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Verdolini N, Amoretti S, Montejo L, García-Rizo C, Hogg B, Mezquida G, Rabelo-da-Ponte FD, Vallespir C, Radua J, Martinez-Aran A, Pacchiarotti I, Rosa AR, Bernardo M, Vieta E, Torrent C, Solé B. Corrigendum to "Resilience and mental health during the COVID-19 pandemic" [J. Affect. Disord. 2021 Mar 15;283:156-164]. J Affect Disord 2023; 333:572. [PMID: 37147247 PMCID: PMC10155861 DOI: 10.1016/j.jad.2023.04.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- N Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - S Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - L Montejo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - C García-Rizo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Spain
| | - B Hogg
- Centre Fórum Research Unit, Parc de Salut Mar, 410, Llull St., 08019 Barcelona, Catalonia, Spain; Hospital del Mar Medical Research Institute (IMIM), 88, Dr. Aiguader St., 08003 Barcelona, Catalonia, Spain; Predoctoral Program, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), UAB Campus, Plaça Cívica, 08193, Bellaterra, Barcelona, Spain
| | - G Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Spain
| | - F D Rabelo-da-Ponte
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), 2350, Ramiro Barcelos St., 211, Protásio Alves Av., Santa Cecilia, Porto Alegre, RS 90035-903, Brazil; Department of Pharmacology, Health Science Basic Institute, Postgraduate Program in Psychiatry and Behavioral Sciences and Postgraduate Program of Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), 110, Paulo Gama Av., Farroupilha, Porto Alegre, RS 90040-060, Brazil
| | - C Vallespir
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - J Radua
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - A Martinez-Aran
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - I Pacchiarotti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
| | - A R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), 2350, Ramiro Barcelos St., 211, Protásio Alves Av., Santa Cecilia, Porto Alegre, RS 90035-903, Brazil; Department of Pharmacology, Health Science Basic Institute, Postgraduate Program in Psychiatry and Behavioral Sciences and Postgraduate Program of Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), 110, Paulo Gama Av., Farroupilha, Porto Alegre, RS 90040-060, Brazil
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Spain
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain.
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain.
| | - B Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170, Villarroel St., 08037 Barcelona, Catalonia, Spain
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Solé B, Verdolini N, Amoretti S, Montejo L, Rosa AR, Hogg B, Garcia-Rizo C, Mezquida G, Bernardo M, Martinez-Aran A, Vieta E, Torrent C. Corrigendum to "Effects of the COVID-19 pandemic and lockdown in Spain: Comparison between community controls and patients with a psychiatric disorder. Preliminary results from the BRIS-MHC STUDY" [J. Affect Disord. 2021 Feb 15; 281:13-23]. J Affect Disord 2023; 333:571. [PMID: 37120393 PMCID: PMC10140190 DOI: 10.1016/j.jad.2023.04.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- B Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - N Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - S Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - L Montejo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - A R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Pharmacology, Postgraduate Program in Psychiatry and Behavioral Sciences and Postgraduate Program of Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - B Hogg
- Centre Fórum Research Unit, Parc de Salut Mar, Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Predoctoral program, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Spain
| | - C Garcia-Rizo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - G Mezquida
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - M Bernardo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - A Martinez-Aran
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain.
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), CIBERSAM, Neuroscience Institute, University of Barcelona, Spain
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Bioque M, Catarina Matias-Martins A, Llorca-Bofí V, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Moreno C, Roldán A, Martinez-Aran A, Baeza I, Bergé D, García-Rizo C, Mas Herrero S, Bernardo M. Neutrophil to Lymphocyte Ratio in Patients With a First Episode of Psychosis: A Two-Year Longitudinal Follow-up Study. Schizophr Bull 2022; 48:1327-1335. [PMID: 35876785 PMCID: PMC9673249 DOI: 10.1093/schbul/sbac089] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS A pro-inflammatory phenotype has been related to psychotic disorders. The neutrophil-lymphocyte ratio (NLR) is an accessible biomarker that could be helpful to characterize this systemic inflammation state. STUDY DESIGN This study evaluated the NLR in a cohort of 310 subjects with a first episode of psychosis (FEP) and a matched group of 215 healthy controls, recruited in 16 Spanish centers participating in the PEPs Project. We investigated the NLR measures over 2 years in a prospective, naturalistic study. STUDY RESULTS At baseline, the FEP group showed a significant higher mean NLR compared to the control group (1.96 ± 1.11 vs 1.72 ± 0.74, P = 0.03). These ratio differences between groups grew at the 24 months follow-up visit (2.04 ± 0.86 vs 1.65 ± 0.65, P < 0.001). Within the FEP group, there were no significant differences in NLR across the follow-up visits, between genders or diagnosis groups (affective vs nonaffective). NLR values did not correlate with the Positive and Negative Symptoms Scale scores. The group of patients who did not reach remission criteria at the end of the study showed a significant higher NLR than those who remitted (2.1896 ± 0.85 vs 1.95 ± 0.87, P = 0.042). A significant correlation between antipsychotic doses and NLR was found at the two-years follow-up visit (r=0.461, P < 0.001). CONCLUSIONS Our results highlight the existence of an underlying predisposition of FEP patients to present an increased mean NLR. The use of NLR in clinical practice could be helpful to identify this inflammatory imbalance.
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Affiliation(s)
- Miquel Bioque
- To whom correspondence should be addressed; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; tel: 34932275400 (X 4568), fax: 34932275548, e-mail:
| | | | - Vicent Llorca-Bofí
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona (Navarra), Spain,Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Eduard Vieta
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Sílvia Amoretti
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain,Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Bioaraba, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain,School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Psychiatry Department, Institut d’Investigació Biomèdica-Sant Pau, (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Anabel Martinez-Aran
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Immaculada Baeza
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniel Bergé
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Pompeu Fabra University (UPF), Barcelona, Spain
| | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Mas Herrero
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain
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Salagre E, Grande I, Jiménez E, Mezquida G, Cuesta MJ, Llorente C, Amoretti S, Lobo A, González-Pinto A, Carballo JJ, Corripio I, Verdolini N, Castro-Fornieles J, Legido T, Carvalho AF, Vieta E, Bernardo M. Trajectories of suicidal ideation after first-episode psychosis: a growth mixture modeling approach. Acta Psychiatr Scand 2021; 143:418-433. [PMID: 33501646 DOI: 10.1111/acps.13279] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/08/2021] [Accepted: 01/20/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The period immediately after the onset of first-episode psychosis (FEP) may present with high risk for suicidal ideation (SI) and attempts, although this risk may differ among patients. Thus, we aimed to identify trajectories of SI in a 2-years follow-up FEP cohort and to assess baseline predictors and clinical/functional evolution for each trajectory of SI. METHODS We included 334 FEP participants with data on SI. Growth mixture modeling was used to identify trajectories of SI. Putative sociodemographic, clinical, and cognitive predictors of the distinct trajectories were examined using multinomial logistic regression. RESULTS We identified three distinct trajectories: Non-SI trajectory (85.53% sample), Improving SI trajectory (9.58%), and Worsening SI trajectory (6.89%). Multinomial logistic regression model revealed that greater baseline pessimistic thoughts, anhedonia, and worse perceived family environment were associated with higher baseline SI followed by an Improving trajectory. Older age, longer duration of untreated psychosis, and reduced sleep predicted Worsening SI trajectory. Regarding clinical/functional evolution, individuals within the Improving SI trajectory displayed moderate depression at baseline which ameliorated during the study period, while the Worsening SI subgroup exhibited persistent mild depressive symptoms and greater functional impairment at follow-up assessments. CONCLUSION Our findings delineated three distinct trajectories of SI among participants with FEP, one experiencing no SI, another in which SI might depend on acute depressive symptomatology, and a last subset where SI might be associated with mild but persistent clinical and functional impairments. These data provide insights for the early identification and tailored treatment of suicide in this at-risk population.
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Affiliation(s)
- Estela Salagre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Iria Grande
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IdiSNa), Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IdiSNa), Pamplona, Spain
| | - Cloe Llorente
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Sílvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA Health Research Institute, University of the Basque Country, Vitoria, Spain
| | - Juan José Carballo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Teresa Legido
- Neuroscience Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, the Centre for Addiction and Mental Health, Toronto, ON, Canada.,The IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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González-Ortega I, Alberich-Mesa S, Echeburúa E, Bernardo M, Cabrera B, Amoretti S, Lobo A, Arango C, Corripio I, Vieta E, De La Serna E, Rodriguez-Jimenez R, Segarra R, López-Ilundain J, Sánchez-Torres A, Cuesta M, González-Pinto A. Social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis. Eur Psychiatry 2021. [PMCID: PMC9471624 DOI: 10.1192/j.eurpsy.2021.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Objectives The aim of the study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. Methods The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. Results At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively). Conclusions Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship. Disclosure This work was supported by the Carlos III Institute of Health and European Fund for Regional Development (PI08/1213, PI11/ 01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/ 00359, PI16/01164, PI18/00805), the Basque Foundation for He
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Arnaiz JA, Rodrigues-Silva C, Mezquida G, Amoretti S, Cuesta MJ, Fraguas D, Lobo A, González-Pinto A, Díaz-Caneja MC, Corripio I, Vieta E, Baeza I, Mané A, García-Rizo C, Bioque M, Saiz J, Bernardo M, Mas S. The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis. Psychopharmacology (Berl) 2021; 238:665-676. [PMID: 33230696 DOI: 10.1007/s00213-020-05715-5] [Citation(s) in RCA: 6] [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] [Received: 07/23/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The role of Olanzapine therapeutic drug monitoring is controversial. The present study explores the associations of Olanzapine plasma concentrations with clinical response and metabolic side effects in first episode psychosis (FEP) after 2 months of treatment. METHODS Forty-seven patients were included. Improvement in clinical symptomatology was assessed using the PANSS. Metabolic assessment included weight, blood pressure, waist circumference, blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. RESULTS The Olanzapine plasma concentrations after 2 months of treatment were positively correlated with weight gain (r = 0.49, p = 0.003), and a concentration > 23.28 ng/mL was identified as a positive predictor of weight gain (≥ 7%). The Olanzapine concentration to dose (C/D) ratio was positively correlated with the percentage of improvement in the total PANSS (r = 0.46, p = 0.004), and a C/D ratio > 2.12 was identified as a positive predictor of a good response (percentage of improvement > 30%) after 2 months of treatment. We also identified several factors that could alter Olanzapine pharmacokinetics: gender (p = 0.03), diagnosis (p = 0.05), smoking habit (p = 0.05), and co-medications such as valproic acid (p = 0.05) and anxiolytics (p = 0.01). DISCUSSION In conclusion, our results suggest that therapeutic drug monitoring of Olanzapine could be helpful to evaluate therapeutic efficacy and metabolic dysfunction in FEP patients treated with Olanzapine.
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Affiliation(s)
- J A Arnaiz
- Phase I Unit, Clinical Pharmacology Department, Hospital Clinic de Barcelona (HCB), Barcelona, Spain.,Department of Basic Clinical Practice, University of Barcelona (UB), Casanova 143, E-08036, Barcelona, Spain
| | - C Rodrigues-Silva
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - G Mezquida
- Department of Basic Clinical Practice, University of Barcelona (UB), Casanova 143, E-08036, Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, HCB, Barcelona, Catalunya, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - S Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, HCB, Barcelona, Catalunya, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - M J Cuesta
- Departmentof Psychiatry, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IdiSNa), Pamplona, Spain
| | - D Fraguas
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, IdISSC, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - A Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine and Psychiatry, Zaragoza University, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - A González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Bioaraba, Spain
| | - M C Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - I Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - I Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - A Mané
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Autonomous university of Barcelona (UAB), Barcelona, Spain
| | - C García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Medicine, Barcelona, UB, Spain
| | - M Bioque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Medicine, Barcelona, UB, Spain
| | - J Saiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - M Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Medicine, Barcelona, UB, Spain
| | - S Mas
- Department of Basic Clinical Practice, University of Barcelona (UB), Casanova 143, E-08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. .,Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.
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González-Ortega I, González-Pinto A, Alberich S, Echeburúa E, Bernardo M, Cabrera B, Amoretti S, Lobo A, Arango C, Corripio I, Vieta E, de la Serna E, Rodriguez-Jimenez R, Segarra R, López-Ilundain JM, Sánchez-Torres AM, Cuesta MJ, Zorrilla I, López P, Bioque M, Mezquida G, Barcones F, De-la-Cámara C, Parellada M, Espliego A, Alonso-Solís A, Grasa EM, Varo C, Montejo L, Castro-Fornieles J, Baeza I, Dompablo M, Torio I, Zabala A, Eguiluz JI, Moreno-Izco L, Sanjuan J, Guirado R, Cáceres I, Garnier P, Contreras F, Bobes J, Al-Halabí S, Usall J, Butjosa A, Sarró S, Landin-Romero R, Ibáñez A, Selva G. Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis. Psychol Med 2020; 50:2702-2710. [PMID: 31637990 DOI: 10.1017/s0033291719002794] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 01/15/2023]
Abstract
BACKGROUND Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
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Affiliation(s)
- I González-Ortega
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
- The National Distance Education University (UNED), Vitoria, Spain
| | - A González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - S Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
- The National Distance Education University (UNED), Vitoria, Spain
| | - E Echeburúa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Personality, Assessment and Psychological Treatment, University of the Basque Country, San Sebastián, Spain
| | - M Bernardo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - B Cabrera
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - S Amoretti
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Lobo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
| | - C Arango
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - I Corripio
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - E de la Serna
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - R Rodriguez-Jimenez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - R Segarra
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - J M López-Ilundain
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - A M Sánchez-Torres
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - M J Cuesta
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - I Zorrilla
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - P López
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - M Bioque
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - G Mezquida
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - F Barcones
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
- Department of Family Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - C De-la-Cámara
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
| | - M Parellada
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - A Espliego
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - A Alonso-Solís
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E M Grasa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - C Varo
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - L Montejo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Castro-Fornieles
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - I Baeza
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - M Dompablo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - I Torio
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - A Zabala
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - J I Eguiluz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - J Sanjuan
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- INCLIVA, University of Valencia, Hospital Clinico Universitario of Valencia, Spain
| | - R Guirado
- Neurobiology Unit, Department of Cell Biology, Interdisciplinary Research Structure for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Valencia, Spain
| | - I Cáceres
- Department of Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - P Garnier
- Department of Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - F Contreras
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Bobes
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, University of Oviedo, Oviedo, Spain
| | - S Al-Halabí
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, University of Oviedo, Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias, INEUROPA, Oviedo, Spain
| | - J Usall
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona (UB), Sant Boi de Llobregat, Barcelona, Spain
| | - A Butjosa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona (UB), Sant Boi de Llobregat, Barcelona, Spain
| | - S Sarró
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain
| | - R Landin-Romero
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain
| | - A Ibáñez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRyCIS), University of Alcalá, Madrid, Spain
| | - G Selva
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
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8
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Bioque M, Parellada E, García-Rizo C, Amoretti S, Fortea A, Oriolo G, Palau P, Boix-Quintana E, Safont G, Bernardo M. Clozapine and paliperidone palmitate antipsychotic combination in treatment-resistant schizophrenia and other psychotic disorders: A retrospective 6-month mirror-image study. Eur Psychiatry 2020; 63:e71. [PMID: 32669145 PMCID: PMC7443780 DOI: 10.1192/j.eurpsy.2020.72] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Around 30% of patients with schizophrenia are considered treatment resistant (TRS). Only around 40% of TRS patients respond to clozapine. Long acting injectable antipsychotics could be a useful augmentation strategy for nonresponders. Methods: We conducted a multicenter, observational, naturalistic, retrospective, 6-month mirror-image study to evaluate the efficacy and tolerability of clozapine and paliperidone palmitate association in 50 patients with TRS and other psychotic disorders. Clinical outcomes and side effects were systematically assessed. Results: Six months after starting the combined treatment, participants showed a significant relief of symptoms, decreasing the Brief Psychiatric Rating Scale total score from 18.32 ± 7.71 to 7.84 ± 5.16 (p < 0.001). The number of hospitalizations, the length of hospital stays and the number of visits to emergency services also decreased, while an increase of the functionality was observed (Personal and Social Performance total score increased from 46.06 ± 118.7 to 60.86 ± 18.68, p < 0.001). There was also a significant decrease in the number and severity of side effects with the combination therapy, decreasing the Udvalg for Kliniske Undersogelser total score from 10.76 ± 8.04 to 8.82 ± 6.63 (p = 0.004). Conclusions: This study provides the first evidence that combining clozapine with paliperidone palmitate in patients with TRS and other psychotic disorders could be effective and safe, suggesting further research with randomized controlled trials of augmentation strategies for clozapine nonresponder patients. Policy Significance Statement: Patients with psychotic disorders such as schizophrenia show a variable response to antipsychotic treatments. Around 30% of patients are considered treatment resistant, indicated by insufficient symptom control to at least two different drugs. In these resistant cases, clozapine should be indicated, as it has shown to be superior to other options. However, only 40% of patients respond to clozapine, being necessary to establish which treatments could best potentiate clozapine action. Combining clozapine with long acting injectable antipsychotics, and particularly paliperidone palmitate, could be a useful strategy. We conducted a multicenter study of 50 patients with treatment-resistant schizophrenia and other psychotic disorders comparing the efficacy and tolerability in the 6 month-period prior and after starting the clozapine and paliperidone palmitate association. Our study suggests that this combination could be effective and safer, laying the groundwork for future clinical trials with this combination.
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Affiliation(s)
- Miquel Bioque
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Eduard Parellada
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sílvia Amoretti
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Adriana Fortea
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Fundació Clinic per a la Recerca Biomèdica (FCRB), Barcelona, Spain
| | - Giovanni Oriolo
- Psychiatry Department, Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Day Hospital, Centre Psicoteràpia Barcelona (CPB), Barcelona, Spain
| | - Pol Palau
- Psychiatry Department, Hospital General de Granollers, Granollers, Spain
| | | | - Gemma Safont
- Psychiatry Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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9
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Amoretti S, Cabrera B, Torrent C, Mezquida G, Lobo A, González-Pinto A, Parellada M, Corripio I, Vieta E, de la Serna E, Butjosa A, Contreras F, Sarró S, Penadés R, Sánchez-Torres AM, Cuesta M, Bernardo M. Cognitive reserve as an outcome predictor: first-episode affective versus non-affective psychosis. Acta Psychiatr Scand 2018; 138:441-455. [PMID: 30105820 DOI: 10.1111/acps.12949] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [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] [Accepted: 07/25/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Cognitive reserve (CR) refers to the brain's capacity to cope with pathology in order to minimize the symptoms. CR is associated with different outcomes in severe mental illness. This study aimed to analyze the impact of CR according to the diagnosis of first-episode affective or non-affective psychosis (FEP). METHOD A total of 247 FEP patients (211 non-affective and 36 affective) and 205 healthy controls were enrolled. To assess CR, common proxies have been integrated (premorbid IQ; education-occupation; leisure activities). The groups were divided into high and low CR. RESULTS In non-affective patients, those with high CR were older, had higher socioeconomic status (SES), shorter duration of untreated psychosis, and a later age of onset. They also showed greater performance in most cognitive domains. In affective patients, those with a greater CR showed a higher SES, better functioning, and greater verbal memory performance. CONCLUSION CR plays a differential role in the outcome of psychoses according to the diagnosis. Specifically, in order to address the needs of non-affective patients with low CR, cognitive rehabilitation treatments will need to be 'enriched' by adding pro-cognitive pharmacological agents or using more sophisticated approaches. However, a functional remediation therapy may be of choice for those with an affective psychosis and low CR.
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Affiliation(s)
- S Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - B Cabrera
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - C Torrent
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - G Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - A Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Medicine and Psychiatry, Zaragoza University, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - A González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain.,University of the Basque Country (UPV-EHU), Vitoria, Spain
| | - M Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - I Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - E de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Butjosa
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - F Contreras
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Psychiatry Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Sarró
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - R Penadés
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - A M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Torrent C, Reinares M, Martinez-Arán A, Cabrera B, Amoretti S, Corripio I, Contreras F, Sarró S, González-Pinto A, Lobo A, Cuesta MJ, Sánchez-Torres A, Bergé D, Castro-Fornieles J, Moreno C, Bernardo M, Vieta E. Affective versus non-affective first episode psychoses: A longitudinal study. J Affect Disord 2018; 238:297-304. [PMID: 29902733 DOI: 10.1016/j.jad.2018.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to assess (1) whether there were clinical, neuropsychological and functional differences between and within affective and non-affective psychoses at baseline and two years-follow-up and (2) to explore clinical and neuropsychological predictors of psychosocial functioning in the whole sample. METHOD This is a subanalysis from a multicentre, naturalistic, longitudinal prospective study ('Phenotype-genotype and environmental interaction. Application of a predictive model in first psychotic episodes'). The sample consisted of 192 patients with a first psychotic episode (FEP): 142 with non-affective psychoses and 50 with affective psychoses. Student t-tests, paired t-tests, Pearson correlations, ANOVAs and regression analyses were performed. RESULTS At baseline, the groups differed in perseverative errors (WCST), Premorbid Adjustment Scale (PAS), family history of psychiatric disorder, negative (PANSS) and manic symptoms (YMRS). At two years follow-up, the groups differed in all the PANSS subscales and in depressive symptoms assessed by the MADRS. When the whole sample was considered, the regression model which best explained the estimated variance in functioning at follow-up (41%) was composed by PANSS total score and verbal fluency assessed by the FAS (COWAT). CONCLUSIONS We found clinical and neurocognitive differences at baseline which decreased in the follow-up. Reduced performances at baseline in executive functions in combination with symptom severity (PANSS) were predictors of FEP patients' poor functional outcome.
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Affiliation(s)
- C Torrent
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martinez-Arán
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Cabrera
- Barcelona Clínic Schizophrenia Unit, Hospital Clinic de Barcelona, CIBERSAM, Barcelona, Spain
| | - S Amoretti
- Barcelona Clínic Schizophrenia Unit, Hospital Clinic de Barcelona, CIBERSAM, Barcelona, Spain
| | - I Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Santa Creu and Sant Pau Hospital; Autonomous University of Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - F Contreras
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - S Sarró
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - A González-Pinto
- Department of Psychiatry, University Hospital of Alava-Santiago, Vitoria, Spain
| | - A Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza. Instituto de Investigación Aragón, CIBERSAM, Zaragoza, Spain
| | - M J Cuesta
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain, IdiSNA
| | - A Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain, IdiSNA
| | - D Bergé
- Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona and CIBERSAM, Barcelona, Spain
| | - J Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology. Institut Clínic of Neurosciences, IDIBAPS, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain
| | - C Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain
| | - M Bernardo
- Barcelona Clínic Schizophrenia Unit, Hospital Clinic de Barcelona, CIBERSAM, Barcelona, Spain
| | - E Vieta
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
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Amoretti S, Bernardo M, Bonnin CM, Bioque M, Cabrera B, Mezquida G, Solé B, Vieta E, Torrent C. The impact of cognitive reserve in the outcome of first-episode psychoses: 2-year follow-up study. Eur Neuropsychopharmacol 2016; 26:1638-48. [PMID: 27511320 DOI: 10.1016/j.euroneuro.2016.07.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [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: 02/29/2016] [Revised: 06/20/2016] [Accepted: 07/02/2016] [Indexed: 12/17/2022]
Abstract
The concept of cognitive reserve (CR) suggests that the premorbid intelligence quotient (IQ), years of education and leisure activities provide more efficient cognitive networks and therefore allow a better management of some conditions associated to cognitive impairment. Fifty-two DSM-IV diagnosed FEP subjects were matched with 41 healthy controls by age, gender and parental socio-economic status. All subjects were assessed clinically, neuropsychologically and functionally at baseline and after a two-year follow-up. To assess CR at baseline, three proxies have been integrated: premorbid IQ, years of education-occupation and leisure activities. Higher CR was associated with better cognitive, functional and clinical outcomes at baseline. The CR proxy was able to predict working memory, attention, executive functioning, verbal memory and global composite cognitive score accounting for 48.9%, 19.1%, 16.9%, 10.8% and 14.9% respectively of the variance at two-year follow-up. CR was also significantly predictive of PANSS negative scale score (12.5%), FAST global score (13.4%) and GAF (13%) at two-year follow-up. In addition, CR behaved as a mediator of working memory (B=4.123) and executive function (B=3.298) at baseline and of working memory (B=5.034) at 2-year follow-up. An additional analysis was performed, in order to test whether this mediation could be attributed mainly to the premorbid IQ. We obtained that this measure was not enough by itself to explain this mediation. CR may contribute to neuropsychological and functional outcome. Specific programs addressed to improve cognition and functioning conducted at the early stages of the illness may be helpful in order to prevent cognitive and functional decline.
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Affiliation(s)
- S Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain.
| | - C M Bonnin
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - B Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - G Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - B Solé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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