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Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00757-8. [PMID: 38642570 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00367-2. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00476-8. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Delgado-Parada E, Alonso-Sánchez M, Ayuso-Mateos JL, Robles-Camacho M, Izquierdo A. Liaison psychiatry before and after the COVID-19 pandemic. Psychiatry Res 2022; 314:114651. [PMID: 35640325 PMCID: PMC9124364 DOI: 10.1016/j.psychres.2022.114651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION the COVID-19 pandemic had an impact on hospital admissions. The clinical profiles of patients referred to liaison psychiatry teams (LPT) remained stable over the last few decades. We postulate changes in patient profiles due to the COVID-19 pandemic. MATERIALS AND METHODS a total of 384 patients admitted to a tertiary care University Hospital in Madrid (Spain) and referred to LPTs were recruited. Patients referred 5 months before and after the first admission for COVID-19 were included. Clinical and sociodemographic characteristics were collected, and non-parametric hypothesis contrast tests were used to study possible differences between both periods. RESULTS patients referred during the pandemic were significantly older (U = 2.006; p = .045), most of them were admitted to medical hospitalization units (χ2 (2) = 5.962; p = 015), and with a different reason for admission. There was an increase in the rate of adjustment disorders (χ2 (1) =7.893; p = 005) and delirium (χ2 (1) =9.413; p = 002), as well as psychiatric comorbidity (χ2 (2) = 9.930; p = .007), and a reduction in the proportion of patients treated for substance misuse (χ2 (5) = 19.152; p = .002). The number of deaths increased significantly (χ2 (1) = 6.611; p = .010). In persons over 65 years inappropriate prescription was significantly lower (χ2 (1) = 8.200; p = .004). CONCLUSIONS the pandemic had an impact on the activity of the LPTs due to the change in the clinical profile and evolution of referred patients, maintaining standards of care that are reflected through prescription.
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Affiliation(s)
- E Delgado-Parada
- Department of Psychiatry, Hospital Universitario de La Princesa, c/ Diego de León, 62, (28006) Madrid, Spain; Instituto de Investigación Sanitaria Hospital Universitario de la Princesa (IIS-Princesa), c/ Diego de León, 62, (28006) Madrid, Spain
| | - M Alonso-Sánchez
- Department of Psychiatry, Hospital Universitario de La Princesa, c/ Diego de León, 62, (28006) Madrid, Spain.
| | - J L Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, c/ Diego de León, 62, (28006) Madrid, Spain; Instituto de Investigación Sanitaria Hospital Universitario de la Princesa (IIS-Princesa), c/ Diego de León, 62, (28006) Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Av/ Monforte de Lemos, 3-5. Pabellón 11. Planta 0 (28029) Madrid, Spain; Departament of Psychiatry, Universidad Autónoma de Madrid, c/ Arzobispo Morcillo, 4, (28029) Madrid, Spain
| | - M Robles-Camacho
- Department of Psychiatry, Hospital Universitario de La Princesa, c/ Diego de León, 62, (28006) Madrid, Spain
| | - A Izquierdo
- Department of Psychiatry, Hospital Universitario de La Princesa, c/ Diego de León, 62, (28006) Madrid, Spain; Instituto de Investigación Sanitaria Hospital Universitario de la Princesa (IIS-Princesa), c/ Diego de León, 62, (28006) Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Av/ Monforte de Lemos, 3-5. Pabellón 11. Planta 0 (28029) Madrid, Spain; Departament of Psychiatry, Universidad Autónoma de Madrid, c/ Arzobispo Morcillo, 4, (28029) Madrid, Spain
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Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdoli A, Abdollahi M, Abdullah AYM, Abhilash ES, Abu-Gharbieh E, Acuna JM, Addolorato G, Adebayo OM, Adekanmbi V, Adhikari K, Adhikari S, Adnani QES, Afzal S, Agegnehu WY, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed H, Ahmed Rashid T, Akunna CJ, Al Hamad H, Alam MZ, Alem DT, Alene KA, Alimohamadi Y, Alizadeh A, Allel K, Alonso J, Alvand S, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Arabloo J, Arshad M, Artamonov AA, Aryan Z, Asaad M, Asemahagn MA, Astell-Burt T, Athari SS, Atnafu DD, Atorkey P, Atreya A, Ausloos F, Ausloos M, Ayano G, Ayanore MAA, Ayinde OO, Ayuso-Mateos JL, Azadnajafabad S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Badiye AD, Bagheri N, Bagherieh S, Bairwa M, Bakkannavar SM, Bakshi RK, Balchut/Bilchut AH, Bärnighausen TW, Barra F, Barrow A, Baskaran P, Belo L, Bennett DA, Benseñor IM, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bintoro BS, Blokhina EAE, Bodicha BBA, Boloor A, Bosetti C, Braithwaite D, Brenner H, Briko NI, Brunoni AR, Butt ZA, Cao C, Cao Y, Cárdenas R, Carvalho AF, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Castro-de-Araujo LFS, Cattaruzza MS, Chakraborty PA, Charan J, Chattu VK, Chaurasia A, Cherbuin N, Chu DT, Chudal N, Chung SC, Churko C, Ciobanu LG, Cirillo M, Claro RM, Costanzo S, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Dachew BA, Dadras O, Dai X, Damiani G, Dandona L, Dandona R, Daniel BD, Danielewicz A, Darega Gela J, Davletov K, de Araujo JAP, de Sá-Junior AR, Debela SA, Dehghan A, Demetriades AK, Derbew Molla M, Desai R, Desta AA, Dias da Silva D, Diaz D, Digesa LE, Diress M, Dodangeh M, Dongarwar D, Dorostkar F, Dsouza HL, Duko B, Duncan BB, Edvardsson K, Ekholuenetale M, Elgar FJ, Elhadi M, Elmonem MA, Endries AY, Eskandarieh S, Etemadimanesh A, Fagbamigbe AF, Fakhradiyev IR, Farahmand F, Farinha CSES, Faro A, Farzadfar F, Fatehizadeh A, Fauk NK, Feigin VL, Feldman R, Feng X, Fentaw Z, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Francis JM, Franklin RC, Gaal PA, Gad MM, Gallus S, Galvano F, Ganesan B, Garg T, Gebrehiwot MGD, Gebremeskel TG, Gebremichael MA, Gemechu TR, Getacher L, Getachew ME, Getachew Obsa A, Getie A, Ghaderi A, Ghafourifard M, Ghajar A, Ghamari SH, Ghandour LA, Ghasemi Nour M, Ghashghaee A, Ghozy S, Glozah FN, Glushkova EV, Godos J, Goel A, Goharinezhad S, Golechha M, Goleij P, Golitaleb M, Greaves F, Grivna M, Grosso G, Gudayu TW, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Hafezi-Nejad N, Haj-Mirzaian A, Hall BJ, Halwani R, Handiso TB, Hankey GJ, Hariri S, Haro JM, Hasaballah AI, Hassanian-Moghaddam H, Hay SI, Hayat K, Heidari G, Heidari M, Hendrie D, Herteliu C, Heyi DZ, Hezam K, Hlongwa MM, Holla R, Hossain MM, Hossain S, Hosseini SK, hosseinzadeh M, Hostiuc M, Hostiuc S, Hu G, Huang J, Hussain S, Ibitoye SE, Ilic IM, Ilic MD, Immurana M, Irham LM, Islam MM, Islam RM, Islam SMS, Iso H, Itumalla R, Iwagami M, Jabbarinejad R, Jacob L, Jakovljevic M, Jamalpoor Z, Jamshidi E, Jayapal SK, Jayarajah UU, Jayawardena R, Jebai R, Jeddi SA, Jema AT, Jha RP, Jindal HA, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabthymer RH, Kamble BD, Kandel H, Kanno GG, Kapoor N, Karaye IM, Karimi SE, Kassa BG, Kaur RJ, Kayode GA, Keykhaei M, Khajuria H, Khalilov R, Khan IA, Khan MAB, Kim H, Kim J, Kim MS, Kimokoti RW, Kivimäki M, Klymchuk V, Knudsen AKS, Kolahi AA, Korshunov VA, Koyanagi A, Krishan K, Krishnamoorthy Y, Kumar GA, Kumar N, Kumar N, Lacey B, Lallukka T, Lasrado S, Lau J, Lee SW, Lee WC, Lee YH, Lim LL, Lim SS, Lobo SW, Lopukhov PD, Lorkowski S, Lozano R, Lucchetti G, Madadizadeh F, Madureira-Carvalho ÁM, Mahjoub S, Mahmoodpoor A, Mahumud RA, Makki A, Malekpour MR, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martinez-Villa FA, Matzopoulos R, Maulik PK, Mayeli M, McGrath JJ, Meena JK, Mehrabi Nasab E, Menezes RG, Mensink GBM, Mentis AFA, Meretoja A, Merga BT, Mestrovic T, Miao Jonasson J, Miazgowski B, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mini GK, Mirica A, Mirijello A, Mirmoeeni S, Mirrakhimov EM, Misra S, Moazen B, Mobarakabadi M, Moccia M, Mohammad Y, Mohammadi E, Mohammadian-Hafshejani A, Mohammed TA, Moka N, Mokdad AH, Momtazmanesh S, Moradi Y, Mostafavi E, Mubarik S, Mullany EC, Mulugeta BT, Murillo-Zamora E, Murray CJL, Mwita JC, Naghavi M, Naimzada MD, Nangia V, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nepal S, Neupane SPP, Neupane Kandel S, Nigatu YT, Nowroozi A, Nuruzzaman KM, Nzoputam CI, Obamiro KO, Ogbo FA, Oguntade AS, Okati-Aliabad H, Olakunde BO, Oliveira GMM, Omar Bali A, Omer E, Ortega-Altamirano DV, Otoiu A, Otstavnov SS, Oumer B, P A M, Padron-Monedero A, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pardhan S, Parekh T, Park EK, Parry CDH, Pashazadeh Kan F, Patel J, Pati S, Patton GC, Paudel U, Pawar S, Peden AE, Petcu IR, Phillips MR, Pinheiro M, Plotnikov E, Pradhan PMS, Prashant A, Quan J, Radfar A, Rafiei A, Raghav PR, Rahimi-Movaghar V, Rahman A, Rahman MM, Rahman M, Rahmani AM, Rahmani S, Ranabhat CL, Ranasinghe P, Rao CR, Rasali DP, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Renzaho AMN, Rezaei N, Rezaei S, Rezaeian M, Riahi SM, Romero-Rodríguez E, Roth GA, Rwegerera GM, Saddik B, Sadeghi E, Sadeghian R, Saeed U, Saeedi F, Sagar R, Sahebkar A, Sahoo H, Sahraian MA, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Samy AM, Sanmarchi F, Santric-Milicevic MM, Sarikhani Y, Sathian B, Saya GK, Sayyah M, Schmidt MI, Schutte AE, Schwarzinger M, Schwebel DC, Seidu AA, Senthil Kumar N, SeyedAlinaghi S, Seylani A, Sha F, Shahin S, Shahraki-Sanavi F, Shahrokhi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shams-Beyranvand M, Sheikhbahaei S, Sheikhi RA, Shetty A, Shetty JK, Shiferaw DS, Shigematsu M, Shiri R, Shirkoohi R, Shivakumar KM, Shivarov V, Shobeiri P, Shrestha R, Sidemo NB, Sigfusdottir ID, Silva DAS, Silva NTD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sleet DA, Solmi M, SOLOMON YONATAN, Song S, Song Y, Sorensen RJD, Soshnikov S, Soyiri IN, Stein DJ, Subba SH, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Taheri M, Tan KK, Tareke M, Tarkang EE, Temesgen G, Temesgen WA, Temsah MH, Thankappan KR, Thapar R, Thomas NK, Tiruneh C, Todorovic J, Torrado M, Touvier M, Tovani-Palone MR, Tran MTN, Trias-Llimós S, Tripathy JP, Vakilian A, Valizadeh R, Varmaghani M, Varthya SB, Vasankari TJ, Vos T, Wagaye B, Waheed Y, Walde MT, Wang C, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wubetu AD, Xu S, Yamagishi K, Yang L, Yesera GEE, Yigit A, Yiğit V, Yimaw AEAE, Yon DK, Yonemoto N, Yu C, Zadey S, Zahir M, Zare I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zuniga YMH, Gakidou E. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 2022; 400:185-235. [PMID: 35843246 PMCID: PMC9289789 DOI: 10.1016/s0140-6736(22)00847-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING Bill & Melinda Gates Foundation.
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Castelpietra G, Knudsen AKS, Agardh EE, Armocida B, Beghi M, Iburg KM, Logroscino G, Ma R, Starace F, Steel N, Addolorato G, Andrei CL, Andrei T, Ayuso-Mateos JL, Banach M, Bärnighausen TW, Barone-Adesi F, Bhagavathula AS, Carvalho F, Carvalho M, Chandan JS, Chattu VK, Couto RA, Cruz-Martins N, Dargan PI, Deuba K, da Silva DD, Fagbamigbe AF, Fernandes E, Ferrara P, Fischer F, Gaal PA, Gialluisi A, Haagsma JA, Haro JM, Hasan MT, Hasan SS, Hostiuc S, Iacoviello L, Iavicoli I, Jamshidi E, Jonas JB, Joo T, Jozwiak JJ, Katikireddi SV, Kauppila JH, Khan MA, Kisa A, Kisa S, Kivimäki M, Koly KN, Koyanagi A, Kumar M, Lallukka T, Langguth B, Ledda C, Lee PH, Lega I, Linehan C, Loureiro JA, Madureira-Carvalho ÁM, Martinez-Raga J, Mathur MR, McGrath JJ, Mechili EA, Mentis AFA, Mestrovic T, Miazgowski B, Mirica A, Mirijello A, Moazen B, Mohammed S, Mulita F, Nagel G, Negoi I, Negoi RI, Nwatah VE, Padron-Monedero A, Panda-Jonas S, Pardhan S, Pasovic M, Patel J, Petcu IR, Pinheiro M, Pollok RCG, Postma MJ, Rawaf DL, Rawaf S, Romero-Rodríguez E, Ronfani L, Sagoe D, Sanmarchi F, Schaub MP, Sharew NT, Shiri R, Shokraneh F, Sigfusdottir ID, Silva JP, Silva R, Socea B, Szócska M, Tabarés-Seisdedos R, Torrado M, Tovani-Palone MR, Vasankari TJ, Veroux M, Viner RM, Werdecker A, Winkler AS, Hay SI, Ferrari AJ, Naghavi M, Allebeck P, Monasta L. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019. Lancet Reg Health Eur 2022; 16:100341. [PMID: 35392452 PMCID: PMC8980870 DOI: 10.1016/j.lanepe.2022.100341] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation.
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Affiliation(s)
- Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy
| | | | - Emilie E. Agardh
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Benedetta Armocida
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | | | | | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy
| | - Rui Ma
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Fabrizio Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - Nicholas Steel
- Department of Primary Care and Public Health, University of East Anglia, Norwich, UK
- Public Health England, London, UK
| | | | | | - Tudorel Andrei
- Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania
| | - Jose L Ayuso-Mateos
- CIBERSAM, Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Felix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Márcia Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Vijay Kumar Chattu
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
- Independent Consultant, Athens, Greece
| | - Rosa A.S. Couto
- Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal
- Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal
| | - Paul I. Dargan
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Keshab Deuba
- National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Adeniyi Francis Fagbamigbe
- Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
- Population and Behavioural Sciences, University of St Andrews, St Andrews, UK
| | - Eduarda Fernandes
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
| | - Florian Fischer
- Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
| | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | | | - Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
| | - M. Tasdik Hasan
- Department of Pharmacy, University of Huddersfield, Huddersfield, UK
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Syed Shahzad Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elham Jamshidi
- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran
- Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jost B. Jonas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Joonas H. Kauppila
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Moien A.B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, UK
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Mika Kivimäki
- Department of Epidemiology and Public Health University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kamrun Nahar Koly
- Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- Division of Psychology and Language Sciences, University College London, London, UK
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Caterina Ledda
- Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Ilaria Lega
- National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy
| | - Christine Linehan
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Áurea M Madureira-Carvalho
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
- Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal
| | - Jose Martinez-Raga
- Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Manu Raj Mathur
- Health Policy Research Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - John J. McGrath
- Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Enkeleint A. Mechili
- Department of Healthcare, University of Vlora, Vlora city, Albania
- Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Antonio Mirijello
- Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
- Medical School, University of Thessaly, Larissa, Greece
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany
| | - Ionut Negoi
- Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Ruxandra Irina Negoi
- Department of Anatomy and Embryology Romania, Bucharest, Romania
- Cardio-Aid, Bucharest, Romania
| | - Vincent Ebuka Nwatah
- Department of Pediatrics, National Hospital, Abuja, Nigeria
- Department of International Public Health, University of Liverpool, Liverpool, UK
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, UK
- School of Dentistry, University of Leeds, Leeds, UK
| | - Ionela-Roxana Petcu
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Marina Pinheiro
- Department of Chemistry, University of Porto, Porto, Portugal
| | | | - Maarten J. Postma
- University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- University College London Hospitals, London, UK
- Academic Public Health England, London, UK
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- Department of Psychosocial Science University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland
| | - Nigussie Tadesse Sharew
- Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands
- Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Farhad Shokraneh
- London Institute for Healthcare Engineering, King's College London, London, UK
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - João Pedro Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Renata Silva
- Department of Biological Sciences, University of Porto, Porto, Portugal
| | - Bogdan Socea
- Surgery, "Sf. Pantelimon" Emergency Clinical Hospital Bucharest, Bucharest, Romania
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Marco Torrado
- Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal
- Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, UK
| | - Tommi Juhani Vasankari
- UKK Institute, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Russell M. Viner
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Andrea Werdecker
- Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alize J. Ferrari
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
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Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, Abdoli A, Abualhasan A, Abu-Gharbieh E, Akram TT, Al Hamad H, Alahdab F, Alanezi FM, Alipour V, Almustanyir S, Amu H, Ansari I, Arabloo J, Ashraf T, Astell-Burt T, Ayano G, Ayuso-Mateos JL, Baig AA, Barnett A, Barrow A, Baune BT, Béjot Y, Bezabhe WMM, Bezabih YM, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bijani A, Biswas A, Bolla SR, Boloor A, Brayne C, Brenner H, Burkart K, Burns RA, Cámera LA, Cao C, Carvalho F, Castro-de-Araujo LFS, Catalá-López F, Cerin E, Chavan PP, Cherbuin N, Chu DT, Costa VM, Couto RAS, Dadras O, Dai X, Dandona L, Dandona R, De la Cruz-Góngora V, Dhamnetiya D, Dias da Silva D, Diaz D, Douiri A, Edvardsson D, Ekholuenetale M, El Sayed I, El-Jaafary SI, Eskandari K, Eskandarieh S, Esmaeilnejad S, Fares J, Faro A, Farooque U, Feigin VL, Feng X, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fillit H, Fischer F, Gaidhane S, Galluzzo L, Ghashghaee A, Ghith N, Gialluisi A, Gilani SA, Glavan IR, Gnedovskaya EV, Golechha M, Gupta R, Gupta VB, Gupta VK, Haider MR, Hall BJ, Hamidi S, Hanif A, Hankey GJ, Haque S, Hartono RK, Hasaballah AI, Hasan MT, Hassan A, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari-Soureshjani R, Herteliu C, Househ M, Hussain R, Hwang BF, Iacoviello L, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iso H, Iwagami M, Jabbarinejad R, Jacob L, Jain V, Jayapal SK, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kalani R, Kandel A, Kandel H, Karch A, Kasa AS, Kassie GM, Keshavarz P, Khan MAB, Khatib MN, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Koroshetz WJ, Koyanagi A, Kumar GA, Kumar M, Lak HM, Leonardi M, Li B, Lim SS, Liu X, Liu Y, Logroscino G, Lorkowski S, Lucchetti G, Lutzky Saute R, Magnani FG, Malik AA, Massano J, Mehndiratta MM, Menezes RG, Meretoja A, Mohajer B, Mohamed Ibrahim N, Mohammad Y, Mohammed A, Mokdad AH, Mondello S, Moni MAA, Moniruzzaman M, Mossie TB, Nagel G, Naveed M, Nayak VC, Neupane Kandel S, Nguyen TH, Oancea B, Otstavnov N, Otstavnov SS, Owolabi MO, Panda-Jonas S, Pashazadeh Kan F, Pasovic M, Patel UK, Pathak M, Peres MFP, Perianayagam A, Peterson CB, Phillips MR, Pinheiro M, Piradov MA, Pond CD, Potashman MH, Pottoo FH, Prada SI, Radfar A, Raggi A, Rahim F, Rahman M, Ram P, Ranasinghe P, Rawaf DL, Rawaf S, Rezaei N, Rezapour A, Robinson SR, Romoli M, Roshandel G, Sahathevan R, Sahebkar A, Sahraian MA, Sathian B, Sattin D, Sawhney M, Saylan M, Schiavolin S, Seylani A, Sha F, Shaikh MA, Shaji KS, Shannawaz M, Shetty JK, Shigematsu M, Shin JI, Shiri R, Silva DAS, Silva JP, Silva R, Singh JA, Skryabin VY, Skryabina AA, Smith AE, Soshnikov S, Spurlock EE, Stein DJ, Sun J, Tabarés-Seisdedos R, Thakur B, Timalsina B, Tovani-Palone MR, Tran BX, Tsegaye GW, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vlassov V, Vu GT, Vu LG, Wang YP, Wimo A, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yang L, Yano Y, Yonemoto N, Yu C, Yunusa I, Zadey S, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Murray CJL, Vos T. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7:e105-e125. [PMID: 34998485 PMCID: PMC8810394 DOI: 10.1016/s2468-2667(21)00249-8] [Citation(s) in RCA: 983] [Impact Index Per Article: 491.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING Bill & Melinda Gates Foundation and Gates Ventures.
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Rodríguez-Gómez I, Sánchez-Martín C, García-García FJ, García-Esquinas E, Miret M, Jiménez-Pavón D, Guadalupe-Grau A, Mañas A, Carnicero JA, Casajus JA, Ayuso-Mateos JL, Rodríguez-Artalejo F, Rodríguez-Mañas L, Ara I. The Medium-Term Changes in Health-Related Behaviours among Spanish Older People Lifestyles during Covid-19 Lockdown. J Nutr Health Aging 2022; 26:485-494. [PMID: 35587761 PMCID: PMC9020156 DOI: 10.1007/s12603-022-1781-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim was to evaluate general changes and investigate the association between diet quality, physical activity (PA), and sedentary time (ST) during COVID-19 lockdown and the subsequent 7-month changes in health-related behaviours and lifestyles in older people. PARTICIPANTS 1092 participants (67-97y) from two Spanish cohorts were included. DESIGN Telephone-based questionaries were used to evaluate health-related behaviours and lifestyle. Multinomial logistic regression analyses with diet quality, PA, and ST during lockdown as predictors for health-related behaviours changes post-lockdown were applied. RESULTS Diet quality, PA, and ST significantly improved post-lockdown, while physical component score of the SF-12 worsened. Participants with a low diet quality during lockdown had higher worsening of post-lockdown ST and anxiety; whereas those with high diet quality showed less likelihood of remaining abstainers, worsening weight, and improving PA. Lower ST was associated with a higher likelihood of remaining abstainers, and worsening weight and improving social contact; nevertheless, higher ST was linked to improvement in sleep quality. Lower PA was more likely to decrease alcohol consumption, while higher PA showed the opposite. However, PA was more likely to be associated to remain abstainers. CONCLUSIONS Despite improvements in lifestyle after lockdown, it had health consequences for older people. Particularly, lower ST during lockdown seemed to provide the most medium-term remarkable lifestyle improvements.
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Affiliation(s)
- I Rodríguez-Gómez
- Ignacio Ara Royo, PhD, GENUD-Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III, s/n, 45071, Toledo, Spain, Tel: +34 925268800 (Ext.5543); E-mail: ; @iara_royo
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9
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Nichols E, Abd-Allah F, Abdoli A, Abualhasan A, Abu-Gharbieh E, Afshin A, Akinyemi RO, Alanezi FM, Alipour V, Almasi-Hashiani A, Arabloo J, Ashraf-Ganjouei A, Ayano G, Ayuso-Mateos JL, Baig AA, Banach M, Barboza MA, Barker-Collo SL, Baune BT, Bhagavathula AS, Bhattacharyya K, Bijani A, Biswas A, Boloor A, Brayne C, Brenner H, Burkart K, Burugina Nagaraja S, Carvalho F, Castro-de-Araujo LFS, Catalá-López F, Cerin E, Cherbuin N, Chu DT, Dai X, de Sá-Junior AR, Djalalinia S, Douiri A, Edvardsson D, El-Jaafary SI, Eskandarieh S, Faro A, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Gaidhane S, Galluzzo L, Gebremeskel GG, Ghashghaee A, Gialluisi A, Gnedovskaya EV, Golechha M, Gupta R, Hachinski V, Haider MR, Haile TG, Hamiduzzaman M, Hankey GJ, Hay SI, Heidari G, Heidari-Soureshjani R, Ho HC, Househ M, Hwang BF, Iacoviello L, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iwagami M, Iyamu IO, Jha RP, Kalani R, Karch A, Kasa AS, Khader YS, Khan EA, Khatib MN, Kim YJ, Kisa S, Kisa A, Kivimäki M, Koyanagi A, Kumar M, Landires I, Lasrado S, Li B, Lim SS, Liu X, Madhava Kunjathur S, Majeed A, Malik P, Mehndiratta MM, Menezes RG, Mohammad Y, Mohammed S, Mokdad AH, Moni MA, Nagel G, Naveed M, Nayak VC, Nguyen CT, Nguyen HLT, Nunez-Samudio V, Olagunju AT, Ostroff SM, Otstavnov N, Owolabi MO, Pashazadeh Kan F, Patel UK, Phillips MR, Piradov MA, Pond CD, Pottoo FH, Prada SI, Radfar A, Rahim F, Rana J, Rashedi V, Rawaf S, Rawaf DL, Reinig N, Renzaho AMN, Rezaei N, Rezapour A, Romoli M, Roshandel G, Sachdev PS, Sahebkar A, Sahraian MA, Samaei M, Saylan M, Sha F, Shaikh MA, Shibuya K, Shigematsu M, Shin JI, Shiri R, Silva DAS, Singh JA, Singhal D, Skryabin VY, Skryabina AA, Soheili A, Sotoudeh H, Spurlock EE, Szoeke CEI, Tabarés-Seisdedos R, Taddele BW, Tovani-Palone MR, Tsegaye GW, Vacante M, Venketasubramanian N, Vidale S, Vlassov V, Vu GT, Wang YP, Weiss J, Weldemariam AH, Westerman R, Wimo A, Winkler AS, Wu C, Yadollahpour A, Yesiltepe M, Yonemoto N, Yu C, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Murray CJL, Vos T. Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study. BMC Med Inform Decis Mak 2021; 21:241. [PMID: 34380485 PMCID: PMC8356410 DOI: 10.1186/s12911-021-01590-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. METHODS Using cognitive testing data and data on functional limitations from Wave A (2001-2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. RESULTS Our algorithm had a cross-validated predictive accuracy of 88% (86-90), and an area under the curve of 0.97 (0.97-0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3-4) in individuals 70-79, 11% (9-12) in individuals 80-89 years old, and 28% (22-35) in those 90 and older. CONCLUSIONS Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys.
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10
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Bralten J, Mota NR, Klemann CJHM, De Witte W, Laing E, Collier DA, de Kluiver H, Bauduin SEEC, Arango C, Ayuso-Mateos JL, Fabbri C, Kas MJ, van der Wee N, Penninx BWJH, Serretti A, Franke B, Poelmans G. Genetic underpinnings of sociability in the general population. Neuropsychopharmacology 2021; 46:1627-1634. [PMID: 34054130 PMCID: PMC8280100 DOI: 10.1038/s41386-021-01044-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 02/03/2023]
Abstract
Levels of sociability are continuously distributed in the general population, and decreased sociability represents an early manifestation of several brain disorders. Here, we investigated the genetic underpinnings of sociability in the population. We performed a genome-wide association study (GWAS) of a sociability score based on four social functioning-related self-report questions from 342,461 adults in the UK Biobank. Subsequently we performed gene-wide and functional follow-up analyses. Robustness analyses were performed in the form of GWAS split-half validation analyses, as well as analyses excluding neuropsychiatric cases. Using genetic correlation analyses as well as polygenic risk score analyses we investigated genetic links of our sociability score to brain disorders and social behavior outcomes. Individuals with autism spectrum disorders, bipolar disorder, depression, and schizophrenia had a lower sociability score. The score was significantly heritable (SNP h2 of 6%). We identified 18 independent loci and 56 gene-wide significant genes, including genes like ARNTL, DRD2, and ELAVL2. Many associated variants are thought to have deleterious effects on gene products and our results were robust. The sociability score showed negative genetic correlations with autism spectrum, disorders, depression, schizophrenia, and two sociability-related traits-loneliness and social anxiety-but not with bipolar disorder or Alzheimer's disease. Polygenic risk scores of our sociability GWAS were associated with social behavior outcomes within individuals with bipolar disorder and with major depressive disorder. Variation in population sociability scores has a genetic component, which is relevant to several psychiatric disorders. Our findings provide clues towards biological pathways underlying sociability.
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Grants
- MC_PC_17228 Medical Research Council
- MC_QA137853 Medical Research Council
- Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115916. The research programme Computing Time National Computing Facilities Processing Round pilots 2018 with project number 17666, which is (partly) financed by the Dutch Research Council (NWO). And lastly, the Dutch national e-infrastructure with the support of SURF Cooperative.
- EU H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking with grant agreement 777394 (AIMS-2-TRIALS), the Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III (PI14/00397, PI14/02103, PIE16/00055, PI17/00819, PI17/00481), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), EU Structural Funds, EU Seventh Framework Program under grant agreement FP7-HEALTH-2013-2.2.1-2-603196 (Project PSYSCAN), Fundación Familia Alonso, Fundación Alicia Koplowitz.
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Affiliation(s)
- Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Nina R Mota
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | | | - Ward De Witte
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emma Laing
- Lilly Research Centre, Eli Lilly and Company, Surrey, UK
| | | | - Hilde de Kluiver
- Department of Psychiatry, Amsterdam University Medical Center/GGZ in Geest, Vrije Universiteit, Amsterdam, The Netherlands
| | - Stephanie E E C Bauduin
- Department of Psychiatry, Leiden Institute for Brain and Cognition/Psychiatric Neuroimaging, Leiden University Medical Center, Leiden, The Netherlands
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Jose L Ayuso-Mateos
- Department of Psychiatry, Instituto de Investigación Sanitaria La Princesa (IIS-IP), CIBERSAM, Universidad Autónoma de Madrid, Madrid, Spain
| | - Chiara Fabbri
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Martien J Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Nic van der Wee
- Department of Psychiatry, Leiden Institute for Brain and Cognition/Psychiatric Neuroimaging, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam University Medical Center/GGZ in Geest, Vrije Universiteit, Amsterdam, The Netherlands
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
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11
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Ayuso-Mateos JL, Miret M, Lopez-Garcia P, Alem A, Chisholm D, Gureje O, Hanlon C, Jordans M, Kigozi F, Lund C, Petersen I, Semrau M, Shidhaye R, Thornicroft G. Effective methods for knowledge transfer to strengthen mental health systems in low- and middle-income countries - CORRIGENDUM. BJPsych Open 2021; 7:e128. [PMID: 34240692 PMCID: PMC8281223 DOI: 10.1192/bjo.2021.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Ayuso-Mateos JL, Mediavilla R, Rodriguez KR, Bravo MF. Informing the response to COVID-19 in Spain: priorities for mental health research. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:79-82. [PMID: 33992223 PMCID: PMC8114090 DOI: 10.1016/j.rpsm.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/01/2023]
Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),, Madrid, Spain.
| | - R Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - K R Rodriguez
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain
| | - M F Bravo
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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13
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Ayuso-Mateos JL, Mediavilla R, Rodriguez KR, Bravo MF. Informing the response to COVID-19 in Spain: priorities for mental health research. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:79-82. [PMID: 34127209 PMCID: PMC8193968 DOI: 10.1016/j.rpsmen.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/12/2023]
Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),, Madrid, Spain.
| | - R Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - K R Rodriguez
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain
| | - M F Bravo
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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14
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de la Torre-Luque A, Ojagbemi A, Caballero FF, Lara E, Moreno-Agostino D, Bello T, Olaya B, Haro JM, Gureje O, Ayuso-Mateos JL. Cross-cultural comparison of symptom networks in late-life major depressive disorder: Yoruba Africans and the Spanish Population. Int J Geriatr Psychiatry 2020; 35:1060-1068. [PMID: 32394534 DOI: 10.1002/gps.5329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/08/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The concept of European psychologisation of depression versus somatisation in non-European populations has been the basis of several studies of cultural psychopathology in the general population. Little is currently known about cross-cultural differences and similarities in late-life depression symptom reporting. We cross-culturally compared symptom reporting in the context of Major Depressive Disorder (MDD) among community-dwelling older adults from Spain and Nigeria. METHODS We relied on data from two household multistage probability samples comprising 3,715 persons aged 65 years or older in the Spanish and Nigerian populations. All participants underwent assessments for MDD using the World Mental Health Survey version of the Composite International Diagnostic Interview. Cross-cultural comparison of broad somatic and psychological categories as well as relationship and influence of individual symptoms were analysed using the Symptom Network Analysis approach. RESULTS Current MDD was diagnosed in 232 and 195 older persons from Spain and Nigeria, respectively. The symptom network of the two samples were invariant in terms of global strength, S(GSPAIN , GNIGERIA ) = 7.56, P = .06, with psychological and somatic symptoms demonstrating centrality in both countries. However, country-specific relationships and influence of individual symptoms were found in the network structure of both samples, M(GSPAIN , GNIGERIA ) = 2.95, P < .01. CONCLUSION Broad somatic and psychological symptoms categories contributed to the structural network of older Africans and their peers from the Spanish population. Variations in the relationship and influence of individual symptoms suggests that the functional and "communicative" role of individual symptoms may be differentiated by context specific imperatives. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain.,Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Francisco F Caballero
- Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain.,Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Elvira Lara
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.,WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, University of Ibadan, Ibadan, Nigeria
| | - Beatriz Olaya
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Josep M Haro
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.,WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, University of Ibadan, Ibadan, Nigeria.,Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jose L Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
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15
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Guido D, Leonardi M, Mellor-Marsá B, Moneta MV, Sanchez-Niubo A, Tyrovolas S, Giné-Vázquez I, Haro JM, Chatterji S, Bobak M, Ayuso-Mateos JL, Arndt H, Koupil I, Bickenbach J, Koskinen S, Tobiasz-Adamczyk B, Panagiotakos D, Raggi A. Pain rates in general population for the period 1991-2015 and 10-years prediction: results from a multi-continent age-period-cohort analysis. J Headache Pain 2020; 21:52. [PMID: 32404046 PMCID: PMC7218619 DOI: 10.1186/s10194-020-01108-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 12/04/2022] Open
Abstract
Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates. Methods We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content “self-reported pain experienced at the time of the interview”, with a dichotomous (yes or no) modality. Results Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10–20% increase in pain rate is foreseen; among females only, a 10–15% increase in pain rates is foreseen for those aged 36–50. Conclusions Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates.
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Affiliation(s)
- Davide Guido
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Blanca Mellor-Marsá
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Maria V Moneta
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josep M Haro
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jose L Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | | | - Ilona Koupil
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Beata Tobiasz-Adamczyk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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16
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Raggi A, Leonardi M, Mellor-Marsá B, Moneta MV, Sanchez-Niubo A, Tyrovolas S, Giné-Vázquez I, Haro JM, Chatterji S, Bobak M, Ayuso-Mateos JL, Arndt H, Hossin MZ, Bickenbach J, Koskinen S, Tobiasz-Adamczyk B, Panagiotakos D, Corso B. Predictors of pain in general ageing populations: results from a multi-country analysis based on ATHLOS harmonized database. J Headache Pain 2020; 21:45. [PMID: 32375641 PMCID: PMC7201730 DOI: 10.1186/s10194-020-01116-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. METHODS We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. RESULTS A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). CONCLUSIONS Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Blanca Mellor-Marsá
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Maria V Moneta
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josep M Haro
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jose L Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | | | - Muhammad Z Hossin
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Beata Tobiasz-Adamczyk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Barbara Corso
- National Research Council, Neuroscience Institute, Padova, Italy
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17
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de la Torre-Luque A, de la Fuente J, Sanchez-Niubo A, Caballero FF, Prina M, Muniz-Terrera G, Haro JM, Ayuso-Mateos JL. Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study. Acta Psychiatr Scand 2019; 140:541-551. [PMID: 31566713 DOI: 10.1111/acps.13107] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 09/23/2019] [Indexed: 12/12/2022]
Abstract
AIMS To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. METHODS Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. RESULTS Almost 85% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). CONCLUSIONS The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.
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Affiliation(s)
- A de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - J de la Fuente
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - A Sanchez-Niubo
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - F F Caballero
- Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain.,Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M Prina
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - G Muniz-Terrera
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - J M Haro
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - J L Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
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18
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Prina M, Panagiotakos D, Prince M, Bobak M, Sanderson W, Scherbov S, Ayuso-Mateos JL, Haro JM. AN INTRODUCTION TO THE ATHLOS PROJECT: AGEING TRAJECTORIES OF HEALTH: LONGITUDINAL OPPORTUNITIES AND SYNERGIES. Innov Aging 2019. [PMCID: PMC6845877 DOI: 10.1093/geroni/igz038.2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
ATHLOS is a 5-year project, funded by the European Union’s Horizon 2020 Research and Innovation Program. Its aim is to achieve a better understanding of healthy ageing, utilising longitudinal data from existing cohort studies. The measure of healthy ageing used within ATHLOS is based on the definition used by the World Health Organization as the ongoing process of developing and maintaining functional ability to enable well-being in older age. The first step of the project was to harmonise 17 community based cohort studies of ageing, covering 38 countries over the world and over 411,000 individuals. In this talk we will discuss the work of the different work packages of the project, including a description of the existing evidence on risk factors of healthy ageing.
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Affiliation(s)
| | | | - Martin Prince
- Global Health Institute, King’s College London, London, England, United Kingdom
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, England, United Kingdom
| | - Warren Sanderson
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Niederosterreich, Austria
| | - Serguei Scherbov
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Niederosterreich, Austria
| | - Jose L Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Madrid, Spain
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19
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Affiliation(s)
- Jose L. Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
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Ayuso-Mateos JL, Miret M, Lopez-Garcia P, Alem A, Chisholm D, Gureje O, Hanlon C, Jordans M, Kigozi F, Lund C, Petersen I, Semrau M, Shidhaye R, Thornicroft G. Effective methods for knowledge transfer to strengthen mental health systems in low- and middle-income countries. BJPsych Open 2019; 5:e72. [PMID: 31530323 PMCID: PMC6688465 DOI: 10.1192/bjo.2019.50] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Emerald project's focus is on how to strengthen mental health systems in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). This was done by generating evidence and capacity to enhance health system performance in delivering mental healthcare.A common problem in scaling-up interventions and strengthening mental health programmes in LMICs is how to transfer research evidence, such as the data collected in the Emerald project, into practice. AIMS To describe how core elements of Emerald were implemented and aligned with the ultimate goal of strengthening mental health systems, as well as their short-term impact on practices, policies and programmes in the six partner countries. METHOD We focused on the involvement of policy planners, managers, patients and carers. RESULTS Over 5 years of collaboration, the Emerald consortium has provided evidence and tools for the improvement of mental healthcare in the six LMICs involved in the project. We found that the knowledge transfer efforts had an impact on mental health service delivery and policy planning at the sites and countries involved in the project. CONCLUSIONS This approach may be valid beyond the mental health context, and may be effective for any initiative that aims at implementing evidence-based health policies for health system strengthening.
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Affiliation(s)
- Jose L. Ayuso-Mateos
- Professor of Psychiatry, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid; and Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Maria Miret
- Journalist, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Spain
| | - Pilar Lopez-Garcia
- Associate Professor, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid; Instituto de Investigación Sanitaria Princesa (IIS Princesa); and Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Atalay Alem
- Professor of Psychiatry, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Dan Chisholm
- Programme Manager for Mental Health, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Oye Gureje
- Professor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South Africa
| | - Charlotte Hanlon
- Reader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; and Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Mark Jordans
- Reader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Fred Kigozi
- Senior Consultant Psychiatrist, Butabika National Referral Mental Hospital, Uganda
| | - Crick Lund
- Professor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Inge Petersen
- Research Director and Professor, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Maya Semrau
- Research Fellow, Global Health and Infection Department, Brighton and Sussex Medical School; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rahul Shidhaye
- Clinical Psychiatrist, Public Health Foundation of India; and CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
| | - Graham Thornicroft
- Professor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Psychiatry, King's College London, UK
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Semrau M, Alem A, Ayuso-Mateos JL, Chisholm D, Gureje O, Hanlon C, Jordans M, Kigozi F, Lund C, Petersen I, Shidhaye R, Thornicroft G. Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme. BJPsych Open 2019; 5:e73. [PMID: 31530325 PMCID: PMC6700480 DOI: 10.1192/bjo.2018.90] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/30/2018] [Accepted: 12/02/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a large treatment gap for mental, neurological or substance use (MNS) disorders. The 'Emerging mental health systems in low- and middle-income countries (LMICs)' (Emerald) research programme attempted to identify strategies to work towards reducing this gap through the strengthening of mental health systems. AIMS To provide a set of proposed recommendations for mental health system strengthening in LMICs. METHOD The Emerald programme was implemented in six LMICs in Africa and Asia (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda) over a 5-year period (2012-2017), and aimed to improve mental health outcomes in the six countries by building capacity and generating evidence to enhance health system strengthening. RESULTS The proposed recommendations align closely with the World Health Organization's key health system strengthening 'building blocks' of governance, financing, human resource development, service provision and information systems; knowledge transfer is included as an additional cross-cutting component. Specific recommendations are made in the paper for each of these building blocks based on the body of data that were collected and analysed during Emerald. CONCLUSIONS These recommendations are relevant not only to the six countries in which their evidential basis was generated, but to other LMICs as well; they may also be generalisable to other non-communicable diseases beyond MNS disorders. DECLARATION OF INTEREST None.
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Affiliation(s)
- Maya Semrau
- Research Fellow in Implementation Research, Centre for Global Health Research, Brighton and Sussex Medical School; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Atalay Alem
- Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Jose L. Ayuso-Mateos
- Chairman and Director, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid; and Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Dan Chisholm
- Programme Manager for Mental Health, Regional Office for Europe, Department of Mental Health and Substance Abuse, World Health Organization, Switzerland
| | - Oye Gureje
- Professor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South Africa
| | - Charlotte Hanlon
- Reader in Global Mental Health, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Adjunct Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Mark Jordans
- Reader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Fred Kigozi
- Senior Consultant Psychiatrist and Researcher, Butabika National Referral and Teaching Hospital, Uganda
| | - Crick Lund
- Professor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Inge Petersen
- Research Professor and Director, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Rahul Shidhaye
- Clinical Psychiatrist, Public Health Foundation of India; and CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
| | - Graham Thornicroft
- Professor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Psychiatry, King's College London, UK
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Sanchez-Niubo A, Egea-Cortés L, Olaya B, Caballero FF, Ayuso-Mateos JL, Prina M, Bobak M, Arndt H, Tobiasz-Adamczyk B, Pająk A, Leonardi M, Koupil I, Panagiotakos D, Tamosiunas A, Scherbov S, Sanderson W, Koskinen S, Chatterji S, Haro JM. Cohort Profile: The Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project. Int J Epidemiol 2019; 48:1052-1053i. [PMID: 31329885 PMCID: PMC6693815 DOI: 10.1093/ije/dyz077] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Albert Sanchez-Niubo
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Laia Egea-Cortés
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Francisco Félix Caballero
- Department Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Jose L Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - Matthew Prina
- Social Epidemiology Research Group. Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Global Health Institute, King's College London, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagienllonian University Medical College, Krakow, Poland
| | | | - Ilona Koupil
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Sergei Scherbov
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria
- Austrian Academy of Science, Vienna Institute of Demography, Vienna, Austria
- Russian Presidential Academy of National Economy and Public Administration (RANEPA), Moscow, Russian Federation
| | - Warren Sanderson
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria
- Department of Economics, Stony Brook University, Stony Brook, NY, USA
| | - Seppo Koskinen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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23
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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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24
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Canal-Rivero M, López-Moríñigo JD, Setién-Suero E, Ruiz-Veguilla M, Ayuso-Mateos JL, Ayesa-Arriola R, Crespo-Facorro B. Predicting suicidal behaviour after first episode of non-affective psychosis: The role of neurocognitive functioning. Eur Psychiatry 2018; 53:52-57. [PMID: 29929113 DOI: 10.1016/j.eurpsy.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/07/2018] [Revised: 06/06/2018] [Accepted: 06/09/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Suicide has been recognised as one of the major causes of premature death in psychosis. However, predicting suicidal behaviour (SB) is still challenging in the clinical setting and the association of neurocognition with SB in psychosis remains poorly understood. This study aimed to investigate the role of neurocognitive performance as predictor of SB. Also, we sought to explore differences in the evolution of clinical and neurocognitive functioning between participants with/without history of suicide attempts (SA) over follow-up period. METHODS The sample of the study is composed by 517 patients. Sociodemographic, clinical, functional and neurocognitive measures were evaluated at baseline as well as 1-year and 3 years after first episode of psychosis. Bivariate and multivariate analyses explored the influence of these variables as putative baseline predictors of SB. Repeated measures analyses of variance tested differences in clinical and neurocognitive outcomes at 1- and 3-year follow-up. RESULTS Global cognitive functioning (GCF) (OR = 1.83, 95% CI = 1.25-2.67) and severe depressive symptoms (OR = 1.17, 95% CI = 1.07-1.28) predicted SB. Longitudinal analyses revealed that patients with SB at follow-up presented with higher levels of remission in terms of positive psychotic symptoms and depression. In addition, those with a history of SB had worse GCF and visual memory than those without such antecedents. CONCLUSIONS GCF was found to be the most robust predictor of SB along with severe depressive symptomatology. Hence, poorer cognitive performance in FEP appears to emerge as a risk factor for suicidal behaviour from early stages of the illness and a comprehensive neurocognitive assessment may contribute to risk assessment.
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Affiliation(s)
- M Canal-Rivero
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - J D López-Moríñigo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E Setién-Suero
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M Ruiz-Veguilla
- Seville Biomedicine Institute Neurodevelopment and Psychosis Group (IBIS), Virgen del Rocío University Hospital, CSIC, University of Seville, UGC Mental Health HVR, Spain
| | - J L Ayuso-Mateos
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Spain; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - R Ayesa-Arriola
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - B Crespo-Facorro
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Kamenov K, Twomey C, Cabello M, Prina AM, Ayuso-Mateos JL. The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis. Psychol Med 2017; 47:1337. [PMID: 28007047 DOI: 10.1017/s003329171600341x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Grande I, Sanchez-Moreno J, Sole B, Jimenez E, Torrent C, Bonnin CM, Varo C, Tabares-Seisdedos R, Balanzá-Martínez V, Valls E, Morilla I, Carvalho AF, Ayuso-Mateos JL, Vieta E, Martinez-Aran A. High cognitive reserve in bipolar disorders as a moderator of neurocognitive impairment. J Affect Disord 2017; 208:621-627. [PMID: 28029429 DOI: 10.1016/j.jad.2016.10.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 08/01/2016] [Revised: 10/05/2016] [Accepted: 10/17/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cognitive reserve (CR) reflects the capacity of the brain to endure neuropathology, minimize clinical manifestations and successfully complete cognitive tasks. The present study aims to determine whether high CR may constitute a moderator of cognitive functioning in bipolar disorder (BD). METHODS 102 patients with BD and 32 healthy controls were enrolled. All patients met DSM-IV criteria for I or II BD and were euthymic (YMRS≤6 and HDRS≤8) during a 6-month period. All participants were tested with a comprehensive neuropsychological battery, and a Cerebral Reserve Score (CRS) was estimated. Subjects with a CRS below the group median were classified as having low CR, whereas participants with a CRS above the median value were considered to have high CR. RESULTS Participants with BD with high CR displayed a better performance in measures of attention (digits forward: F=4.554, p=0.039); phonemic and semantic verbal fluency (FAS: F=9.328, p=0.004; and Animal Naming: F=8.532, p=0.006); and verbal memory (short cued recall of California Verbal Learning Test: F=4.236, p=0.046), after multivariable adjustment for potential confounders, including number of admissions and prior psychotic symptoms. LIMITATIONS The cross-sectional design of the study does not allow the establishment of causal inferences. Additionally, the small size of the sample may have limited some results. CONCLUSIONS High cognitive reserve may therefore be a valuable construct to explore for predicting neurocognitive performance in patients with BD regarding premorbid status.
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Affiliation(s)
- I Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J Sanchez-Moreno
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Sole
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jimenez
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnin
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Varo
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - R Tabares-Seisdedos
- Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia, Spain
| | - V Balanzá-Martínez
- La Fe University and Polytechnic Hospital, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - E Valls
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - I Morilla
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Fortaleza, CE, Brazil
| | - J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, CIBERSAM, Madrid, Spain
| | - E Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - A Martinez-Aran
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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27
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Anaya C, Torrent C, Caballero FF, Vieta E, Bonnin CDM, Ayuso-Mateos JL. Cognitive reserve in bipolar disorder: relation to cognition, psychosocial functioning and quality of life. Acta Psychiatr Scand 2016; 133:386-98. [PMID: 26719018 DOI: 10.1111/acps.12535] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [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: 11/09/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Cognitive reserve (CR) is a concept that was postulated as a protective factor for some clinical symptoms after the observation that there is not a direct relationship between the degree of brain damage and its clinical manifestation. This study aimed to explore the association between CR and the main outcomes in bipolar disorder (BD): cognitive functions, psychosocial functioning and perceived quality of life. METHOD A sample of 224 euthymic bipolar patients was assessed with a neuropsychological battery, the Functioning Assessment Short Test and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). CR was calculated through three proxies: estimated premorbid Intelligent Quotient, educational level and occupational attainment. Relationships between CR and cognitive functions, psychosocial functioning and quality of life were assessed by multiple linear regression models. RESULTS Higher CR was associated with better cognitive functioning (P < 0.001 in processing speed, working memory, verbal and visual memory, and executive function; P = 0.026 in attention) and better psychosocial functioning (P = 0.008). For quality of life, CR was positively associated with the physical component of the SF-36 (P = 0.016) but negatively associated with the mental component (P = 0.004). CONCLUSION The results suggest that CR may play an important role in the course and prognosis of bipolar patients and it should be considered in both clinical and research settings related to BD.
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Affiliation(s)
- C Anaya
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Torrent
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - F F Caballero
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
| | - E Vieta
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - C Del Mar Bonnin
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
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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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Lara E, Olaya B, Garin N, Miret M, Ayuso-Mateos JL, Moneta MV, Haro JM. Is cognitive impairment associated with suicidality? A population-based study. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- Jose L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa and CIBERSAM, Madrid, Spain.
| | - Pedro Pita Barros
- Nova School of Business and Economics, Universidade Nova de Lisboa, Portugal
| | - Ricardo Gusmão
- Centro de Estudos de Doenças Crónicas, Departamento de Saúde Mental, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
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Ayesa-Arriola R, Pérez-Iglesias R, Rodríguez-Sánchez JM, Pardo-García G, Tabares-Seisdedos R, Ayuso-Mateos JL, Vázquez-Barquero JL, Crespo-Facorro B. Predictors of neurocognitive impairment at 3 years after a first episode non-affective psychosis. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:23-8. [PMID: 23228461 DOI: 10.1016/j.pnpbp.2012.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 08/02/2012] [Revised: 10/22/2012] [Accepted: 11/23/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Neurocognitive impairment is a core component of schizophrenia. However, patients show great variability in the level and course of deficits. The goal of the present longitudinal study was to identify predictors of neurocognitive impairment in first episode psychosis patients. METHODS Neurocognitive performance was analyzed in a cohort of 146 patients 3 years after a first episode non-affective psychosis. Subgroups, impaired vs. unimpaired, were compared on baseline clinical, neuropsychological, premorbid and sociodemographic characteristics. RESULTS Fifty-nine percent of participants presented general neurocognitive impairment and regression analyses demonstrated that clinical and sociodemographic characteristics were not predictive variables. A model composed of premorbid IQ, verbal memory and motor dexterity correctly classified 79.6% of the individuals. CONCLUSIONS The present study gives information on frequency and neurocognitive profile of subtypes of patients showing impairment. Our results suggest general neurocognitive impairment is a trait dimension of the disorder related to specific cognitive dysfunctions.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IFIMAV, School of Medicine, University of Cantabria, Santander, Spain.
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Nuevo R, Van Os J, Arango C, Chatterji S, Ayuso-Mateos JL. Evidence for the early clinical relevance of hallucinatory-delusional states in the general population. Acta Psychiatr Scand 2013; 127:482-93. [PMID: 22943634 DOI: 10.1111/acps.12010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [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: 01/22/2023]
Abstract
OBJECTIVE To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters. METHOD General population-based household surveys of randomly selected adults between 18 and 65 years of age were carried out. SETTING 52 countries participating in the World Health Organization's World Health Survey were included. PARTICIPANTS 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated. RESULTS Compared with isolated delusions and hallucinations, co-occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92-0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0-3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5-14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3-22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9-12.4). Co-occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8-2.3). CONCLUSION The results suggest that the co-occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.
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Affiliation(s)
- R Nuevo
- Department of Psychiatry, Universidad Autonoma de Madrid, Hospital Universitario de la Princesa, Madrid, Spain
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Anaya C, Martinez Aran A, Ayuso-Mateos JL, Wykes T, Vieta E, Scott J. A systematic review of cognitive remediation for schizo-affective and affective disorders. J Affect Disord 2012; 142:13-21. [PMID: 22840620 DOI: 10.1016/j.jad.2012.04.020] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [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: 11/16/2011] [Revised: 04/02/2012] [Accepted: 04/29/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cognitive remediation is accepted as an important therapeutic intervention in schizophrenia, but few studies provide data on whether the benefits extend to affective disorders. OBJECTIVES To review quantitatively studies of cognitive remediation with samples that included cases of schizoaffective disorder, affective psychosis, unipolar and/or bipolar disorders. METHODS Twenty one studies met preliminary inclusion criteria, comprising a total of 940 participants of which 35% had an affective or schizoaffective disorder. Effect sizes (ES) for pre- to post-intervention change in cognitive performance were estimated. RESULTS A meta-analysis of 16 studies gave a pooled ES for change in cognitive function of 0.32 (95% Confidence Intervals 0.20 to 0.43) and produced statistical homogeneity. Overall, ES were significantly positively correlated with higher proportion of schizo-affective and affective cases (r=0.61; p=0.007), even when age, gender and duration of therapy were included as covariates in the analysis (r=.59, p=0.017). LIMITATIONS The quality of and small number of affective disorder only studies mean the findings must be treated with caution. CONCLUSIONS The estimated ES reflect those reported in the literature on cognitive remediation for schizophrenia. As such a conservative interpretation is that cognitive remediation has at least equivalent benefits in affective and schizo-affective disorder as demonstrated in schizophrenia. Further studies are urgently required to examine the durability of any gains with cognitive remediation in affective populations and to determine if any changes in cognitive deficits lead to improvements in symptoms or functioning and/or whether post-intervention cognitive changes differ in character or magnitude from those reported in schizophrenia.
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Affiliation(s)
- Celia Anaya
- Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Hospital de la Princesa, Madrid, Spain
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Sánchez-Portocarrero J, Jiménez-Escrig A, Pérez-Cecilia E, Ayuso-Mateos JL, Roca V, Yague MR, Barquero M, Ramirez C, Seijas EV. AIDS dementia complex: incidence, clinical profile and impact of zidovudine treatment*. Eur J Neurol 2012; 3:191-7. [PMID: 21284769 DOI: 10.1111/j.1468-1331.1996.tb00422.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study aimed to determine the incidence of AIDS dementia complex (ADC), the clinical data which distinguish it from other neurological complications of HIV infection, and the impact of zidovudine (AZT) therapy on the appearance and course of this condition. Data on the neurological complications of HIV patients treated at a community hospital from 1988 to 1992 were collected prospectively. Out of 500 AIDS patients treated at the hospital, there were 142 patients with neurological complications, with an average of 1.42 complications/patient There were 23 patients diagnosed as having ADC; with an estimated incidence of 4.6%, it was the most frequent neurological complication, after cerebral toxoplasmosis. Age was higher in patients with ADC as first manifestation of AIDS with respect to ADC patients with previous AIDS diagnosed. Compared with the group of patients suffering from other neurological complications, patients with ADC showed significant differences in several biological markers of progression to AIDS, such as hemoglobin, hematocrit, global lymphocyte count, serum β2-microglobulin and serum IgA. CD4 count was similar in both groups. Ten ADC patients had been treated previously with AZT. Dementia continued progressing in seven of these patients and remained stable in three. Of the other 13 cases not treated previously with the drug, eight received AZT therapy, and a favourable response was obtained in three patients (p = 0.068). ADC represents a major neurological complication in AIDS patients. AZT therapy may delay the appearance of ADC, but not prevent it. A trend towards a favourable response to AZT was observed in ADC patients who had not been treated with it previously.
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Affiliation(s)
- J Sánchez-Portocarrero
- Department of Neurology, Hospital Universitario San Carlos, Madrid, SpainHIV Unit, Hospital Universitario San Carlos, Madrid, SpainDepartment of Internal Medicine, Hospital Universitario San Carlos, Madrid, SpainDepartment of Neurology, Hospital Ramón y Cajal, Madrid, SpainDepartment of Medicine and Psychiatry, Cantabria University, Cantabria, Spain
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Dowrick C, Shiels C, Page H, Ayuso-Mateos JL, Casey P, Dalgard OS, Dunn G, Lehtinen V, Salmon P, Whitehead M. Predicting long-term recovery from depression in community settings in Western Europe: evidence from ODIN. Soc Psychiatry Psychiatr Epidemiol 2011; 46:119-26. [PMID: 20035318 DOI: 10.1007/s00127-009-0179-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [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: 02/02/2009] [Accepted: 12/15/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To test the impact of socio-economic and psychological adversity and healthcare on long-term recovery from depression. METHOD A community sample of 347 people with depressive disorders was followed up after 9 years. Baseline socio-economic adversity, social support, healthcare use, and psychiatric history were identified. Respondents completed self-report instruments on current depressive status (Beck depression inventory) and longstanding psychosocial adversity (sexual, physical or emotional abuse). Univariate analyses tested for association between recovery and respondent characteristics. RESULTS Follow-up was achieved for 182 (52%) of the sample, of whom 75 (41%) indicated recovery from depression. Psychological adversity definitely and socio-economic adversity probably were associated with lack of recovery. Baseline healthcare had no apparent impact on outcome. Rurality and support after life events were associated with recovery. History of depression was associated with non-recovery. CONCLUSION Psychological adversity is, and socio-economic adversity may be, associated with long-term non-recovery from depression in community settings.
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Affiliation(s)
- Christopher Dowrick
- School of Population, Community and Behavioural Sciences, University of Liverpool, Whelan Building, Liverpool, L69 3GB, UK.
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Nuevo R, Leighton C, Dunn G, Dowrick C, Lehtinen V, Dalgard OS, Casey P, Vázquez-Barquero JL, Ayuso-Mateos JL. Impact of severity and type of depression on quality of life in cases identified in the community. Psychol Med 2010; 40:2069-2077. [PMID: 20146833 DOI: 10.1017/s0033291710000164] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [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: 11/06/2022]
Abstract
BACKGROUND The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level. METHOD A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36. RESULTS Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent). CONCLUSIONS These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity.
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Affiliation(s)
- R Nuevo
- Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
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Sanchez-Moreno J, Martinez-Aran A, Tabarés-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL. Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom 2009; 78:285-97. [PMID: 19602917 DOI: 10.1159/000228249] [Citation(s) in RCA: 274] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Accepted: 10/17/2008] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bipolar disorder has generally been regarded as having a better functional outcome than schizophrenia. However, studies have suggested low functioning in bipolar patients even when they are in clinical remission. Our aim was to determine the degree of functioning and disability in bipolar patients. Secondly, we reviewed factors potentially associated with the low functioning of bipolar patients. METHOD The authors conducted an extensive Medline and Pubmed search of the published literature from 1980 up to December 2007, using a variety of search terms to find relevant articles. Bibliographies of retrieved papers were further analysed for publications of interest. Articles that reported clinically significant findings on functioning and disability, and research reports were reviewed in detail. RESULTS From these articles, we determined that bipolar disorder is associated with significant impairment in work, family and social life, beyond the acute phases of the illness. The aspects that appear to increase the risk of low functioning and disability in bipolar patients are mainly subsyndromal symptoms and neurocognitive impairment, among others. CONCLUSIONS Suitable pharmacological and psychological interventions may improve the level of functioning and reduce the disability in bipolar patients. Potential targets to be considered for intervention should be residual symptoms, comorbid conditions and neurocognitive deficits. Further research is required to better identify the factors that best predict functioning in bipolar patients.
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Affiliation(s)
- J Sanchez-Moreno
- Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
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Abstract
BACKGROUND For some phenomena the mean of population distributions predicts the proportion of people exceeding a threshold value. AIMS To investigate whether in depression, too, the population mean predicts the number of individuals at the extreme end of the distribution. METHOD We used data from the European Outcome in Depression International Network (ODIN) study from populations in Finland, Norway and the UK to create models that predicted the prevalence of depression based on the mean Beck Depression Inventory (BDI) score. The models were tested on data from Ireland and Spain. RESULTS Mean BDI score correlated well with the prevalence of depression determined by clinical interviews. A model based on the beta distribution best fitted the BDI distribution. Both models predicted the depression prevalence in Ireland and Spain fairly well. CONCLUSIONS The mean of a continuous population distribution of mood predicts the prevalence of depression. Characteristics of both individuals and populations determine depression rates.
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Affiliation(s)
- J L Veerman
- The University of Queensland, School of Population Health, Herston Road, Herston Qld 4006, Australia.
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Rosa AR, Franco C, Martínez-Aran A, Sánchez-Moreno J, Reinares M, Salamero M, Arango C, Ayuso-Mateos JL, Kapczinski F, Vieta E. Functional impairment in patients with remitted bipolar disorder. Psychother Psychosom 2009; 77:390-2. [PMID: 18716425 DOI: 10.1159/000151520] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Martorell A, Gutierrez-Recacha P, Pereda A, Ayuso-Mateos JL. Identification of personal factors that determine work outcome for adults with intellectual disability. J Intellect Disabil Res 2008; 52:1091-1101. [PMID: 18557967 DOI: 10.1111/j.1365-2788.2008.01098.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Access to employment for people with intellectual disability (ID) has become a social priority. The aim of the present study is to try to determine which variables [sociodemographic variables, intelligence quotient (IQ), presence or absence of a psychiatric disorder, functioning, self-determination, and behavioural problems] could most reliably account for access to remunerated employment of people with ID. METHODS Two groups of people with ID participated in this study: (1) 69 workers in a sheltered-employment programme; and (2) 110 clients of programmes in sheltered workshops. Both programmes were run by the Pardo-Valcarce Foundation in Madrid (Spain). The following variables were assessed for every participant: IQ, functioning, behavioural problems, self-determination and presence of psychiatric symptoms. A binary logistic regression analysis was carried out in order to identify the variables that best explained work outcome (sheltered workshop programme vs. sheltered employment programme). RESULTS Although IQ showed no significant differences between the two groups of participants, the remaining variables did: behavioural problems, functioning, psychiatric symptoms and self-determination significantly explained work outcome. As for sociodemographic variables, whereas gender did not show any significant relationship with the labour status of the participants, significant differences were found when considering variables such as age and pension benefits. CONCLUSIONS All the main variables considered, except IQ, turned out to be significant. Our findings should be considered encouraging, as they apparently show that both personal and social efforts can help individuals to overcome their low intellectual functioning in order to achieve access to employment. Such study highlights the importance of a prior psychopathological evaluation and efforts to enhance self-determination in order to improve work inclusion for people with ID.
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Affiliation(s)
- A Martorell
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
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Martorell A, Pereda A, Salvador-Carulla L, Ochoa S, Ayuso-Mateos JL. Validation of the Subjective and Objective Family Burden Interview (SOFBI/ECFOS) in primary caregivers to adults with intellectual disabilities living in the community. J Intellect Disabil Res 2007; 51:892-901. [PMID: 17910541 DOI: 10.1111/j.1365-2788.2007.00962.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND There is little information on the psychometric properties of instruments for assessing family care burden in adults with intellectual disabilities (ID). The aim of this study is therefore to analyse the usefulness of the 'Subjective and Objective Family Burden Interview' (SOFBI) in the assessment of principal caregivers in Spain. METHODS The SOFBI was administered to 166 principal caregivers of adults with ID in a vocational centre. The psychometric analysis included: internal consistency, inter-rater and test-retest reliability, construct validity, convergent validity with the World Health Organization's Disability Assessment Schedule II, and feasibility. RESULTS The Cronbach's alpha was 0.88 for the overall interview and always above 0.7 in the quantitative subdomains. The Kappa coefficients for test-retest were between 0.5 and 0.8, whereas inter-rater agreement was nearly perfect. Maximum-likelihood factor analysis showed four well-defined factors, which fitted the previously designed domains. Feasibility was also good. CONCLUSIONS The SOFBI is a multi-domain, modular instrument which is feasible, reliable and valid for measuring the burden of family caregivers to adults with ID living in the community.
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Affiliation(s)
- A Martorell
- Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
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Abstract
OBJECTIVE Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here. METHOD The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature. RESULTS Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed. CONCLUSION It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users.
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Ayuso-Mateos JL, Pereda A, Dunn G, Vazquez-Barquero JL, Casey P, Lehtinen V, Dalgard O, Wilkinson G, Dowrick C. Predictors of compliance with psychological interventions offered in the community. Psychol Med 2007; 37:717-725. [PMID: 17094818 DOI: 10.1017/s0033291706009317] [Citation(s) in RCA: 17] [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: 11/07/2022]
Abstract
BACKGROUND This study sought to evaluate the acceptance of two brief psychological interventions for depressed individuals, contacted through a community survey, and to look for predictors of adherence at the patient level. METHOD The authors used data from the Outcomes of Depression International Network (ODIN) study, which included a randomized controlled trial in which depressed individuals from five European countries, and nine geographical areas were assigned to one of three groups: individual problem-solving treatment, group psychoeducation, or control group. In this analysis, we included all of the individuals who had been assigned to one of the psychological interventions. Compliance with intervention was defined in two different ways. Multiple logistic regression was used to see which variables might predict an individual's compliance with psychological treatment. RESULTS Psychological intervention was offered to 236 subjects. Treatment was completed by 128 subjects and not by 108 (compliance definition A). Three variables were found to have an effect on compliance A: the presence of a confidant, the use of antidepressant medication during the previous 6 months, and the previous use of any social or health services. On the other hand, 164 subjects had agreed to at least start the treatment, and 72 had not (compliance definition B). The three factors associated with compliance B were presence of a confidant, previous use of services, and the 'desire for change' score. CONCLUSIONS Social support and previous use of services are the main predictors of compliance with a psychological treatment in depressed individuals from the community. Implications for clinical practice and community programs are discussed.
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Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, Madrid, Spain.
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Vieta E, Cieza A, Stucki G, Chatterji S, Nieto M, Sánchez-Moreno J, Jaeger J, Grunze H, Ayuso-Mateos JL. Developing core sets for persons with bipolar disorder based on the International Classification of Functioning, Disability and Health. Bipolar Disord 2007; 9:16-24. [PMID: 17391346 DOI: 10.1111/j.1399-5618.2007.00322.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [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] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Functioning is increasingly being taken into account when assessing the impact of bipolar disorder (BD) on the individual, as well as the effectiveness of treatments. With the International Classification of Functioning, Disability and Health (ICF), we can now rely on a globally agreed-upon framework and system for classifying the typical spectrum of problems in functioning, given the environmental context in which subjects live. ICF Core Sets are subgroups of ICF items selected to capture those aspects of functioning that are most likely to be affected by specific disorders. Within a given disorder, both Brief and Comprehensive Core Sets can be established to serve specific purposes. OBJECTIVE The aim of this paper is to outline the development process of the ICF Core Sets for BD. METHODS The final definition of ICF Core Sets for BD will be determined at an ICF Core-Sets Consensus Conference, which will integrate evidence from preliminary studies, namely (a) semi-structured interviews with people with BD in different countries, (b) a Delphi exercise with international experts participating and (c) a cross-sectional study. CONCLUSION ICF Core Sets are being designed with the goal of providing useful standards for research, clinical practice and teaching. We believe that these ICF Core Sets for BD will stimulate research leading to improved understanding of functioning, disability and health in BD. Such research, we hope, will lead to interventions and accommodations to improve restoration and maintenance of functioning and minimise disability among people with BD throughout the world.
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Affiliation(s)
- E Vieta
- Bipolar Disorders Programme, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
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Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzalez-Pinto A, Daban C, Alvarez-Grandi S, Fountoulakis K, Kaprinis G, Tabares-Seisdedos R, Ayuso-Mateos JL. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 2007; 9:103-13. [PMID: 17391354 DOI: 10.1111/j.1399-5618.2007.00327.x] [Citation(s) in RCA: 382] [Impact Index Per Article: 22.5] [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] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Few studies have examined the clinical, neuropsychological and pharmacological factors involved in the functional outcome of bipolar disorder despite the gap between clinical and functional recovery. METHODS A sample of 77 euthymic bipolar patients were included in the study. Using an a priori definition of low versus good functional outcome, based on the psychosocial items of the Global Assessment of Functioning (GAF, DSM-IV), and taking also into account their occupational adaptation, the patients were divided into two groups: good or low occupational functioning. Patients with high (n = 46) and low (n = 31) functioning were compared on several clinical, neuropsychological and pharmacological variables and the two patient groups were contrasted with healthy controls (n = 35) on cognitive performance. RESULTS High- and low-functioning groups did not differ with respect to clinical variables. However, bipolar patients in general showed poorer cognitive performance than healthy controls. This was most evident in low-functioning patients and in particular on verbal memory and executive function measures. CONCLUSIONS Low-functioning patients were cognitively more impaired than highly functioning patients on verbal recall and executive functions. The variable that best predicted psychosocial functioning in bipolar patients was verbal memory.
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Affiliation(s)
- A Martinez-Aran
- Institute of Neurosciences, University Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
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Gutierrez-Recacha P, Chisholm D, Haro JM, Salvador-Carulla L, Ayuso-Mateos JL. Cost-effectiveness of different clinical interventions for reducing the burden of schizophrenia in Spain. Acta Psychiatr Scand 2006:29-38. [PMID: 17087813 DOI: 10.1111/j.1600-0447.2006.00917.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [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] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate the cost-effectiveness of interventions for reducing the burden of schizophrenia in Spain. METHOD The study examined the cost-effectiveness of seven different types of clinical interventions at the level of Spanish population: i) current situation; ii) older antipsychotics alone; iii) new antipsychotics alone (risperidone); iv) older antipsychotics plus psychosocial treatment; v) new antipsychotics plus psychosocial treatment; vi) older antipsychotics plus case management and psychosocial treatment; vii) new antipsychotics plus case management and psychosocial treatment. RESULTS Interventions based on the combination of haloperidol with psychosocial treatment or psychosocial treatment plus case management proved to be the most efficient strategies. CONCLUSION The relatively modest additional cost of concurrent psychosocial treatment has significant health gains, thereby making such a combined strategy for schizophrenia more cost-effective than pharmacology alone.
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Affiliation(s)
- P Gutierrez-Recacha
- Department of Psychiatry, Hospital Universitario de la Princesa, Autónoma University, Madrid, Spain
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Abstract
Serotonin syndrome, which occurs as a result of enhanced serotonin concentration in the central nervous system, is a well-known adverse effect of serotonin-active medications. The concomitant use of antidepressant drugs associated with lithium as a co-adjuvant seems to increase the risk of this adverse reaction. We report a case of the serotonin syndrome during treatment with lithium and venlafaxine, an antidepressant with a dual selective re-uptake inhibition mechanism, and review the literature for similar cases. A 71-year-old woman developed serotonin syndrome while receiving treatment with moderate doses of lithium and venlafaxine for refractory depression. She had been taking higher doses of venlafaxine during the previous months with no significant secondary effects. Use of the Naranjo adverse drug reaction probability algorithm indicated a probable relationship between serotonin syndrome and treatment with lithium and venlafaxine.
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Affiliation(s)
- J Adan-Manes
- Service of Psychiatry, Hospital Universitario de la Princesa, Madrid, Spain
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Ayuso-Mateos JL, Gutierrez-Recacha P, Haro JM, Chisholm D. Estimating the prevalence of schizophrenia in Spain using a disease model. Schizophr Res 2006; 86:194-201. [PMID: 16859895 DOI: 10.1016/j.schres.2006.06.003] [Citation(s) in RCA: 25] [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] [Received: 12/05/2005] [Revised: 05/28/2006] [Accepted: 06/05/2006] [Indexed: 11/20/2022]
Abstract
There are two main sources of information on the epidemiology of schizophrenia: prevalence and incidence studies. Prevalence rates can be estimated from incidence figures, and vice versa. The present article aims to provide an estimate of the prevalence of schizophrenia in Spain, calculated from epidemiological and demographic data, using a disease model of schizophrenia which applies the specific methodology of the WHO Global Burden of Disease project. Our model assumes a causal relationship between incidence and prevalence, but takes into account other competing risk factors of mortality; this approach is more realistic than one assuming a simple linear relationship between both parameters. Our findings indicate an estimated mean prevalence of 3.0 per 1000 inhabitants per year for men, but slightly lower for women: 2.86 per 1000. Our model enables us to compare incidence figures with those provided by prevalence studies and obtain accurate estimates of the distribution of schizophrenia in the general population, which can be used to better identify treatment needs and the consequent allocation of resources.
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Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, c/ Diego de Leon 62 28006, Madrid, Spain.
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Ayuso-Mateos JL, Salvador-Carulla L, Chisholm D. [Use of quality of life measures in mental health economics and care planning]. Actas Esp Psiquiatr 2006; 34:1-6. [PMID: 16525899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Quality of life measurement is a key element in health economics and healthcare planning, particularly in chronic diseases associated to high morbidity and disability (i.e., mental disorders). This paper provides a critical review on the theoretical background of utility, on the methods for developing measures based on health preferences or values, and the composite indexes derived from them (DALY and QALY). Then the practical use in mental health is revised both in burden of disease studies and cost-utility analysis. There is an important requirement on the part of mental health researchers and policy makers alike to pay close attention to the underlying methods and construction of utility-based estimates of health outcome.
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Affiliation(s)
- J L Ayuso-Mateos
- Departamento de Psiquiatría, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid.
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