Belen Arranz | Universitat de Barcelona (original) (raw)
Papers by Belen Arranz
![Research paper thumbnail of [3H]Paroxetine and [3H]Citalopram as Markers of the Human Brain 5-HT Uptake Site](https://attachments.academia-assets.com/120796252/thumbnails/1.jpg)
](Neuropsychopharmacology, Dec 1, 1994
CRC Press eBooks, Jun 6, 2023
European psychiatry (Ed. Española), 2007
ResumenAntecedentesRealizamos un estudio observacional naturalista multicéntrico no distribuido a... more ResumenAntecedentesRealizamos un estudio observacional naturalista multicéntrico no distribuido al azar de 24 horas que describía por primera vez la efectividad y la seguridad de la olanzapina intramuscular (IM) para controlar la agitación y la agresión en pacientes del “mundo real” con psicosis. Se comprobó los datos obtenidos así con los comunicados a partir de ensayos clínicos doble ciego distribuidos al azar.MétodoSe seleccionó a 92 pacientes que asistían a entornos de urgencias psiquiátricas. Los sujetos del estudio fueron 44 pacientes varones y 48 mujeres con una edad media de 36,5 ± 12 años y diagnósticos del DSM-IV-TR de esquizofrenia (48,9%), trastorno psicótico no especificado (23,9%) o trastorno bipolar (27,2%). Se administró 10 mg de olanzapina IM a todos los pacientes. Se permitía una segunda inyección opcional a las 2 horas o más de acuerdo con la política del hospital. Se realizaron evaluaciones (PANSS-EC y CGI-S) en la línea de base y 2 y 24 horas después de la inyec...
Adicciones, Apr 1, 2022
Manejo clínico de los pacientes adultos con un trastorno mental grave y un diagnóstico comórbido ... more Manejo clínico de los pacientes adultos con un trastorno mental grave y un diagnóstico comórbido de trastorno por uso de sustancias Clinical management of adult patients with serious mental disorder and comorbid diagnosis of substance use disorder
Revista de Psiquiatría y Salud Mental, Apr 1, 2016
c m t y a c d En el año 2013 la Sociedad Española de Psiquiatría Biológica, a través de su presid... more c m t y a c d En el año 2013 la Sociedad Española de Psiquiatría Biológica, a través de su presidente, Miguel Bernardo, planteó la posibilidad de elaborar una guía clínica de patología dual ante la falta de evidencias claras sobre cómo definir y abordar esta patología en el ámbito clínico. Los algoritmos terapéuticos utilizados actualmente no incluyen a los pacientes con trastornos psiquiátricos y consumo de sustancias, aunque sí existen árboles de decisión diferenciales para los pacientes con un trastorno psiquiátrico o para aquellos con un consumo de sustancias. Con el desarrollo en las 2 últimas décadas de los tratamientos integrados y los planes de tratamiento individualizados, cada vez es mayor la demanda de pautas de tratamiento multidisciplinares, en las que se integren simultáneamente intervenciones para los pacientes con ambos trastornos. Por otra parte, al analizar la información existente en este campo, se observó la existencia de una gran variabilidad en el abordaje y el tratamiento de los pacientes con un trastorno psiquiátrico conjuntamente con un trastorno por consumo de sustancias (patología dual), variabilidad que generaba cierta incertidumbre entre los clínicos a la hora de la toma de decisiones, fundamentalmente en relación con el tratamiento. Además, en los últimos años la morbimortalidad de la patología dual ha generado un problema de salud
Adicciones, Apr 12, 2017
Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que... more Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que en la población general. El infradiagnóstico de patología dual puede tener diversas consecuencias negativas; una valoración precoz con herramientas de cribaje como la escala CAGE podría mejorar el pronóstico de estos pacientes. El objetivo de este estudio es valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios con una CAGE modificada, considerando la influencia de edad, género, y diagnóstico psiquiátrico. Se realizó un estudio descriptivo observacional, multicéntrico. La escala CAGE de 4 ítems, camuflada en un cuestionario de vida saludable, se aplicó utilizando el punto de corte de 1. Se valoraron 559 pacientes. El 54% eran mujeres, y la edad media fue de 50,07 años. 182 pacientes presentaron una puntuación ≥1 (45,1% de los hombres y 21,9% de las mujeres). El género fue el predictor principal de un resultado positivo en la escala CAGE, siendo 3,03 veces más probable que los hombres obtengan una puntuación ≥1 (p < ,001, 95% IC: 0,22-0,49). El trastorno bipolar y los trastornos de personalidad presentaron las tasas más altas de puntuaciones ≥1 (45,2 y 44,9%, respectivamente) con una asociación significativa entre diagnóstico y un resultado positivo (p = ,002). Los pacientes de más de 60 años mostraron 2,5 veces menos probabilidades de obtener una puntuación positiva (p = ,017, 95% IC: 0,19-0,85). Cuestionarios específicos, como CAGE, pueden ser herramientas sencillas y útiles para valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios. Los pacientes hombres con trastorno bipolar o de personalidad presentan un riesgo más elevado de TUA.
European Psychiatry, Apr 1, 2017
Managing bipolar disorder in pregnancy and postpartum is a challenge. There is lack of literature... more Managing bipolar disorder in pregnancy and postpartum is a challenge. There is lack of literature to inform that and an urgent need for more data. Objectives To develop and validate a risk prediction model for individual prognosis of the risk of recurrence of bipolar disorder for women in the perinatal period. Aims To provide evidence-based information to help women and the clinicians that look after them make decisions about their care, taking into account the most recent scientific knowledge and their individual characteristics. Methods The development of the model will be done in retrospective data from a large clinical cohort from the Bipolar Disorder Research Network (BDRN.org). The validation will be done in a prospectively recruited sample. Participants will be 2181 parous women with a lifetime diagnosis of bipolar disorder from BDRN and 300 prospectively recruited pregnant women with a history of postpartum psychosis or bipolar disorder. Predictors will be chosen based on clinical experience and literature, from data collected via semi-structured interview (in pregnancy and 3 months postpartum, medical and psychiatric notes) e.g. medication, smoking, parity, obstetric complications and sleep. Results N/A. Conclusions We will present the full prediction model (regression coefficients and model intercept) and report performance measures (with CIs). We will discuss its potential clinical use and implications for future research.
European Psychiatry, Mar 1, 2016
Introduction Sleep impairment has been described as a core mechanism of bipolar disorder (BD) fre... more Introduction Sleep impairment has been described as a core mechanism of bipolar disorder (BD) frequently associated low global function and quality of life (QoL) [1]. Aim To investigate the impact of sleep disturbance in daily functioning and QoL in a sample of euthymic BD patients with presence and absence of sleep complaints, assessed with a valid sleep quality questionnaire [2]. Methods Naturalistic, multicenter, cross-sectional study. Sample: 119 euthymic outpatients with BD [34.5%males; mean age (SD)=46.28 (12.22)]: (1) without sleep complaints (60.5%); (2) with sleep complaints (31.9%) and insomnia diagnosis (7.6%). Instruments: Cuestionario de Oviedo de Calidad de Sueno (COS), FAST, SF-36, HDRS, CGI and SCIP. Results No significant differences were found between groups in age, sex, global severity illness, and cognitive impairment ( P >0.05). Likewise, there was not statistical difference neither in daily function ( P >0.05) nor in QoL ( P >0.05), with the exception of emotional role ( t =2.26; P Conclusions Despite 39.5% euthymic patients with BD experienced sleep complaints, this study showed that sleep disturbance not affected patients' daily functioning and QoL. Both groups report similar outcomes.
European Neuropsychopharmacology, Feb 1, 2018
Lifetime prevalence of substance use disorders (SUD) in patients with schizophrenia is nearly 50%... more Lifetime prevalence of substance use disorders (SUD) in patients with schizophrenia is nearly 50%. Nicotine, alcohol, and cannabis are the substances most frequently used, with a high percentage of poly-substance users. There are few available data about pharmacological approaches in this population. Amongst antipsychotics, clozapine shows positive evidence in the literature. The aim of the present article is to provide systematic review on the efficacy of clozapine in SUD improvement in schizophrenic patients. PRISMA recommendations were followed (PROSPERO id: CRD42017059299). Five studies for nicotine use and nine studies for SUD (other than nicotine) were analyzed. Regarding nicotine use, results from randomized controlled trials (RCT) have found a decrease in nicotine use after 12 weeks of 200-600mg/day clozapine, as compared with lower doses. In SUD improvement (other than nicotine), RCT have shown superiority of clozapine when compared with risperidone, in short-term studies (from 4 to 12 weeks) performed in cannabis users. In long-term studies (1 year), clozapine was equal to ziprasidone in reducing cannabis use and equal to treatment as usual in reducing alcohol use. We conclude that positive results on nicotine use are scarce and derived from studies with a low degree of evidence. Evidence of clozapine on SUD (other than nicotine) is stronger, especially when clozapine is compared with first generation antipsychotics in poly-substance users. When compared with second generation antipsychotics, clozapine was superior to risperidone but equal to olanzapine or ziprasidone in poly-substance and cannabis users.
PubMed, May 3, 2001
So far, there is increasing evidence of the active role of molecular biology in the psychiatric n... more So far, there is increasing evidence of the active role of molecular biology in the psychiatric nosology as well as in the identification of psychiatric fenotypes. In this respect, the neurotransmitter serotonin (5-HT) has been involved in the etiopathogeny of multiple psychiatry conditions, such as affective disorder, schizophrenia, panic disorder, obsessive-compulsive disorder, alcoholism, eating disorder and personality disorder. The 5-HT2 receptor family includes the subtype 5-HT2A, a G protein coupled receptor whose activation leads to the stimulation of the enzyme phospholipase C and to the subsequent hydrolysis of the membrane located phosphoinositides, with the synthesis of the second messengers inositol triphosphate and diacylglicerol. This paper includes a review of the main findings concerning the polymorphism of the 5-HT2A in psychiatric disorders.
European Psychiatry, Jun 1, 2022
Evidences suggest that high BDNF serum levels are related to good cognitive functioning(Mora et a... more Evidences suggest that high BDNF serum levels are related to good cognitive functioning(Mora et al., 2019). Results require further explorations. The present pilot study targets to identify the neurobiological correlates of response, investigating the potential neuroprotective role of the FR. Objectives: Assess the effectiveness of FR in ameliorate cognitive deficits measured with BAC-A and psychosocial functioning with FAST, in modifying BDNF levels in a sample of euthymic patients with BD, compared to standard treatment. Methods: Two arms(1:1)randomized, rater-blinded, controlled study of 30out-patients with BD-I and BD-II, according to DSM-5 criteria. Patients between 18 and 55 years in euthymic phase. Neurocognitive and clinical assessments, at the same times, serum assessment of BDNF levels will be performed. All patients will be assessed at baseline(T0), at the end of treatment(T1) and at the 3-month follow-up(T2). Results: After treatment, patients receiving FR show better cognitive and psychosocial performance than those receiving TAU. Conclusions: Given the important role of neutrophins in the pathogenesis of BD, identifying BD-specific biomarkers would contribute to understand the underlying neuro-pathophysiological processes and to personalize treatments. Disclosure: No significant relationships.
Journal of Affective Disorders, Apr 1, 2020
Background: Cannabis use is markedly prevalent among patients with bipolar disorder (BD). However... more Background: Cannabis use is markedly prevalent among patients with bipolar disorder (BD). However, to date, there have been no studies on this issue with a sex-based approach. This study examines if lifetime cannabis use (LCU) is differently associated with clinical course, functioning, and quality of life (QoL) in patients with BD by sex. Methods: Secondary analysis of a cross-sectional, naturalistic, multicentre study. LCU was defined as having had at least one day of use per month for at least 12 consecutive months in a patient's life. Results: A total of 224 patients with BD were included (65.2% women). Patients with LCU were younger (p = 0.001) and had their first hospitalization earlier (p<0.005) than those without LCU, regardless of sex. Among women, LCU was associated with being single (p = 0.006), worse sexual functioning (p = 0.006), financial functioning (p = 0.009), QoL [bodily pain (p = 0.009), vitality (p = 0.027), social functioning (p = 0.037), emotional role (p = 0.038), mental health (p = 0.001), and mental summary component (p = 0.012)]. After controlling for confounders, among women, LCU was associated with worse QoL, specifically on bodily pain (p = 0.049) and mental health (p = 0.016) subscales. Among males, no statistically significant differences were found between LCU and no LCU (NLCU) in any of the variables of the study. Limitations: This study was a secondary analysis not powered specifically to analyze cannabis use. Conclusions: LCU was associated with a younger age at first hospitalization in both women and men, while only women reported worse QoL on bodily pain and mental health subscales. Clinicians and public health providers should be aware of this and inform their patients and the general population of these detrimental effects. occurrence of manic and mixed episodes (Gibbs et al., 2015; Weinstock et al., 2016), greater risk of attempted suicide (Ostergaard et al., 2017), higher prevalence of psychotic symptoms (Braga et al., 2012; van Rossum, Boomsma, Tenback, Reed, and van Os, 2009; Weinstock et al., 2016), and decreased compliance with treatment (van Rossum et al., 2009). Along these lines, LCU has also been associated with earlier onset of BD (Lagerberg et al., 2016) and an increased risk of hospital stays due to affective episodes (Lagerberg et al., 2016). However, the mechanisms underlying the influence of cannabis on clinical course are unknown, and, to date, there have been no studies
Revista de Psiquiatría y Salud Mental, Feb 1, 2023
Translational Psychiatry, Jan 29, 2020
Bipolar disorder (BD) has been identified as a life-course illness with different clinical manife... more Bipolar disorder (BD) has been identified as a life-course illness with different clinical manifestations from an at-risk to a late stage, supporting the assumption that it would benefit from a staging model. In a previous study, we used a clustering approach to stratify 224 patients with a diagnosis of BD into five clusters based on clinical characteristics, functioning, cognition, general health, and health-related quality of life. This study was design to test the construct validity of our previously developed k-means clustering model and to confirm its longitudinal validity over a span of 3 years. Of the 224 patients included at baseline who were used to develop our model, 129 (57.6%) reached the 3-year follow-up. All life domains except mental health-related quality of life (QoL) showed significant worsening in stages (p < 0.001), suggesting construct validity. Furthermore, as patients progressed through stages, functional decline (p < 0.001) and more complex treatment patterns (p = 0.002) were observed. As expected, at 3 years, the majority of patients remained at the same stage (49.6%), or progressed (20.9%) or regressed (23.3%) one stage. Furthermore, 85% of patients who stayed euthymic during that period remained at the same stage or regressed to previous stages, supporting its longitudinal validity. For that reason, this study provides evidence of the construct and longitudinal validity of an empirically developed, comprehensive staging model for patients with BD. Thus, it may help clinicians and researchers to better understand the disorder and, at the same time, to design more accurate and personalized treatment plans.
CRC Press eBooks, Jun 6, 2023
Journal of Psychiatric Research, Feb 1, 2022
Sexual functioning in bipolar disorder (BD) is dependent on multiple clinical and demographic det... more 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.
International Journal of Molecular Sciences, 2019
Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, and phy... more Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, and physical and emotional symptoms. Although its pathophysiology is largely unknown, immune-inflammatory pathways may be involved. We examined serum interleukin (IL)-6, high sensitivity C-reactive protein (hs-CRP), CXCL-8, and IL-10 in 67 female FM patients and 35 healthy women while adjusting for age, body mass index (BMI), and comorbid disorders. We scored the Fibromyalgia Severity Score, Widespread Pain Index (WPI), Symptom Severity Scale (SSS), Hospital Anxiety (HADS-A), and Depression Scale and the Perceived Stress Scale (PSS-10). Clinical rating scales were significantly higher in FM patients than in controls. After adjusting for covariates, IL-6, IL-10, and CXCL-8 were lower in FM than in HC, whereas hs-CRP did not show any difference. Binary regression analyses showed that the diagnosis FM was associated with lowered IL-10, quality of sleep, aerobic activities, and increased HADS-A and...
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2015
Dual están relacionados por orden alfabético en el Anexo.
Neuropsychopharmacology, Dec 1, 1994
CRC Press eBooks, Jun 6, 2023
European psychiatry (Ed. Española), 2007
ResumenAntecedentesRealizamos un estudio observacional naturalista multicéntrico no distribuido a... more ResumenAntecedentesRealizamos un estudio observacional naturalista multicéntrico no distribuido al azar de 24 horas que describía por primera vez la efectividad y la seguridad de la olanzapina intramuscular (IM) para controlar la agitación y la agresión en pacientes del “mundo real” con psicosis. Se comprobó los datos obtenidos así con los comunicados a partir de ensayos clínicos doble ciego distribuidos al azar.MétodoSe seleccionó a 92 pacientes que asistían a entornos de urgencias psiquiátricas. Los sujetos del estudio fueron 44 pacientes varones y 48 mujeres con una edad media de 36,5 ± 12 años y diagnósticos del DSM-IV-TR de esquizofrenia (48,9%), trastorno psicótico no especificado (23,9%) o trastorno bipolar (27,2%). Se administró 10 mg de olanzapina IM a todos los pacientes. Se permitía una segunda inyección opcional a las 2 horas o más de acuerdo con la política del hospital. Se realizaron evaluaciones (PANSS-EC y CGI-S) en la línea de base y 2 y 24 horas después de la inyec...
Adicciones, Apr 1, 2022
Manejo clínico de los pacientes adultos con un trastorno mental grave y un diagnóstico comórbido ... more Manejo clínico de los pacientes adultos con un trastorno mental grave y un diagnóstico comórbido de trastorno por uso de sustancias Clinical management of adult patients with serious mental disorder and comorbid diagnosis of substance use disorder
Revista de Psiquiatría y Salud Mental, Apr 1, 2016
c m t y a c d En el año 2013 la Sociedad Española de Psiquiatría Biológica, a través de su presid... more c m t y a c d En el año 2013 la Sociedad Española de Psiquiatría Biológica, a través de su presidente, Miguel Bernardo, planteó la posibilidad de elaborar una guía clínica de patología dual ante la falta de evidencias claras sobre cómo definir y abordar esta patología en el ámbito clínico. Los algoritmos terapéuticos utilizados actualmente no incluyen a los pacientes con trastornos psiquiátricos y consumo de sustancias, aunque sí existen árboles de decisión diferenciales para los pacientes con un trastorno psiquiátrico o para aquellos con un consumo de sustancias. Con el desarrollo en las 2 últimas décadas de los tratamientos integrados y los planes de tratamiento individualizados, cada vez es mayor la demanda de pautas de tratamiento multidisciplinares, en las que se integren simultáneamente intervenciones para los pacientes con ambos trastornos. Por otra parte, al analizar la información existente en este campo, se observó la existencia de una gran variabilidad en el abordaje y el tratamiento de los pacientes con un trastorno psiquiátrico conjuntamente con un trastorno por consumo de sustancias (patología dual), variabilidad que generaba cierta incertidumbre entre los clínicos a la hora de la toma de decisiones, fundamentalmente en relación con el tratamiento. Además, en los últimos años la morbimortalidad de la patología dual ha generado un problema de salud
Adicciones, Apr 12, 2017
Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que... more Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que en la población general. El infradiagnóstico de patología dual puede tener diversas consecuencias negativas; una valoración precoz con herramientas de cribaje como la escala CAGE podría mejorar el pronóstico de estos pacientes. El objetivo de este estudio es valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios con una CAGE modificada, considerando la influencia de edad, género, y diagnóstico psiquiátrico. Se realizó un estudio descriptivo observacional, multicéntrico. La escala CAGE de 4 ítems, camuflada en un cuestionario de vida saludable, se aplicó utilizando el punto de corte de 1. Se valoraron 559 pacientes. El 54% eran mujeres, y la edad media fue de 50,07 años. 182 pacientes presentaron una puntuación ≥1 (45,1% de los hombres y 21,9% de las mujeres). El género fue el predictor principal de un resultado positivo en la escala CAGE, siendo 3,03 veces más probable que los hombres obtengan una puntuación ≥1 (p < ,001, 95% IC: 0,22-0,49). El trastorno bipolar y los trastornos de personalidad presentaron las tasas más altas de puntuaciones ≥1 (45,2 y 44,9%, respectivamente) con una asociación significativa entre diagnóstico y un resultado positivo (p = ,002). Los pacientes de más de 60 años mostraron 2,5 veces menos probabilidades de obtener una puntuación positiva (p = ,017, 95% IC: 0,19-0,85). Cuestionarios específicos, como CAGE, pueden ser herramientas sencillas y útiles para valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios. Los pacientes hombres con trastorno bipolar o de personalidad presentan un riesgo más elevado de TUA.
European Psychiatry, Apr 1, 2017
Managing bipolar disorder in pregnancy and postpartum is a challenge. There is lack of literature... more Managing bipolar disorder in pregnancy and postpartum is a challenge. There is lack of literature to inform that and an urgent need for more data. Objectives To develop and validate a risk prediction model for individual prognosis of the risk of recurrence of bipolar disorder for women in the perinatal period. Aims To provide evidence-based information to help women and the clinicians that look after them make decisions about their care, taking into account the most recent scientific knowledge and their individual characteristics. Methods The development of the model will be done in retrospective data from a large clinical cohort from the Bipolar Disorder Research Network (BDRN.org). The validation will be done in a prospectively recruited sample. Participants will be 2181 parous women with a lifetime diagnosis of bipolar disorder from BDRN and 300 prospectively recruited pregnant women with a history of postpartum psychosis or bipolar disorder. Predictors will be chosen based on clinical experience and literature, from data collected via semi-structured interview (in pregnancy and 3 months postpartum, medical and psychiatric notes) e.g. medication, smoking, parity, obstetric complications and sleep. Results N/A. Conclusions We will present the full prediction model (regression coefficients and model intercept) and report performance measures (with CIs). We will discuss its potential clinical use and implications for future research.
European Psychiatry, Mar 1, 2016
Introduction Sleep impairment has been described as a core mechanism of bipolar disorder (BD) fre... more Introduction Sleep impairment has been described as a core mechanism of bipolar disorder (BD) frequently associated low global function and quality of life (QoL) [1]. Aim To investigate the impact of sleep disturbance in daily functioning and QoL in a sample of euthymic BD patients with presence and absence of sleep complaints, assessed with a valid sleep quality questionnaire [2]. Methods Naturalistic, multicenter, cross-sectional study. Sample: 119 euthymic outpatients with BD [34.5%males; mean age (SD)=46.28 (12.22)]: (1) without sleep complaints (60.5%); (2) with sleep complaints (31.9%) and insomnia diagnosis (7.6%). Instruments: Cuestionario de Oviedo de Calidad de Sueno (COS), FAST, SF-36, HDRS, CGI and SCIP. Results No significant differences were found between groups in age, sex, global severity illness, and cognitive impairment ( P >0.05). Likewise, there was not statistical difference neither in daily function ( P >0.05) nor in QoL ( P >0.05), with the exception of emotional role ( t =2.26; P Conclusions Despite 39.5% euthymic patients with BD experienced sleep complaints, this study showed that sleep disturbance not affected patients' daily functioning and QoL. Both groups report similar outcomes.
European Neuropsychopharmacology, Feb 1, 2018
Lifetime prevalence of substance use disorders (SUD) in patients with schizophrenia is nearly 50%... more Lifetime prevalence of substance use disorders (SUD) in patients with schizophrenia is nearly 50%. Nicotine, alcohol, and cannabis are the substances most frequently used, with a high percentage of poly-substance users. There are few available data about pharmacological approaches in this population. Amongst antipsychotics, clozapine shows positive evidence in the literature. The aim of the present article is to provide systematic review on the efficacy of clozapine in SUD improvement in schizophrenic patients. PRISMA recommendations were followed (PROSPERO id: CRD42017059299). Five studies for nicotine use and nine studies for SUD (other than nicotine) were analyzed. Regarding nicotine use, results from randomized controlled trials (RCT) have found a decrease in nicotine use after 12 weeks of 200-600mg/day clozapine, as compared with lower doses. In SUD improvement (other than nicotine), RCT have shown superiority of clozapine when compared with risperidone, in short-term studies (from 4 to 12 weeks) performed in cannabis users. In long-term studies (1 year), clozapine was equal to ziprasidone in reducing cannabis use and equal to treatment as usual in reducing alcohol use. We conclude that positive results on nicotine use are scarce and derived from studies with a low degree of evidence. Evidence of clozapine on SUD (other than nicotine) is stronger, especially when clozapine is compared with first generation antipsychotics in poly-substance users. When compared with second generation antipsychotics, clozapine was superior to risperidone but equal to olanzapine or ziprasidone in poly-substance and cannabis users.
PubMed, May 3, 2001
So far, there is increasing evidence of the active role of molecular biology in the psychiatric n... more So far, there is increasing evidence of the active role of molecular biology in the psychiatric nosology as well as in the identification of psychiatric fenotypes. In this respect, the neurotransmitter serotonin (5-HT) has been involved in the etiopathogeny of multiple psychiatry conditions, such as affective disorder, schizophrenia, panic disorder, obsessive-compulsive disorder, alcoholism, eating disorder and personality disorder. The 5-HT2 receptor family includes the subtype 5-HT2A, a G protein coupled receptor whose activation leads to the stimulation of the enzyme phospholipase C and to the subsequent hydrolysis of the membrane located phosphoinositides, with the synthesis of the second messengers inositol triphosphate and diacylglicerol. This paper includes a review of the main findings concerning the polymorphism of the 5-HT2A in psychiatric disorders.
European Psychiatry, Jun 1, 2022
Evidences suggest that high BDNF serum levels are related to good cognitive functioning(Mora et a... more Evidences suggest that high BDNF serum levels are related to good cognitive functioning(Mora et al., 2019). Results require further explorations. The present pilot study targets to identify the neurobiological correlates of response, investigating the potential neuroprotective role of the FR. Objectives: Assess the effectiveness of FR in ameliorate cognitive deficits measured with BAC-A and psychosocial functioning with FAST, in modifying BDNF levels in a sample of euthymic patients with BD, compared to standard treatment. Methods: Two arms(1:1)randomized, rater-blinded, controlled study of 30out-patients with BD-I and BD-II, according to DSM-5 criteria. Patients between 18 and 55 years in euthymic phase. Neurocognitive and clinical assessments, at the same times, serum assessment of BDNF levels will be performed. All patients will be assessed at baseline(T0), at the end of treatment(T1) and at the 3-month follow-up(T2). Results: After treatment, patients receiving FR show better cognitive and psychosocial performance than those receiving TAU. Conclusions: Given the important role of neutrophins in the pathogenesis of BD, identifying BD-specific biomarkers would contribute to understand the underlying neuro-pathophysiological processes and to personalize treatments. Disclosure: No significant relationships.
Journal of Affective Disorders, Apr 1, 2020
Background: Cannabis use is markedly prevalent among patients with bipolar disorder (BD). However... more Background: Cannabis use is markedly prevalent among patients with bipolar disorder (BD). However, to date, there have been no studies on this issue with a sex-based approach. This study examines if lifetime cannabis use (LCU) is differently associated with clinical course, functioning, and quality of life (QoL) in patients with BD by sex. Methods: Secondary analysis of a cross-sectional, naturalistic, multicentre study. LCU was defined as having had at least one day of use per month for at least 12 consecutive months in a patient's life. Results: A total of 224 patients with BD were included (65.2% women). Patients with LCU were younger (p = 0.001) and had their first hospitalization earlier (p<0.005) than those without LCU, regardless of sex. Among women, LCU was associated with being single (p = 0.006), worse sexual functioning (p = 0.006), financial functioning (p = 0.009), QoL [bodily pain (p = 0.009), vitality (p = 0.027), social functioning (p = 0.037), emotional role (p = 0.038), mental health (p = 0.001), and mental summary component (p = 0.012)]. After controlling for confounders, among women, LCU was associated with worse QoL, specifically on bodily pain (p = 0.049) and mental health (p = 0.016) subscales. Among males, no statistically significant differences were found between LCU and no LCU (NLCU) in any of the variables of the study. Limitations: This study was a secondary analysis not powered specifically to analyze cannabis use. Conclusions: LCU was associated with a younger age at first hospitalization in both women and men, while only women reported worse QoL on bodily pain and mental health subscales. Clinicians and public health providers should be aware of this and inform their patients and the general population of these detrimental effects. occurrence of manic and mixed episodes (Gibbs et al., 2015; Weinstock et al., 2016), greater risk of attempted suicide (Ostergaard et al., 2017), higher prevalence of psychotic symptoms (Braga et al., 2012; van Rossum, Boomsma, Tenback, Reed, and van Os, 2009; Weinstock et al., 2016), and decreased compliance with treatment (van Rossum et al., 2009). Along these lines, LCU has also been associated with earlier onset of BD (Lagerberg et al., 2016) and an increased risk of hospital stays due to affective episodes (Lagerberg et al., 2016). However, the mechanisms underlying the influence of cannabis on clinical course are unknown, and, to date, there have been no studies
Revista de Psiquiatría y Salud Mental, Feb 1, 2023
Translational Psychiatry, Jan 29, 2020
Bipolar disorder (BD) has been identified as a life-course illness with different clinical manife... more Bipolar disorder (BD) has been identified as a life-course illness with different clinical manifestations from an at-risk to a late stage, supporting the assumption that it would benefit from a staging model. In a previous study, we used a clustering approach to stratify 224 patients with a diagnosis of BD into five clusters based on clinical characteristics, functioning, cognition, general health, and health-related quality of life. This study was design to test the construct validity of our previously developed k-means clustering model and to confirm its longitudinal validity over a span of 3 years. Of the 224 patients included at baseline who were used to develop our model, 129 (57.6%) reached the 3-year follow-up. All life domains except mental health-related quality of life (QoL) showed significant worsening in stages (p < 0.001), suggesting construct validity. Furthermore, as patients progressed through stages, functional decline (p < 0.001) and more complex treatment patterns (p = 0.002) were observed. As expected, at 3 years, the majority of patients remained at the same stage (49.6%), or progressed (20.9%) or regressed (23.3%) one stage. Furthermore, 85% of patients who stayed euthymic during that period remained at the same stage or regressed to previous stages, supporting its longitudinal validity. For that reason, this study provides evidence of the construct and longitudinal validity of an empirically developed, comprehensive staging model for patients with BD. Thus, it may help clinicians and researchers to better understand the disorder and, at the same time, to design more accurate and personalized treatment plans.
CRC Press eBooks, Jun 6, 2023
Journal of Psychiatric Research, Feb 1, 2022
Sexual functioning in bipolar disorder (BD) is dependent on multiple clinical and demographic det... more 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.
International Journal of Molecular Sciences, 2019
Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, and phy... more Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, and physical and emotional symptoms. Although its pathophysiology is largely unknown, immune-inflammatory pathways may be involved. We examined serum interleukin (IL)-6, high sensitivity C-reactive protein (hs-CRP), CXCL-8, and IL-10 in 67 female FM patients and 35 healthy women while adjusting for age, body mass index (BMI), and comorbid disorders. We scored the Fibromyalgia Severity Score, Widespread Pain Index (WPI), Symptom Severity Scale (SSS), Hospital Anxiety (HADS-A), and Depression Scale and the Perceived Stress Scale (PSS-10). Clinical rating scales were significantly higher in FM patients than in controls. After adjusting for covariates, IL-6, IL-10, and CXCL-8 were lower in FM than in HC, whereas hs-CRP did not show any difference. Binary regression analyses showed that the diagnosis FM was associated with lowered IL-10, quality of sleep, aerobic activities, and increased HADS-A and...
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2015
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