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Rodríguez-Mondragón L, Moreno-Encinas A, Graell M, Román FJ, Sepúlveda AR. A case-control study to differentiate parents' personality traits on anorexia nervosa and affective disorders. Fam Process 2024. [PMID: 38520285 DOI: 10.1111/famp.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/25/2024]
Abstract
Eating disorders (ED) and affective disorders (AD) in adolescent population and several investigations have pointed out that specific family dynamics play a major role in the onset, course, and maintenance of both disorders. The aim of this study was to extend the literature of this topic by exploring differences between parents' personality traits, coping strategies, and expressed emotion comparing groups of adolescents with different mental conditions (anorexia nervosa vs. affective disorder vs. control group) with a case-control study design. A total of 50 mothers and 50 fathers of 50 girls with anorexia nervosa (AN), 40 mothers and 40 fathers of 40 girls with affective disorder (AD), and 50 mothers and 50 fathers of 50 girls with no pathology that conformed the control group (CG) were measured with the Temperament and Character Inventory (TCI), the COPE Inventory, the Family Questionnaire (FQ), and psychopathology variables, anxiety, and depression. Both parents of girls with AN showed a significant difference in personality, coping strategies, and expressed emotion compared to both parents in the CG, while they presented more similarities to parents of girls in the AD group. Identifying personality traits, expressed emotion, coping strategies, and psychopathology of parents and their daughters will allow improvements in the interventions with the adolescents, parents, and families.
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Affiliation(s)
- L Rodríguez-Mondragón
- Biological and Health Psychology Department, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - A Moreno-Encinas
- Biological and Health Psychology Department, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - M Graell
- Section Head of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
- CIBERSAM, Madrid, Spain
| | - F J Román
- Biological and Health Psychology Department, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - A R Sepúlveda
- Biological and Health Psychology Department, School of Psychology, Autonomous University of Madrid, Madrid, Spain
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2
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Barrios V, Martín-Rivada Á, Guerra-Cantera S, Campillo-Calatayud A, Camarneiro RA, Graell M, Chowen JA, Argente J. Reduction in Pappalysin-2 Levels and Lower IGF-I Bioavailability in Female Adolescents With Anorexia Nervosa. J Clin Endocrinol Metab 2024; 109:e920-e931. [PMID: 38066647 DOI: 10.1210/clinem/dgad713] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Indexed: 02/21/2024]
Abstract
CONTEXT Anorexia nervosa (AN) can cause severe undernutrition associated with alterations in the IGF axis. Pappalysins (PAPP-A, PAPP-A2) and stanniocalcins (STC-1, STC-2) modulate IGF binding-protein (IGFBP) cleavage and IGF bioavailability, but their implications in AN are unknown. OBJECTIVE We determined serum levels of PAPP-As and STCs in relationship with classical IGF axis parameters in female adolescents with AN and their association with nutritional status and secondary amenorrhea. METHODS Parameters of the IGF axis were determined in fasting serum samples of 68 female adolescents with AN at diagnosis and 62 sex- and age-matched controls. Standardized body mass index (BMI) and bone mineral density (BMD) were calculated. RESULTS Patients with AN had lower concentrations of total and free IGF-I, total IGFBP-3, acid-labile subunit (ALS), insulin, PAPP-A2, STC-1, and STC-2 and higher levels of IGF-II and IGFBP-2. Their free/total IGF-I ratio was decreased and the intact/total IGFBP-3 and -4 ratios increased. BMI was directly related to total IGF-I and intact IGFBP-3 and inversely with IGFBP-2 and intact IGFBP-4. Weight loss was directly correlated with intact IGFBP-4 and negatively with intact IGFBP-3, ALS, STC-2, and PAPP-A2 concentrations. BMD was directly related to intact IGFBP-3 and inversely with intact IGFBP-4 and PAPP-A2 levels. Patients with amenorrhea had lower levels of total IGF-I and IGFBP-3 than those with menses. CONCLUSION The reduction of PAPP-A2 in patients with AN may be involved in a decline in IGFBP cleavage, which could underlie the decrease in IGF-I bioavailability that is influenced by nutritional status and amenorrhea.
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Affiliation(s)
- Vicente Barrios
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
| | - Álvaro Martín-Rivada
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Santiago Guerra-Cantera
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Ana Campillo-Calatayud
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Ricardo A Camarneiro
- Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain
| | - Montserrat Graell
- Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, E-28009 Madrid, Spain
| | - Julie A Chowen
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- IMDEA, Food Institute, CEIUAM+CSI, Cantoblanco, E-28049 Madrid, Spain
| | - Jesús Argente
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- IMDEA, Food Institute, CEIUAM+CSI, Cantoblanco, E-28049 Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
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Beltrán-Garrayo L, Larsen JK, Eisinga R, Vink JM, Blanco M, Graell M, Sepúlveda AR. Childhood obesity and adolescent follow-up depressive symptoms: exploring a moderated mediation model of body esteem and gender. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02348-9. [PMID: 38326572 DOI: 10.1007/s00787-023-02348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 12/03/2023] [Indexed: 02/09/2024]
Abstract
Obesity is a well-recognized risk factor for adolescent depressive symptoms, but mediating mechanisms of this association have scarcely been studied. This study is unique in examining an indirect pathway of this link via body esteem (BE) prospectively from childhood (8-12 years) to adolescence (13-18 years). In addition, potential gender moderation was examined. This study utilized data from a case-control study comparing 100 children with and without obesity matched on important confounders (age, gender, and socioeconomic status). Our findings provide support for the mediating role of BE in the link between childhood weight status and adolescent depressive symptoms at a 5-year follow-up. This mediation effect did not differ between boys and girls. The findings suggest the relevance of specifically targeting children's BE in preventive intervention programs among children with obesity to prevent future mental health problems.
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Affiliation(s)
- Lucia Beltrán-Garrayo
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Rob Eisinga
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Miriam Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
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4
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Beltrán-Garrayo L, Solar M, Blanco M, Graell M, Sepúlveda AR. Examining associations between obesity and mental health disorders from childhood to adolescence: A case-control prospective study. Psychiatry Res 2023; 326:115296. [PMID: 37331070 DOI: 10.1016/j.psychres.2023.115296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
Childhood obesity and mental disorders often co-exist. To date, most of the studies are cross-sectional, involve the assessment of a specific disorder, and rely on self-report questionnaires. This study aimed to provide a comprehensive psychological assessment to examine the concurrent and prospective association between childhood obesity and mental health problems. We compared 34 children with obesity with 37 children with normal weight at baseline, and at a five-year follow-up, to examine the development of mental health disorders from childhood (8-12 years) to adolescence (13-18 years). Both assessments included a clinical interview and self-reported measures of psychosocial and family markers. Findings showed that the obesity group had a higher prevalence of mental disorders, and psychological comorbidity increased in five years. Prospectively, childhood obesity was associated with a psychological diagnosis in adolescence. Moreover, the obesity group displayed higher severity of symptoms at both times. Finally, body esteem contributed to predicting mental health disorders in adolescence regardless of weight status, while eating symptomatology was a specific marker for the obesity group. Therefore, in the management of childhood obesity is suggested to address also psychosocial variables such as weight-related teasing and body esteem, to prevent the onset or development of mental health problems.
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Affiliation(s)
- Lucia Beltrán-Garrayo
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - María Solar
- Research & Development Department, Hogrefe TEA Ediciones, Madrid, Spain
| | - Miriam Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
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5
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Morón-Nozaleda MG, Yáñez S, Camarneiro RA, Gutiérrez-Priego S, Muñoz-Domenjó A, García-López C, Adrados García S, Jiménez García R, Trujillo EM, Faya M, Graell M. Feasibility and acceptability of a hospital-at-home program for adolescents with eating disorders: Making progress in community/family-based treatments. Int J Eat Disord 2023; 56:790-795. [PMID: 36932901 DOI: 10.1002/eat.23907] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE To explore the feasibility and acceptability of a novel hospital-at-home (HaH) program for adolescent patients with a severe eating disorder (ED). METHOD Retrospective description of the program during its first year of activity. The feasibility construct is based on accessibility, recruitment, rate of retention, avoidance of hospital stays, and management of crisis situations. Caregivers completed a satisfaction questionnaire on discharge, including an item on perceived safety. All patients referred to the program were included. RESULTS Fifty-nine female patients with a mean age of 14.69 years (SD = 1.67) were admitted. The mean stay was 39.14 days (SD = 14.47). On admission, 32.2% of patients presented nonsuicidal self-harm behavior and 47.5% had comorbid mental disorders. All patients were screened in the first 48 h after referral, and the program retention rate was 91.52%. As for use of health services, 2016.03 hospital stays were avoided, and only 16.12% of the 31 calls received for urgent care required emergency department visits. Families gave the program an overall satisfaction score of 4.95/5, and all described it as "very safe." DISCUSSION The HaH program described is a feasible and acceptable care model in adolescents with severe EDs and comorbidities. Effectiveness studies should be performed. PUBLIC SIGNIFICANCE Eating disorders are a major concern for public health. The adolescent HaH program presented marks an advance in intensive community treatments for patients with severe EDs and comorbidities.
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Affiliation(s)
| | - Silvia Yáñez
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ricardo Antonio Camarneiro
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Silvia Gutiérrez-Priego
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Andrea Muñoz-Domenjó
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Cristina García-López
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | | | - Eva Maria Trujillo
- Comenzar de Nuevo; Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - Mar Faya
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Montserrat Graell
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.,CIBER de Salud Mental (CIBERSAM), Madrid, Spain
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6
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Diaz-Marsa M, Pemau A, de la Torre-Luque A, Vaz-Leal F, Rojo-Moreno L, Beato-Fernandez L, Graell M, Carrasco-Diaz A, Carrasco JL. Executive dysfunction in eating disorders: Relationship with clinical features. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110649. [PMID: 36181959 DOI: 10.1016/j.pnpbp.2022.110649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/09/2022] [Accepted: 09/25/2022] [Indexed: 10/14/2022]
Abstract
UNLABELLED Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed. METHOD 75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests. RESULTS Patients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype. CONCLUSIONS Executive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED.
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Affiliation(s)
- Marina Diaz-Marsa
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain; Hospital Clínico San Carlos, Spain
| | - Andres Pemau
- Faculty of Psychology, Universidad Complutense de Madrid, Spain.
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain
| | | | | | | | - Montserrat Graell
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Hospital Universitario Niño Jesus, Spain
| | | | - Jose Luis Carrasco
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; School of Medicine, Universidad Complutense de Madrid, Spain; Hospital Clínico San Carlos, Spain
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7
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Rojo M, Lacruz T, Solano S, Gutiérrez A, Beltrán‐Garrayo L, Veiga OL, Graell M, Sepúlveda AR. Family-reported barriers and predictors of short-term attendance in a multidisciplinary intervention for managing childhood obesity: A psycho-family-system based randomised controlled trial (ENTREN-F). Eur Eat Disord Rev 2022; 30:746-759. [PMID: 35644038 PMCID: PMC9796111 DOI: 10.1002/erv.2913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study was aimed to examine patient enrolment in the pre-intervention stage, family-reported barriers, attendance rates and underlying predictors of short-term attendance in a family-system-based randomised controlled trial for managing childhood obesity in children aged 8-12-years-old (ENTREN-F). METHOD Psychosocial and anthropometric measures were collected through primary health referral. The data were used for descriptive analyses of sample characteristics and linear regression analyses. RESULTS Low enrolment rates and several family-reported barriers were observed in the pre-intervention stage. Logistical barriers were the most frequent family-reported reason for attrition in the different stages of the study. Having a first face-to-face orientation session with the families and the use of motivational interviewing helped to improve adherence in the initial phases of the study. After 6 months of intervention, family based treatments (FBTs) under consideration achieve greater adherence compared with the standard intervention. Moreover, family involvement was a predictor of success for better treatment adherence rates. By contrast, participants who attended a brief standard intervention, mothers with primary education, greater body mass index, higher levels of depressive symptomatology and more critical comments towards their children, children with higher weight status and lower levels of self-reported depressive symptoms at baseline attended interventions less frequently. CONCLUSIONS In future programmes a comprehensive screening of modifiable factors related to family and their setting characteristics is paramount prior to intervention, identifying key barriers related to drop-out, especially in the case of less-advantaged families.
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Affiliation(s)
- Marta Rojo
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
| | - Tatiana Lacruz
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
| | - Santos Solano
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
| | - Ana Gutiérrez
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
| | - Lucía Beltrán‐Garrayo
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
| | - Oscar L. Veiga
- Department of Physical Education, Sport & Human MotricityAutonomous University of MadridMadridSpain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Clinical PsychologyNiño Jesús Children's HospitalMadridSpain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)MadridSpain
| | - Ana Rosa Sepúlveda
- Faculty of PsychologyDepartment of Biological and Health PsychologyAutonomous University of MadridMadridSpain
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8
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Salazar de Pablo G, Moreno D, Gonzalez-Pinto A, Paya B, Castro-Fonieles J, Baeza I, Graell M, Arango C, Rapado-Castro M, Moreno C. Affective symptom dimensions in early-onset psychosis over time: a principal component factor analysis of the Young Mania Rating Scale and the Hamilton Depression Rating Scale. Eur Child Adolesc Psychiatry 2022; 31:1715-1728. [PMID: 34052909 DOI: 10.1007/s00787-021-01815-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/23/2021] [Indexed: 12/11/2022]
Abstract
Early-onset psychosis (EOP) is a complex disorder characterized by a wide range of symptoms, including affective symptoms. Our aim was to (1) examine the dimensional structure of affective symptoms in EOP, (2) evaluate the predominance of the clinical dimensions and (3) assess the progression of the clinical dimensions over a 2-year period. STROBE-compliant prospective principal component factor analysis of Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale-21 (HDRS-21) at baseline, 6-months, 1-year and 2-year follow-up. We included 108 EOP individuals (mean age = 15.5 ± 1.8 years, 68.5% male). The factor analysis produced a four-factor model including the following dimensions: mania, depression/anxiety, sleep and psychosis. It explained 47.4% of the total variance at baseline, 60.6% of the total variance at 6-months follow-up, 54.5% of the total variance at 1-year follow-up and 49.5% of the total variance at 2-year follow-up. According to the variance explained, the mania factor was predominant at baseline (17.4%), 6-month follow-up (23.5%) and 2-year follow-up (26.1%), while the depression/anxiety factor was predominant at 1-year follow-up (23.1%). The mania factor was the most stable; 58.3% items that appeared in this factor (with a load > 0.4) at any time point appeared in the same factor at ≥ 3/4 time points. Affective symptoms are frequent and persistent in EOP. Mania seems to be the most predominant and stable affective dimension. However, depression and anxiety may gain predominance with time. A comprehensive evaluation of the dimensional structure and the progression of affective symptoms may offer clinical and therapeutic advantages.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dolores Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, Biomedical Research Networking Centre in Mental Health, BioAraba Research Institute, OSI Araba-University Hospital, University of the Basque Country (EHU/UPV), CIBERSAM, Vitoria, Spain
| | - Beatriz Paya
- Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Josefina Castro-Fonieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, School of Medicine, Universidad Autónoma, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain. .,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia.
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
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9
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Rojo M, Lacruz T, Solano S, Vivar M, Del Río A, Martínez J, Foguet S, Marín M, Moreno-Encinas A, Veiga ÓL, Cabanas V, Rey C, Graell M, Sepúlveda AR. ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care. Obes Res Clin Pract 2022; 16:319-329. [PMID: 35871907 DOI: 10.1016/j.orcp.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/14/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Pediatric obesity is a primary public health concern, and designing effective programs for managing it is of the utmost importance. The objective of this study was to describe the protocol study of a three-arm, parallel, randomized controlled trial aimed at assessing the efficacy of a family-system-based intervention ("ENTREN-F" program) for managing childhood obesity, compared to the "ENTREN" program (no "F" - without specific family-system-based workshop) and a control group (behavioral monitoring). METHODS/DESIGN The ENTREN-F program was a multicomponent family-system-based intervention carried out by a multidisciplinary team in the primary health care setting. The program targeted children between 8 and 12 years with overweight and obesity (P ≥ 85th). Parents were actively involved in the process. The contents were designed using the Cognitive Behavioral Therapy (CBT) principles. The program comprised individual behavioral monitoring, a healthy habits workshop for children and their parents, a CBT workshop for children, and a family-system-based workshop for parents, enhancing parental management skills plus family functioning. The trial's primary outcomes included changes in child body mass index (BMI) z-scores, child's psychological well-being, and family functioning over six months. Secondary outcomes included changes in eating behavior, physical activity, self-esteem, parental distress, parental feeding practices, and parental modeling. DISCUSSION To our knowledge, this is one of the few randomized controlled trials to assess the efficacy of a multicomponent program that considers health from a comprehensive perspective, trying to improve children's psychological well-being and family functioning besides weight loss. This study, therefore, addresses a gap in the literature. If found to be efficacious, it suggests a new potential health service for translation into National Primary Health Care services in Spain, one of the ten countries with the highest prevalence of obesity in Europe.
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Affiliation(s)
- Marta Rojo
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain.
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Santos Solano
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Mario Vivar
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Andrea Del Río
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Jone Martínez
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Sara Foguet
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Marta Marín
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Alba Moreno-Encinas
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Óscar Luis Veiga
- Department of Physical Education, Sport & Human Motricity, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - Verónica Cabanas
- Department of Physical Education, Sport & Human Motricity, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - Consuelo Rey
- Valdelasfuentes Primary Health Care Center (Alcobendas), Public Health System from Madrid, Spain
| | - Montserrat Graell
- Child and Adolescent Psychiatry and Psychology Department, University Hospital Niño Jesús, Centro de Investigación Biomédica en Red de SaludMental (CIBERSAM), Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain.
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10
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Sepúlveda AR, Moreno-Encinas A, Nova E, Gómez-Martínez S, Marcos A, Carrobles JA, Graell M. Biological, psychological and familial specific correlates in eating disorders at onset: a control-case study protocol (ANOBAS). Actas Esp Psiquiatr 2022; 50:92-105. [PMID: 35312995 PMCID: PMC10803833] [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] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
The complexity in the development of an eating disorder (ED) pose methodological challenges when addressing risk factors of this pathology. Pike et al. (2008) proposed to use a case-control design for this type of research.
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Affiliation(s)
| | | | - Esther Nova
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - A. Marcos
- School of Psychology. Autonomous University of Madrid, Spain
| | | | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
- CIBERSAM (Biomedical Research Networking Centre for Mental Health, Ministry of Health), Spain
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11
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Baenas I, Etxandi M, Munguía L, Granero R, Mestre-Bach G, Sánchez I, Ortega E, Andreu A, Moize VL, Fernández-Real JM, Tinahones FJ, Diéguez C, Frühbeck G, Le Grange D, Tchanturia K, Karwautz A, Zeiler M, Imgart H, Zanko A, Favaro A, Claes L, Shekriladze I, Serrano-Troncoso E, Cecilia-Costa R, Rangil T, Loran-Meler ME, Soriano-Pacheco J, Carceller-Sindreu M, Navarrete R, Lozano M, Linares R, Gudiol C, Carratala J, Plana MT, Graell M, González-Parra D, Gómez-del Barrio JA, Sepúlveda AR, Sánchez-González J, Machado PPP, Håkansson A, Túry F, Pászthy B, Stein D, Papezová H, Gricova J, Bax B, Borisenkov MF, Popov SV, Gubin DG, Petrov IM, Isakova D, Mustafina SV, Kim YR, Nakazato M, Godart N, van Voren R, Ilnytska T, Chen J, Rowlands K, Voderholzer U, Monteleone AM, Treasure J, Jiménez-Murcia S, Fernández-Aranda F. Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study. Nutrients 2021; 14:nu14010100. [PMID: 35010974 PMCID: PMC8746935 DOI: 10.3390/nu14010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/29/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.
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Affiliation(s)
- Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, School of Psychology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 La Rioja, Spain;
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Emilio Ortega
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Alba Andreu
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
| | - Violeta L. Moize
- Endocrinology and Nutrition Division, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036 Barcelona, Spain; (E.O.); (A.A.); (V.L.M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Jose-Manuel Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Unit of Diabetes, Endocrinology and Nutrition, Hospital de Girona Dr. Josep Trueta-Institut d’Investigació Biomèdica de Girona (IDIBGI), 17007 Girona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital-Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
| | - Carlos Diéguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, 15782 Santiago de Compostela, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, 31008 Pamplona, Spain
| | - Daniel Le Grange
- Eating Disorders Program, Department of Psychiatry, University of California, San Francisco, CA 94143, USA;
| | - Kate Tchanturia
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (A.K.); (M.Z.)
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (A.K.); (M.Z.)
| | - Hartmut Imgart
- Parkland Klinik, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Annika Zanko
- Parkland Klinik, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Angela Favaro
- Department of Neuroscience, University of Padua and Neuroscience Center (PNC), 35122 Padua, Italy;
| | - Laurence Claes
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium;
- Clinical Psychology, Faculty of Medicine and Health Sciences, University Antwerp, 2000 Antwerp, Belgium
| | - Ia Shekriladze
- D. Uznadze Institute of Psychology, Ilia State University, 0162 Tbilisi, Georgia;
| | - Eduardo Serrano-Troncoso
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu- Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; (E.S.-T.); (R.C.-C.)
| | - Raquel Cecilia-Costa
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu- Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; (E.S.-T.); (R.C.-C.)
| | - Teresa Rangil
- Department of Psychiatry, Germans Trias i Pujol University Hospital-IGTP, 08916 Barcelona, Spain; (T.R.); (M.E.L.-M.)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Maria Eulalia Loran-Meler
- Department of Psychiatry, Germans Trias i Pujol University Hospital-IGTP, 08916 Barcelona, Spain; (T.R.); (M.E.L.-M.)
| | - José Soriano-Pacheco
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau)-Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain; (J.S.-P.); (M.C.-S.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
| | - Mar Carceller-Sindreu
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau)-Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain; (J.S.-P.); (M.C.-S.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
| | - Rosa Navarrete
- Centro de Diagnóstico de Enfermedades Moleculares, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | | | | | - Carlota Gudiol
- Infectious Diseases Department, Hospital Universitari Bellvitge-Institut de Investigació Biomedica de Bellvitge (IDIBELL)-Institut Català d’Oncologia-Hospitalet, 08908 Barcelona, Spain; (C.G.); (J.C.)
- REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jordi Carratala
- Infectious Diseases Department, Hospital Universitari Bellvitge-Institut de Investigació Biomedica de Bellvitge (IDIBELL)-Institut Català d’Oncologia-Hospitalet, 08908 Barcelona, Spain; (C.G.); (J.C.)
- REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maria T. Plana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Institute of Neuroscience, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
| | - Montserrat Graell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesus, 28009 Madrid, Spain
| | - David González-Parra
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC)-Institute of Biomedicine of Salamanca (IBSAL)-University of Salamanca, 37008 Salamanca, Spain;
| | - José A. Gómez-del Barrio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; (M.T.P.); (M.G.); (J.A.G.-d.B.)
- Unidad de Trastornos de la Conducta Alimentaria, Hospital Universitario “Marqués de Valdecilla”, Avda, Valdecilla s/n, 39011 Santander, Spain
- Instituto de Investigación Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Ana R. Sepúlveda
- Facultad de Psicología, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | - Jéssica Sánchez-González
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
| | - Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Unit—Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal;
| | - Anders Håkansson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
- Gambling Disorder Unit, Malmö Addiction Center, 205 02 Malmö, Sweden
| | - Ferenc Túry
- Institute of Behavioral Sciences, Semmelweis University, 1085 Budapest, Hungary;
| | - Bea Pászthy
- 1st Department of Paediatrics, Semmelweis University, 1085 Budapest, Hungary;
| | - Daniel Stein
- Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 52 621, Israel;
| | - Hana Papezová
- Department of Psychiatry, 1st Medical Faculty of Charles University, 11000 Prague, Czech Republic; (H.P.); (J.G.)
| | - Jana Gricova
- Department of Psychiatry, 1st Medical Faculty of Charles University, 11000 Prague, Czech Republic; (H.P.); (J.G.)
| | - Brigita Bax
- Eating Disorders Center, Vilnius University Vilnius, 01513 Vilnius, Lithuania;
| | - Mikhail F. Borisenkov
- Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, 167982 Syktyvkar, Russia; (M.F.B.); (S.V.P.)
| | - Sergey V. Popov
- Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, 167982 Syktyvkar, Russia; (M.F.B.); (S.V.P.)
| | - Denis G. Gubin
- Laboratory for Chronobiology and Chronomedicine, Department of Biology, Tyumen State Medical University, 625023 Tyumen, Russia;
- Tyumen Cardiology Research Institute, Tomsk Research Medical Center, 634009 Tyumen, Russia
| | - Ivan M. Petrov
- Department of Biological & Medical Physics UNESCO, Tyumen State Medical University, 625023 Tyumen, Russia;
| | - Dilara Isakova
- Department of Therapy and Endocrinology, Tyumen State Medical University, 625023 Tyumen, Russia;
| | - Svetlana V. Mustafina
- Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital-Inje University, Seoul 01757, Korea;
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan;
| | - Nathalie Godart
- CESP, Université Paris-Saclay, UVSQ, INSERM U 1178, 94805 Villejuif, France;
- Department of Psychiatry, Institut Mutualiste Montsouris, School of Medicine, Université Paris Descartes, 75006 Paris, France
- UFR des Sciences de la Santé Simone Veil (UVSQ), Praticienne Hospitalière, Fondation Santé des Etudiants de France, 78180 Paris, France
| | - Robert van Voren
- Department of Political Science, Vytautas Magnus University, 44248 Kaunas, Lithuania;
| | - Tetiana Ilnytska
- Institute of Psychiatry of Taras Shevchenko, National University of Kyiv, 01033 Kyiv, Ukraine;
| | - Jue Chen
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 280, Shanghai 200030, China;
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | | | - Alessio M. Monteleone
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Universitá degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK; (K.T.); (K.R.); (J.T.)
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (S.J.-M.); (F.F.-A.); Tel.: +34-93-260-7227 (S.J.-M. & F.F.-A.)
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 Barcelona, Spain; (I.B.); (M.E.); (L.M.); (I.S.); (J.S.-G.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Barcelona, Spain; (R.G.); (J.-M.F.-R.); (F.J.T.); (C.D.); (G.F.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (S.J.-M.); (F.F.-A.); Tel.: +34-93-260-7227 (S.J.-M. & F.F.-A.)
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Diaz-Marsa M, MacDowell K, de laTorre-Luque A, Caso JR, Faya M, Gutierrez S, Soto M, Pemau A, Diaz-Carracedo P, Carrasco-Diaz A, Leza JC, Graell M, Carrasco JL. Inflammatory dysregulation in women with an eating disorder: Relationships with altered emotional reactivity. Int J Eat Disord 2021; 54:1843-1854. [PMID: 34418141 DOI: 10.1002/eat.23598] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Some studies suggest that inflammatory signaling dysregulation may contribute to eating disorder (ED) pathophysiology. However, little is known about the influence of inflammatory response on altered processes seen among patients with ED, such as emotional processing and reactivity. OBJECTIVES The objectives were: (a) to investigate the systemic inflammatory response in ED women; and (b) to analyze the role of inflammatory markers in emotional reactivity. METHOD Concentrations of several intercellular and intracellular inflammatory mediators (cytokines, prostaglandin by-products and enzymes, TBARS, and MAPK proteins) were quantified in plasma and PBMCs from 68 women with an ED (m = 22.01 years, SD = 9.15) and 35 healthy controls (m = 18.54 years, SD = 4.21). Moreover, emotional reactivity to affective pictures (those without either food or thinness content) was studied using the adult (>18 years old) sample (n = 41). RESULTS Between-group differences were revealed for most markers (TNF-α, PGE2 , COX2, and ratio of activated MAPK proteins), pointing to increased inflammatory response in patients (p < .01). Women with ED showed heightened emotional reactivity, regardless of picture valence. Principal components derived from inflammatory markers showed an explanatory loading on patient's emotional reaction, in terms of valence and arousal. CONCLUSION This study corroborates the altered systemic inflammatory response in patients with ED. The inflammatory dysregulation may contribute to ED phenotype, as seen by its relationship with heightened emotional reactivity, even though the inflammatory markers were not evaluated throughout the emotional reactivity protocol.
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Affiliation(s)
- Marina Diaz-Marsa
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,IIS Hospital Clinico San Carlos, Madrid, Spain
| | - Karina MacDowell
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Pharmacology and Toxicology, School of Medicine, UCM, Madrid, Spain.,IIS Hospital 12 de Octubre, IUIN-UCM, Madrid, Spain
| | - Alejandro de laTorre-Luque
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Javier R Caso
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Pharmacology and Toxicology, School of Medicine, UCM, Madrid, Spain.,IIS Hospital 12 de Octubre, IUIN-UCM, Madrid, Spain
| | - Mar Faya
- Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesus, Madrid, Spain
| | - Silvia Gutierrez
- Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesus, Madrid, Spain
| | - Marta Soto
- IIS Hospital Clinico San Carlos, Madrid, Spain
| | - Andres Pemau
- Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Alvaro Carrasco-Diaz
- Education and Psychology Faculty, Francisco de Vitoria University, Madrid, Spain
| | - Juan C Leza
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Pharmacology and Toxicology, School of Medicine, UCM, Madrid, Spain.,IIS Hospital 12 de Octubre, IUIN-UCM, Madrid, Spain
| | - Montserrat Graell
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesus, Madrid, Spain
| | - Jose L Carrasco
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,IIS Hospital Clinico San Carlos, Madrid, Spain
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Sepúlveda AR, Blanco M, Solano S, Lacruz T, Román FJ, Parks M, Veiga O, Rojo M, Graell M. The Spanish version of the Home Environment Survey (HES) among families of children with overweight/obesity: a validation study. Eat Weight Disord 2021; 26:2153-2163. [PMID: 33159301 DOI: 10.1007/s40519-020-01056-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/14/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of this article was to validate the Spanish version of the Home Environment Survey (HES-S) and was divided in two studies: (1) to assess the reliability, convergent validity of HES-S in a survey of 145 parents of children with overweight/obesity; (2) to study the magnitude of the association between children's BMI status with the latent scores theoretically defined by the HES model. METHODS To test the scale and the model, a confirmatory factor analysis (CFA) and a path analysis were carried out among a sample of 156 parents of preadolescents (106 overweight/obesity and 50 normal-weight children). No CFA or EFA were carried out in the validation of the original instrument. RESULTS Study 1, both the Physical Activity and the Eating Habits components of the scale showed adequate levels of internal consistency for the majority of the scales, except for two. One of them, Healthy Eating Parental Policies (HEP) subscale was reduced after excluded two items, although it did not improve substantially. This model indicated that there was a significant association between the two Eating Habits scales and the child's weight status, but child's weight was not associated with the Physical Activity components. Convergent validity was confirmed by correlations with related variables: family eating habits (F-EAT), parent's physical activity (IPAQ), and children's physical activity (assessed via accelerometers during one week). Study 2, our results replicated the original four factor structure proposed for physical activity (CFI = 0.99; RMSEA = 0.03), but the original factor structure of the eating habits component was not supported. In addition, the relationship of the child's weight status, the Physical Activity components, and the two scales of Eating Habits (Parental Modeling and Policies) was explored with a path analysis showing good fit indices (CFI = 0.95; RMSEA = 0.06). Child's BMI was negatively associated with Healthy Eating Parental Role Modeling (r = - 0.21) and with Healthy Eating Parental Policies (r = - 0.19), but not with the factors of Child's Physical Activity model. CONCLUSION To our knowledge, this is the first instrument to assess obesogenic family environment in Spanish speaking countries, which is a relevant dimension within a health perspective so as to implement new policies and strategies in obesity tertiary prevention. Overall, the confirmatory factor analysis of the HES-S has only provided additional support for one part related to Physical Activity. In addition, Child's BMI was correlated with scales of Eating Habits but not with Child's Physical Activity factor. These results clearly suggest that further research is warranted. LEVEL III Case-control analytic study.
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Affiliation(s)
- Ana R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - M Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - S Solano
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - T Lacruz
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - F J Román
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - M Parks
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - O Veiga
- Department of Physical Education, Sport and Human Movement, Faculty of Education, Autonomous University of Madrid, Madrid, Spain
| | - M Rojo
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - M Graell
- Section of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
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Sepúlveda AR, Moreno-Encinas A, Martínez-Huertas JA, Anastasiadou D, Nova E, Marcos A, Gómez-Martínez S, Villa-Asensi JR, Mollejo E, Graell M. Toward a Biological, Psychological and Familial Approach of Eating Disorders at Onset: Case-Control ANOBAS Study. Front Psychol 2021; 12:714414. [PMID: 34566794 PMCID: PMC8458812 DOI: 10.3389/fpsyg.2021.714414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Eating disorders (ED) are considered as heterogeneous disorders with a complex multifactor etiology that involves biological and environmental interaction. Objective: The aim was to identify specific ED bio-psychological-familial correlates at illness onset. Methods: A case-control (1:1) design was applied, which studied 50 adolescents diagnosed with ED at onset (12-17 years old) and their families, paired by age and parents' socio-educational level with three control samples (40 with an affective disorder, 40 with asthma, and 50 with no pathology) and their respective families. Biological, psychological, and familial correlates were assessed using interviews, standardized questionnaires, and a blood test. Results: After performing conditional logistic regression models for each type of variable, those correlates that showed to be specific for ED were included in a global exploratory model (R 2 = 0.44). The specific correlates identified associated to the onset of an ED were triiodothyronine (T3) as the main specific biological correlate; patients' drive for thinness, perfectionism and anxiety as the main psychological correlates; and fathers' emotional over-involvement and depression, and mothers' anxiety as the main familial correlates. Conclusion: To our knowledge, this is the first study to use three specific control groups assessed through standardized interviews, and to collect a wide variety of data at the illness onset. This study design has allowed to explore which correlates, among those measured, were specific to EDs; finding that perfectionism and family emotional over-involvement, as well as the T3 hormone were relevant to discern ED cases at the illness onset from other adolescents with or without a concurrent pathology.
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Affiliation(s)
- Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Alba Moreno-Encinas
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | | | - Dimitra Anastasiadou
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Esther Nova
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | | | - Encarna Mollejo
- Psychiatry Service, Hospital Universitario del Sureste, Arganda del Rey, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, Niño Jesús University Children’s Hospital, Madrid, Spain
- CIBERSAM, Madrid, Spain
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Rojo M, Solano S, Lacruz T, Baile JI, Blanco M, Graell M, Sepúlveda AR. Linking Psychosocial Stress Events, Psychological Disorders and Childhood Obesity. Children (Basel) 2021; 8:211. [PMID: 33802090 PMCID: PMC8000555 DOI: 10.3390/children8030211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022]
Abstract
There is scientific evidence that supports a strong association between early exposure to stressful life events and the presence of health complications throughout adulthood and, to a lesser extent, in adolescence and childhood. The aim of this study was to examine the accumulation of Psychosocial Stress Events (PSE) and the prevalence of mental disorders in children from 8 to 12 years. The association between these factors and child weight measurements was analysed. A cross-sectional study was conducted among 200 children classified by weight status (obesity, overweight and normal-weight). The assessment was carried out in primary care centres and primary schools. An experienced team carried out a structured medical-psychosocial history and a semi-structured interview aimed at identifying an early diagnosis of psychological disorders. Children filled out a questionnaire to evaluate PSE. The obesity group presented the greatest accumulation of PSE and highest prevalence of psychiatric diagnosis, compared to overweight and normal-weight children. To exceed four or more stressful events was positively associated with psychological problems and child body mass index (BMI z-score). A predictive model confirmed the interaction between a larger number of PSE and the occurrence of a psychiatric diagnosis as variables that predispose children by 26.2 times more to increased weight status. In conclusion, the accumulation of PSE in the family, school and social environments of the children was related to greater psychological distress. If not managed, the likelihood of suffering from other health complications, such as excess weight, may increase. It is important to monitor these variables to ensure positive health outcomes while specifically addressing childhood obesity. This is especially relevant for children from a disadvantaged social background and disharmonious family environments.
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Affiliation(s)
- Marta Rojo
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (M.R.); (S.S.); (T.L.); (M.B.)
| | - Santos Solano
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (M.R.); (S.S.); (T.L.); (M.B.)
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (M.R.); (S.S.); (T.L.); (M.B.)
| | - José I. Baile
- Department of Health and Psychology, Faculty of Health Sciences and Education, Open University of Madrid, 28400 Collado-Villalba, Spain;
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (M.R.); (S.S.); (T.L.); (M.B.)
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (M.R.); (S.S.); (T.L.); (M.B.)
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Moreno-Encinas A, Graell M, Martínez-Huertas JÁ, Faya M, Treasure J, Sepúlveda AR. Adding maintaining factors to developmental models of anorexia nervosa: An empirical examination in adolescents. Eur Eat Disord Rev 2021; 29:548-558. [PMID: 33621386 DOI: 10.1002/erv.2826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE A biopsychosocial approach has been proposed to explain the pathogenesis of anorexia nervosa (AN), despite only a few of the existing etiological models having received empirical support. The aim of this study was to empirically investigate Herpertz-Dahlmann, Seitz, and Konrad (2011, https://doi.org/10.1007/s00406-011-0246-y)'s developmental model and to consider if interpersonal reactions to the illness might serve as maintaining factors following the model proposed by Treasure and Schmidt (2013, https://doi.org/10.1186/2050-2974-1-13) METHOD: One hundred adolescents and their families were participated in the study: 50 diagnosed with AN, paired by age and parents' socio-economic status with 50 adolescents without a pathology. Biological, psychological and familial variables were assessed using ten questionnaires and a blood analysis test. Additionally, structural equation modeling was conducted to assess two hypothetical models. RESULTS The fit of both models was good after the addition of two covariate parameters (e.g., Comparative Fit Index > 0.96 and Tucker-Lewis Index > 0.95). Premorbid traits were linked to body dissatisfaction and to the number of stressful life events; this in turn was linked to AN symptoms. Biological and familial consequences reinforced this pathology. CONCLUSIONS Our findings provide support for both models, suggesting that inter relationships between bio-psycho-familial variables can influence the course of AN during adolescence.
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Affiliation(s)
- Alba Moreno-Encinas
- School of Psychology, Autonomous University of Madrid, Biological and Health Psychology Department, Madrid, Spain
| | - Montserrat Graell
- Child and Adolescent Psychiatry and Psychology Department, University Hospital Niño Jesús, CIBERSAM, Madrid, Spain
| | | | - Mar Faya
- Child and Adolescent Psychiatry and Psychology Department, University Hospital Niño Jesús, CIBERSAM, Madrid, Spain
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ana Rosa Sepúlveda
- School of Psychology, Autonomous University of Madrid, Biological and Health Psychology Department, Madrid, Spain
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Sepúlveda AR, Lacruz T, Solano S, Blanco M, Moreno A, Rojo M, Beltrán L, Graell M. Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress. Children (Basel) 2020; 7:children7110225. [PMID: 33187289 PMCID: PMC7696176 DOI: 10.3390/children7110225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 01/18/2023]
Abstract
This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment.
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Affiliation(s)
- Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
- Correspondence: ; Tel.: +34-914-975-214
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Santos Solano
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Alba Moreno
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Marta Rojo
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Lucía Beltrán
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, 28009 Madrid, Spain;
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18
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Graell M, Morón-Nozaleda MG, Camarneiro R, Villaseñor Á, Yáñez S, Muñoz R, Martínez-Núñez B, Miguélez-Fernández C, Muñoz M, Faya M. Children and adolescents with eating disorders during COVID-19 confinement: Difficulties and future challenges. Eur Eat Disord Rev 2020; 28:864-870. [PMID: 32729139 DOI: 10.1002/erv.2763] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To present the adaptations to treatment protocols made in a child and adolescent eating disorders (ED) unit during the eight-week confinement period mandated in response to the COVID-19 pandemic and examine clinical and treatment variables in the outpatient, day hospital, and inpatient care programs. METHOD Description of the implementation of a combined teletherapy program for outpatient and day-hospital patients and the adaptations made to the inpatient protocol. Retrospective review of medical records and analysis of general and specific variables related to the pandemic and confinement. RESULTS We held 1,329 (73.10%) telehealth consultations and 489 (26.9%) face-to-face outpatient visits with 365 patients undergoing treatment in the outpatient clinic or day hospital. Twenty-eight (7.67%) were initial evaluations. Twenty-two patients were newly admitted and 68 ED-related emergencies were attended. Almost half of the children and adolescents studied experienced reactivation of ED symptoms despite treatment, and severe patients (25%) presented self-harm and suicide risk. CONCLUSIONS The implementation of a combined teletherapy program has enabled continuity of care during confinement for children and adolescents with ED. Delivery of treatment to adolescents in the day hospital program posed the biggest challenge due to their greater degrees of severity and higher hospitalization rates. An adapted inpatient program should be maintained throughout confinement, as the need for hospitalization of children and adolescents with ED does not decrease with lockdown.
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Affiliation(s)
- Montserrat Graell
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - M Goretti Morón-Nozaleda
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ricardo Camarneiro
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Ángel Villaseñor
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Silvia Yáñez
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Rudiger Muñoz
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Beatriz Martínez-Núñez
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - María Muñoz
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Mar Faya
- Psychiatry and Clinical Psychology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Sepulveda AR, Almendros C, Berbel E, Andrés P, Parks M, Graell M. Psychometric properties of the Spanish version of the Experience of Caregiving Inventory (ECI) among caregivers of individuals with an eating disorder. Eat Weight Disord 2020; 25:299-307. [PMID: 30284216 DOI: 10.1007/s40519-018-0587-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/24/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of this study was to examine the psychometric properties of the Spanish version of the Experience of Caregiving Inventory (ECI-S), which is designed to assess the caregiver's appraisal of the impact of caring for a relative with a serious mental illness. METHODS A cross-sectional study was conducted among 320 caregivers of a relative with an eating disorder to examine: (a) descriptive statistics; (b) internal consistency reliability; (c) the fit of the original ten-factor structure of the ECI through exploratory factor analysis, using a semi-confirmatory approach, for each subscale individually, and (d) concurrent validity. A total of 307 caregivers completed the scale. RESULTS Reliability of the ECI subscales scores was acceptable (α = 0.63-0.89). Results replicated the original ten-factor structure of the instrument. The concurrent validity was supported by correlations of the ECI-negative subscale with psychological distress (GHQ-12, 0.43), and with depression and anxiety (HADS, 0.48 and 0.49, respectively). CONCLUSIONS The Spanish version of the ECI (ECI-S) demonstrated good psychometric properties in terms of validity and reliability that were similar to the original version. It is an acceptable and valid instrument for assessing the impact on family members of caring for a relative with an eating disorder and can be recommended for use in clinical settings in Spain. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Ana R Sepulveda
- Faculty of Psychology, Autonomous University of Madrid, Calle Iván Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049, Madrid, Spain.
| | - Carmen Almendros
- Faculty of Psychology, Autonomous University of Madrid, Calle Iván Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049, Madrid, Spain
| | - Enrique Berbel
- Spanish National Eating Disorder Association (ADANER), Calle del Comandante Zorita, 50, 28020, Madrid, Spain
| | - Patricia Andrés
- Eating Disorders Unit, Child and Adolescent University Hospital "Niño Jesús", Avenida de Menendez Pelayo 65, 28009, Madrid, Spain
| | - Melissa Parks
- Faculty of Psychology, Autonomous University of Madrid, Calle Iván Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049, Madrid, Spain
| | - Montserrat Graell
- Eating Disorders Unit, Child and Adolescent University Hospital "Niño Jesús", Avenida de Menendez Pelayo 65, 28009, Madrid, Spain
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Moreno-Encinas A, Sepúlveda AR, Kurland V, Lacruz T, Nova E, Graell M. Identifying psychosocial and familial correlates and the impact of the stressful life events in the onset of anorexia nervosa: Control-case study (ANOBAS): Psychosocial and familial correlates and stressful life events in AN. Psychiatry Res 2020; 284:112768. [PMID: 31931274 DOI: 10.1016/j.psychres.2020.112768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/18/2019] [Revised: 12/24/2019] [Accepted: 01/04/2020] [Indexed: 11/15/2022]
Abstract
Anorexia nervosa (AN) is a multifactorial illness. Although several studies have determined which factors could predispose AN, few studies have determined which factors could precipitate it. What is more, it has been suggested that having experienced stressful life events (SLE) could be related to the onset of AN. The aim of this study was to explore specific psychosocial and familial correlates and the impact of SLE in the onset of AN. Following a case-control design, 40 adolescents diagnosed with AN were matched to three control groups, 40 healthy adolescents, 40 adolescents with affective disorders, 40 adolescents with asthma and their families by sex, age and socioeconomic status. Diagnostic interviews K-DSADS and questionnaires were used. The results empathised that no specific predisposing correlates were found for AN. Similarly, the increase of the amount of SLE prior to the onset is an overall characteristic for psychiatric disorders, which in AN it is only specifically related to psychological correlates, but no to cortisol. In terms of specific SLE, those related to interpersonal problems were frequent at the onset of AN. The results highlight the consequences of SLEs in the emotional well-being of the AN adolescents, that could be specific for this psychopathology.
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Affiliation(s)
| | - A R Sepúlveda
- School of Psychology. Autonomous University of Madrid, Spain
| | - V Kurland
- School of Psychology. Autonomous University of Madrid, Spain
| | - T Lacruz
- School of Psychology. Autonomous University of Madrid, Spain
| | - E Nova
- Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain
| | - M Graell
- Deparment of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre for Mental Health, Ministry of Health), Madrid, Spain
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Caso JR, Graell M, Navalón A, MacDowell KS, Gutiérrez S, Soto M, Leza JC, Carrasco JL, Marsá MD. Dysfunction of inflammatory pathways in adolescent female patients with anorexia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 2020; 96:109727. [PMID: 31398429 DOI: 10.1016/j.pnpbp.2019.109727] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/03/2019] [Accepted: 08/03/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND The pathogenesis of Eating Disorders is still unknown. However, a growing body of evidence shows that there are changes in cytokine levels and an alteration in the stress response in patients with anorexia nervosa (AN). For this reason, we decided to test whether there are differences in immune parameters involved in the regulation of the inflammatory response between female adolescents with AN and healthy adolescents. METHODS The sample 27 drug-naïve AN patients the study sample included 27 AN patients at a very early stage of the disease and 23 healthy controls. Plasma and peripheral blood mononuclear cells (PBMCs) were obtained for biochemical study. RESULTS Plasma levels of the pro-inflammatory cytokines TNF-α and IL-1β were significantly increased in patients with AN, while the levels of prostaglandins PGE2 (proinflammatory) and 15d-PGJ2, (anti-inflammatory) were lower compared with controls. Protein expression in PBMCs of cyclooxygenase-2 (COX-2) and the activated forms of the mitogen-activated protein kinases p38 and ERK were also increased in the AN group. Expression levels of the anti-inflammatory factor peroxisome proliferator-activated receptor gamma (PPARγ) were significantly decreased in patients. Plasma levels of lipid peroxidation markers -TBARS- were not increased in patients with AN. Components of the biochemical inflammatory response (COX-2, PGE2, TBARS, 15d-PGJ2, ERK, p65 NFκB) and glucocorticoid receptor -GR- expression and the scores on the impulsivity measures in the BARRATT, EDI and BITE questionnaires showed a significant correlation within the AN patients group. CONCLUSIONS The results for female adolescent patients with AN indicate that there is a dysfunction of intra- and intercellular inflammatory pathways characterized by higher levels of pro-inflammatory parameters in plasma and a decrease in one of the controlling cytoplasmic-nuclear pathways implicated in their modulation (i.e. PPARγ) with, at this very early stage of the disease, no effect on oxidative stress markers plasma levels. Most notably, higher severity of illness (restrictive and purging behaviour) correlated with higher levels of inflammatory markers.
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Affiliation(s)
- Javier R Caso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Dept. of Pharmacology & Toxicology, Faculty of Medicine, Complutense University (UCM), IUIN-UCM, IIS Hospital 12 de Octubre (i+12). Madrid, Spain
| | - Montserrat Graell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesús, Madrid, Spain
| | - Aida Navalón
- Dept. of Psychiatry, Legal Medicine & Pathology, Faculty of Medicine, (UCM), IIS Hospital Clínico San Carlos, Madrid, Spain
| | - Karina S MacDowell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Dept. of Pharmacology & Toxicology, Faculty of Medicine, Complutense University (UCM), IUIN-UCM, IIS Hospital 12 de Octubre (i+12). Madrid, Spain
| | - Silvia Gutiérrez
- Child and Adolescent Psychiatry and Psychology Service, Child Hospital Niño Jesús, Madrid, Spain
| | - Marta Soto
- Dept. of Psychiatry, Legal Medicine & Pathology, Faculty of Medicine, (UCM), IIS Hospital Clínico San Carlos, Madrid, Spain
| | - Juan C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Dept. of Pharmacology & Toxicology, Faculty of Medicine, Complutense University (UCM), IUIN-UCM, IIS Hospital 12 de Octubre (i+12). Madrid, Spain
| | - José L Carrasco
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Dept. of Psychiatry, Legal Medicine & Pathology, Faculty of Medicine, (UCM), IIS Hospital Clínico San Carlos, Madrid, Spain
| | - Marina Díaz Marsá
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Dept. of Psychiatry, Legal Medicine & Pathology, Faculty of Medicine, (UCM), IIS Hospital Clínico San Carlos, Madrid, Spain.
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22
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Sepulveda AR, Blanco M, Nova E, Marcos A, Martínez SG, Carrobles JA, Graell M. Identifying the relationship between biological, psychosocial and family markers associated with childhood obesity: Case-control "ANOBAS" study. Psychoneuroendocrinology 2019; 110:104428. [PMID: 31590062 DOI: 10.1016/j.psyneuen.2019.104428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/09/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The recent increase in childhood obesity prevalence rates illustrates the extreme relevance of biological, psychosocial and familial factors implicated in body weight status, which at the moment remain unclear. The study aims to compare biological, psychosocial and familial markers between preadolescents with obesity and their non-overweight peers, and explore the relationship with psychiatric diagnosis on these markers. Both groups were composed of 40% of males with a mean age of 10 years, and no differences in socio-demographic variables were found between groups. No sex differences were found on bio/psycho/family markers. While 48% (n = 24) of the preadolescents with obesity presented a DSM-IV diagnosis (OGD), only 2% (n = 1) of the non-overweight peers (NG) met diagnostic criteria. Significant differences were found for all bio/psycho/family markers among obese preadolescents with the exceptions of cortisol, peptide YY and maternal state-anxiety and depression. The preadolescents with obesity without a diagnosis (OGND) presented greater levels of leptin than NG (p = 0.01). For psychosocial markers, statistically significant differences were found between groups in the majority of the variables (p < 0.01), with the exception of trait anxiety where a tendency towards significance was revealed (p = 0.06). For family markers, we found statistically significant differences in emotional over-involvement (p = 0.01), with NG mothers presenting lower scores than OGD and OGND. Include psychosocial and family factors in obesity intervention programs is necessary. Also, health professionals working with children with obesity must take care to assess the presence of a psychiatric diagnosis amongst this population.
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Affiliation(s)
- Ana R Sepulveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Esther Nova
- Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain
| | - Ascension Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain
| | | | - José A Carrobles
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Montserrat Graell
- Eating Disorders Unit, Child and Adolescence Psychiatry Department, Niño Jesus University Hospital, CIBERSAM, Madrid, Spain
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23
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Sepúlveda AR, Compte EJ, Faya M, Villaseñor A, Gutierrez S, Andrés P, Graell M. Spanish validation of the Eating Disorder Examination Questionnaire for Adolescents (EDE-Q-A): confirmatory factor analyses among a clinical sample. Eat Disord 2019; 27:565-576. [PMID: 30758263 DOI: 10.1080/10640266.2019.1567154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Most studies of eating disorders (ED) among adolescents have relied on the use of self-report questionnaires given its cost-effectiveness compared to interviews approaches. The Eating Disorders Examination Questionnaire (EDE-Q) is one of the most commonly used self-report measures of eating psychopathology, despite issues regarding the underlying latent structure and its validity in this population. Given the lack of validated measures among Hispanic clinical samples, the current study aimed to validate previously suggested models for the adolescent version (EDE-Q-A) among female teenage patients with ED in Spain (Mage = 15.45, SD = 1.59). Results failed to replicate the theoretical 4-factor structure, and a 2-factor model previously validated in a Hispanic-American community sample showed best fit over a 3-factor and a single-factor model. Excellent levels of internal consistency were observed for the two dimensions of the retained model and for the Global Score of the EDE-Q-A. Significant correlations with well-established measures of ED (Eating Disorders Inventory; EDI-2) and self-esteem are presented as evidence for convergent and concurrent validity. Sensitivity analyses showed a similar pattern of association between the retained model of the EDE-Q-A and the EDI-2. Current findings may contribute to development of evidence-based knowledge on ED among Hispanic clinical populations.
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Affiliation(s)
- Ana R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Emilio J Compte
- DBT-Eating Disorders team, Fundación Foro, Buenos Aires, Argentina.,School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Mar Faya
- Eating Disorders Unit, Child and Adolescence Psychiatry Service, CIBERSAM, Niño Jesus University Hospital, Madrid, Spain
| | - Angel Villaseñor
- Eating Disorders Unit, Child and Adolescence Psychiatry Service, CIBERSAM, Niño Jesus University Hospital, Madrid, Spain
| | - Silvia Gutierrez
- Eating Disorders Unit, Child and Adolescence Psychiatry Service, CIBERSAM, Niño Jesus University Hospital, Madrid, Spain
| | - Patricia Andrés
- Eating Disorders Unit, Child and Adolescence Psychiatry Service, CIBERSAM, Niño Jesus University Hospital, Madrid, Spain
| | - Montserrat Graell
- Eating Disorders Unit, Child and Adolescence Psychiatry Service, CIBERSAM, Niño Jesus University Hospital, Madrid, Spain
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24
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Graell M, de Andrés P, Sepúlveda AR, Moreno A, Villaseñor Á, Faya M, Martínez‐Cantarero C, Gómez‐Martínez S, Marcos A, Morandé G, Nova E. The adolescent onset anorexia nervosa study (ANABEL): Design and baseline results. Int J Methods Psychiatr Res 2018; 27:e1739. [PMID: 30133037 PMCID: PMC6877151 DOI: 10.1002/mpr.1739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 06/05/2018] [Accepted: 07/16/2018] [Indexed: 11/06/2022] Open
Abstract
The anorexia nervosa adolescent longitudinal biomarker assessment study (ANABEL) is a 2-year longitudinal study. OBJECTIVE Evaluate several clinical, biochemical, immunological, psychological, and family variables and their interactions in adolescent onset eating disorders (EDs) patients and their 2-year clinical and biological outcome. This article illustrates the framework and the methodology behind the research questions, as well as describing general features of the sample. METHODS A longitudinal study of 114 adolescents with EDs seeking treatment was performed. Only adolescents were selected during 4 years (2009-2013). The variables were collected at different times: baseline, 6, 12, 18, and 24 months of the start of treatment. Diagnoses were completed through the semi-structured Kiddie-Schedule for Affective Disorders and Schizophrenia interview. RESULTS At baseline, the mean age was 15.11 (SD = 1.36). The mean ED duration was 10 months (SD = 5.75). The mean body mass index was 16.1 (SD = 1.8). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis at baseline for restrictive anorexia nervosa was 69.6%, 17.4% for purgative anorexia nervosa, and 24.3% for other specified feeding disorder. At 12 months, 19.4% were in partial remission, whereas at 24 months, 13.8% had fully recovered and 29.2% had partially recovered. CONCLUSIONS There was an acceptable physical and psychopathological improvement during the first year of treatment, with recovery being more evident during the first 6 months.
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Affiliation(s)
- Montserrat Graell
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)España
| | - Patricia de Andrés
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
| | | | - Alba Moreno
- School of PsychologyAutonomous University of MadridMadridSpain
| | - Ángel Villaseñor
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
| | - Mar Faya
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
| | - Carmen Martínez‐Cantarero
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
| | - Sonia Gómez‐Martínez
- Immunonutrition Research Group, Department of Metabolism and NutritionInstitute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC)MadridSpain
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and NutritionInstitute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC)MadridSpain
| | - Gonzalo Morandé
- Child and Adolescent Psychiatry and Psychology DepartmentHospital Infantil Universitario Niño JesúsMadridSpain
| | - Esther Nova
- Immunonutrition Research Group, Department of Metabolism and NutritionInstitute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC)MadridSpain
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25
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García S, Alberich S, Martínez-Cengotitabengoa M, Arango C, Castro-Fornieles J, Parellada M, Baeza I, Moreno C, Micó JA, Berrocoso E, Graell M, Otero S, Simal T, González-Pinto A. The complex association between the antioxidant defense system and clinical status in early psychosis. PLoS One 2018; 13:e0194685. [PMID: 29698400 PMCID: PMC5919675 DOI: 10.1371/journal.pone.0194685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 03/07/2018] [Indexed: 11/19/2022] Open
Abstract
Oxidative stress is a pathophysiological mechanism potentially involved in psychiatric disorders. The objective of this study was to assess the relationship between total antioxidant status (TAS) and the functional status of patients with a first episode of psychosis at the onset of the disease. For this purpose, a sample of 70 patients aged between 9 and 17 years with a first episode of psychosis were followed up for a period of two years. Blood samples were drawn to measure TAS levels at three time points: at baseline, at one year, and at two years. Clinical symptoms and functioning were also assessed at the same time points using various scales. Linear regression analysis was performed to investigate the relationship between TAS and clinical status at each assessment, adjusting for potential confounding factors. The distribution of clinical variables was grouped in different percentiles to assess the dose-response in the relation between clinical variables and TAS. At baseline, patient's score on Children's Global Assessment Scale (CGAS) was directly and significantly associated with TAS with a monotonic increase in percentiles, and surprising this association was reversed after one and two years of follow-up with a monotonic decrease. In summary at the onset of the illness, TAS is positively related to clinical status, whereas as the illness progresses this correlation is reversed and becomes negative. This may be the result of an adaptive response.
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Affiliation(s)
- Saínza García
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- BioAraba Research Institute, OSI Araba, Department of Psychiatry, Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Vitoria, Spain
| | - Susana Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- BioAraba Research Institute, OSI Araba, Department of Psychiatry, Araba University Hospital, Vitoria, Spain
| | - Mónica Martínez-Cengotitabengoa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- BioAraba Research Institute, OSI Araba, Department of Psychiatry, Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Vitoria, Spain
- Psychobiology Department, National Distance Education University (UNED), Vitoria, Spain
| | - Celso Arango
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, IiSGM, Madrid, Spain
- School of Medicine, Complutense University, Madrid, Spain
| | - Josefina Castro-Fornieles
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Mara Parellada
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, IiSGM, Madrid, Spain
- School of Medicine, Complutense University, Madrid, Spain
| | - Inmaculada Baeza
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, IiSGM, Madrid, Spain
- School of Medicine, Complutense University, Madrid, Spain
| | - Juan Antonio Micó
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Neuropsychopharmacology & Psychobiology Research Group, University of Cádiz, Cadiz, Spain
- Institute of Research and Innovation in Biomedical Sciences, INiBICA, Cádiz, Spain
| | - Esther Berrocoso
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Neuropsychopharmacology & Psychobiology Research Group, University of Cádiz, Cadiz, Spain
- Institute of Research and Innovation in Biomedical Sciences, INiBICA, Cádiz, Spain
| | - Montserrat Graell
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry and Psychology Department, Niño Jesús University Children's Hospital, La Princesa Institute for Health Research, Madrid, Spain
| | - Soraya Otero
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, Santander, Spain
- Child and Adolescent Psychiatry Unit, Marqués de Valdecilla University Hospital, Santander, Spain
- School of Medicine, University of Cantabria, Santander, Spain
| | - Tatiana Simal
- Department of Psychiatry, Miguel Servet University Hospital, Zaragoza, Spain
| | - Ana González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- BioAraba Research Institute, OSI Araba, Department of Psychiatry, Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Vitoria, Spain
- * E-mail:
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26
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Parks M, Anastasiadou D, Sánchez JC, Graell M, Sepulveda AR. Experience of caregiving and coping strategies in caregivers of adolescents with an eating disorder: A comparative study. Psychiatry Res 2018; 260:241-247. [PMID: 29220681 DOI: 10.1016/j.psychres.2017.11.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Received: 11/21/2016] [Revised: 09/19/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022]
Abstract
Caring for a relative with an eating disorder (ED) is associated with heightened psychological distress, which, according to a stress-coping model, may be influenced by coping and appraisal. However, limited quantitative studies have assessed coping in ED caregivers. This cross-sectional study aims to assess 1) the differences in coping between caregivers of three groups: patients with an ED, patients with a substance use disorder, and healthy teens, and 2) the patient and caregiver variables associated with coping and appraisal of the caregiving experience. A one-way MANOVA was significant for caregiver group for mothers, but not fathers. Mothers of both patient groups used more self-sufficient problem focused coping than mothers of healthy teens. Patient caregivers did not significantly differ from caregivers of healthy teens in their use of avoidance. Mothers used social support strategies more than fathers. A positive experience of caregiving was significantly associated with the use of approach-oriented coping in ED caregivers and a negative experience of caregiving was significantly associated with avoidance in ED mothers. Older ED caregivers were less likely to use avoidance. Future interventions could help ED caregivers to recognize their coping preferences and how to appropriately use these strategies when faced with illness-related stressors.
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Affiliation(s)
- Melissa Parks
- Autonomous University of Madrid, Faculty of Psychology, Calle Ivan Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049 Madrid, Spain
| | - Dimitra Anastasiadou
- Faculty of Information and Communication Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou 156, 08018 Barcelona, Spain
| | - Julio César Sánchez
- Proyecto Hombre - Programa Soporte, Calle Martin de los Heros, 68, 28008 Madrid, Spain
| | - Montserrat Graell
- Child and Adolescent University Hospital "Niño Jesus," Eating Disorders Unit, Avenida de Menendez Pelayo 65, 28009 Madrid, Spain
| | - Ana R Sepulveda
- Autonomous University of Madrid, Faculty of Psychology, Calle Ivan Pavlov 6, Ciudad Universitaria Cantoblanco Campus, 28049 Madrid, Spain.
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27
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Castro-Fornieles J, Bargalló N, Calvo A, Arango C, Baeza I, Gonzalez-Pinto A, Parellada M, Graell M, Moreno C, Otero S, Janssen J, Rapado-Castro M, de la Serna E. Gray matter changes and cognitive predictors of 2-year follow-up abnormalities in early-onset first-episode psychosis. Eur Child Adolesc Psychiatry 2018; 27:113-126. [PMID: 28707138 DOI: 10.1007/s00787-017-1013-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 06/02/2017] [Indexed: 11/26/2022]
Abstract
This study aims to examine regional gray matter (GM) changes over a period of 2 years in patients diagnosed with early-onset first-episode psychosis (EO-FEP), and to identify baseline predictors of abnormalities at the follow-up. Fifty-nine patients with EO-FEP aged 11-17 years were assessed. Magnetic resonance imaging was carried out at admission and 2 years later. Changes over time were assessed with voxel-based morphometry. Fifty-nine patients (34 schizophrenia-SCZ, 15 bipolar disorder-BP, and 10 other psychotic disorders) and 70 healthy controls were assessed. At baseline no differences were found between the EO-FEP groups and control subjects. Over time, SCZ patients presented a larger GM decrease in the orbitofrontal cortex, anterior midline frontal cortex, cingulate, left caudate, and thalamus. BP patients also had a larger GM decrease in the right putamen, right orbitofrontal cortex, and anterior and midline region of the right superior frontal gyrus and left caudate, but with fewer areas showing significant differences than in the comparison between SCZ and controls. In the cross-sectional analysis, only SCZ patients showed differences with respect to controls in some GM areas. Significant baseline predictors of a 2-year reduction in GM were IQ and working memory. EO-FEP patients did not show differences in GM compared to controls at baseline. Both SCZ and BP patients showed a greater decrease in specific areas during the first 2 years. At follow-up, only SCZ patients differed significantly from controls in specific brain areas. The GM reduction was predicted by baseline cognitive variables.
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Affiliation(s)
- Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Villarroel, 170, 08036, Barcelona, Spain.
- Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain.
| | - Nuria Bargalló
- Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Anna Calvo
- Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Villarroel, 170, 08036, Barcelona, Spain
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, Hospital Santiago Apóstol, CIBERSAM, EHU/University of the Basque Country, Vitoria, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, CIBERSAM, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Soraya Otero
- Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, CIBERSAM, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Villarroel, 170, 08036, Barcelona, Spain
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28
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Parellada M, Llorente C, Calvo R, Gutierrez S, Lázaro L, Graell M, Guisasola M, Dorado ML, Boada L, Romo J, Dulin E, Sanz I, Arango C, Moreno C. Randomized trial of omega-3 for autism spectrum disorders: Effect on cell membrane composition and behavior. Eur Neuropsychopharmacol 2017; 27:1319-1330. [PMID: 28935269 DOI: 10.1016/j.euroneuro.2017.08.426] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 07/17/2017] [Accepted: 08/20/2017] [Indexed: 12/12/2022]
Abstract
A high ω6/ω3 ratio [fatty acid (FA) index] in the cell membrane has been associated with inadequate brain development. It has started to be used as a biomarker of treatment efficacy in human diseases. The aim of this study was to investigate if omega-3 supplementation improves erythrocyte membrane ω6/ω3, plasma antioxidant status (TAS) and autistic behaviors. A randomized, crossover, placebo-controlled study was designed to investigate the effect of 8 weeks of supplementation with ω3 (962mg/d and 1155mg/d for children and adolescents, respectively). Sixty-eight children and adolescents with Autism Spectrum Disorders (ASD) completed the full protocol. Primary outcome measures were erythrocyte membrane FA composition and TAS. Secondary outcome measures were Social Responsiveness Scale and Clinical Global Impression-Severity. Treatment with ω3 improved the erythrocyte membrane ω6/ω3 ratio (treatment effect p<0.008, d=0.66; within subjects effect p<0.007, d=0.5) without changing TAS. There was a within subjects significant improvement in Social Motivation and Social Communication subscales scores, with a moderate to large effect size (p=0.004, d=0.73 and p=0.025, d=0.79 respectively), but no treatment effect (treatment-placebo order). Carryover effects cannot be discarded as responsible for the results in behavioral measures. In conclusion, supplementation with ω3 FA might be studied as an add-on to behavioral therapies in ASD. Optimal duration of treatment requires further investigation. With regard to side effects, the effect of this supplementation on the lipid profile needs monitoring.
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Affiliation(s)
- Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; IiSGM, CIBERSAM, Spain; School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Cloe Llorente
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rosa Calvo
- Hospital Clínic of Barcelona, CIBERSAM, Spain
| | - Silvia Gutierrez
- Hospital Infantil Niño Jesus (Madrid), CIBERSAM, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, UCM, Madrid, Spain
| | | | - Montserrat Graell
- Hospital Infantil Niño Jesus (Madrid), CIBERSAM, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, UCM, Madrid, Spain
| | - Maria Guisasola
- School of Medicine, Universidad Complutense, Madrid, Spain; Experimental Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maria Luisa Dorado
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Leticia Boada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; IiSGM, CIBERSAM, Spain
| | - Jose Romo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Elena Dulin
- Biochemistry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Inmaculada Sanz
- Biochemistry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; IiSGM, CIBERSAM, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; IiSGM, CIBERSAM, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
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29
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Elegido A, Graell M, Andrés P, Gheorghe A, Marcos A, Nova E. Increased naive CD4 + and B lymphocyte subsets are associated with body mass loss and drive relative lymphocytosis in anorexia nervosa patients. Nutr Res 2017; 39:43-50. [PMID: 28385288 DOI: 10.1016/j.nutres.2017.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/12/2016] [Accepted: 02/03/2017] [Indexed: 12/12/2022]
Abstract
Anorexia nervosa (AN) is an atypical form of malnutrition with peculiar changes in the immune system. We hypothesized that different lymphocyte subsets are differentially affected by malnutrition in AN, and thus, our aim was to investigate the influence of body mass loss on the variability of lymphocyte subsets in AN patients. A group of 66 adolescent female patients, aged 12-17 years, referred for their first episode of either AN or feeding or eating disorders not elsewhere classified were studied upon admission (46 AN-restricting subtype, 11 AN-binge/purging subtype, and 9 feeding or eating disorders not elsewhere classified). Ninety healthy adolescents served as controls. White blood cells and lymphocyte subsets were analyzed by flow cytometry. Relationships with the body mass index (BMI) z score were assessed in linear models adjusted by diagnostic subtype and age. Leukocyte numbers were lower in AN patients than in controls, and relative lymphocytosis was observed in AN-restricting subtype. Lower CD8+, NK, and memory CD8+ counts were found in eating disorder patients compared with controls. No differences were found for CD4+ counts or naive and memory CD4+ subsets between the groups. Negative associations between lymphocyte percentage and the BMI z score, as well as between the B cell counts, naive CD4+ percentage and counts, and the BMI z score, were found. In conclusion, increased naive CD4+ and B lymphocyte subsets associated with body mass loss drive the relative lymphocytosis observed in AN patients, which reflects an adaptive mechanism to preserve the adaptive immune response.
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Affiliation(s)
- Ana Elegido
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain
| | - Montserrat Graell
- Eating Disorders Unit, Child and Adolescent Psychiatry and Psychology Department, Children University Hospital Niño Jesús, Av Menéndez Pelayo, 65, 28009 Madrid, Spain; CIBERSAM, Biomedical Research Networking Centre for Mental Health, Ministry of Health, Spain
| | - Patricia Andrés
- Eating Disorders Unit, Child and Adolescent Psychiatry and Psychology Department, Children University Hospital Niño Jesús, Av Menéndez Pelayo, 65, 28009 Madrid, Spain
| | - Alina Gheorghe
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain
| | - Esther Nova
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain.
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Solano S, Lacruz T, Blanco M, Moreno T, Real B, Graell M, Sepúlveda AR. Perinatal factors and their influence on childhood obesity: a case-control study. An Sist Sanit Navar 2016; 39:347-355. [PMID: 28032870 DOI: 10.23938/assn.0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/30/2016] [Accepted: 08/30/2016] [Indexed: 11/18/2022]
Abstract
Background. The aetiology of childhood obesity is complex. It involves the interaction of genetic and environmental factors. Obstetric complications have been associated with the development of mental disorder and other medical conditions. The aim of this research is to study the association between perinatal complications and childhood obesity.
Methods. We present data from a case-control study composed of 60 mothers of obese children and 92 mothers of healthy control children between 8-12 years. We interviewed the mothers and we studied obstetric complications with the Lewis –Murray Scale. We compared the two groups with chi - square analysis and odds ratios.
Results. We found a higher prevalence of obstetric complications in delivery in the group with obesity. The most frequent obstetric complication was emergency caesarean; a significant difference was shown with the control group (p < 0.05).
Conclusion. Obstetric complications are related to the development of childhood obesity. It is important to study the perinatal period as a relevant factor, in order to develop and implement prevention programs.
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Jeffery D, del-Valle MF, Perez-Ruiz M, Graell M, Larumbe-Zabala E. Poor Physical Activity Levels and Physical Fitness in Adolescents with Anorexia after Hospitalization. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000488193.95209.ec] [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: 11/21/2022]
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Anastasiadou D, Sepulveda AR, Sánchez JC, Parks M, Álvarez T, Graell M. Family Functioning and Quality of Life among Families in Eating Disorders: A Comparison with Substance-related Disorders and Healthy Controls. Eur Eat Disorders Rev 2016; 24:294-303. [DOI: 10.1002/erv.2440] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 01/12/2016] [Accepted: 01/18/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Dimitra Anastasiadou
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Ana R. Sepulveda
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | | | - Melissa Parks
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Tamara Álvarez
- Department of Biological and Health Psychology, Faculty of Psychology; Autonomous University of Madrid; Madrid Spain
| | - Montserrat Graell
- Eating Disorders Program, Child and Adolescence Psychiatry Department; Niño Jesus University Hospital, CIBERSAM; Madrid Spain
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Anastasiadou D, Sepulveda AR, Parks M, Cuellar-Flores I, Graell M. The relationship between dysfunctional family patterns and symptom severity among adolescent patients with eating disorders: A gender-specific approach. Women Health 2015; 56:695-712. [DOI: 10.1080/03630242.2015.1118728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Del Rey-Mejías Á, Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Castro-Fornieles J, Baeza I, Espliego A, Merchán-Naranjo J, González-Pinto A, de la Serna E, Payá B, Graell M, Arango C, Parellada M. Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis. Eur Child Adolesc Psychiatry 2015; 24:1447-59. [PMID: 25726022 DOI: 10.1007/s00787-015-0693-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 11/13/2014] [Accepted: 02/10/2015] [Indexed: 01/10/2023]
Abstract
The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP.
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Affiliation(s)
- Ángel Del Rey-Mejías
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
| | - David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Jessica Merchán-Naranjo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Ana González-Pinto
- Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, Vitoria, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Beatriz Payá
- Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain
| | - Montserrat Graell
- Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
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Parellada M, Castro-Fornieles J, Gonzalez-Pinto A, Pina-Camacho L, Moreno D, Rapado-Castro M, Otero S, de la Serna E, Moreno C, Baeza I, Graell M, Arango C. Predictors of functional and clinical outcome in early-onset first-episode psychosis: the child and adolescent first episode of psychosis (CAFEPS) study. J Clin Psychiatry 2015; 76:e1441-8. [PMID: 26580481 DOI: 10.4088/jcp.13m08863] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/12/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The objective of this study was to study baseline clinical and biological predictors of 2-year outcome in a cohort of children and adolescents with a first episode of psychosis. METHOD Standard instruments were used to evaluate symptoms and functioning in 110 children and adolescents (mean age = 15.47 years) with first episode of psychosis at admission (between 2003 and 2005) and after 2-year follow-up. Clinical assessments included diagnostic assessment to yield DSM-IV diagnosis, developmental, premorbid, and past-year data, together with structural neuroimaging and other biological parameters (genetics and oxidative stress). Eighty-three subjects had assessments at baseline (including the Strauss-Carpenter Outcome Scale [SCOS]) and at 2-year follow-up. Association and multistep regression analyses were conducted to show correlates and predictors of primary outcome measures: functional outcome (Children's Global Assessment Scale [CGAS]), improvement (CGAS change), and primary negative symptoms (Proxy for the Deficit Syndrome Scale). RESULTS The SCOS predicted 27.46% (P < .001) of the variance in CGAS score at 2 years. Baseline severity (measured by CGAS) predicted 30.9% (P < .001) of CGAS improvement after 2 years, and SCOS total score predicted an added 24.1% (P < .001). A diagnosis of nonaffective psychosis, primary negative symptoms, and less white matter at baseline predicted more primary negative symptoms at follow-up. The prediction of functional outcome was not increased by genetic, oxidative stress, or neurostructural markers. CONCLUSIONS Baseline clinical assessments have a better predictive value than biological assessments for 2-year follow-up functioning of children and adolescents with a first episode of psychosis. Patients with primary negative symptoms at baseline continue to have negative symptoms 2 years later, and neurostructural markers predict these. Clinicians must still rely on clinical variables to judge the functional prognosis of early-onset first psychotic episodes.
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Affiliation(s)
- Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Ibiza 43, Madrid 28009, Spain
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Rapado-Castro M, Bartholomeusz CF, Castro-Fornieles J, González-Pinto A, Otero S, Baeza I, Moreno C, Graell M, Janssen J, Bargalló N, Pantelis C, Desco M, Arango C. Gender effects on brain changes in early-onset psychosis. Eur Child Adolesc Psychiatry 2015; 24:1193-205. [PMID: 25589436 DOI: 10.1007/s00787-014-0669-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
Progressive loss of cortical gray matter (GM) and increase of cerebrospinal fluid (CSF) have been reported in early-onset psychosis (EOP). EOP typically begins during adolescence, a time when developmental brain trajectories differ by gender. This study aimed to determine gender differences in progression of brain changes in this population. A sample of 61 (21 females) adolescents with a first psychotic episode and a matched sample of 70 (23 females) controls underwent both baseline and 2-year follow-up anatomical brain imaging assessments. Regional GM and CSF volumes were obtained using automated methods based on the Talairach's proportional grid system. At baseline, only male patients showed a clear pattern of alterations in the frontal lobe relative to controls (smaller GM and larger CSF volumes). However, parallel longitudinal changes for male and female patients relative to controls were observed, resulting in a common pattern of brain changes across both genders: rate of left frontal lobe GM volume loss was larger in male (-3.8%) and female patients (-4.2%) than in controls (-0.7% males; -0.4% females). The reverse was found for the CSF volume in the left frontal lobe. While the GM and CSF volumes of females with EOP appear to be within the normal range at initial illness onset, our results point to a similar trajectory of increased/accelerated brain changes in both male and female patients with EOP. The pattern of progression of brain changes in psychosis appears to be independent of gender or structural alterations on appearance of psychotic symptoms.
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Affiliation(s)
- Marta Rapado-Castro
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia.
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Josefina Castro-Fornieles
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ana González-Pinto
- Hospital Santiago Apóstol de Vitoria, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Kronikgune, EHU-UPV, Vitoria, Spain
| | - Soraya Otero
- Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Spain
| | - Inmaculada Baeza
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Montserrat Graell
- Psychiatry and Psychology Department, Hospital Infantil Universitario Niño Jesús, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Nuria Bargalló
- Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Manuel Desco
- Department of Bioengineering and Aerospatial Engineering, University Carlos III de Madrid, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
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Sanchez-Gistau V, Baeza I, Arango C, González-Pinto A, de la Serna E, Parellada M, Graell M, Paya B, Llorente C, Castro-Fornieles J. The affective dimension of early-onset psychosis and its relationship with suicide. J Child Psychol Psychiatry 2015; 56:747-755. [PMID: 25256792 DOI: 10.1111/jcpp.12332] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 09/01/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The affective dimension has scarcely been studied in early-onset psychosis. Our aims were to investigate the prevalence and type of affective symptoms in the prodromal and acute phases of early-onset psychosis and to examine their relationship with suicide. We also sought to establish whether the presence of premorbid antecedents or the presence of affective symptoms during the prodromal and acute phase might predict a later diagnosis of bipolar disorder (BP) or schizophrenia (SZ). METHOD Participants were 95 youths, aged 9-17 years, experiencing a first episode of a psychotic disorder (FEP) according to DSM-IV criteria. Prodromal affective symptoms in the year prior to the onset of full-blown psychosis were assessed by means of the K-SADS. Affective symptoms during the acute episode were evaluated using the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Suicidality was assessed during the acute episode and at 6 and 12 months. RESULTS Half of the patients experienced affective symptoms during the prodrome, with depressive symptoms being the most frequently reported. During the acute episode, 23.2% presented depressive, 41.4% mixed and 18.9% manic symptoms. After logistic regression analysis, only the presence of depressive symptoms was significantly associated with suicidality during the 12 months following the FEP. Neither early premorbid antecedents nor the prevalence or type of affective symptoms during the FEP predicted a diagnosis of BP or SZ at 12 months. However, both depressive and manic prodromal symptoms were associated with a later diagnosis of BP. CONCLUSIONS The FEP of both SZ and BP is preceded by an identifiable prodromal phase. Early detection programs should target young people at clinical risk for the extended psychosis phenotype. The high prevalence of affective symptoms during the early phases of psychosis may encourage clinicians to identify and treat them in order to prevent suicide behaviour.
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Affiliation(s)
- Vanessa Sanchez-Gistau
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Barcelona, 2009-SGR-1119, Generalitat de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Barcelona, 2009-SGR-1119, Generalitat de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Celso Arango
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Hospital Santiago Apóstol, EHU/University of the Basque Country, Vitoria, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Beatriz Paya
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Cloe Llorente
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Barcelona, 2009-SGR-1119, Generalitat de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Pina-Camacho L, Garcia-Prieto J, Parellada M, Castro-Fornieles J, Gonzalez-Pinto AM, Bombin I, Graell M, Paya B, Rapado-Castro M, Janssen J, Baeza I, Del Pozo F, Desco M, Arango C. Predictors of schizophrenia spectrum disorders in early-onset first episodes of psychosis: a support vector machine model. Eur Child Adolesc Psychiatry 2015; 24:427-40. [PMID: 25109600 DOI: 10.1007/s00787-014-0593-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 03/31/2014] [Accepted: 07/29/2014] [Indexed: 12/21/2022]
Abstract
Identifying early-onset schizophrenia spectrum disorders (SSD) at a very early stage remains challenging. To assess the diagnostic predictive value of multiple types of data at the emergence of early-onset first-episode psychosis (FEP), various support vector machine (SVM) classifiers were developed. The data were from a 2-year, prospective, longitudinal study of 81 patients (age 9-17 years) with early-onset FEP and a stable diagnosis during follow-up and 42 age- and sex-matched healthy controls (HC). The input was different combinations of baseline clinical, neuropsychological, magnetic resonance imaging brain volumetric and biochemical data, and the output was the diagnosis at follow-up (SSD vs. non-SSD, SSD vs. HC, and non-SSD vs. HC). Enhanced recursive feature elimination was performed for the SSD vs. non-SSD classifier to select and rank the input variables with the highest predictive value for a diagnostic outcome of SSD. After validation with a test set and considering all baseline variables together, the SSD vs. non-SSD, SSD vs. HC and non-SSD vs. HC classifiers achieved an accuracy of 0.81, 0.99 and 0.99, respectively. Regarding the SSD vs. non-SSD classifier, a combination of baseline clinical variables (severity of negative, disorganized symptoms and hallucinations or poor insight) and neuropsychological variables (impaired attention, motor coordination, and global cognition) showed the highest predictive value for a diagnostic outcome of SSD. Neuroimaging and biochemical variables at baseline did not add to the predictive value. Thus, comprehensive clinical/cognitive assessment remains the most reliable approach for differential diagnosis during early-onset FEP. SVMs may constitute promising multivariate tools in the search for predictors of diagnostic outcome in FEP.
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Affiliation(s)
- Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón. School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Ibiza 43, 28009, Madrid, Spain,
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Fraga A, Caggianesse V, Carrera O, Graell M, Morandé G, Gutiérrez E. Seasonal BMI differences between restrictive and purging anorexia nervosa subtypes. Int J Eat Disord 2015; 48:35-41. [PMID: 25327157 DOI: 10.1002/eat.22357] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Seasonal differences in anorexia nervosa is an area of research which has received scarce attention in the literature. The aim of this study was to explore patterns of seasonal variation in body weight in anorexia nervosa patients admitted to an eating disorders unit from January 2007 to December 2011. METHOD Anorexia nervosa restrictive (ANR) and binge eating/purging (ANBP) subtypes were compared with respect to BMI on admission during the Warm and Cold Semester, and in terms of lenght of hospital stay. RESULTS The main result was that BMI differences between ANBP and ANR patients were due to bodyweight differences during the colder months of the year (p < 0.01) whereas no difference in bodyweight on admission was observed between both subtypes during the Warm Semester months. Furthermore, ANR patients' bodyweight was lower when admitted during the Cold compared to the Warm Semester (p < 0.05). Length of stay was significantly associated with reduced BMI in ANR patients (p < 0.01), but not so for ANBP patients. DISCUSSION To our knowledge, this is the first study in the literature providing data on seasonal variations in the BMI on admission of anorexia nervosa patients, and in the length of hospitalization.
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Affiliation(s)
- Angela Fraga
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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Sepúlveda AR, Anastasiadou D, Rodríguez L, Almendros C, Andrés P, Vaz F, Graell M. Spanish validation of the Family Questionnaire (FQ) in families of patients with an eating disorder. Psicothema 2014; 26:321-7. [PMID: 25069550 DOI: 10.7334/psicothema2013.310] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The objective of this study is to evaluate the psychometric properties of the Spanish version of the Family Questionnaire (FQ) and to further examine the differences between mothers' and fathers' emotional response to an eating disorder (ED). METHOD A total of 382 carers of patients with an ED participated in the study, with ages ranging from forty to fifty-three years old. RESULTS The use of confirmatory factor analysis according to gender supported both factor models of the FQ, with only minor differences in comparison to the original study performed in 2002 by Wiedemann and collegues. The internal consistency of the Spanish version of the FQ was good. Mothers displayed significantly higher levels of emotional over-involvement than fathers, while gender differences in critical comments were nonsignificant. The correlation of the two subscales of the FQ with a conceptually related measure (Expressed Emotion) and two unrelated ones (negative caregiving experience, distress) supports the convergent and concurrent validity of the instrument in both samples. CONCLUSIONS The FQ has adequate psychometric properties and may be of value in assessing the impact of ED symptoms on the family environment. Finally, interventions that aim to reduce Expressed Emotion in carers may consider a gender-specific approach.
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Martínez-Cengotitabengoa M, Micó JA, Arango C, Castro-Fornieles J, Graell M, Payá B, Leza JC, Zorrilla I, Parellada M, López MP, Baeza I, Moreno C, Rapado-Castro M, González-Pinto A. Basal low antioxidant capacity correlates with cognitive deficits in early onset psychosis. A 2-year follow-up study. Schizophr Res 2014; 156:23-9. [PMID: 24768133 DOI: 10.1016/j.schres.2014.03.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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: 11/13/2013] [Revised: 02/07/2014] [Accepted: 03/25/2014] [Indexed: 12/13/2022]
Abstract
The objective of the study is to examine the association of baseline total antioxidant status (TAS) and glutathione (GSH) levels with short- and long-term cognitive functioning in patients with early onset first-episode psychosis, comparing affective and non-affective psychoses. We analysed 105 patients with an early onset-first episode psychosis (age 9-17 years) and 97 healthy controls. Blood samples were taken at admission for measurement of TAS and GSH, and cognitive performance was assessed at baseline and at 2years of follow-up. Regression analysis was used to assess the relationship between TAS/GSH levels at baseline and cognitive performance at both time points, controlling for confounders. Baseline TAS and GSH levels were significantly lower in patients than healthy controls. In patients, baseline TAS was positively associated with the global cognition score at baseline (p=0.048) and two years later (p=0.005), while TAS was not associated with cognitive functioning in healthy controls. Further, baseline TAS in patients was specifically associated with the memory domain at baseline and with the memory and attention domains two years later. Stratifying by affective and non-affective psychoses, significant associations were only found between TAS and cognition in the non-affective psychosis group. Baseline GSH levels were not associated with cognitive functioning at either time point in either group. The antioxidant defence capacity in early onset first-episode psychotic patients is directly correlated with global cognition at baseline and at 2years of follow-up, especially in non-affective psychosis.
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Affiliation(s)
- Mónica Martínez-Cengotitabengoa
- Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; National Distance Education University (UNED)-Centro Asociado de Vitoria, Spain.
| | - Juan Antonio Micó
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology and Psychobiology Research Group, University of Cadiz, Cadiz, Spain
| | - Celso Arango
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; Medical School, Universidad Complutense, Madrid, Spain
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR-1119, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain; Department of Psychiatry and Psychobiology, University of Barcelona, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain
| | - Beatriz Payá
- Child and Adolescent Psychiatry and Psychology Unit, University Hospital Marques de Valdecilla, Santander, Spain
| | - Juan Carlos Leza
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Pharmacology, Medical School, Universidad Complutense, Madrid, Spain
| | - Iñaki Zorrilla
- Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - M Purificación López
- Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; University of the Basque Country, Spain
| | - Inmaculada Baeza
- Department of Psychiatry, Clinic Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Marta Rapado-Castro
- Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; University of the Basque Country, Spain
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Pina-Camacho L, Diaz-Caneja C, Garcia-Prieto J, Parellada M, Castro-Fornieles J, Gonzalez-Pinto A, Bombin I, Graell M, Otero S, Rapado-Castro M, Janssen J, Baeza I, Del Pozo F, Desco M, Arango C. EPA-0882 - Prediction of diagnosis of early-onset schizophrenia spectrum disorders using support vector machines. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78212-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Fraguas D, Del Rey-Mejías A, Moreno C, Castro-Fornieles J, Graell M, Otero S, Gonzalez-Pinto A, Moreno D, Baeza I, Martínez-Cengotitabengoa M, Arango C, Parellada M. Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: a 2-year longitudinal study. Schizophr Res 2014; 152:130-8. [PMID: 24332406 DOI: 10.1016/j.schres.2013.11.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 11/01/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
Longer duration of untreated psychosis (DUP) in adult patients with first-episode psychosis (FEP) has been associated with poor clinical and social outcomes. We aimed to estimate the influence of DUP on outcome at 2-year follow-up in subjects with an early-onset (less than 18 years of age) FEP of less than 6 months' duration. A total of 80 subjects (31.3% females, mean age 16.0±1.8 years) were enrolled in the study. The influence of DUP on outcome was estimated using multiple regression models (two linear models for influence of DUP on the C-GAF at 2 years and C-GAF change through the follow-up period, and a logistic model for influence of DUP on 41 PANSS remission at 2 years in schizophrenia patients (n=47)). Mean DUP was 65.3±54.7 days. Median DUP was 49.5 days. For the whole sample (n=80), DUP was the only variable significantly related to C-GAF score at 2-year follow-up (Beta=-0.13, p<0.01), while DUP and premorbid adjustment (Beta=-0.01, p<0.01; and Beta=-0.09, p=0.04, respectively) were the only variables significantly related to C-GAF change. In schizophrenia patients, DUP predicted both C-GAF score at 2 years and C-GAF change, while in patients with affective psychosis (n=22), DUP was unrelated to outcome. Lower baseline C-GAF score (OR=0.91, p<0.01) and shorter DUP (OR=0.98, p=<0.01) were the only variables that significantly predicted clinical remission in schizophrenia patients. In conclusion, longer DUP was associated with lower C-GAF at 2 years, less increase in C-GAF, and lower rates of clinical remission in early-onset FEP. Our findings support the importance of early detection programs, which help shorten DUP.
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Affiliation(s)
- David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Angel Del Rey-Mejías
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-111, CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clínic of Barcelona, Spain; Department of Psychiatry and Psychobiology, University of Barcelona, Spain
| | - Montserrat Graell
- Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Soraya Otero
- Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain
| | - Ana Gonzalez-Pinto
- Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Vitoria, CIBERSAM, Spain
| | - Dolores Moreno
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, SGR-111, CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clínic of Barcelona, Spain; Department of Psychiatry and Psychobiology, University of Barcelona, Spain
| | | | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
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Carral-Fernández L, Sepulveda AR, Gómez del Barrio A, Graell M, Treasure J. The Spanish validation of an Eating Disorders Symptom Impact Scale (EDSIS) among caregivers. Psychiatry Res 2013; 209:626-31. [PMID: 23537846 DOI: 10.1016/j.psychres.2013.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 02/05/2013] [Accepted: 02/16/2013] [Indexed: 11/18/2022]
Abstract
The aim of this study was to examine the psychometric properties of the Spanish version of the Eating Disorders Symptom Impact Scale (EDSIS-S), which is designed to evaluate an eating disorders-specific caregiving experience. A cross-sectional study was conducted among 187 Spanish caregivers of relatives with an eating disorder. Measures included the Experience of Caregiving Inventory (ECI) and General Health Questionnaire (GHQ-12). Socio-demographic variables of the carers and clinical variables of the patients were collected. Results supported the factorial structure, reliability and convergent validity of the instrument and the instrument was acceptable for assessing the eating disorders-specific experience of caregiving in Spain. Almost all of the factor loadings were >0.40. Cronbach's alpha coefficients were mostly superior to 0.70. The EDSIS-S instrument has good psychometric properties and is similar to the original in terms of validity and reliability. Further examination of the factor structure of this instrument among adult samples is indicated. From a clinical perspective, the EDSIS allows for tailoring caregiver interventions to address the specific impact of symptoms on individual carers.
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Bombin I, Mayoral M, Castro-Fornieles J, Gonzalez-Pinto A, de la Serna E, Rapado-Castro M, Barbeito S, Parellada M, Baeza I, Graell M, Payá B, Arango C. Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses. Psychol Med 2013; 43:757-768. [PMID: 22831788 DOI: 10.1017/s0033291712001535] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders. Method Seventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls. RESULTS EOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405). CONCLUSIONS Cognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.
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Affiliation(s)
- I Bombin
- Department of Psychology, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.
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Sepúlveda AR, Anastasiadou D, del Río AM, Graell M. The Spanish Validation of Level of Expressed Emotion Scale for Relatives of People with Eating Disorders. Span j psychol 2013; 15:825-39. [DOI: 10.5209/rev_sjop.2012.v15.n2.38894] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Expressed emotion (EE) is considered a general predictor of poor outcome across a range of conditions, including eating disorders, and is valuable in measuring the effect of family interventions. There are no self-report questionnaires validated in Spanish to measure EE among relatives of patients with a psychiatric condition. The aim of this study was to examine the psychometric properties of the Spanish version of the Level of Expressed Emotion scale (LEE) among relatives of eating disorder patients. A cross-sectional study of 270 relatives of patients with an eating disorder was conducted to examine the factor structure, reliability and validity of the LEE scale. Results indicated that the LEE-S (Spanish version) did not correspond to the a priori subscales described in the original version. The refined 45-item LEE-S scale consisted of four factors which explained 25.5% of variance in EE for relatives. Reliability was acceptable (α ranged from .73 to .86). The discriminant validity of the subscales was moderately supported by correlations with psychological distress (GHQ-12; rho = .34) and specific caregiving experience (EDSIS; rho = .39). The LEE-S instrument has adequate psychometric properties and may be of value to assess families at risk of a negative emotional climate at home.
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de la Serna E, Andrés-Perpiñá S, Puig O, Baeza I, Bombin I, Bartrés-Faz D, Arango C, Gonzalez-Pinto A, Parellada M, Mayoral M, Graell M, Otero S, Guardia J, Castro-Fornieles J. Cognitive reserve as a predictor of two year neuropsychological performance in early onset first-episode schizophrenia. Schizophr Res 2013. [PMID: 23182439 DOI: 10.1016/j.schres.2012.10.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The concept of cognitive reserve (CR) has been defined as individual differences in the efficient utilization of brain networks which allow some people to cope better than others with brain pathology. CR has been developed mainly in the field of aging and dementia after it was observed that there appears to be no direct relationship between the degree of brain pathology and the severity of clinical manifestations of this damage. The present study applies the concept of CR to a sample of children and adolescents with a first episode of schizophrenia, aiming to assess the possible influence of CR on neuropsychological performance after two year follow-up, controlling for the influence of clinical psychopathology. METHODS 35 patients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder (SSD) and 98 healthy controls (HC) matched for age and gender were included. CR was assessed at baseline, taking into account premorbid IQ, educational-occupational level and leisure activities. Clinical and neuropsychological assessments were completed by all patients at two year follow-up. RESULTS The CR proxy was able to predict working memory and attention at two year follow-up. Verbal memory and cognitive flexibility were not predicted by any of the variables included in the regression model. The SSD group obtained lower scores than HC on CR. CR measures correctly classified 79.8% of the sample as being SSD or HC. CONCLUSIONS Lower scores on CR were observed in SSD than in HC and the CR measure correctly classified a high percentage of the sample into the two groups. CR may predict SSD performance on working memory and attention tasks.
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Affiliation(s)
- Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
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Mayoral M, Bombín I, Castro-Fornieles J, González-Pinto A, Otero S, Parellada M, Moreno D, Baeza I, Graell M, Rapado M, Arango C. Longitudinal study of neurological soft signs in first-episode early-onset psychosis. J Child Psychol Psychiatry 2012; 53:323-31. [PMID: 22023091 DOI: 10.1111/j.1469-7610.2011.02475.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent decades, the assessment of neurological soft signs (NSS) in patients with psychosis has become a subject of special interest. The study of the progression of NSS during adolescence will provide valuable information about the role of NSS as endophenotypes or biomarkers and about brain development at a stage in which brain maturation has not yet been completed. METHODS Neurological soft signs were assessed in a sample of 110 first episodes of early-onset psychosis (EOP) and 98 healthy children and adolescents at two different times in a 2-year follow-up period. RESULTS Patients with EOP showed more NSS than controls both at baseline (p < .001) and the 2-year follow-up (p < .001). No differences were found in the number of signs among the different diagnostic subgroups (schizophrenia, bipolar disorder, and other psychoses). When we examined the changes in NSS over the follow-up, the reduction of NSS in the patients was greater than the controls for 'Motor coordination' (p = .032), 'Others' (p < .001), and 'Total score' (p < .001) of the NES. CONCLUSION Despite the greater reduction of NSS in patients than in controls along the follow-up, patients still have more neurological signs than healthy controls; therefore, these signs may be considered a trait marker. NSS do not seem to be specific to schizophrenia as they are present in different EOPs.
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Affiliation(s)
- M Mayoral
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Janssen J, Alemán-Gómez Y, Reig S, Schnack HG, Parellada M, Graell M, Moreno C, Moreno D, Mateos-Pérez JM, Udias JM, Arango C, Desco M. Regional specificity of thalamic volume deficits in male adolescents with early-onset psychosis. Br J Psychiatry 2012; 200:30-6. [PMID: 22116979 DOI: 10.1192/bjp.bp.111.093732] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Thalamic volume deficits are associated with psychosis but it is unclear whether the volume reduction is uniformly distributed or whether it is more severe in particular thalamic regions. AIMS To quantify whole and regional thalamic volume in males with early-onset psychosis and healthy male controls. METHOD Brain scans were obtained for 80 adolescents: 46 individuals with early-onset psychosis with a duration of positive symptoms less than 6 months and 34 healthy controls. All participants were younger than 19 years. Total thalamic volumes were assessed using FreeSurfer and FSL-FIRST, group comparisons of regional thalamic volumes were studied with a surface-based approach. RESULTS Total thalamic volume was smaller in participants with early-onset psychosis relative to controls. Regional thalamic volume reduction was most significant in the right anterior mediodorsal area and pulvinar. CONCLUSIONS In males with minimally treated early-onset psychosis, thalamic volume deficits may be most pronounced in the anterior mediodorsal and posterior pulvinar regions, adding strength to findings from post-mortem studies in adults with psychosis.
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Affiliation(s)
- Joost Janssen
- Unidad de Medicina y Cirugía Experimental, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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Reig S, Parellada M, Castro-Fornieles J, Janssen J, Moreno D, Baeza I, Bargalló N, González-Pinto A, Graell M, Ortuño F, Otero S, Arango C, Desco M. Multicenter study of brain volume abnormalities in children and adolescent-onset psychosis. Schizophr Bull 2011; 37:1270-80. [PMID: 20478821 PMCID: PMC3196940 DOI: 10.1093/schbul/sbq044] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of "schizophrenia" or "other psychosis" showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents.
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Affiliation(s)
- Santiago Reig
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain,To whom correspondence should be addressed; tel: +34-91-586-6678, fax: +34-91-426-5108; e-mail:
| | - Mara Parellada
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josefina Castro-Fornieles
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Universidad de Barcelona, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi I Sunyer), Hospital Clínic Universitari de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Joost Janssen
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Dolores Moreno
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Inmaculada Baeza
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Institut de Neurociències, Hospital Clínic i Universitari, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Nuria Bargalló
- Departamento de Radiología, Centro de Diagnóstico por la Imagen, Hospital Clínico, Barcelona, Spain
| | - Ana González-Pinto
- Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Vitoria, Spain
| | - Montserrat Graell
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Felipe Ortuño
- Departamento de Psiquiatría y Psicología Médica, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Soraya Otero
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Cantabria, Spain
| | - Celso Arango
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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