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Sánchez-Ortí JV, Correa-Ghisays P, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernandez-Mijares A, Vivas-Lalinde J, Crespo-Facorro B, Tabarés-Seisdedos R. Inflammation and lipid metabolism as potential biomarkers of memory impairment across type 2 diabetes mellitus and severe mental disorders. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110817. [PMID: 37327846 DOI: 10.1016/j.pnpbp.2023.110817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/20/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Neurocognitive impairment is a transdiagnostic feature across several psychiatric and cardiometabolic conditions. The relationship between inflammatory and lipid metabolism biomarkers and memory performance is not fully understood. This study aimed to identify peripheral biomarkers suitable to signal memory decline from a transdiagnostic and longitudinal perspective. METHODS Peripheral blood biomarkers of inflammation, oxidative stress and lipid metabolism were assessed twice over a 1-year period in 165 individuals, including 30 with schizophrenia (SZ), 42 with bipolar disorder (BD), 35 with major depressive disorder (MDD), 30 with type 2 diabetes mellitus (T2DM), and 28 healthy controls (HCs). Participants were stratified by memory performance quartiles, taking as a reference their global memory score (GMS) at baseline, into categories of high memory (H; n = 40), medium to high memory (MH; n = 43), medium to low memory (ML; n = 38) and low memory (L; n = 44). Exploratory and confirmatory factorial analysis, mixed one-way analysis of covariance and discriminatory analyses were performed. RESULTS L group was significantly associated with higher levels of tumor necrosis factor-alpha (TNF-α) and lower levels of apolipoprotein A1 (Apo-A1) compared to those from the MH and H groups (p < 0.05; η2p = 0.06-0.09), with small to moderate effect sizes. Moreover, the combination of interleukin-6 (IL-6), TNF-α, c-reactive protein (CRP), Apo-A1 and Apo-B compounded the transdiagnostic model that best discriminated between groups with different degrees of memory impairment (χ2 = 11.9-49.3, p < 0.05-0.0001). CONCLUSIONS Inflammation and lipid metabolism seem to be associated with memory across T2DM and severe mental illnesses (SMI). A panel of biomarkers may be a useful approach to identify individuals at greater risk of neurocognitive impairment. These findings may have a potential translational utility for early intervention and advance precision medicine in these disorders.
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Affiliation(s)
- Joan Vicent Sánchez-Ortí
- INCLIVA - Health Research Institute, Valencia, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
| | - Vicent Balanzá-Martínez
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Mental Health Unit of Catarroja, Valencia, Spain.
| | - Gabriel Selva-Vera
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Víctor M Victor
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain; Department of Physiology, University of Valencia, Valencia, Spain
| | | | | | | | - Benedicto Crespo-Facorro
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; Department of Psychiatry, Faculty of Medicine, University of Sevilla, HU Virgen del Rocío IBIS, Spain
| | - Rafael Tabarés-Seisdedos
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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Ayesa-Arriola R, Miguel-Corredera M, de la Foz VOG, Neergaard KD, Correa-Ghisays P, Setién-Suero E, Crespo-Facorro B. Education and long-term outcomes in first episode psychosis: 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:66-77. [PMID: 33952364 DOI: 10.1017/s0033291721001112] [Citation(s) in RCA: 3] [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] [Indexed: 01/16/2023]
Abstract
BACKGROUND Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. METHODS Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. RESULTS Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. CONCLUSIONS Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Margarita Miguel-Corredera
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | | | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Psychology and TMAP, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
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Correa-Ghisays P, Vicent Sánchez-Ortí J, Balanzá-Martínez V, Fuentes-Durá I, Martinez-Aran A, Ruiz-Bolo L, Correa-Estrada P, Ruiz-Ruiz JC, Selva-Vera G, Vila-Francés J, Macias Saint-Gerons D, San-Martín C, Ayesa-Arriola R, Tabarés-Seisdedos R. MICEmi: A method to identify cognitive endophenotypes of mental illnesses. Eur Psychiatry 2022; 65:e85. [PMID: 36440538 PMCID: PMC9807453 DOI: 10.1192/j.eurpsy.2022.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.
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Affiliation(s)
- Patricia Correa-Ghisays
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | - Lara Ruiz-Bolo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | - Juan Carlos Ruiz-Ruiz
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- Intelligent Data Analysis Laboratory (IDAL), University of Valencia, Spain
| | - Diego Macias Saint-Gerons
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Constanza San-Martín
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rafael Tabarés-Seisdedos
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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Sánchez-Ortí JV, Balanzá-Martínez V, Correa-Ghisays P, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernández-Mijares A, Vivas-Lalinde J, Crespo-Facorro B, Tabarés-Seisdedos R. Specific metabolic syndrome components predict cognition and social functioning in people with type 2 diabetes mellitus and severe mental disorders. Acta Psychiatr Scand 2022; 146:215-226. [PMID: 35359023 DOI: 10.1111/acps.13433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Obesity and metabolic diseases such as metabolic syndrome (MetS) are more prevalent in people with type 2 diabetes mellitus (T2DM), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ). MetS components might be associated with neurocognitive and functional impairments in these individuals. The predictive and discriminatory validity of MetS and its components regarding those outcomes were assessed from prospective and transdiagnostic perspectives. METHODS Metabolic syndrome components and neurocognitive and social functioning were assessed in 165 subjects, including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 healthy controls (HCs). A posteriori, individuals were classified into two groups. The MetS group consisted of those who met at least three of the following criteria: abdominal obesity (AO), elevated triglycerides (TG), reduced high-density lipoprotein cholesterol (HDL), elevated blood pressure (BP), and elevated fasting glucose (FPG); the remaining participants comprised the No-MetS group. Mixed one-way analysis of covariance and linear and binary logistic regression analyses were performed. RESULTS Cognitive impairment was significantly greater in the MetS group (n = 82) than in the No-MetS group (n = 83), with small effect sizes (p < 0.05; η²p = 0.02 - 0.03). In both groups, the most robust associations between MetS components and neurocognitive and social functioning were observed with TG and FPG (p < 0.05). There was also evidence for a significant relationship between cognition and BP in the MetS group (p < 0.05). The combination of TG, FPG, elevated systolic BP and HDL best classified individuals with greater cognitive impairment (p < 0.001), and TG was the most accurate (p < 0.0001). CONCLUSIONS Specific MetS components are significantly associated with cognitive impairment across somatic and psychiatric disorders. Our findings provide further evidence on the summative effect of MetS components to predict cognition and social functioning and allow the identification of individuals with worse outcomes. Transdiagnostic, lifestyle-based therapeutic interventions targeted at that group hold the potential to improve health outcomes.
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Affiliation(s)
- Joan Vicent Sánchez-Ortí
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.,Mental Health Unit of Catarroja, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Faculty of Psychology, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Víctor M Victor
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Physiology, University of Valencia, Valencia, Spain
| | - Irene Escribano-Lopez
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain
| | | | | | - Benedicto Crespo-Facorro
- TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Department of Psychiatry, Faculty of Medicine, University of Sevilla, HU Virgen del Rocío IBIS, Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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Garés-Caballer M, Sánchez-Ortí JV, Correa-Ghisays P, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernandez-Mijares A, Vivas-Lalinde J, Vieta E, Leza JC, Tabarés-Seisdedos R. Immune–Inflammatory Biomarkers Predict Cognition and Social Functioning in Patients With Type 2 Diabetes Mellitus, Major Depressive Disorder, Bipolar Disorder, and Schizophrenia: A 1-Year Follow-Up Study. Front Neurol 2022; 13:883927. [PMID: 35720107 PMCID: PMC9201031 DOI: 10.3389/fneur.2022.883927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background Systemic, low-grade immune–inflammatory activity, together with social and neurocognitive performance deficits are a transdiagnostic trait of people suffering from type 2 diabetes mellitus (T2DM) and severe mental illnesses (SMIs), such as schizophrenia (SZ), major depressive disorder (MDD), and bipolar disorder (BD). We aimed to determine if immune–inflammatory mediators were significantly altered in people with SMIs or T2DM compared with healthy controls (HC) and whether these biomarkers could help predict their cognition and social functioning 1 year after assessment. Methods We performed a prospective, 1-year follow-up cohort study with 165 participants at baseline (TB), including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 HC; and 125 at 1-year follow-up (TY), and determined executive domain (ED), global social functioning score (GSFS), and peripheral blood immune–inflammatory and oxidative stress biomarkers. Results Participants with SMIs and T2DM showed increased peripheral levels of inflammatory markers, such as interleukin-10 (p < 0.01; η2p = 0.07) and tumor necrosis factor-α (p < 0.05; η2p = 0.08); and oxidative stress biomarkers, such as reactive oxygen species (ROS) (p < 0.05; η2p = 0.07) and mitochondrial ROS (p < 0.01; η2p = 0.08). The different combinations of the exposed biomarkers anticipated 46–57.3% of the total ED and 23.8–35.7% of GSFS for the participants with SMIs. Limitations Participants' treatment, as usual, was continued without no specific interventions; thus, it was difficult to anticipate substantial changes related to the psychopharmacological pattern. Conclusion People with SMIs show significantly increased levels of peripheral immune–inflammatory biomarkers, which may contribute to the neurocognitive and social deficits observed in SMIs, T2DM, and other diseases with systemic immune–inflammatory activation of chronic development. These parameters could help identify the subset of patients who could benefit from immune–inflammatory modulator strategies to ameliorate their functional outcomes.
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Affiliation(s)
- Marta Garés-Caballer
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Mental Health Unit of Catarroja, Valencia, Spain
| | - Gabriel Selva-Vera
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Joan Vila-Francés
- IDAL—Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Victor M. Victor
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Department of Physiology, University of Valencia, Valencia, Spain
| | - Irene Escribano-Lopez
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain
| | | | | | - Eduard Vieta
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Barcelona Bipolar and Depressive Disorders Unit, Institute of Neurosciences, Hospital Clínic of Barcelona, University of Barcelona, IDIBAPS, Catalonia, Spain
| | - Juan C. Leza
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
- INCLIVA—Health Research Institute, Valencia, Spain
- TMAP—Evaluation Unit of Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- *Correspondence: Rafael Tabarés-Seisdedos
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6
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Correa-Ghisays P, Sánchez-Ortí JV, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, Victor VM, Escribano-López I, Hernández-Mijares A, Vivas-Lalinde J, San-Martín C, Crespo-Facorro B, Tabarés-Seisdedos R. Transdiagnostic neurocognitive deficits in patients with type 2 diabetes mellitus, major depressive disorder, bipolar disorder, and schizophrenia: A 1-year follow-up study. J Affect Disord 2022; 300:99-108. [PMID: 34965401 DOI: 10.1016/j.jad.2021.12.074] [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: 05/24/2021] [Revised: 11/05/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Neurocognition impairments are critical factors in patients with major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ), and also in those with somatic diseases such as type 2 diabetes mellitus (T2DM). Intriguingly, these severe mental illnesses are associated with an increased co-occurrence of diabetes (direct comorbidity). This study sought to investigate the neurocognition and social functioning across T2DM, MDD, BD, and SZ using a transdiagnostic and longitudinal approach. METHODS A total of 165 participants, including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 healthy controls (HC), were assessed twice at a 1-year interval using a comprehensive, integrated test battery on neuropsychological and social functioning. RESULTS Common neurocognitive impairments in somatic and psychiatric disorders were identified, including deficits in short-term memory and cognitive reserve (p < 0.01, η²p=0.08-0.31). Social functioning impairments were observed in almost all the disorders (p < 0.0001; η²p=0.29-0.49). Transdiagnostic deficits remained stable across the 1-year follow-up (p < 0.001; η²p=0.13-0.43) and could accurately differentiate individuals with somatic and psychiatric disorders (χ² = 48.0, p < 0.0001). LIMITATIONS The initial sample size was small, and high experimental mortality was observed after follow-up for one year. CONCLUSIONS This longitudinal study provides evidence of some possible overlap in neurocognition deficits across somatic and psychiatric diagnostic categories, such as T2DM, MDD, BD, and SZ, which have high comorbidity. This overlap may be a result of shared genetic and environmental etiological factors. The findings open promising avenues for research on transdiagnostic phenotypes of neurocognition in these disorders, in addition to their biological bases.
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Affiliation(s)
- Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Faculty of Psychology, University of Valencia, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain
| | - Joan Vicent Sánchez-Ortí
- TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Faculty of Psychology, University of Valencia, Valencia 46010, Spain
| | - Vicent Balanzá-Martínez
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain; Unitat de Salut Mental de Catarroja, Valencia 46470, Spain
| | - Gabriel Selva-Vera
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia 46100, Spain
| | | | - Victor M Victor
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain; Department of Physiology, University of Valencia, Valencia 46010, Spain
| | - Irene Escribano-López
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain
| | - Antonio Hernández-Mijares
- Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia 46017, Spain; Department of Medicine, University of Valencia, Valencia 46010, Spain
| | | | - Constanza San-Martín
- TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; Departament of Physioterapy, University of Valencia, Valencia 46010, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; Hospital Universitario Virgen del Roció-IBIS- University of Sevilla, Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid 28029, Spain; TMAP - Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia 46010, Spain; INCLIVA - Health Research Institute, Valencia 46010, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Blasco-Ibáñez 17, Valencia 46010, Spain.
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7
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Aliño-Dies M, Sánchez-Ortí JV, Correa-Ghisays P, Balanzá-Martínez V, Vila-Francés J, Selva-Vera G, Correa-Estrada P, Forés-Martos J, San-Martín Valenzuela C, Monfort-Pañego M, Ayesa-Arriola R, Ruiz-Veguilla M, Crespo-Facorro B, Tabarés-Seisdedos R. Grip Strength, Neurocognition, and Social Functioning in People WithType-2 Diabetes Mellitus, Major Depressive Disorder, Bipolar Disorder, and Schizophrenia. Front Psychol 2020; 11:525231. [PMID: 33324271 PMCID: PMC7723830 DOI: 10.3389/fpsyg.2020.525231] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength (GS) is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses (SMIs). Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. METHODS Assessments of social functioning, cognitive performance, and GS (measured with an electronic dynamometer) were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates (p < 0.01). To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed (p < 0.05). RESULTS Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. CONCLUSION GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning.
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Affiliation(s)
- María Aliño-Dies
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- Faculty of Psychology, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
| | - Patricia Correa-Ghisays
- Faculty of Psychology, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- INCLIVA Health Research Institute, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joan Vila-Francés
- IDAL – Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- INCLIVA Health Research Institute, Valencia, Spain
| | | | - Jaume Forés-Martos
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- INCLIVA Health Research Institute, Valencia, Spain
| | - Constanza San-Martín Valenzuela
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Manuel Monfort-Pañego
- Department of Physical Education Teacher Training, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Miguel Ruiz-Veguilla
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Hospital Universitario Virgen del Roció-IBIS, University of Sevilla, Seville, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Hospital Universitario Virgen del Roció-IBIS, University of Sevilla, Seville, Spain
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- TMAP – Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, University of Valencia, Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- INCLIVA Health Research Institute, Valencia, Spain
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8
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San Martín-Valenzuela C, Borras-Barrachina A, Gallego JJ, Urios A, Mestre-Salvador V, Correa-Ghisays P, Ballester MP, Escudero-García D, Tosca J, Montón C, Ríos MP, Kosenko E, Felipo V, Tabares-Seisdedos R, Selva-Vera G, Montoliu C. Motor and Cognitive Performance in Patients with Liver Cirrhosis with Minimal Hepatic Encephalopathy. J Clin Med 2020; 9:E2154. [PMID: 32650464 PMCID: PMC7408738 DOI: 10.3390/jcm9072154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/28/2022] Open
Abstract
Minimal hepatic encephalopathy (MHE) is associated with mild cognitive impairment and frailty. This study aims to identify cognitive and motor differences in cirrhotic patients with and without MHE, and the correlations between motor signs and cognitive performance. Gait, balance, hand strength and motor speed performance were evaluated in 66 cirrhotic patients (38 without and 28 with MHE, according to the Psychometric Hepatic Encephalopathy Score (PHES). Cognitive performance was measured with the Mini-Mental State Examination, Verbal Fluency Test, Aprendizaje Verbal España-Complutense Test (TAVEC), Wechsler Adult Intelligence Scale III, Hamilton Depression and Anxiety Rating Scale and Functioning Assessment Short Test (FAST). MHE patients performed worse than patients without MHE in cognitive and autonomous functioning, learning and long-term memory, and verbal fluency. The same pattern was found in gait, center of pressure movement, variability of hand strength performance and hand motor speed. In MHE patients, high correlations were found between balance and FAST test, gait velocity and verbal skills, hand strength variability and anxiety and depression, and motor speed and FAST and TAVEC. MHE patients showed worse motor and cognitive performance than patients without MHE. MHE patients could have impaired movement control expressed as bradykinesia, and this reduced motor performance could correlate with cognitive performance.
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Affiliation(s)
- Constanza San Martín-Valenzuela
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.M.-V.); (A.B.-B.); (V.M.-S.); (R.T.-S.)
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain;
| | - Aroa Borras-Barrachina
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.M.-V.); (A.B.-B.); (V.M.-S.); (R.T.-S.)
| | - Juan-José Gallego
- INCLIVA, Health Research Institute, 46010 Valencia, Spain; (J.-J.G.); (A.U.); (M.-P.B.)
| | - Amparo Urios
- INCLIVA, Health Research Institute, 46010 Valencia, Spain; (J.-J.G.); (A.U.); (M.-P.B.)
| | - Víctor Mestre-Salvador
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.M.-V.); (A.B.-B.); (V.M.-S.); (R.T.-S.)
| | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain;
- Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - María-Pilar Ballester
- INCLIVA, Health Research Institute, 46010 Valencia, Spain; (J.-J.G.); (A.U.); (M.-P.B.)
- Digestive Medicine Unit, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (D.E.-G.); (J.T.); (C.M.)
| | - Desamparados Escudero-García
- Digestive Medicine Unit, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (D.E.-G.); (J.T.); (C.M.)
- Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Joan Tosca
- Digestive Medicine Unit, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (D.E.-G.); (J.T.); (C.M.)
| | - Cristina Montón
- Digestive Medicine Unit, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain; (D.E.-G.); (J.T.); (C.M.)
| | - María-Pilar Ríos
- Digestive Service, Arnau de Vilanova Hospital, 46015 Valencia, Spain;
| | - Elena Kosenko
- Institute of Theoretical and Experimental Biophysics of Russian Academy of Sciences, 142290 Pushchino, Russia;
| | - Vicente Felipo
- Laboratory of Neurobiology, Príncipe Felipe Research Center, 46012 Valencia, Spain;
| | - Rafael Tabares-Seisdedos
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.M.-V.); (A.B.-B.); (V.M.-S.); (R.T.-S.)
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain;
- Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Gabriel Selva-Vera
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.M.-V.); (A.B.-B.); (V.M.-S.); (R.T.-S.)
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain;
- Unit of Psychiatry and Psychological Medicine, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Carmina Montoliu
- INCLIVA, Health Research Institute, 46010 Valencia, Spain; (J.-J.G.); (A.U.); (M.-P.B.)
- Department of Pathology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
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9
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Correa-Ghisays P, Sánchez-Ortí JV, Ayesa-Arriola R, Setién-Suero E, Balanzá-Martínez V, Selva-Vera G, Ruiz-Ruiz JC, Vila-Francés J, Martinez-Aran A, Vivas-Lalinde J, Conforte-Molina C, San-Martín C, Martínez-Pérez C, Fuentes-Durá I, Crespo-Facorro B, Tabarés-Seisdedos R. Visual memory dysfunction as a neurocognitive endophenotype in bipolar disorder patients and their unaffected relatives. Evidence from a 5-year follow-up Valencia study. J Affect Disord 2019; 257:31-37. [PMID: 31299402 DOI: 10.1016/j.jad.2019.06.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 04/15/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Scarce research has focused on Visual Memory (VM) deficits as a possible neurocognitive endophenotype of bipolar disorder (BD). The main aim of this longitudinal, family study with healthy controls was to explore whether VM dysfunction represents a neurocognitive endophenotype of BD. METHODS Assessment of VM by Rey-Osterrieth Complex Figure Test (ROCF) was carried out on a sample of 317 subjects, including 140 patients with BD, 60 unaffected first-degree relatives (BD-Rel), and 117 genetically-unrelated healthy controls (HC), on three occasions over a 5-year period (T1, T2, and T3). BD-Rel group scores were analyzed only at T1 and T2. RESULTS Performance of BD patients was significantly worse than the HC group (p < 0.01). Performance of BD-Rel was also significantly different from HC scores at T1 (p < 0.01) and T2 (p = 0.05), and showed an intermediate profile between the BD and HC groups. Only among BD patients, there were significant differences according to sex, with females performing worse than males (p = 0.03). Regarding other variables, education represented significant differences only in average scores of BD-Rel group (p = 0.01). LIMITATIONS Important attrition in BD-Rel group over time was detected, which precluded analysis at T3. CONCLUSIONS BD patients show significant deficits in VM that remain stable over time, even after controlling sociodemographic and clinical variables. Unaffected relatives also show stable deficits in VM. Accordingly, the deficit in VM could be considered a potential endophenotype of BD, which in turn may be useful as a predictor of the evolution of the disease. Further studies are needed to confirm these findings.
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Affiliation(s)
- Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Faculty of Psychology, University of Valencia, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; University Hospital Marqués de Valdecilla. Department of Psychiatry, IDIVAL, Santander, Spain; Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain
| | - Esther Setién-Suero
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; University Hospital Marqués de Valdecilla. Department of Psychiatry, IDIVAL, Santander, Spain; Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain
| | - Vicent Balanzá-Martínez
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | | | | | - Constanza San-Martín
- TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Departament of Physioterapiy, University of Valencia, Valencia, Spain
| | | | | | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
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10
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Setién-Suero E, Martínez-García O, de la Foz VOG, Vázquez-Bourgon J, Correa-Ghisays P, Ferro A, Crespo-Facorro B, Ayesa-Arriola R. Age of onset of Cannabis use and cognitive function in first-episode non-affective psychosis patients: Outcome at three-year follow-up. Schizophr Res 2018; 201:159-166. [PMID: 29861266 DOI: 10.1016/j.schres.2018.05.036] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/04/2018] [Accepted: 05/26/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND In recent years, the effects of cannabis use on cognitive functions in patients with psychosis have been widely studied. Recently, special emphasis has been placed on the impact of age at the onset of consumption on cognition in these patients. METHOD 349 patients with a first episode of non-affective psychosis were studied. Patients were classified as cannabis users and non-users. Users were divided, according to their age when they began using cannabis, into: early-onset (age < 16) and late-onset (age ≥ 16) users. Differences between groups at baseline were studied based on sociodemographic, clinical, and cognitive variables. The groups were longitudinally (3-year) compared on cognitive variables. RESULTS Out of the 349 patients included in this study, 38.7% (N = 135) were cannabis users. Of them, 39.3% (N = 53) were early-onset and 60.7% (N = 82) were late-onset cannabis users. No baseline differences were found between the early-onset and late-onset groups on cognitive domains. Longitudinally, only patients who had withdrawn from cannabis use during follow-up showed a significant improvement in verbal memory. CONCLUSION Our results did not show differences between the early-onset group and the other two groups in long-term cognitive performance, even if they kept consuming cannabis during the first three years of disease progression. Further studies are needed to elucidate the true relationship between early-onset cannabis use and cognitive function in patients with a first episode of psychosis.
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Affiliation(s)
- Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - Obdulia Martínez-García
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Víctor Ortiz-García de la Foz
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Javier Vázquez-Bourgon
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Patricia Correa-Ghisays
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Adele Ferro
- Department of Pathophysiology and Transplantation, Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
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11
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Tatay-Manteiga A, Correa-Ghisays P, Cauli O, Kapczinski FP, Tabarés-Seisdedos R, Balanzá-Martínez V. Staging, Neurocognition and Social Functioning in Bipolar Disorder. Front Psychiatry 2018; 9:709. [PMID: 30618879 PMCID: PMC6305735 DOI: 10.3389/fpsyt.2018.00709] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction: Bipolar disorder (BD) is associated with significant neurocognitive and functional impairment, which may progress across stages. The 'latent stage' of BD remains understudied. This cross-sectional study assessed staging, neurocognition and social functioning among BD patients and their healthy siblings. Methods: Four groups were included: euthymic type I BD patients in the early (n = 25) and late (n = 23) stages, their healthy siblings (latent stage; n = 23) and healthy controls (n = 21). All 92 subjects underwent a comprehensive neuropsychological battery of processing speed, verbal learning/memory, visual memory, working memory, verbal fluency, executive cognition, and motor speed. Social functioning was assessed using the FAST scale. Results: Siblings' social functioning was identical to that of controls, and significantly better than both early- (p < 0.005) and late- (p < 0.001) stage patients. Although all patients were strictly euthymic, those at late stages had a significantly worse social functioning than early-stage patients (p < 0.001). Compared to controls, increasingly greater neurocognitive dysfunction was observed across stages of BD (F = 1.59; p = 0.005). Healthy siblings' performance lied between those of controls and patients, with deficits in tasks of processing speed, executive attention, verbal memory/learning, and visual memory. Both early- and late-stage patients had a more severe and widespread dysfunction than siblings, with no significant differences between them. Conclusions: Genetic vulnerability to BD-I seems to be associated with neurocognitive impairments, whereas social dysfunction would be the result of the clinical phenotype. Staging models of BD should take into account these divergent findings in the latent stage.
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Affiliation(s)
- Amparo Tatay-Manteiga
- Department of Psychiatry, General University Hospital Consortium of Valencia, Valencia, Spain
| | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia, Spain
| | - Flavio P Kapczinski
- McMaster's Department of Psychiatry and Behavioral Neurosciences, Hamilton, ON, Canada.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Tabarés-Seisdedos
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,Catarroja Mental Health Unit, Valencia, Spain
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