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Buesa J, Lizaran M, Almansa B, Ghosn F, Campos-Berga L, Hervás D, Andreu J, Sierra P, Livianos L, Vento M, Diago V, García-Blanco A. Understanding the course of attention deficit hyperactivity disorder in children born after a threatened preterm labor: a 6-year cohort study. Am J Obstet Gynecol MFM 2024; 6:101289. [PMID: 38280551 DOI: 10.1016/j.ajogmf.2024.101289] [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] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Recent research suggests that children born after suspected preterm labor may observe a potential cluster with different attention deficit hyperactivity disorder features, depending on the time of birth. However, the evolution of symptoms and their predictors remain unknown in this population. OBJECTIVE This study aimed to examine the trajectories of attention deficit hyperactivity disorder symptoms of children born after suspected preterm labor, between ages 2 and 6 years, considering prematurity condition and comparing with controls. In addition, this study aimed to find potential modifiable predictors of evolution to enhance prognosis. STUDY DESIGN In this prospective cohort study, 119 mother-child pairs who experienced suspected preterm labor and 60 controls were included. Patients were divided according to prematurity condition in full term (n=27), late preterm (n=55), and very preterm (n=37). Attention deficit hyperactivity disorder symptoms were assessed at ages 2 and 6 years. The association between potential modifying factors (group, time of assessment, sex, birthweight percentile, maternal history of trauma, maternal anxiety at diagnosis, and maternal anxiety during the children's assessments) and disorder trajectories was assessed by adjusting the Bayesian mixed linear models. All analyses were performed in R (version 4.3.0; R Foundation for Statistical Computing, Vienna, Austria). RESULTS An interaction emerged between time and group, with late-preterm neonates born after suspected preterm labor being the only group to improve from ages 2 to 6 years (-2.26 points in Conners scale per percentile decrease and 0.98 probability of effect). Another interaction between time and maternal anxiety at postnatal time assessments intensified over time (0.07 and 0.84). Predictors of symptom severity included lower weight percentile at birth (-0.2 and 0.96), male sex (-2.99 and <0.99), higher maternal anxiety at diagnosis (+0.08 and 0.99), and maternal history of trauma (+0.23 and 0.98). CONCLUSION Unlike very-preterm and full-term children, those born late preterm showed an improvement over time, probably because late-preterm children do not carry the sequelae derived from severe prematurity but benefit from close monitoring. As maternal psychopathology emerged as a determinant modifier of course and severity, it is crucial to develop targeted psychological interventions for pregnant individuals and reevaluate monitoring programs for their offspring, regardless of prematurity.
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Affiliation(s)
- Julia Buesa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Marta Lizaran
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Belén Almansa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Farah Ghosn
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Laura Campos-Berga
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - David Hervás
- Department of Applied Statistics, Operations Research, and Quality, Universitat Politècnica de Valencia, Valencia, Spain (Dr Hervás)
| | - Julia Andreu
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Pilar Sierra
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Lorenzo Livianos
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Máximo Vento
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Neonatology Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Vento)
| | - Vicente Diago
- Division of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Diago)
| | - Ana García-Blanco
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco).
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2
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Bertó C, Almansa-Tomás B, Ferrín M, Livianos L, Rojo L, Barberá M, García-Blanco A. Are Socially Relevant Scenes Abnormally Processed in Complex Trauma-Exposed Children? J Child Adolesc Trauma 2023; 16:1031-1040. [PMID: 38045849 PMCID: PMC10689592 DOI: 10.1007/s40653-023-00549-7] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 12/05/2023]
Abstract
Abnormal attentional processes to socially relevant information may underlie behavioral dysfunctional symptoms in children exposed to a complex trauma. Attentional biases to social scenes close to real-world situations and their association with behavioral symptomatology were examined in complex trauma-exposed children. A visual dot-probe task involving neutral versus emotional (i.e., threatening, sad, or happy) scenes was applied to twenty-one maltreated children (mean age 10.43; 42.8% female; 61.1% White). These children were exposed to a complex trauma (i.e., severe, repeated, multiple, prolonged, and interpersonal) and were safeguarded in a juvenile welfare home after all parental responsibility was removed. Twenty-four comparable non-maltreated children (mean age 10.13; 29.2% female; 76% White), served as control group. All participants were at risk of social exclusion and every legal representative completed the Child Behavior Checklist (CBCL). Complex trauma-exposed children showed an attentional bias toward threatening scenes, while the control group showed an attentional bias toward sad scenes. There were no differences for happy scenes between groups. Attentional bias toward threatening scenes was associated with withdrawn symptoms in complex trauma-exposed children. Children exposed to a complex trauma show an abnormal attention to threatening social situations, which can trigger maladaptive behaviors such as withdrawn. The understanding of how complex trauma-exposed children process affective environmental information may provide new targets in the social skills interventions such as diminishing maladaptive behaviors and improving coping strategies to face threatening situations.
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Affiliation(s)
- Clara Bertó
- Department of Psychiatry and Psychology, Hospital Francesc de Borja, Gandía, Spain
| | | | - Maite Ferrín
- University of Southampton, Southampton, UK
- ReCognition Health, London, UK
| | - Lorenzo Livianos
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Luis Rojo
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - María Barberá
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana García-Blanco
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain
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3
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Plumed J, Gago B, González-Valls PI, Sierra P, Livianos L, Zapata C, García-Blanco A. Differentiation of self and social functioning in severe mental disorders. Psychoanalytic Psychology 2022. [DOI: 10.1037/pap0000422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Cañada Y, García-Blanco A, García-Portilla MP, Fuente-Tomás LDL, Navalón P, Arranz B, Sánchez-Autet M, Hervás-Marín D, Livianos L, Sierra P. Affective temperaments and sexual functioning in euthymic patients with bipolar disorder. J Psychiatr Res 2022; 146:201-209. [PMID: 35007941 DOI: 10.1016/j.jpsychires.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/23/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022]
Abstract
Sexual functioning in bipolar disorder (BD) is dependent on multiple clinical and demographic determinants that can eventually lead to sexual dysfunction. However, the contribution of affective temperaments remains unstudied in this population. In this cross-sectional multicentric work, we studied the impact of temperament traits on sexual functioning in 100 euthymic BD outpatients treated only with mood stabilizers with or without benzodiazepines. Temperament was evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Autoquestionnaire (TEMPS-A) and sexual functioning with the Changes on Sexual Functioning Questionnaire (CSFQ-14). The effect of temperament on sexual functioning was analyzed using Bayesian ordinal regression models, which included age, gender, BD type, dominant polarity, metabolic syndrome, marital status, and affective symptomatology. Our results showed that hyperthymic traits predicted a significantly higher CSFQ-14 score for global sexual functioning (OR = 1.222; 95% CI [1.073, 1.431]), desire (OR = 1.164; 95% CI [1.025, 1.357]), arousal (OR = 1.278; 95% CI: [1.083, 1.551]), and orgasm (OR = 1.182; 95% CI [1.037, 1.365]). We did not find a significant contribution for other types of temperaments. Better sexual functioning was also associated with a better quality of life. Our findings highlight the importance of temperament traits in sexual functioning in euthymic BD, which may have implications in sexual dysfunction prevention.
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Affiliation(s)
- Yolanda Cañada
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Mental Health Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Ana García-Blanco
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain; Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain.
| | - M Paz García-Portilla
- Center of Biomedical Investigation Network in Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Lorena de la Fuente-Tomás
- Center of Biomedical Investigation Network in Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Pablo Navalón
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Belén Arranz
- Center of Biomedical Investigation Network in Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | | | - David Hervás-Marín
- Department of Biostatistics, Health Research Institute La Fe, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBERESP, Group 17, Valencia, Spain
| | - Pilar Sierra
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
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Sierra P, González MF, Buesa J, Zalve G, Cardozo JC, Matamoros JM, García-Blanco A, Livianos L. A Possible Trait and Status Marker in Bipolar Disorder: The Electroretinogram-Pattern. Actas Esp Psiquiatr 2022; 50:42-50. [PMID: 35103296 PMCID: PMC10803831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 06/14/2023]
Abstract
The similarity between retinal cells and neurons of the central nervous system allows non-invasive methods to study retinal function, such as the Electroretinogram-Pattern (PERG) to be postulated as possible biomarkers, useful and safe in the study of psychiatric pathologies such as Bipolar Disorder (BD). The objective of the present study is to characterize the differences in the results in the PERG of patients with BD and healthy subjects, as well as to evaluate a possible correlation between these results and the affective decompensations of the manic pole in the group of bipolar patients.
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Affiliation(s)
- Pilar Sierra
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain
- Department of Medicine, University of Valencia de Valencia, Valencia, Spain
| | | | - Julia Buesa
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Gloria Zalve
- Department of Neurophysiology, Peset Hospital, Valencia, Spain
| | | | - José Manuel Matamoros
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain
- Department of Medicine, University of Valencia de Valencia, Valencia, Spain
- CIBERESP-17, Valencia, Spain
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6
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Cañada Y, Sabater A, Sierra P, Balanzá-Martínez V, Berk M, Dodd S, Navalón P, Livianos L, García-Blanco A. The effect of concomitant benzodiazepine use on neurocognition in stable, long-term patients with bipolar disorder. Aust N Z J Psychiatry 2021; 55:1005-1016. [PMID: 33153268 DOI: 10.1177/0004867420969819] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Neurocognitive dysfunction is a common feature of bipolar disorder even in euthymia, and psychopharmacological treatment could have an effect on cognition. Long-term prescription of benzodiazepines in bipolar disorder is a common practice, and their effect on neurocognition has not been well studied in this population. The aim of this study was to evaluate the impact of concomitant benzodiazepine long-term use on neurocognitive function in stable euthymic bipolar disorder patients. METHODS Seventy-three euthymic bipolar disorder outpatients and 40 healthy individuals were assessed using a neurocognitive battery. Patients were classified in two groups according to the presence of benzodiazepines in their treatment: the benzodiazepine group (n = 34) and the non- benzodiazepine group (n = 39). Neurocognitive performance was compared between the groups using a multivariate analysis of covariance, considering age, number of depressive episodes, adjuvant antipsychotic drugs, Young Mania Rating Scale score and Hamilton Depression Rating Scale score as covariates. RESULTS Both bipolar disorder groups (benzodiazepine and non-benzodiazepine) showed an impairment in memory domains (Immediate Visual Memory [p = 0.013], Working Memory [p < 0.001], and Letter-Number Sequence [p < 0.001] from the Wechsler Memory Scale-Revised-III) and slower processing speed functions (Stroop Colour [p < 0.001]) relative to the control group. Nevertheless, the benzodiazepine group showed a greater impairment in executive functions (Conceptual Level Responses [p = 0.024] from the Wisconsin Card Sorting Test and Frontal Assessment Battery [p = 0.042]). CONCLUSION Although memory and processing speed impairments were found in bipolar disorder, regardless of their benzodiazepine treatment, benzodiazepine users presented additional neurocognitive impairments in terms of executive functioning. These findings support restricted prescription of benzodiazepines in individuals with bipolar disorder.
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Affiliation(s)
- Yolanda Cañada
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Ana Sabater
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pilar Sierra
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,Center of Biomedical Investigation Network in Mental Health (CIBERSAM), Madrid, Spain
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia.,Orygen - The National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Seetal Dodd
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia.,Orygen - The National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Pablo Navalón
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain.,CIBERESP-17, Valencia, Spain
| | - Ana García-Blanco
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.,Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain.,Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
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7
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García-Blanco A, García-Portilla MP, Fuente-Tomás LDL, Batalla M, Sánchez-Autet M, Arranz B, Safont G, Arqués S, Livianos L, Sierra P. Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients With Bipolar Disorder. J Sex Med 2020; 17:930-940. [PMID: 32139195 DOI: 10.1016/j.jsxm.2020.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 01/20/2020] [Accepted: 01/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND In addition to factors intrinsic to bipolar disorder (BD), sexual functioning (SF) can be affected by extrinsic causes, such as psychotropic drugs. However, the effect of mood stabilizers on SF and quality of life (QoL) is an underexplored research area. AIM To analyze SF in BD outpatients in euthymia for at least 6 months treated only with mood stabilizers and the association between SF and QoL. METHODS A multicenter cross-sectional study was conducted in 114 BD outpatients treated with (i) lithium alone (L group); (ii) anticonvulsants alone (valproate or lamotrigine; A group); (iii) lithium plus anticonvulsants (L+A group); or (iv) lithium plus benzodiazepines (L+B group). The Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14) was used. Statistical analyses were performed to compare CSFQ-14 scores among the pharmacological groups. An adaptive lasso was used to identify potential confounding variables, and linear regression models were used to study the association of the CSFQ-14 with QoL. MAIN OUTCOME MEASURES Self-reports on phases of the sexual response cycle (ie, desire, arousal, and orgasm) and QoL were assessed. RESULTS The A group had better total SF scores than the L group and the L+B group. Relative to the A group, the L and L+B groups had worse sexual desire; the L group had worse sexual arousal; and the L+A group and the L+B group had worse sexual orgasm. Regarding sociodemographic factors, being female and older age were associated with worse total SF and all subscale scores. Among all subscales scores, higher sexual arousal scores were associated with better QoL. CLINICAL IMPLICATIONS Potential modified extrinsic factors such as psychotropic medication that can affect SF can be addressed and adjusted to lessen side effects on SF. STRENGTHS & LIMITATIONS Sample of patients with euthymic BD in treatment with mood stabilizers and no antipsychotics or antidepressants, substance use as an exclusion criterion, and use of a validated, gender-specific scale to evaluate SF. Major limitations were cross-sectional design, sample size, and lack of information about stability of relationship with partner. CONCLUSIONS Lithium in monotherapy or in combination with benzodiazepines is related to worse total SF and worse sexual desire than anticonvulsants in monotherapy. While the addition of benzodiazepines or anticonvulsants to lithium negatively affects sexual orgasm, sexual arousal (which plays a significant role in QoL) improves when benzodiazepines are added to lithium. Anticonvulsants in monotherapy have the least negative effects on SF in patients with BD. García-Blanco A, García-Portilla MP, Fuente-Tomás L de la, et al. Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients With Bipolar Disorder. J Sex Med 2020;17:930-940.
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Affiliation(s)
| | - María P García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Lorena de la Fuente-Tomás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - María Batalla
- La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Belén Arranz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, University Hospital Mutua Terrassa, University of Barcelona, Barcelona, Spain
| | | | - Lorenzo Livianos
- La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBERESP-17, Valencia, Spain
| | - Pilar Sierra
- La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain.
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8
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Luperdi SC, Tabarés-Seisdedos R, Livianos L, Vieta E, Cuesta MJ, Balanzá-Martínez V. Neurocognitive endophenotypes in schizophrenia and bipolar disorder: A systematic review of longitudinal family studies. Schizophr Res 2019; 210:21-29. [PMID: 31272906 DOI: 10.1016/j.schres.2019.06.014] [Citation(s) in RCA: 20] [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: 09/27/2018] [Revised: 03/16/2019] [Accepted: 06/17/2019] [Indexed: 01/28/2023]
Abstract
Although there is substantial evidence supporting the existence of neurocognitive impairment in patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD), few studies have explored the field from an endophenotypic perspective. The present systematic review sought to identify longitudinal family studies exploring suitable neurocognitive endophenotypes in unaffected relatives of patients with SZ and/or BD. Following the PRISMA statement, only five follow-up studies met the inclusion criteria, comprising 79 SZ patients, 159 SZ unaffected relatives of SZ, 131 BD patients, 77 unaffected relatives of BD, and 248 controls. Verbal memory, auditory attention, face memory and emotion processing were found as putative endophenotypic candidates for SZ, whereas this strategy identified none for BD. Substantial heterogeneity and lack of standardization in global neurocognitive assessment within this area should be pointed out; nevertheless, several candidate endophenotypes were identified for SZ, except for executive impairment.
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Affiliation(s)
- Sussy C Luperdi
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; PhD Program in Medicine. University of Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Public Health (CIBERESP-Grupo 17), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Vicent Balanzá-Martínez
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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9
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Gago B, Perea M, Sierra P, Livianos L, Cañada-Martínez A, García-Blanco A. Do affective episodes modulate moral judgment in individuals with bipolar disorder? J Affect Disord 2019; 245:289-296. [PMID: 30419529 DOI: 10.1016/j.jad.2018.11.067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 10/04/2018] [Accepted: 11/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bipolar disorder (BD) patients experience altered emotional states and deficits in social adaptation that may also be involved in deontological moral judgments in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. METHODS In the present study we compared the utilitarian responses of BD patients in their different states (euthymia, mania, depression) and healthy controls to moral dilemmas with low (impersonal dilemma) and high (personal dilemma) emotional saliency. RESULTS Our findings revealed an increased tendency to utilitarian judgments in the three groups of BD patients in impersonal dilemmas relative to healthy individuals. In addition, utilitarian responses were increased during manic and depressive episodes in personal moral dilemmas relative to control group. Furthermore, we found no differences in social adaptation between utilitarian and deontological BD responders, though the depressive BD had a lower adaptation than the euthymic individuals. LIMITATIONS The recording of response times, the exhaustive control of medication effect, or the inclusion of a non-moral condition in the battery of moral dilemmas would provide a better characterization of moral judgment in BD. CONCLUSIONS For impersonal dilemmas, BD patients exhibited more utilitarian reasoning, which is also affected by emotional engagement for personal dilemmas during acute episodes of mania and depression. Social adaptation is not associated to utilitarian reasoning, but is rather influenced by mood state.
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Affiliation(s)
- Belén Gago
- University of Valencia, Valencia, Spain; "Institut Pere Mata" University Hospital, Reus, Spain
| | | | - Pilar Sierra
- University of Valencia, Valencia, Spain; "La Fe" University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Lorenzo Livianos
- University of Valencia, Valencia, Spain; "La Fe" University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | | | - Ana García-Blanco
- University of Valencia, Valencia, Spain; "La Fe" Health Research Institute, Valencia, Spain.
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Plumed J, Gimeno N, Barberá M, Ruiz E, Conesa L, Rojo-Bofill LM, Livianos L, Rojo L. Burlas como factor de riesgo para conductas alimentarias anómalas: estudio prospectivo en una población adolescente. Revista de Psiquiatría y Salud Mental 2019; 12:17-27. [DOI: 10.1016/j.rpsm.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/12/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
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García-Blanco A, González-Valls P, Iranzo-Tatay C, Rojo-Moreno L, Sierra P, Livianos L. Hypoesthesia in generalised anxiety disorder and major depression disorder. Int J Psychiatry Clin Pract 2018; 22:310-313. [PMID: 29320917 DOI: 10.1080/13651501.2017.1417441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: The determination of soft signs can be a conducive practice to understand the differential etiology between depression and anxiety. This study aims at examining malleolar hypoesthesia role in distinguishing between patients with generalised anxiety disorder (GAD) and major depression disorder (MDD). Methods: This study examines the presence of malleolar hypoesthesia in patients with GAD (n = 47) compared to patients with MDD (n = 48) and healthy individuals (controls; n = 99). The Wartenberg wheel, a medical device for neurological use, was employed to determine the presence of hypoesthesia on both sides of the ankles. Results: The data revealed: i) MDD patients showed higher hypoesthesia than GAD patients (p = .008), ii) participants with hypoesthesia had higher anxiety and depression scores than participants without hypoesthesia (all p < .001) and iii) logistic regression model indicated that hypoesthesia can be a predictor of MDD relative to GAD diagnosis (Odds Ratio: 17.43 (1.40-217.09; p = .026)). Conclusions: Malleolar hypoesthesia was higher in MDD than GAD. The detection of hypoesthesia may help to investigate the differential etiology between MDD and GAD diagnosis.
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Affiliation(s)
- Ana García-Blanco
- a Health Research Institute La Fe , Valencia , Spain.,b Department of Personality , University of Valencia , Valencia , Spain
| | | | | | - Luis Rojo-Moreno
- a Health Research Institute La Fe , Valencia , Spain.,c Department of Medicine , University of Valencia , Valencia , Spain.,d CIBERESP , Valencia , Spain
| | - Pilar Sierra
- a Health Research Institute La Fe , Valencia , Spain.,c Department of Medicine , University of Valencia , Valencia , Spain
| | - Lorenzo Livianos
- a Health Research Institute La Fe , Valencia , Spain.,c Department of Medicine , University of Valencia , Valencia , Spain.,d CIBERESP , Valencia , Spain
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12
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Bertó C, Ferrin M, Barberá M, Livianos L, Rojo L, García-Blanco A. Abnormal emotional processing in maltreated children diagnosed of Complex Posttraumatic Stress Disorder. Child Abuse Negl 2017; 73:42-50. [PMID: 28945995 DOI: 10.1016/j.chiabu.2017.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/10/2017] [Accepted: 09/13/2017] [Indexed: 06/07/2023]
Abstract
Maltreated children usually show a specific pattern of emotional and behavioral symptoms that exceed those relating to posttraumatic stress disorder (PTSD). These symptoms have been defined as Complex PTSD (CPTSD). The underlying attentional mechanisms of abnormal emotional processing and their relation to the clinical presentation of CPTSD are not well understood. A visual dot-probe paradigm involving pre-attentive (i.e., 500ms) and attentive (i.e., 1500ms) presentation rates of neutral versus emotional (i.e., angry, happy or sad) facial expressions was applied. Twenty-one maltreated CPTSD children were compared with twenty-six controls. The results are as follows: an attention bias away from threatening faces and an attentional bias towards sad faces were observed in maltreated CPTSD children during pre-attentive and attentive processing. Whereas the attentional bias away from angry faces was associated with social problems, the attentional bias towards sad faces was associated with depressive and withdrawn symptoms. Therefore, CPTSD children develop maladaptive negative cognitive styles, which may underlie not only social problems (by a cognitive avoidance of threatening stimuli) but also depressive symptoms (by a cognitive approach to sad stimuli). Attention processing abnormalities should be considered as therapeutic targets for new treatment approaches in this population.
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Affiliation(s)
- Clara Bertó
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Maite Ferrin
- University of Southampton, UK; Institute of Psychiatry, London, UK
| | - María Barberá
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Luis Rojo
- Department of Psychiatry and Clinical Psychology, University and Polytechnic Hospital La Fe, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Ana García-Blanco
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain; Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
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Merizalde M, Navalón P, González MF, Domínguez A, Livianos L, Martínez JC. Manic espisode, confusional syndrome and reversible splenial lesion after abrupt withdrawal of oxcarbazepine. J Affect Disord 2017; 210:122-124. [PMID: 28027511 DOI: 10.1016/j.jad.2016.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/04/2016] [Accepted: 12/17/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anticonvulsants are considered a second line option for bipolar disorder, it is known that the abrupt withdrawal is rarely related with demyelinated lesions of the splenium of the corpus callosum. Oxcarbazepine is used in bipolar disorder although it is not stated in the data sheet. CLINICAL CASE We presented a case of a 50 years old woman with bipolar disorder who is treated with lithium and oxcarbazepine, she presented a manic episode and a confusional syndrome after she stopped taking the medication. The magnetic resonance showed a restricted diffusion area at the splenium of the corpus callosum and bifrontal hygromas that disappear two weeks later. CONCLUSIONS The results of this study suggest that for a patient presenting with a mild encephalopathy and reversible splenial lesion, one should consider whether it is related to withdrawal of oxcarbazepine.
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Livianos L, García-Blanco AC, Civera M, González-Valls PI, Echevarría H, García-Moncho JM, Cardozo JC, Castell R, Jávega C, Matamoros JM, Rubio G, Rojo-Moreno L. Is Hypoesthesia of the Malleolus a Subtle Neurological Sign in Anxiety? J Neuropsychiatry Clin Neurosci 2016; 28:332-334. [PMID: 26792097 DOI: 10.1176/appi.neuropsych.15080202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined the presence of neurological soft signs, an accessible diagnostic instrument, in patients with anxiety. Individuals with anxiety were more likely to manifest hypoesthesia than healthy controls, and patients who showed hypoesthesia exhibited greater symptoms of anxiety and depression.
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Affiliation(s)
- Lorenzo Livianos
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Ana C García-Blanco
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Montserrat Civera
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Pablo I González-Valls
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Humberto Echevarría
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Juan Miguel García-Moncho
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Joana Catalina Cardozo
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Rocío Castell
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - César Jávega
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - José Manuel Matamoros
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Gemma Rubio
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
| | - Luis Rojo-Moreno
- From the Dept. of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain (LL, MC, PIG-V, HE, JMG-M, JCC, RC, CJ, JMM, GR, LR-M); the Dept. of Medicine, University of Valencia, Valencia, Spain (LL, ACG-B, LR-M); CIBERESP, Valencia, Spain (LL, LR-M); and the Neonatology Unit, La Fe Health Research Institute, Valencia, Spain (ACG-B)
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Sabater A, García-Blanco AC, Verdet HM, Sierra P, Ribes J, Villar I, Lara MJ, Arnal P, Rojo L, Livianos L. Comparative neurocognitive effects of lithium and anticonvulsants in long-term stable bipolar patients. J Affect Disord 2016; 190:34-40. [PMID: 26480209 DOI: 10.1016/j.jad.2015.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/20/2015] [Accepted: 10/02/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of choosing a mood-stabilizing drug (lithium or anticonvulsants) or a combination of them with minimal neurocognitive effects is to stimulate the development of criteria for a therapeutic adequacy, particularly in Bipolar Disorder (BD) patients who are clinically stabilized. METHOD Three groups of BD patients were established according to their treatment: (i) lithium monotherapy (n=29); (ii) lithium together with one or more anticonvulsants (n=28); and (iii) one or more anticonvulsants (n=16). A group of healthy controls served as the control (n=25). The following tests were applied: Wechsler Adult Intelligence Scale, Trail Making Test, Wechsler Memory Scale, Rey Complex Figure Test, Stroop color-word test, Wisconsin Card Sorting Test, Tower of Hanoi, Frontal Assessment Battery, and Reading the Mind in the Eyes Test. RESULTS Relative to healthy controls, BD patients showed the following: (i) those on lithium monotherapy, but not other BD groups, had preserved short-term auditory memory, long-term memory, and attention; (ii) those who took only anticonvulsants showed worse findings in short-term visual memory, working memory, and several executive functions; and (iii) all BD patients showed worse performance in processing speed, resistance to interference, and emotion recognition. LIMITATIONS Medication alone cannot explain why all BD patients showed common cognitive deficits despite different pharmacological treatment. CONCLUSION The impairment on some executive functions and emotion recognition is an inherent trait in BD patients, regardless of their pharmacological treatment. However, while memory, attention, and most of the executive functions are preserved in long-term stable BD patients, these cognitive functions are impaired in those who take anticonvulsants.
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Affiliation(s)
- Ana Sabater
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Ana C García-Blanco
- Health Research Institute La Fe, Valencia, Spain; University of Valencia, Spain.
| | - Hélade M Verdet
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pilar Sierra
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain
| | - Josep Ribes
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Irene Villar
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Mª José Lara
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pilar Arnal
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Luis Rojo
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain
| | - Lorenzo Livianos
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain
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Livianos L, González-Valls PI, García-Blanco AC, Tobella H, Díaz-Alonso I, Alberola N, García-Aznar S, Bellot R, Saiz V, Ros L. Hypoesthesia of the malleolus as a soft sign in depression. J Affect Disord 2015; 171:128-31. [PMID: 25305426 DOI: 10.1016/j.jad.2014.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 09/15/2014] [Accepted: 09/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical signs often are present in many psychiatric conditions, making up a fundamental part of them and accompanying the psychiatric manifestations themselves. Identifying minor neurological signs is especially of interest due to they are easily accessible through simple neurological examination and could be a useful if underused tool for the diagnostic process and patient therapy. METHOD A group of depressed patients (n=85) and group of healthy individuals (n=101) that served as control were examined using the Wartenberg wheel, a medical device for neurological use, in order to determine the presence of hypoesthesia on both sides of their ankles. RESULTS The data revealed: (i) patients with depression are generally more likely to present malleolar hypoesthesia than healthy participants; and (ii) participants who presented malleolar hypoesthesia presented greater depressive symptomatology as well as greater anxiety symptomatology at the time of assessment. LIMITATIONS Although all patients in this study were taking psychotropic medication, anxiolytics and antidepressants are not associated with skin sensitivity. As is usual, the categorization of hypoesthesia is based on participant subjectivity. However, this subjectivity cannot explain the differences between depressed patients and healthy individuals. CONCLUSIONS The present findings corroborate that localized tactile sensitivity is altered in depression and correlates with anxiety-depressive symptomatology, even on a subclinical level. The observation of neurological soft signs such as the detection of malleolar hypoesthesia in patients with depressive symptomatology is easily accessible using a simple neurological examination, and it could became a powerful tool that could provide objective information on affective disorders.
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Affiliation(s)
- Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain; University of Valencia, Department of Medicine, Valencia, Spain; CIBERESP, Spain
| | - Pablo I González-Valls
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Ana C García-Blanco
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain.
| | - Helena Tobella
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Ignacio Díaz-Alonso
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Núria Alberola
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Susana García-Aznar
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Ramón Bellot
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Vanessa Saiz
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
| | - Lourdes Ros
- Department of Psychiatry, La Fe University and Polytechnic Hospital, 46010 Valencia, Spain
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Sierra P, Cámara R, Tobella H, Livianos L. ¿Cuál es la relevancia real y el manejo de las principales alteraciones tiroideas en los pacientes bipolares? Revista de Psiquiatría y Salud Mental 2014; 7:88-95. [DOI: 10.1016/j.rpsm.2013.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/24/2013] [Accepted: 07/26/2013] [Indexed: 11/15/2022]
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Rojo-Moreno L, Rubio T, Plumed J, Barberá M, Serrano M, Gimeno N, Conesa L, Ruiz E, Rojo-Bofill L, Beato L, Livianos L. Teasing and disordered eating behaviors in Spanish adolescents. Eat Disord 2013; 21:53-69. [PMID: 23241090 DOI: 10.1080/10640266.2013.741988] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study is to investigate the associations between peer teasing and body dissatisfaction (BD), emotional symptoms, drive for thinness (DT), and abnormal eating behaviors, as well as to analyze the mediating role of gender and body mass index (BMI) in such disorders. We screened 57,997 school children between 13 and 16 years of age. Scores in weight-related teasing and competency-related teasing were higher among girls, as well as overweight or obese individuals. Weight-teasing correlated more strongly with abnormal eating attitudes and behaviors, whereas competency-teasing correlated with emotional symptoms. Multiple linear regression analysis showed that weight-teasing is significantly and independently associated with BD, especially in boys. Multivariate analysis revealed a significant association between weight-teasing and abnormal eating in girls, although its predictive value was very low (Exp(B) = 1.009). Mediation analysis and Path analysis showed the mediating role of DT in this association. Interventions on teasing do not seem to be a priority in eating disorder prevention programs.
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Affiliation(s)
- Luis Rojo-Moreno
- Department of Medicine, University of Valencia, Valencia, Spain.
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Iranzo C, Arques S, Arnau F, Rubio T, Pino A, Calvillo F, Livianos L. P-1088 - Simplifying oral treatment with long-acting risperidone. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75255-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Rojo-Moreno L, García-Miralles I, Plumed J, Barberá M, Morales MM, Ruiz E, Livianos L. Children's eating attitudes test: validation in a sample of Spanish schoolchildren. Int J Eat Disord 2011; 44:540-6. [PMID: 20957702 DOI: 10.1002/eat.20855] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2010] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To validate the Spanish version of the Children's Eating Attitudes Test (ChEAT). METHOD The factor structure and other psychometric characteristics of the questionnaire were examined using the answers of 38,554 schoolchildren. Diagnostic efficiency was based on a standardized clinical interview of 968 schoolchildren who had previously completed the questionnaire. RESULTS Five factors ("preoccupation with thinness," "dieting," "social pressure to eat," "purging," and "preoccupation with food and oral control") explained 46% of the variance. Cronbach's α was .858 for the total scale. The area under the receiver operating characteristic curve was .851. Sensitivity (SE) was 27% and specificity (SP) 96% for a cut-off of 20. A more appropriate cut-off was 15, where SE and SP were 62% and 90% respectively, and the positive and negative predictive values 27 and 98%. DISCUSSION The ChEAT psychometric characteristics are adequate. The questionnaire is valid. A cut-off point of 15 is recommended for adolescents.
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Rojo-Moreno L, Plumed JJ, Fons MB, Gonzalez-Piqueras JC, Rojo-Bofill L, Livianos L. Auditory hallucinations in anorexia nervosa. Eur Eat Disord Rev 2011; 19:494-500. [PMID: 21394834 DOI: 10.1002/erv.1084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The paper describes two case studies of patients with anorexia nervosa who suffer from auditory hallucinations as the only psychotic symptom. A review of the literature regarding clinical cases of anorexic patients with hallucinations is discussed. Hallucinations in anorexic patients are conceptualized according to different theoretical models which point to a dimensional view of eating disorders.
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Rojo L, Barberá M, Plumed J, Sangüesa MC, Livianos L. [Hospitalization due to eating behavior disorders. Patient and family satisfaction]. Actas Esp Psiquiatr 2009; 37:267-275. [PMID: 19960385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE In this paper, we assess the quality of an inpatient unit for eating disorders from the patients' and their parents perspective in order to clarify some clinical questions concerning inpatient treatment. METHOD A satisfaction questionnaire was designed with open and closed questions separately for the patients and their relatives. The first type of items (53 for patients and 15 for relatives) were analyzed by the standard statistical methods. The second type (one question per questionnaire) was studied with the help of qualitative techniques. It was sent to all discharged patients (n = 299). We obtained the data from the answers (n = 174) and then looked for correlations with factors as compulsory admission at the hospital, age of patients and duration of the disorder. RESULTS A high level of general satisfaction was obtained by patients and parents answering the closed questions. The open one, discriminates among shades of meaning. coercive factors, such as compulsory admission, did not affect the level of satisfaction in our study. While most patients were concerned about excessive supervision and lack of privacy, many parents considered control measures as scarce and asked for support upon discharge. CONCLUSION Along general lines, hospitalization has been satisfactory for both the patients and their family. Forced admission did not significantly intervene in the subsequent satisfaction of the patient.
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Affiliation(s)
- L Rojo
- Unidad de Trastornos Alimentarios, Servicio de Psiquiatría, Hospital Universitario La Fe Valencia.
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Sierra P, Livianos L, Rojo L. [The importance of loss in the genesis of depressive disorders]. Actas Esp Psiquiatr 2009; 37:128-136. [PMID: 19533424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The role of loss has been carefully examined in the investigation of depression since it constitutes a central aspect of most of the life events that lead to depression. METHODS In the present study, a review was made of the different studies on the role of loss, focusing on its different aspects and different types, the association between loss and some mental diseases, loss and prognosis, relationship between hopelessness and loss, variations of the events of loss based on different factors, also considering loss in the childhood. RESULTS Loss constitutes a central role in the appearance of many depressive disorders. It can act as a provoking agent, a vulnerability factor or an agent that can modify the form, severity and course of a depressive disorder. Different factors such as the genetic one, gender or moment of life when the loss takes place, can modulate the influence of loss events.
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Affiliation(s)
- P Sierra
- Unidad de Psiquiatría, Hospital Universitario La Fe Valencia.
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Garcia-Portilla MP, Saiz PA, Benabarre A, Sierra P, Perez J, Rodriguez A, Livianos L, Torres P, Bobes J. The prevalence of metabolic syndrome in patients with bipolar disorder. J Affect Disord 2008; 106:197-201. [PMID: 17631970 DOI: 10.1016/j.jad.2007.06.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 06/12/2007] [Accepted: 06/12/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous studies on the prevalence of metabolic syndrome (MetS) in patients with bipolar disorder have reported rates 11% and 79% higher than in their respective general populations. This study evaluates the prevalence of MetS in a group of 194 Spanish patients with bipolar disorder. METHODS Naturalistic, multicentre, cross-sectional study. Patients were evaluated for presence of MetS according to modified NCEP ATP III criteria. RESULTS Mean age was 46.6 (SD 13.9); 49.2% were male. Forty-six percent were in remission. Patients were receiving 2.9 (SD 1.3) drugs. Overall prevalence of MetS was 22.4%. Fifty-four percent met the criterion for abdominal obesity, 36.1% for hypertriglyceridemia, 38.2% for low HDL cholesterol, 20.9% for hypertension, and 12.2% for high fasting glucose. The multivariate analysis for MetS retained only the BMI variable in the model. LIMITATIONS Cross-sectional study design. CONCLUSIONS The prevalence of MetS in patients with bipolar disorder is 58% higher than that reported for the general Spanish population. MetS is associated with BMI. Clinicians should be aware of this issue and appropriately monitor patients with bipolar disorder for MetS as part of the standard of care for these patients.
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Abstract
In a cyclical and recurring illness such as bipolar disorder, prodrome detection is of vital importance. This paper describes manic and depressive prodromal symptoms to relapse, methods used in their detection, problems inherent in their assessment, and patients' coping strategies. A review of the literature on the issue was performed using MEDLINE and EMBASE databases (1965-May 2006). 'Bipolar disorder', 'prodromes', 'early symptoms', 'coping', 'manic' and 'depression' were entered as key words. A hand search was conducted simultaneously and the references of the articles found were used to locate additional articles. The most common depressive prodromes are mood changes, psychomotor symptoms and increased anxiety; the most frequent manic prodromes are sleep disturbances, psychotic symptoms and mood changes. The manic prodromes also last longer. Certain psychological interventions, both at the individual and psychoeducational group level, have proven effective, especially in preventing manic episodes. Bipolar patients are highly capable of detecting prodromal symptoms to relapse, although they do find the depressive ones harder to identify. Learning detection, coping strategies and idiosyncratic prodromes are elements that should be incorporated into daily clinical practice with bipolar patients.
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Affiliation(s)
- Pilar Sierra
- Psychiatric Unit, Hospital La Fe, Valencia 46009, Spain.
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Rojo L, Ruiz E, Domínguez JA, Calaf M, Livianos L. Comorbidity between obesity and attention deficit/hyperactivity disorder: population study with 13-15-year-olds. Int J Eat Disord 2006; 39:519-22. [PMID: 16609984 DOI: 10.1002/eat.20284] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study analyzes whether obese children have a higher risk of attention deficit/hyperactivity "characteristics" (AD/HD) than do children with other nutritional states. METHOD This study included 35,403 participants from 486 community schools. They completed the AD/HD scale of the Strengths and Difficulties Questionnaire (SDQ) and were weighed and measured. 2879 of the participants were obese and 78 were morbidly obese (BMI>40). RESULTS A discrete, nonsignificant, increment was found in the AD/HD characteristics of male participants with morbid obesity, as compared with the other nutritional states. Among morbidly obese females, the prevalence of AD/HD characteristics was slightly superior, although not significantly, to that found in participants with normal weight, overweight or obese (BMI<40). CONCLUSION Among nonclinical populations with a communitarian origin, previous findings reporting high rates of AD/HD in obese children are not replicated. This increment in the prevalence of AD/HD among hospitalized obese children could be the result of selection bias.
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Affiliation(s)
- Luis Rojo
- Department of Medicine, University of Valencia, Spain.
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Abstract
BACKGROUND We explore the role of stress in the onset of eating disorders (EDs) in a community sample of adolescents, the mediating role of psychiatric comorbidity and the quantitative evolution of stress in the year preceding the onset of an ED. METHODS The Life Events and Difficulties Schedule interview was applied to a sample with 32 cases and 32 controls selected from a two-phase epidemiologic study among a representative population of adolescents, followed by a decay model to assess acute and chronic stress in the year preceding the onset of ED. Psychiatric comorbidity was assessed using the SCAN interview. RESULTS Cases (46.9%) and 9.4% of controls were found to have associated psychiatric comorbidity (chi2 = 11.74, p = .001). Of cases, 6.3% and none of the controls had at least one severe stressful event (N.S). Of cases, 18.8% and 3.1% of controls had at least one major difficulty (Fisher exact test = 0.05). Of cases, 25% and 3.1% of controls had a provoking stressful agent (Fisher exact test = 0.026). Psychiatric comorbidity partially mediated the relationship between stress and EDs. The Structural Equation Modeling Analysis shows that chronic stress is strongly associated with the onset of EDs, both directly (r(2) = 0.38) and indirectly, through psychiatric comorbidity (r2 = 0.56). CONCLUSION Chronic stress and psychiatric comorbidity are strongly associated with the onset of EDs. Psychiatric comorbidity is a partial mediating factor in the association of stress with eating disorders.
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Affiliation(s)
- Luis Rojo
- Eating Disorders Unit, Department of Psychiatry, La Fe University Hospital, School of Medicine, University of Valencia, Spain.
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Abstract
OBJECTIVES The aim of this study was to assess the quality of life in bipolar disorder patients, and to analyze a set of clinical variables and sociodemographic data that could act as quality-of-life predictors. METHODS The study sample included 50 euthymic outpatients attending a specific bipolar patient unit. Patients were assessed with the Clinician-Administered Rating Scale for Mania, and the Hamilton Scale for Depression. To evaluate quality of life, all patients received the Spanish version of the SF-36 Health Survey. At the same time, sociodemographic and clinical data were obtained. The scores were compared with those of a control group representative of the general population. RESULTS The group of bipolar patients obtained statistically significantly lower scores on all the subscales when compared with the control population. No statistically significant differences appeared when comparing the SF-36 scores with the demographic variables. CONCLUSIONS Bipolar patients experience lower functioning and well-being even in the stable phase of the disorder. Due to the great impact of bipolar disorder on many areas, it would be of interest to know the clinical predictors related to patient quality of life, as this would contribute to the design of different clinical interventions.
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Affiliation(s)
- Pilar Sierra
- Psychiatric Unit, La Fe University Hospital, Valencia, Spain.
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Benavent P, Alvarez P, García-Valls JM, Livianos L, Rojo L. [Chinese Polarity Inventory: its adaptation to our setting]. Actas Esp Psiquiatr 2004; 32:363-70. [PMID: 15529226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION The Chinese Polarity Inventory (CPI) is a self-report scale for bipolar disorder assessment, composed of two scales (mania and depression), with 20 items for each one. OBJECTIVES Translate, adapt and validate the CPI to our context. MATERIAL AND METHODS The questionnaire was applied to 123 patients: bipolar disorder in the manic phase (32), depressed (17), remission (30) and mixed state (3). We also established a control group with 30 patients without affective disorder. Internal consistency was assessed using Cronbach's alpha. On the other hand, validity was established using the Clinician Administered Rating Scale for Mania (CARS-M) in manic patients and the Hamilton scale in the depressed ones as a gold standard. RESULTS This scale has good psychometrics qualities. Internal consistence index (Cronbach's alpha) for the manic scale was 0.90 and for depression scale was 0.92. The correlation coefficient between the manic scale and the CARS-M was 0.82 and between the depression scale and the Hamilton scale was 0.67. CONCLUSIONS The CPI is an instrument of rapid and easy application that permits self-report of bipolar disorders. The best benefit for this scale is the possibility of application in the entire course of illness, for clinical and investigation activities and assessment of the treatment response.
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Affiliation(s)
- P Benavent
- Servicio de Psiquiatría, Hospital Universitario La Fe, Valencia.
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Rojo L, Livianos L, Conesa L, García A, Domínguez A, Rodrigo G, Sanjuán L, Vila M. Epidemiology and risk factors of eating disorders: a two-stage epidemiologic study in a Spanish population aged 12-18 years. Int J Eat Disord 2003; 34:281-91. [PMID: 12949920 DOI: 10.1002/eat.10179] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The authors studied the prevalence rates of eating disorders (ED) and their risk factors in a Spanish population aged 12-18 years. METHOD A two-stage epidemiologic study was conducted in the province of Valencia. Educational centers, classrooms, and individuals were selected randomly. The initial sample comprised 544 subjects. During Stage 1, subjects were screened with the 40-item Eating Attitude Test and a sociodemographic questionnaire that evaluates risk factors. During Stage 2, a semistandardized clinical interview was conducted with each participant. A random control group was paired by class, age, and sex. Comorbid psychiatric disorders and partial and subclinical forms were detected using criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). RESULTS Using DSM-IV criteria, the morbidity rate was 2.91%, women comprised 5.17% of the sample, men comprised 0.77% of the sample, and the sex ratio was 6.71. Using DSM-IV criteria, including subclinical forms, the morbidity rate was 5.56%, women comprised 10.3% of the sample, men comprised 1.07% of the sample, and the sex ratio was 9.63. Six risk factors were isolated: psychiatric comorbidity, friend on a diet in the last year, desire to lose weight, desire to be less corpulent, sentimental problems, and diet in the last year. DISCUSSION This is the first Spanish two-stage epidemiologic study to include a control group and to investigate risk factors.
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Affiliation(s)
- Luis Rojo
- Department of Medicine, University of Valencia, Valencia, Spain.
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Solís-Pérez MP, Burguera JA, Palau F, Livianos L, Vila M, Rojo L. [Results of a program of presymptomatic diagnosis of Huntington's disease: evaluation of a 6 year period]. Neurologia 2001; 16:348-52. [PMID: 11738012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To know the uptake of predictive testing of Huntington's disease, the characteristics of the applicants, as well as the consequences for them. METHODS Prospective observational study between January of 1994 and December of 1999 of the predictive testing applicants who entered in the protocol consisted of: informative interview, psychiatric interview, blood extraction for molecular study, as well as outcome and follow-up interviews. RESULTS There were 87 applicants with a 50% risk. The mean age of the applicants was 28 years (SD = 7). Thirty one per cent already had children in the moment of predictive testing. The application rate according to the estimate population with 50% risk for the Comunidad Valenciana is 13,4%. The rate varies depending on the access to the information of the population in risk, being of 24,7% when they have direct access and of 8,3% when they do not have it (p < 0,01). Forty per cent did not come to the post-outcome visit, the positive or negative result for the mutation not influencing over it. Only 6,8% had some adverse event in the six years of follow-up all being slight. CONCLUSIONS The application rate is determined by the access to the information of the population in risk. The fulfilment of the protocol designed for presymptomatic diagnosis of Huntington's disease keeps the adverse events presentation to a minimum.
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Affiliation(s)
- M P Solís-Pérez
- Servicio de Neurología, Hospital Universitario La Fe, Valencia.
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Livianos L, Rojo L, Guillem JL, Villavicencio D, Pino A, Mora R, Vila ML, Domínguez A. [Adaptation of the clinician-administered rating scale for mania]. Actas Esp Psiquiatr 2000; 28:169-77. [PMID: 11000699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION There is no mania rating scale properly adapted in Spain, and it's a true problem in research. METHODS The adaptation process has been the following one: The authors start from CARS-M of Altman et al. First the carry out the translation and back translation which was revised by the author of the scale. Then they fullfill some previous training with video filming and lastly they apply the scale to a group of 24 patients. RESULTS The Clinician-Administered Rating Scale for Mania (CARS-M) shows good psychometric proprieties among those its internal consistency of the scale, the interobservers reliability, and the item-total correlation. These results are lightly worse in the psychoticism sub-scale. CONCLUSIONS This rating scale for mania show itself as a useful instrument in clinic and research.
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