ana miorelli - Academia.edu (original) (raw)
Papers by ana miorelli
Medicine, Dec 1, 2020
Nearly one-third of people with a long-term physical condition have a co-morbid mental health dis... more Nearly one-third of people with a long-term physical condition have a co-morbid mental health disorder such as depression or anxiety. It is important to look into this group of patients to understand how to improve our daily practice to benefit both patients and the health service. Co-morbidity of physical and mental illness such as major depression is well known to increase impairment of functioning levels. Here, we summarize recent findings on the prevalence of co-morbid mental and chronic physical health and the impact on overall health.
Proceedings of The Physiological Society, 2011
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in ... more Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in London and Cambridge, which aims to identify genes conferring susceptibility to psychosis, and associated phenotypes including cognitive dysfunction and cerebral morphology. Methods:First episode psychosis cases have been recruited in South London and Maudsley NHS Trust and in Cambridge. A variety of demographic and clinical data have been collected. In a subset of these, neurocognitive assessments and MRIs have been performed. Samples have been taken for DNA, and in a subset for RNA and proteomic analysis. Genetic association analysis is being undertaken using a candidate gene approach. The genes chosen for the first wave of analysis include the current most promising candidates for suscept-ibility to psychosis (NRG1, dysbindin, DISC1, G72, etc) as well as candidates for susceptibility to cannabis misuse (COMT), cognitive dysfunction, dysregulation of brain morphology or susceptibility to bipolar disorder (e.g. LIS1), and candidates in the dopamine and serotonin neurotransmitter systems. Results:DNA has been collected from 302 patients to date. Of these, 72%aremale, and themeanage is 25 years; 187 areCaucasian; 115 are of black origin; and the rest are of other ormixed ethnicity. Genotyping is being undertaken in this sample and in matched controls. Conclusions:Data is being reported separately for a number of phenotypes forwhich there is already somedata. This presentationwill report the overall genetic association results
Proceedings of The Physiological Society, 2011
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in ... more Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in London and Cambridge, which aims to identify genes conferring susceptibility to psychosis, and associated phenotypes including cognitive dysfunction and cerebral morphology. Methods:First episode psychosis cases have been recruited in South London and Maudsley NHS Trust and in Cambridge. A variety of demographic and clinical data have been collected. In a subset of these, neurocognitive assessments and MRIs have been performed. Samples have been taken for DNA, and in a subset for RNA and proteomic analysis. Genetic association analysis is being undertaken using a candidate gene approach. The genes chosen for the first wave of analysis include the current most promising candidates for suscept-ibility to psychosis (NRG1, dysbindin, DISC1, G72, etc) as well as candidates for susceptibility to cannabis misuse (COMT), cognitive dysfunction, dysregulation of brain morphology or susceptibility to bipolar disorder (e.g. LIS1), and candidates in the dopamine and serotonin neurotransmitter systems. Results:DNA has been collected from 302 patients to date. Of these, 72%aremale, and themeanage is 25 years; 187 areCaucasian; 115 are of black origin; and the rest are of other ormixed ethnicity. Genotyping is being undertaken in this sample and in matched controls. Conclusions:Data is being reported separately for a number of phenotypes forwhich there is already somedata. This presentationwill report the overall genetic association results
The Lancet Psychiatry, 2020
Background Dissociative seizures are paroxysmal events resembling epilepsy or syncope with charac... more Background Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency. Methods In this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544.
Medicine, Dec 1, 2020
Nearly one-third of people with a long-term physical condition have a co-morbid mental health dis... more Nearly one-third of people with a long-term physical condition have a co-morbid mental health disorder such as depression or anxiety. It is important to look into this group of patients to understand how to improve our daily practice to benefit both patients and the health service. Co-morbidity of physical and mental illness such as major depression is well known to increase impairment of functioning levels. Here, we summarize recent findings on the prevalence of co-morbid mental and chronic physical health and the impact on overall health.
Proceedings of The Physiological Society, 2011
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in ... more Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in London and Cambridge, which aims to identify genes conferring susceptibility to psychosis, and associated phenotypes including cognitive dysfunction and cerebral morphology. Methods:First episode psychosis cases have been recruited in South London and Maudsley NHS Trust and in Cambridge. A variety of demographic and clinical data have been collected. In a subset of these, neurocognitive assessments and MRIs have been performed. Samples have been taken for DNA, and in a subset for RNA and proteomic analysis. Genetic association analysis is being undertaken using a candidate gene approach. The genes chosen for the first wave of analysis include the current most promising candidates for suscept-ibility to psychosis (NRG1, dysbindin, DISC1, G72, etc) as well as candidates for susceptibility to cannabis misuse (COMT), cognitive dysfunction, dysregulation of brain morphology or susceptibility to bipolar disorder (e.g. LIS1), and candidates in the dopamine and serotonin neurotransmitter systems. Results:DNA has been collected from 302 patients to date. Of these, 72%aremale, and themeanage is 25 years; 187 areCaucasian; 115 are of black origin; and the rest are of other ormixed ethnicity. Genotyping is being undertaken in this sample and in matched controls. Conclusions:Data is being reported separately for a number of phenotypes forwhich there is already somedata. This presentationwill report the overall genetic association results
Proceedings of The Physiological Society, 2011
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
American Journal of Medical Genetics, 2006
Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in ... more Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in London and Cambridge, which aims to identify genes conferring susceptibility to psychosis, and associated phenotypes including cognitive dysfunction and cerebral morphology. Methods:First episode psychosis cases have been recruited in South London and Maudsley NHS Trust and in Cambridge. A variety of demographic and clinical data have been collected. In a subset of these, neurocognitive assessments and MRIs have been performed. Samples have been taken for DNA, and in a subset for RNA and proteomic analysis. Genetic association analysis is being undertaken using a candidate gene approach. The genes chosen for the first wave of analysis include the current most promising candidates for suscept-ibility to psychosis (NRG1, dysbindin, DISC1, G72, etc) as well as candidates for susceptibility to cannabis misuse (COMT), cognitive dysfunction, dysregulation of brain morphology or susceptibility to bipolar disorder (e.g. LIS1), and candidates in the dopamine and serotonin neurotransmitter systems. Results:DNA has been collected from 302 patients to date. Of these, 72%aremale, and themeanage is 25 years; 187 areCaucasian; 115 are of black origin; and the rest are of other ormixed ethnicity. Genotyping is being undertaken in this sample and in matched controls. Conclusions:Data is being reported separately for a number of phenotypes forwhich there is already somedata. This presentationwill report the overall genetic association results
The Lancet Psychiatry, 2020
Background Dissociative seizures are paroxysmal events resembling epilepsy or syncope with charac... more Background Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency. Methods In this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544.