendations, which integrate research findings into a consensus based on clinical experience and evidence. METHOD A task force formed of experts and clinicians iteratively developed consensus through serial revisions using the Delphi method. Initial survey items were based on systematic literature review published up to June 2013. RESULTS Various risk factors were reported to be implicated in suicide in schizophrenia. Our findings indicate that suicide risk in schizophrenia is mainly related to affective symptoms, history of a suicide attempt and number of psychiatric admissions. Other risk factors identified are given by younger age, closeness to illness onset, older age at illness onset, male sex, substance abuse and period during or following psychiatric discharge. Integrating the evidence and the experience of the task force members, a consensus was reached on 14 clinical recommendations. CONCLUSION Identification of risk factors for suicide in individuals diagnosed with schizophrenia is imperative to improve clinical management and develop strategies to reduce the incidence of suicide in this population. This study provides the critical overview of available data and clinical recommendations on recognition and management of the above-mentioned risk factors.
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Affiliation(s)
- D Popovic
- Bipolar Disorders Program, Hospital Clínic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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16
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Custal N, Arcelus J, Agüera Z, Bove FI, Wales J, Granero R, Jiménez-Murcia S, Sánchez I, Riesco N, Alonso P, Crespo JM, Virgili N, Menchón JM, Fernandez-Aranda F. Treatment outcome of patients with comorbid type 1 diabetes and eating disorders. BMC Psychiatry 2014; 14:140. [PMID: 24885411 PMCID: PMC4030033 DOI: 10.1186/1471-244x-14-140] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/06/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Co-morbidity between Type 1 Diabetes Mellitus (T1DM) and eating disorders (ED) has been previously described; however the effect of this illness on the outcomes for conventional ED treatments has not been previously investigated. This study aims to compare clinical, psychopathological and personality features between two samples of ED individuals: those with comorbid T1DM and those without (No-DM); and to identify differences in treatment outcomes between the groups. METHODS This study compares treatment outcome, dropouts, ED psychopathology and personality characteristics for 20 individuals with ED and T1DM and 20 ED patients without diabetes, matched for diagnostic and treatment type. RESULTS The study found higher dropout rates from therapy in individuals with T1DM and worse treatment outcome in spite of having no significant differences in eating disorder psychopathology, although individuals with T1DM report misusing insulin. CONCLUSIONS The low levels of motivation to change, and insulin abuse in T1DM patients, may suggest that treatment for patients with ED and T1DM should consider the individual's personality and role of insulin abuse when determining the appropriate intervention.
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Affiliation(s)
- Nuria Custal
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Jon Arcelus
- Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK,Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, UK
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Francesca I Bove
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Jackie Wales
- Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Ciber Salud Mental (CIBERsam), Instituto Salud Carlos III, Barcelona, Spain
| | - José M Crespo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Ciber Salud Mental (CIBERsam), Instituto Salud Carlos III, Barcelona, Spain
| | - Nuria Virgili
- Endocrinology and Clinical Nutrition Unit, University Hospital of Bellvitge- IDIBELL, Barcelona, Spain
| | - Jose M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Ciber Salud Mental (CIBERsam), Instituto Salud Carlos III, Barcelona, Spain
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17
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Nivoli AMA, Murru A, Goikolea JM, Crespo JM, Montes JM, González-Pinto A, García-Portilla P, Bobes J, Sáiz-Ruiz J, Vieta E. New treatment guidelines for acute bipolar mania: a critical review. J Affect Disord 2012; 140:125-41. [PMID: 22100133 DOI: 10.1016/j.jad.2011.10.015] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [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] [Received: 12/16/2010] [Revised: 10/11/2011] [Accepted: 10/11/2011] [Indexed: 10/15/2022]
Abstract
A number of treatment guidelines for bipolar disorder have been published and updated in the last few years. They are aimed at providing a synthesis of the best available scientific knowledge, and their application to every-day work should be helpful to clinicians. The aim of this report is to critically review recent guidelines focusing on the treatment of manic/hypomanic and mixed episodes. Guidelines are quite heterogeneous in methodology and conclusions, but they all agree that the treatment of manic/hypomanic and mixed episodes should generally be initiated with a medication such as lithium (Li), valproate (VPA) or atypical antipsychotics (AAP), including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone as monotherapy. All guidelines agree on stopping ongoing antidepressant medication during mania. Combination therapy including Li or VPA with an AAP is suggested usually as second-line choice, sometimes as first-choice treatment for severe mania. Carbamazepine is mostly suggested as second line and not recommended in combination. Other antiepileptic drugs are not recommended for the treatment of mania, although lamotrigine may be maintained if it was prescribed previously for the prevention of depressive episodes. Main sources of discrepancies among guidelines include benefit-risk ratio issues (how much priority is given to efficacy over safety and tolerability), starting with combination versus monotherapy, and how to deal with treatments which are more experience-based than evidence-based (i.e.: electroconvulsive therapy).
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Affiliation(s)
- Alessandra M A Nivoli
- Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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18
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Saus E, Soria V, Escaramís G, Crespo JM, Valero J, Gutiérrez-Zotes A, Martorell L, Vilella E, Menchón JM, Estivill X, Gratacòs M, Urretavizcaya M. A haplotype of glycogen synthase kinase 3β is associated with early onset of unipolar major depression. Genes Brain Behav 2010; 9:799-807. [PMID: 20618448 DOI: 10.1111/j.1601-183x.2010.00617.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Recent findings suggest that glycogen synthase kinase 3β (GSK3β) may play a role in the pathophysiology and treatment of mood disorders. Various genetic studies have shown the association of GSK3β polymorphisms with different mood disorder phenotypes. We hypothesized that genetic variants in the GSK3β gene could partially underlie the susceptibility to mood disorders. We performed a genetic case-control study of 440 psychiatrically screened control subjects and 445 mood disorder patients [256 unipolar major depressive disorder (MDD) and 189 bipolar disorder (BD)]. We genotyped a set of 11 single nucleotide polymorphisms (SNPs) and determined the relative frequency of a known copy number variant (CNV) overlapping the GSK3β by quantitative real-time polymerase chain reaction (PCR). We found no evidence of association with MDD or BD diagnosis, and we further investigated the age at onset (AAO) of the disorder and severity of depressive index episode. We found that rs334555, located in intron 1 of GSK3β, was nominally associated with an earlier AAO of the disease in MDD (P = 0.001). We also identified a haplotype containing three SNPs (rs334555, rs119258668 and rs11927974) associated with AAO of the disorder (permutated P = 0.0025). We detected variability for the CNV, but we could not detect differences between patients and controls for any of the explored phenotypes. This study presents further evidence of the contribution of GSK3β to mood disorders, implicating a specific SNP and a haplotype with an earlier onset of the disorder in a group of well-characterized patients with unipolar MDD. Further replication studies in patients with the same phenotypic characteristics should confirm the results reported here.
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Affiliation(s)
- E Saus
- Genes and Disease Program, Center for Genomic Regulation (CRG-UPF), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain
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Soria V, Martínez-Amorós E, Escaramís G, Valero J, Crespo JM, Gutiérrez-Zotes A, Bayés M, Martorell L, Vilella E, Estivill X, Menchón JM, Gratacòs M, Urretavizcaya M. Resequencing and association analysis of arylalkylamine N-acetyltransferase (AANAT) gene and its contribution to major depression susceptibility. J Pineal Res 2010; 49:35-44. [PMID: 20459461 DOI: 10.1111/j.1600-079x.2010.00763.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [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: 11/27/2022]
Abstract
Circadian rhythms disruptions, including abnormalities of circadian phase position and melatonin secretion, have been described in major depression (MD). Arylalkylamine N-acetyltransferase (AANAT) is a key enzyme of the melatonin pathway involved in circadian oscillations of melatonin levels. We assessed the contribution of AANAT gene variability to susceptibility to MD considering common and rare genetic variations through a sequential sequencing and single nucleotide polymorphism (SNP)-based genotyping approach in a sample of 445 unrelated patients with MD (257 unipolar MD, 188 bipolar depression) and 440 community-based screened control subjects. We identified 17 sequence changes, thirteen of which represented novel sequence variations. We did not observe an over-representation of patients carrying rare variants compared with the healthy controls. Common variants (MAF > 2%) were included in a case-control association analysis that showed significant association after multiple testing correction of two SNPs located in the promoter region of AANAT with MD: rs3760138 (P = 0.00006) and rs4238989 (P = 0.005). Multimarker analysis found significant associations between two three-marker protective haplotypes and a susceptibility three-marker haplotype containing the rare alleles of rs3760138-rs4238989-rs8150 and MD. We present evidence of the association of genetic variability in the AANAT gene with susceptibility to MD. Our results support the hypothesis that the melatonin-signaling pathway and circadian clock mechanisms may contribute to the pathophysiology of MD.
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Affiliation(s)
- Virginia Soria
- CIBERSAM (CIBER en Salud Mental), Mood Disorders Clinical and Research Unit, Psychiatry Department, Bellvitge University Hospital, Idibell, Barcelona, Spain
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Saus E, Soria V, Escaramís G, Vivarelli F, Crespo JM, Kagerbauer B, Menchón JM, Urretavizcaya M, Gratacòs M, Estivill X. Genetic variants and abnormal processing of pre-miR-182, a circadian clock modulator, in major depression patients with late insomnia. Hum Mol Genet 2010; 19:4017-25. [PMID: 20656788 DOI: 10.1093/hmg/ddq316] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Previous studies in mice have reported five different microRNAs (miRNAs; miR-219-1/132/183/96/182) to be modulators of the endogenous circadian clock and have presented experimental evidence for some of the genes involved in the molecular clock machinery as target sites. Moreover, disruption of circadian rhythms has long been implicated in the pathophysiology of major depression (MD). We investigated these miRNAs and some of their target sites at the sequence and functional levels as possible predisposing factors for susceptibility to MD and related chronobiological subphenotypes. Mutational screening was performed in a sample of 359 MD patients and 341 control individuals. We found a significant association between the T allele of the rs76481776 polymorphism in the pre-miR-182 and late insomnia in MD patients. Previous studies have reported an association between insomnia and CLOCK gene, a predicted miR-182 target site. A significant overexpression of miR-182 was detected by quantitative real-time polymerase chain reaction in cells transfected with the mutated form of the pre-miR-182 when compared with wild-type form. Moreover, a significant reduction in luciferase activity of plasmids with 3' UTR of ADCY6, CLOCK and DSIP genes was shown when transfecting cells with the mutated form of pre-miR-182 compared with cells that did not express miR-182. These data indicate that abnormal processing of pre-miR-182 in patients carrying the T allele of the rs76481776 polymorphism may contribute to the dysregulation of circadian rhythms in MD patients with insomnia, which could influence expression levels of the mature form of miR-182 and might increase downregulation in some of its target genes.
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Affiliation(s)
- Ester Saus
- Genes and Disease Program, Center for Genomic Regulation-UPF, and CIBER en Epidemiología y Salud Pública, Barcelona 08003, Catalonia, Spain
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Gratacòs M, Soria V, Urretavizcaya M, González JR, Crespo JM, Bayés M, de Cid R, Menchón JM, Vallejo J, Estivill X. A brain-derived neurotrophic factor (BDNF) haplotype is associated with antidepressant treatment outcome in mood disorders. Pharmacogenomics J 2007; 8:101-12. [PMID: 17505499 DOI: 10.1038/sj.tpj.6500460] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) has been studied extensively in relation to the susceptibility to mood disorders (MD), although it remains to be clarified whether BDNF is a susceptibility locus for MD phenotypes, including therapeutic response to antidepressants. We have performed a single-marker and haplotype association study of eight TagSNPs polymorphisms in the genomic region containing the BDNF gene in 342 control subjects and 374 patients with MD, and have tested the association with antidepressant treatment outcome. None of the eight single nucleotide polymorphisms (TagSNPs) was significantly associated with MD phenotype after Bonferroni correction. In the single-marker analysis, a SNP was found to be associated with the patient's state of 'remitter' after adequate trial with a single antidepressant phenotype (odds ratio (OR)=2.95; P=0.0025). We also identified a haplotype associated with this phenotype. This study supports the implication of BDNF in antidepressant treatment outcome in MD, with specific association with 5' upstream region of BDNF gene.
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Affiliation(s)
- M Gratacòs
- Genes and Disease Program, and CeGen Barcelona Genotyping Node, Center for Genomic Regulation (CRG), Barcelona, Spain
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22
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Alonso P, Menchón JM, Mataix-Cols D, Pifarré J, Urretavizcaya M, Crespo JM, Jiménez S, Vallejo G, Vallejo J. Perceived parental rearing style in obsessive-compulsive disorder: relation to symptom dimensions. Psychiatry Res 2004; 127:267-78. [PMID: 15296826 DOI: 10.1016/j.psychres.2001.12.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [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: 05/02/2002] [Revised: 11/19/2002] [Accepted: 02/18/2003] [Indexed: 10/26/2022]
Abstract
Obsessive-compulsive disorder (OCD) runs in families, but the specific contribution of genetic and environmental factors to its development is not well understood. The aim of this study was to assess whether there are differences in perceived parental child-rearing practices between OCD patients and healthy controls, and whether any relationship exists between parental characteristics, depressive symptoms and the expression of particular OCD symptom dimensions. A group of 40 OCD outpatients and 40 matched healthy controls received the EMBU (Own Memories of Parental Rearing Experiences in Childhood), a self-report measure of perceived parental child-rearing style. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HDRS) were used to assess the severity of obsessive-compulsive and depressive symptoms. The Y-BOCS Symptom Checklist was used to assess the nature of obsessive-compulsive symptoms, considering the following five symptom dimensions: contamination/cleaning, aggressive/checking, symmetry/ordering, sexual/religious and hoarding. Logistic and multiple linear regression analyses were conducted to study the relationship between parental style of upbringing, depressive symptoms and OCD symptom dimensions. Severe OCD (Y-BOCS: 27.0+/-7.4) and mild to moderate depressive symptoms (HDRS: 14.0+/-5.4) were detected in our sample. Compared with healthy controls, OCD patients perceived higher levels of rejection from their fathers. No differences between the groups with respect to perceived levels of overprotection were detected. The seventy of depressive symptoms could not be predicted by scores on any perceived parental characteristics. Hoarding was the only OCD symptom dimension that could be partially predicted by parental traits, specifically low parental emotional warmth. Social/cultural variables such as parental child-rearing patterns, in interaction with biological and genetic factors, may contribute to the expression of the OCD phenotype.
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Affiliation(s)
- Pino Alonso
- Obsessive-Compulsive Disorder Clinical and Research Unit, Department of Psychiatry, Hospital Príncipes de España, Ciudad Sanitaria y Universitaria de Bellvitge, c/ Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
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23
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Crespo JM, Sesar A, Misa MJ, Arias M. [Pseudomigraine as a symptom of carbon monoxide intoxication]. Rev Neurol 2001; 32:1047-8. [PMID: 11562826] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Carbon monoxide poisoning (CO) is a common intoxication. Diagnosis is sometimes difficult since the symptoms may be very varied. We report a case of repeated intoxication which led to several consultations and admission to hospital, since there were headaches and loss of consciousness suggesting basilar migraine. CASE REPORT A 30 year old woman consulted for repeated headaches over the previous six months, normally occurring in the morning, accompanied by vertigo, nausea and vomiting and loss of consciousness on two occasions. Clinical examination and the complementary tests done (laboratory analysis, cerebral MR, ECG, ECG Holter, EEG) were normal. Finally CO intoxication was diagnosed when levels of carboxyhemaglobin of over 30% were found in both the patient and her sister. The cause was a faulty water heater, confirmed on technical inspection. CONCLUSIONS CO intoxication may present as repeated headaches, with or without alteration in consciousness. Finding similar symptoms in other people living in the same place should increase suspicion. In certain case, anamnesis should include details regarding apparatus used for heating, cooking and bathrooms. More carboxyhaemaglobin estimations should be done in Emergency Departments.
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Affiliation(s)
- J M Crespo
- Sección de Neurología; Hospital de Conxo, Santiago de Compostela, España
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Rosel P, Arranz B, San L, Vallejo J, Crespo JM, Urretavizcaya M, Navarro MA. Altered 5-HT(2A) binding sites and second messenger inositol trisphosphate (IP(3)) levels in hippocampus but not in frontal cortex from depressed suicide victims. Psychiatry Res 2000; 99:173-81. [PMID: 11068198 DOI: 10.1016/s0925-4927(00)00076-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [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: 11/25/2022]
Abstract
The binding parameters of 5-HT(2A) and levels of its second messenger, 1,4,5-trisphosphate (IP(3)), were simultaneously studied in frontal cortex and hippocampus from the brains of 18 control subjects and 18 depressed suicide victims. All suicides met DSM-III-R criteria for depressive symptoms, suffered a violent death and had not taken any antidepressant drugs for at least 6 months prior to death. A significant decrease in the number of 5-HT(2A) binding sites (154+/-22 vs. 254+/-36 fmol/mg), together with a significantly lower apparent affinity constant (1.02+/- 0.08 vs. 1. 36+/-0.09 nM), was detected in hippocampus but not in frontal cortex from the depressed suicides compared to the control subjects. Furthermore, IP(3) concentrations were significantly increased in hippocampus (3.2+/-0.3 vs. 2.1+/-0.3 pmol/g) but not in frontal cortex (1.3+/-0.3 vs. 2.7+/-0.5 pmol/g) from the suicide victims. The reported results may indicate a significant hypersensitivity of the 5-HT(2A) postsynaptic receptor located in the hippocampus from depressed suicide victims, giving rise to an enhancement of its intracellular signaling system with higher IP(3) production.
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Affiliation(s)
- P Rosel
- Hormone Unit, Department of Clinical Chemistry, CSU Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona, Spain
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Rosel P, Arranz B, Vallejo J, Oros M, Crespo JM, Menchon JM, Navarro MA. Variations in [3H]imipramine and 5-HT2A but not [3H]paroxetine binding sites in suicide brains. Psychiatry Res 1998; 82:161-70. [PMID: 9754440 DOI: 10.1016/s0925-4927(98)00015-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [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: 11/21/2022]
Abstract
Both the [3H]imipramine and [3H]paroxetine binding sites and the 5-HT2A receptor were simultaneously determined in frontal cortex, cingulate cortex, hippocampus and amygdala from 17 control subjects and 17 depressed suicide victims. A significant decrease in the maximum binding (Bmax) of [3H]imipramine was observed in the hippocampus of suicide victims as compared to control subjects (160 +/- 25 vs. 328 +/- 52 fmol/mg protein; P = 0.007) without changes in the apparent affinity constant (Kd). Furthermore, a significant decrease in the number of 5-HT2A binding sites, together with a significantly lower Kd, was also observed in the hippocampus of suicides as compared to control subjects (129 +/- 18 vs. 225 +/- 32 fmol/mg protein; P = 0.02 and 0.91 +/- 0.07 vs. 1.38 +/- 0.08 nM, respectively; P = 0.006). [3H]Paroxetine binding did not display modifications between the two groups in either Bmax or Kd from any of the brain regions studied. When all four brain regions were taken together, a down-regulation was noted between presynaptic [3H]imipramine binding and the postsynaptic 5-HT2A receptor (r = -0.40; P = 0.0013) in the control group. This correlation did not appear in the suicide group. No correlation was observed between [3H]paroxetine binding and the 5-HT2A receptor in either control subjects or suicides. Taken together, these results suggest that the 5-HT uptake site measured with [3H]imipramine and the 5-HT2A receptors are reliable markers of serotonergic dysfunction.
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Affiliation(s)
- P Rosel
- Department of Clinical Chemistry, Hospital Princeps D'Espanya, Barcelona, Spain
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Ruiz V, Koo M, García E, Crespo JM, Mayoral V, Casals P, Cochs J. [The incidence of intraoperative conciousness in emergency surgery and its possible relation to the post-traumatic stress syndrome. Presentation of three cases]. Rev Esp Anestesiol Reanim 1998; 45:106-9. [PMID: 9612029] [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: 02/07/2023]
Abstract
Intraoperative awakening and recall of specific events is a rare complication (0.2 to 1.3%) of surgery. The possibility of developing serious psychiatric complications, such as posttraumatic stress disorder (PTSD) makes the prevention and detection of intraoperative awareness a subject of special interest. We describe our experience with three patients in whom awareness was detected during emergency surgery under general anesthesia. We conducted two structured interviews with the patients three months after surgery in order to detect the possible development of psychiatric complications. One patient suffered insomnia and reexperience of the event during the first two weeks after surgery. Improvement was spontaneous. None of the patients suffered PTSD. Efforts to decrease the incidence of episodes of intraoperative awakening with specific recall must be based on clinical observation and exhaustive monitoring of the patient, including anesthetic gases, given that no ideal method of monitoring depth of anesthesia exists. Cases should be detected in the first few days after surgery by means of a specific test. Likewise, possible causes for the episode should be explained to the patient, who should be followed for six months so that early diagnosis of PTSD or other psychiatric complications can be made.
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Affiliation(s)
- V Ruiz
- Servicio de Anestesiología y Reanimación, Hospital Prínceps d'Espanya, Barcelona
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27
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Vives Corrons JL, Zarza R, Aymerich JM, Boixadera J, Carrera A, Colomer D, Corbella M, Castro M, Crespo JM, Del Arco A, Erkiaga S, Font L, González I, Juncá J, Lausin A, Manrubia E, Martín Núñez G, Murga MJ, Oliva E, Pérez de Mendiguren B, Pujades MA, Remacha A, Rovira A, Villegas A. [Molecular analysis of glucose-6-dehydrogenase deficiency in Spain]. Sangre (Barc) 1997; 42:391-8. [PMID: 9424740] [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: 02/05/2023]
Abstract
PURPOSE G6PD deficiency is the most frequent enzymopathy-producing genetic polymorphism in humans. Up to now, over 400 putative variants of G6PD have been distinguished on the basis of biochemical characterization of the deficient enzyme. Analysis of the G6PD gene has made possible a precise classification of the G6PD molecular variants by identification of about 80 different point mutations causing much of the phenotypic heterogeneity. In the Spanish population, the analysis of G6PD has led to the identification of 15 different point mutations that underlay the phenotypic heterogeneity of G6PD previously reported by biochemical analysis. The purpose of the study has been to identify the genetic mutation responsible of the G6PD deficiency and to improve the knowledge of its genetic homogeneity. PATIENTS AND METHODS From 50 Spanish males with G6PD deficiency 34 came from out consultation and 16 from the Spanish Study Group on Red Cell Pathology (GEHBTA-Eritropatología) The methods employed included screening of prevalent mutations by ER-PCR, SSCP-PCR, genetic segmentation and biochemical characterization of the deficient enzyme. RESULTS In 31 cases the mutations were characteristic of the four most frequent polymorphic variants found in Spain (G6PD A-376G/202A, G6PD Mediterranean 563T G6PD Union 1360T and G6PD Seattle 344C). Since these mutations either create or abolish a specific site recognized by a restriction endonuclease (RE), they can be rapidly detected by RE digestion of a PCR-amplified product (PCR-RE). In patients where none of these mutations were present (17 cases), the G6PD gene was subjected to PCR single-strand conformation polymorphism (PCR-SSCP) analysis combined with direct PCR-sequencing. By using this procedure, 9 new mutations have been identified, five of them have been also found in other geographical areas and were associated with favism (G6PD A-376G/968C, G6PD Santamaria 376G/542T, G6PD Aures 143C and G6PD Chatham 1003A) or chronic haemolytic anaemia (G6PD Tomah 1153C). The other four mutations are unique and not reported so far: Three of them are associated with favism (G6PD Málaga 542T, G6PD Murcia 209G and G6PD Valladolid 406T) and one with chronic haemolytic anaemia (G6PD Madrid 1155G). The remaining eight cases are under study. CONCLUSION The present study confirms the marked genetic heterogeneity of G6PD deficiency in Spain and demonstrate that the PCR-RE analysis is an easy tool for rapid diagnosis of the molecular defect in subjects with the common forms of G6PD deficiency. Furthermore the fact that G6PD A-376G/202A is the most common variant within Spanish population and the finding of G6PD Aures 43C and G6PD Santamaría 76G/542T, who are polymorphic in Algeria is consistent with a significant gene flow from Africa to Europe through Spain.
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Affiliation(s)
- J L Vives Corrons
- Hospital Clinic i Provincial, Laboratorio Central de Hematología, Barcelona
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