Ignacio García Cabeza - Academia.edu (original) (raw)

Papers by Ignacio García Cabeza

Actas Espanolas De Psiquiatria, Sep 1, 2005

3,4-methylenedioxyamphetamine (MDMA) or "ecstasy" damages serotonin neurons in all animal species... more 3,4-methylenedioxyamphetamine (MDMA) or "ecstasy" damages serotonin neurons in all animal species and there is growing evidence that this finding also applies to humans. This fact, together with the increasing extended use in the young population, has important repercussions in the appearance of specific psychopathologic and cognitive disturbances associated to its use. The authors present two clinical cases, in which psychopathological and cognitive symptoms are detected in MDMA users that support this hypothesis. Problems in the diagnosis of psychiatric disorders associated to MDMA and its clinical and therapeutic implications are discussed.

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PubMed, Sep 23, 2000

Topiramate is a new antiepileptic drug which acts in the sodium channels, GABA and glutamatergic ... more Topiramate is a new antiepileptic drug which acts in the sodium channels, GABA and glutamatergic receptors. It is an efficient treatment in epilepsy and has been approved as co-therapy for partial seizures. Topiramate has a safe profile of side effects, however, as any other antiepileptic drug, could produce psychiatric side effects. We present the case of a woman who develops a schizophreniform disorder after topiramate treatment. Before this one, she also had a very similar disorder when she was treated with vigabatrin. The gabaergic action of topiramate is proposed as the principal reason for the psychotic crisis, in relation to an inhibition in the substantia nigra which could produce an overactivity in ascending dopaminergic systems.

Schizophrenia Research, 2000

Awad defined subjective response to medication as the subjective interpretation of the physiologi... more Awad defined subjective response to medication as the subjective interpretation of the physiological changes that follow its intake. This response is involved in drug compliance and may relate to clinical outcome of the disease. This study examined the variables hypothesized to be related to subjective response to antipsychotics. Sixty schizophrenic in-patients were evaluated with a protocol that examined compliance, hospitalizations, psychopathology, familial and social relationships, degree of autonomy and motivation for life during the year prior to the study. Overall functioning in the previous year was assessed with the Global Assessment Scale (GAS), psychopathology with the Brief Psychopathology Rating Scale (BPRS), insight with the Birchwood scale and side-effects with the Uscandinavian Kociety of Usypharmacology (UKU) side-effects rating scale. Subjective response was evaluated with the Drug Attitude Inventory (DAI-30). The multiple regression analysis revealed that insight and the BPRS paranoid subscale predicted subjective response to antipsychotics (R2=0.31). No relationship was found between subjective response and sociodemographic variables or side-effects. A positive subjective response was related to drug compliance and variables that indicate a more benign clinical course over the previous year. Subjective response to antipsychotics in schizophrenia is related to insight and paranoid ideation.

Acta Psychiatrica Scandinavica, Sep 11, 2002

Kalla O, Aaltonen J, Wahlström J, Lehtinen V, García Cabeza I, González de Chávez M. Duration of ... more Kalla O, Aaltonen J, Wahlström J, Lehtinen V, García Cabeza I, González de Chávez M. Duration of untreated psychosis and its correlates in first‐episode psychosis in Finland and Spain. Acta Psychiatr Scand 2002: 106: 265–275. © Blackwell Munksgaard 2002. Objective: To examine the association of duration of untreated psychosis (DUP) with early course characteristics in first‐episode psychosis in Finland and Spain. Method: Eighty‐six patients from Finland (49) and Spain (37) were evaluated on various early course characteristics. Results: The mean value of DUP was 4.0 months (median 2 months) for the Finnish patients and 9.9 months (median 2 months) for the Spanish ones. In both groups, long DUP was associated with insidious onset, poor global functioning, and laboral incapability. Among the Finnish patients exclusively, long DUP correlated with a weak earlier social network, instability of professional identity, long duration of prodromal symptoms, psychological dependency on the family, and criticism by the parents of the patient. Among the Spanish patients only, longer DUP was associated with more severe positive symptoms at admission. Conclusion: There are universal psychosocial factors influencing DUP, but also cultural differences may have an impact on the treatment delay.

Metas de enfermería, 2016

espanolObjetivos: valorar la importancia que los pacientes conceden a la psicoterapia de grupo en... more espanolObjetivos: valorar la importancia que los pacientes conceden a la psicoterapia de grupo en una unidad de hospitalizacion breve de Psiquiatria y conocer que elementos de ella les han sido de mayor utilidad. Metodo: se realizo un estudio descriptivo transversal, en la Unidad de Hospitalizacion Breve del Hospital Universitario Gregorio Maranon (Madrid). La poblacion de estudio fueron los pacientes con diagnostico de trastorno afectivo ingresados en dicha unidad durante 2014 y que participan en el grupo de psicoterapia que se lleva a cabo a todos los pacientes durante el tiempo que se prolonga su ingreso. Dichos pacientes cumplimentaban un cuaderno de recogida de datos donde se les pasaba una escala de 10 items, derivada de la desarrollada por Kanas y Barr para pacientes hospitalizados sobre factores terapeuticos, donde evaluaban la utilidad de la psicoterapia de grupo, las intervenciones individuales y farmacologicas en su ingreso. Resultados: se evaluaron 102 pacientes, con diagnostico de trastorno afectivo. Los factores mas valorados fueron “el grupo me permite un lugar donde expresar mis emociones”y “el grupo me muestra que no soy el unico con problemas”, estimados entre los tres elementos de mas importancia por el 74,3% y 73,3% de los pacientes, respectivamente. El 94,2% califica como bastante o mucha la ayuda del grupo durante el ingreso, frente al 69,9% de las intervenciones individuales y el 63,8% de las farmacologicas. Conclusiones: los grupos hospitalarios, con intervenciones adaptadas a las caracteristicas del paciente ingresado, pueden tener un valor terapeutico anadido a veces de forma inespecifica, pero tambien con elementos terapeuticos grupales especificos como la universalidad o el altruismo. EnglishObjectives: to assess the importance assigned by patients to Group Psychotherapy in a Short-Term Psychiatric Unit, and to understand which elements have been more useful to them. Method: a descriptive transversal study was conducted in the Short-Term Unit of the Hospital Universitario Gregorio Maranon (Madrid). The study population were those patients with a diagnosis of affective disorder admitted to the unit during 2014, and who participated in the Psychotherapy Group conducted with all patients during their stay. These patients completed a data collection booklet with a 10-item scale, derived from the scale developed by Kanas and Barr for hospitalized patients regarding therapeutic factors, where they were asked to value the usefulness of Group Psychotherapy and individual and pharmacological interventions during their hospital stay. Results: one hundred and two (102) patients with diagnosis of affective disorder were assessed. The best valued factors were: “the group offers me a place where to express my emotions”, and “the group shows me that I am not the only one with problems”, which were placed among the three most important elements by 74.3% and 73.3% of patients, respectively. A 94.2% of patients described the help by the group during their hospital stay as enough or high, vs. 69.9% for individual interventions and 63.8% for pharmacological interventions. Conclusions: hospital groups, with interventions adapted to the characteristics of each hospitalized patient, can offer an additional therapeutical value, sometimes unspecific, but also with specific therapeutic group elements such as universality or altruism.

Medicine - Programa De Formación Médica Continuada Acreditado, Sep 1, 2015

Los trastornos de personalidad se caracterizan por un patrón permanente de vivencia interna y de ... more Los trastornos de personalidad se caracterizan por un patrón permanente de vivencia interna y de comportamiento que se aparta claramente de las expectativas del entorno sociocultural del sujeto. Es una característica generalizada y poco flexible, estable en el tiempo, que tiene su inicio en la adolescencia o en la juventud y que da lugar a un malestar o deterioro. Son definidos en base a una serie de conductas, percepciones, afectos, cogniciones y descripciones de las personas que los padecen. Existen 11 tipos de trastornos de personalidad específicos y uno no especificado y se agrupan en el grupo o cluster A que son personas que se muestran raras o excéntricas, el grupo o cluster B, que se caracteriza por ser personas exageradamente dramáticas, emocionales o erráticas y el grupo o cluster C, cuya característica común es que son ansiosos o temerosos. En esta actualización abordamos los más relevantes en la práctica clínica.

European Psychiatry, Mar 1, 2016

and evaluation six months after hospital discharge. They were evaluated using the PANSS and BPRS ... more and evaluation six months after hospital discharge. They were evaluated using the PANSS and BPRS scales at four different time points of the evolutionary process.

European Neuropsychopharmacology, Nov 1, 1998

espanolObjetivo: evaluar la eficacia de este programa terapeutico para pacientes con psicosis (AT... more espanolObjetivo: evaluar la eficacia de este programa terapeutico para pacientes con psicosis (ATIICO) en la mejora de la adherencia al tratamiento, la actitud hacia la enfermedad, la impresion clinica, los sintomas negativos y positivos, el nivel de insight, el grado de discapacidad y el nivel de calidad de vida. Metodo: se realizo un estudio cuasiexperimental antes-despues sin grupo control. La poblacion de estudio estuvo formada por todos los pacientes incorporados al programa ATIICO. Dichos pacientes fueron evaluados al entrar en el programa y al ano, con escalas de adherencia (CRS, DAI-10); psicopatologia (PANSS); clinica (ICG, GAF); discapacidad (DAS/WHO); insight (Birchwood) y calidad de vida (EuroQol5D). La intervencion consistio en un programa terapeutico desarrollado por un equipo multidisciplinar responsable de elaborar un tratamiento individualizado y adaptado a las necesidades de cada paciente y basado en criterios de: accesibilidad, inmediatez y continuidad, intervenci...

European Neuropsychopharmacology, 1997

European Neuropsychopharmacology, 2000

It has been suggested that the central muscarinic acetylcholine system may be implicated in schiz... more It has been suggested that the central muscarinic acetylcholine system may be implicated in schizophrenia. However, central muscarinic rece tor availability had not previously been studied in vivo. Using ['* P I]IQNB SPECT, we sought to compare the muscarinic receptor availability in vivo in unmedicated schizophrenic patients and normal comparison subjects. Methods: Twelve medication-free schizophrenic patients (mean drug free period 17 days; range 7-180 days) underwent a 60minute [1231]IQNB SPECT scan 21 hours post-injection. A group of ten age-and sex-matched normal controls were imaged under similar conditions for comparison. Regions of interest were drawn on five consecutive slices for caudate, putamen, thalamus and pons, as well as for medial frontal, lateral frontal, lateral temporal and occipital cortex. Binding data was analyzed as nCi/ml (tissue) per mCi injected dose. Results: Muscarinic receptor availability was reduced in schizophrenic patients in all regions of interest with reductions ranging from-33% (p < 0.002) in the caudate to-20% (p < 0.03) in the occipital cortex. Reduced muscarinic receptor availability in vivo and clinical symptoms were correlated exclusively for positive symptoms with the striatum and frontal cortex (r = 0.63 and r = 0.64; p < 0.03) muscarinic receptor availability. Conclusion: These results indicate a substantial reduction in muscarinic acetylcholine receptor availability in vivo in umnedicated schizophrenic patients, possibly implicating the muscarinic system in the etiology of schizophrenia. However, further studies, particularly of medication-naive patients, are needed.)p.2.0461 I ncomplete forms of the neuroleptic malignant syndrome: A continuation of a case series 0. &canovic, Lj. BoriSev, V

European Neuropsychopharmacology, 1998

Medicine - Programa de Formación Médica Continuada Acreditado, 2019

Resumen El DSM-5 ha incluido una nueva clasificacion llamada «trastornos de sintomas somaticos y ... more Resumen El DSM-5 ha incluido una nueva clasificacion llamada «trastornos de sintomas somaticos y trastornos relacionados» que sustituye a los antiguos trastornos somatomorfos que englobaban: trastorno de somatizacion, trastorno por dolor, hipocondria y trastorno conversivo. Las personas con este tipo de trastornos acuden en busca de ayuda a Atencion Primaria y otros entornos medicos y, con menor frecuencia, al ambito de salud mental, generando un alto consumo de recursos para el sistema publico. El origen de estos trastornos no esta bien definido, aunque se han encontrado tanto causas biologicas como psicologicas, teniendo en cuenta la experiencia biografica y los rasgos de personalidad del paciente. En el diagnostico es necesario descartar la presencia de patologia medica subyacente a traves de una exploracion minuciosa y de la realizacion de pruebas complementarias. El tratamiento combina estrategias para el manejo del paciente con intervenciones terapeuticas especificas (medidas farmacologicas y psicoterapeuticas).

Aspectos específicos y diferenciales de la psicoterapia de grupo en la psicosis, 2013

Rehabilitacion Psicosocial, 2015

European Neuropsychopharmacology, 2007

European Neuropsychopharmacology, 2009

European Psychiatry, 2006

ObjectiveThe aim of this longitudinal study was to determine whether the depot formulation of an ... more ObjectiveThe aim of this longitudinal study was to determine whether the depot formulation of an antipsychotic reduces violence in outpatients with schizophrenia as compared to oral administration of the same antipsychotic.MethodsForty-six previously violent patients with schizophrenia were randomised to receive treatment with oral or depot zuclopenthixol for 1 year. Clinicians interviewed patients at baseline and every month thereafter to assess treatment adherence. An interviewer blinded to treatment assignments interviewed an informant about any violent behaviour during the previous month.ResultsViolence during the follow-up year was inversely proportional to treatment adherence, better compliance, and greater reduction of positive symptoms. Lower frequency of violent acts was observed in the depot group. The level of insight at baseline was not significantly associated with violence recidivism. Regardless of route of administration, treatmentnon-adherence was the best predictor ...

Psychiatry Research, 2018

Insight has long been linked to both prognosis and functioning in patients with schizophrenia; li... more Insight has long been linked to both prognosis and functioning in patients with schizophrenia; likewise, it is key to treatment adherence. This study seeks to assess the association between insight, adherence to pharmacological treatment, and disability in schizophrenia, and to study the potential mediating role of adherence between insight and disability. Insight (SUMD), adherence (CRS), and disability (WHO-DAS) were measured in 80 clinically stable patients with DSM-IV TR paranoid schizophrenia. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS). In a first step, predictors of disability were identified using linear regression to identify variables related to disability and further a mediation analysis was carried out. Negative symptoms, insight, and adherence account for 54.2% of the variance in disability. Negative symptoms act directly on disability, while the effect of insight on disability is partially mediated by adherence. Insight is key in disability in schizophrenia and should be leveraged in treatment programs.