Manuel Gurpegui | Universidad de Granada (original) (raw)
Papers by Manuel Gurpegui
Journal of Nervous & Mental Disease, 2020
The aim of this study was to investigate the factors associated with illness insight and medicati... more The aim of this study was to investigate the factors associated with illness insight and medication adherence in bipolar disorder (BD). This is a cross-sectional study (with a retrospective evaluation of longitudinal variables) and a secondary analysis of a BD database. The insight of 108 outpatients (age, 48.2 ± 14.1 years, 69% women, 33% euthymic) was measured with three items of the Association of Methodology and Documentation in Psychiatry scale. Their adherence was assessed through patients' and caregivers' reports, plus serum levels. We performed multivariate logistic regression analyses. Full insight was independently and directly associated with adherence, a social support score, and depressive symptoms and inversely associated with intensity of manic symptoms, problems ever with alcohol, and age at onset of the first symptoms. Medication adherence was independently and directly associated with insight, being married, and having had a psychiatric hospitalization and inversely with having suffered a high number of depressive episodes, intensity of manic symptoms, and heavy tobacco smoking.
Research article Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter ph... more Research article Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study
Bipolar Disorders, 2020
Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder (BD). Met... more Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder (BD). Methods: Electronic MEDLINE/PubMed/Cochrane-Library/Scopus/TripDatabase search until 06/30/2019 for studies comparing antioxidant or oxidative stress markers between BD and healthy controls (HCs). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated for ≥3 studies. Results: Forty-four studies (n = 3,767: BD = 1,979; HCs = 1,788) reported on oxidative stress markers malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS), and total nitrites; antioxidants glutathione (GSH), uric acid, and zinc; or antioxidantenhancing enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and GSH-transferase (GST). Compared with HCs, BD was associated with higher GST (P = .01), CAT (P = .02), nitrites (P < .0001), TBARS (P < .0001), MDA (P = .01), uric acid (P < .0001), and lower GSH (P = .006), without differences in SOD, GPX, and zinc. Compared to HCs, levels were higher in BD-mania for TBARS (P < .0001) and uric acid (P < .0001); in BD-depression for TBARS (P = .02); and BD-euthymia for uric acid (P = .03). Uric acid levels were higher in BD-mania vs BD-depression (P = .002), but not vs BD euthymia. TBARS did not differ between BD-mania and BD-depression. Medication-free BD-mania patients had higher SOD (P = .02) and lower GPX (P < .0001) than HCs. After treatment, BD did not differ from HCs regarding SOD and GPX. Conclusions: Beyond a single biomarker of oxidative stress, the combination of several parameters appears to be more informative for BD in general and taking into account illness polarity. BD is associated with an imbalance in oxidative stress with some phase-specificity for uric acid and TBARS and possible treatment benefits for SOD and GPX. Future studies should take into account confounding factors that can modify oxidative stress status and simultaneously measure oxidative stress markers and antioxidants including different blood sources. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Frontiers in Psychiatry, 2020
The aim of this study is to determine the prevalence of three possible diagnostic specifiers, nam... more The aim of this study is to determine the prevalence of three possible diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their association with important socio-demographic, clinical and course-of-illness variables. Methods: A retrospective and naturalistic study on 108 BD outpatients, who were classified according to the PP, polarity of the first episode and early age at onset (≤20 years) [vs. late (>20 years)] and were characterized by their demographics, clinical data, functionality and social support, among others features. After bivariate analyses, those variables showing certain association (P value < 0.25) with the three dependent variables were entered in logistic regression backward selection procedures to identify the variables independently associated with the PP, polarity of the first episode and early age at onset. Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26% with type II. Around 70% had depressive PP, onset with a depressive episode and onset after age 20. Depressive PP was independently associated with depressive onset, higher score on the CGI severity scale and work disability. Onset with depressive episode was associated with type II BD, longer diagnostic delay and higher score on family disability. Early age at onset (≤20 years) was associate with younger age, longer diagnostic delay, presence of ever psychotic symptoms, current use of antipsychotic drugs and higher social support score. Conclusions: The results of this study show that BD patients with depressive PP, onset with depression and early age at onset may represent greater severity, because they are frequently associated with variables that worsen the prognosis. Our findings match up with the conclusions of two systematic reviews and we also include a disability factor (at family and work) that has not been previously reported. This work contributes to the use of polarity and age at onset in BD patients, as it can become a useful instrument in the prognostic and therapeutic applications.
Archivos de neurobiologiá
![Research paper thumbnail of [Psychiatric complications of abortion]](https://attachments.academia-assets.com/95696461/thumbnails/1.jpg)
](Cuadernos de bioética : revista oficial de la Asociación Española de Bioética y Ética Médica
The psychiatric consequences of induced abortion continue to be the object of controversy. The re... more The psychiatric consequences of induced abortion continue to be the object of controversy. The reactions of women when they became aware of conception are very variable. Pregnancy, whether initially intended or unintended, may provoke stress; and miscarriage may bring about feelings of loss and grief reaction. Therefore, induced abortion, with its emotional implications (of relief, shame and guilt) not surprisingly is a stressful adverse life event. METHODOLOGICAL CONSIDERATIONS: There is agreement among researchers on the need to compare the mental health outcomes (or the psychiatric complications) with appropriate groups, including women with unintended pregnancies ending in live births and women with miscarriages. There is also agreement on the need to control for the potential confounding effects of multiple variables: demographic, contextual, personal development, previous or current traumatic experiences, and mental health prior to the obstetric event. Any psychiatric outcome ...
Schizophrenia Research, 2015
Right click to open a feedback form in a new tab to let us know how this document benefits you.
Neurología (English Edition), 2012
(C. Carnero-Pardo). ♦ En el anexo 1 se relacionan los integrantes del grupo FOTOTRANS.
Schizophrenia Research, 2008
psychiatric diagnosis other than non-affective psychosis, being 14.1% CR. Among subjects without ... more psychiatric diagnosis other than non-affective psychosis, being 14.1% CR. Among subjects without any lifetime diagnosis, 31.7% presented psychotic symptoms, being 3.9% CR. Individuals with any psychiatric diagnosis were nine times more likely to present CR delusion (OR: 9.3; 95% CI: 4.9-17.5), and around 4 time to report CR hallucination (OR: 3.8; 95% CI: 2.3-6.4), compared to those without any lifetime diagnosis. Conclusions: These data clearly point out that psychotic symptoms are widely present in the general population, and also shows us that they are spread among all other psychiatric diagnoses other than psychotic diagnosis. The existence of a symptomatic continuum between subjects from the general population and subjects with clinical psychosis with respect to the occurrence of psychotic experiences support the dimensional model of psychosis.
Schizophrenia Research, 2006
According to the literature, there is an association between schizophrenia and caffeine consumpti... more According to the literature, there is an association between schizophrenia and caffeine consumption, but it is not clear whether schizophrenia is associated with either higher prevalence of daily caffeine intake or the amount consumed. In this study we compared our previously published schizophrenia patients (n = 250) with a control sample (n = 290) after controlling for demographic variables and tobacco and alcohol consumption. Current caffeine intake was less frequent in schizophrenia patients (59%, 147/250) than in controls (70%, 204/290). In the multivariate analyses, caffeine intake was less frequent at an older age and in schizophrenia patients, and more frequent in smokers and alcohol users. Among caffeine consumers, heavy caffeine intake (≥ 200 mg/day) was significantly associated with schizophrenia (64%, 94/147 in schizophrenia versus 36%, 73/204 in controls), as well as older age and smoking. Daily amount of caffeine intake and smoked cigarettes correlated significantly in the schizophrenia group but not in the control group; the correlation of caffeine intake with nicotine dependence was low and non-significant in both groups. The association between current smoking and heavy caffeine intake may be partly explained by a pharmacokinetic effect: tobacco smoke compounds induce caffeine metabolism by the cytochrome P450 1A2. Although schizophrenia by itself may be associated with heavy caffeine intake in caffeine users, part of this association was explained by the association between schizophrenia and smoking. The relationship between caffeine and alcohol intake appeared to be more complex; alcohol and caffeine use were significantly associated, but within caffeine users alcohol was associated with less frequent heavy caffeine consumption among smokers. In future studies, the measurement of plasma caffeine levels will help both to better define heavy caffeine intake and to control for smoking pharmacokinetic effects.
Psychiatry Research, 2012
We examined sex differences in the distribution of psychiatric diagnoses among hospitalized patie... more We examined sex differences in the distribution of psychiatric diagnoses among hospitalized patients, controlling for socio-demographic variables. The sample included 1865 psychiatric inpatients consecutively admitted during a 9-year period. The finding of a higher proportion of men among patients hospitalized for schizophrenia or substance use disorder and a higher proportion of women among those admitted for affective disorders, including bipolar disorder, was stable over time. A better understanding of these differences may help to establish more effective treatment strategies.
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008
Objective: As an indication of potential psychopathology, our aim was to compare, in a non-psychi... more Objective: As an indication of potential psychopathology, our aim was to compare, in a non-psychiatric sample, the variables associated to daily smoking with those associated to nicotine dependence. We also compared dependent and non-dependent smokers on these variables and on the age of onset of daily smoking (AODS). Method: A sample of 290 persons aged 18 or older, recruited in a family medical clinic, were interviewed to inquire about their tobacco, caffeine, alcohol, and illegal drugs consumption, and on their practice of physical exercise. Psychiatric morbidity was assessed with the General Health Questionnaire (GHQ-28) and defined by a score N 6. They also were questioned on their use of psychotropic medication and previous suicide attempt. The smokers answered the Fagerström Test for Nicotine Dependence (FTND) and the question on their age of onset of daily smoking (AODS). Results: In comparison with non-dependent smoking, nicotine dependence was associated with current use of psychotropic medication, psychiatric morbidity, previous suicide attempt, and earlier AODS. Logistic regression analyses showed that nicotine dependence was associated with antecedents of suicide attempt and primary or lower education as well as with high caffeine use and the regular use of illegal drugs; in contrast, daily smoking showed a significant association with high caffeine use, the regular use of illegal drugs and lack of physical exercise. Conclusions: In terms of psychopathology or behavioral disturbance-particularly attempting suicidenicotine dependence adds significant information as opposed to the simple daily smoking, with important implications in clinical and epidemiological psychiatric studies.
Journal of Psychiatric Research, 2013
Objective: Low serum phosphate level is considered one of the metabolic adaptations to the respir... more Objective: Low serum phosphate level is considered one of the metabolic adaptations to the respiratory alkalosis induced by hyperventilation associated with panic disorder. The aim of this study was to assess phosphatemia as a possible state marker for panic disorder. Methods: Sixteen panic disorder patients underwent clinical assessment with a semi-structured interview, a set of rating scales and the self-rated State and Trait Anxiety Inventory (STAI), as well as extraction of venous blood samples at baseline and after 12 weeks of pharmacological treatment. Ten healthy volunteers of similar sex, age and educational level filled out the STAI and gave blood samples at baseline and 12 weeks later. Results: The median (25the75th percentiles) of phosphate levels (mg/dl) was 2.68 (2.22e3.18) among patients and 4.13 (3.74e4.70) among healthy volunteers respectively (P < 0.001). Seven (44%) patients and no healthy volunteers presented low serum phosphate (<2.50 mg/dl) at baseline; this patient abnormality was corrected in all cases after successful treatment. At baseline, the age-adjusted correlation between phosphate levels and state-anxiety was À0.66 (P < 0.001) among all 26 participants and À0.51 (P ¼ 0.05) among the 16 panic disorder patients. Conclusions: Measurement of phosphate levels could be easily introduced into clinical practice as a possible marker for chronic hyperventilation in panic disorder, although further investigations with larger sample sizes are necessary to characterize panic disorder patients with low versus normal phosphate levels.
Journal of Affective Disorders, 2009
Background: Psychopathological vulnerability may be related to certain personality traits. The ai... more Background: Psychopathological vulnerability may be related to certain personality traits. The aim of this study was to explore the association of minor affective psychopathology and the regular use of psychotropic medication with temperament and character profiles from Cloninger's personality model, in a sample of active professional people. Methods: This cross-sectional study included 498 non-clinical subjects, teachers in a local school system. Instruments used included the self-administered General Health Questionnaire (GHQ-28) to measure psychiatric morbidity; the Center for Epidemiologic Studies Depression scale (CES-D) to measure depressive symptoms; documentation of regular use of psychotropic medication; and the Temperament and Character Inventory (TCI-125) for personality traits self-assessment. Results: The proportion of subjects presenting psychiatric morbidity (GHQ-28 N 6) or depressive symptoms (CES-D N 20) was significantly higher among explosive, passive-aggressive, and obsessional temperament profiles, and among schizotypal, moody, melancholic and dependent character profiles. Similar results were observed with the scores on each of the four GHQ-28 subscales (depression, anxiety, social dysfunction, and somatic symptoms). The regular use of psychotropic medications was significantly higher among the passive-aggressive and explosive temperament types, and among the schizoptypal and moody character types. Limitations: Being a cross-sectional study, no causal attributions can be inferred. Subjects on sick leave were excluded, so the sample was not representative of the general population. The data were collected using self-reporting questionnaires, and no specific psychiatric diagnoses were obtained. Conclusions: It is possible to identify certain personality configurations associated with minor psychopathology and concomitant use of psychotropics, among active professional people.
International Clinical Psychopharmacology, 2011
The impact of medication adherence on relapse was assessed in an observational study of patients ... more The impact of medication adherence on relapse was assessed in an observational study of patients with an acute manic or mixed episode who were follow up over 2 years. Adherence was associated with a lower risk of relapse in these patients independent of differences in baseline characteristics. This study was sponsored by Eli Lilly & Company.
International Clinical Psychopharmacology, 2011
We analyzed the presence of work, social life and family life disability in 108 outpatients with ... more We analyzed the presence of work, social life and family life disability in 108 outpatients with a Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) diagnosis of bipolar disorder and their association with previous course-of-illness variables and current psychopathology. Work disability was pragmatically defined as being on a disability pension or in the process of obtaining it; social life or family life disability was defined by a score ≥ 7 in the respective subscales of the Sheehan Disability Scale. At least one type of disability (for work, social life or family life) affected 52-54% of the patients; and two types, 37%. By logistic regression and multiple linear regression analyses we determined the variables independently associated with each type of disability: 1) Work disability was significantly associated with previous repeated manic episodes, three or more hospitalizations, with current depressive symptoms and inversely with the educational attainment. 2) Social life disability significantly increased with the number of hospitalizations and was associated with previous repeated depressive episodes and current depressive symptoms. In alternative models, nicotine dependence and lack of social support were significantly associated with work and social life disability respectively. And 3) family life disability significantly increased with number of hospitalizations, CAGE questionnaire score and age; and was associated with previous repeated manic episodes and current depressive symptoms. In conclusion, previous course-of-illness variables, particularly a high number of manic episodes, and current psychopathologyas indicated by the presence of nicotine dependence or depressive symptomsmay be indicators of disability; previous manic episodes appear to affect disability at work or at family life whereas previous depressive episodes seem to be related with social life disability.
European Psychiatry, 2000
306s FC 12. Schizophrenia III Twin studies constitute a good adequate strategy to evaluate the "e... more 306s FC 12. Schizophrenia III Twin studies constitute a good adequate strategy to evaluate the "endophenotype" present through the schizophrenic spectrum, inimportance of genetic and environmental effects. dependent of its syndromatic presentation. Method: RD and APFC were studied in three independent samples of MZ twins discordant and concordant for psychosis. Samples were: i) 24 pairs with one or two affected twins (10 pairs and 14 pairs respectively) and 13 pairs of well control twins held in the Department of Genetics at the Institute of Psychiatry; ii) 19 MZ pairs concordant, 3 1 pairs discordant drawn from the recent NLMH twin sample; iii) 27 pairs of MZ twins concordant and discordant for psychosis grid related disorders (17 and 10 pairs, respectively) and 10 pairs of well control MZ twins from the ongoing Maudsley twin study. FC12.05 SMOKING IN SCHIZOPHRENIA: PREVALENCE AND ASSOCIATED FEATURES M. Gurpegui l. M.C. Aguilar, J. de Leon'. Dept. qfPs.vchiuf~v and lnsrirure of Neurosciences. Uniue,si(v qf Granuda. Spain 'Dept. qf P.~ychiat~, Uniuer.si~~ r!/ Kenlrrch~! Lexington. USA Dermatoglyphic analysis was conducted blind to concordance and diagnostic status in all the cases. Results: The first study reported higher risk of APFC and RD in MZ affected compared to non-affected twins (0.R = 6.8, 95% CI: 2-23.5) (Van Oi et al. Biol. Psychiafty, 1997). These results have been replicated again in the NIMH twin sample (0.R = 2.4, 95%
European Psychiatry, 2007
Poor diet habits and a more sedentary life may contribute to a worse physical health outcome of p... more Poor diet habits and a more sedentary life may contribute to a worse physical health outcome of persons with schizophrenia, who are subjected to an increased risk of diabetes mellitus and other metabolic complications. These patients report greater euphoria and stimulatory effects in response to alcohol that may contribute to the increased risk for alcohol use disorders, which complicate the functional outcome of schizophrenia. Among subjects in this diagnostic group, those exposed to caffeine consumption tend to drink heavier amount of it, although the psychobiological implication of this finding has not been elucidated. Finally, there is worldwide a greater prevalence of tobacco smoking, heavy smoking and high nicotine dependence; and the available date support a theory of shared vulnerability to both smoking and schizophrenia rather than a self-medication hypothesis. The authors, all of whom have been contributors in this area, will discuss each other presentations
Journal of Nervous & Mental Disease, 2020
The aim of this study was to investigate the factors associated with illness insight and medicati... more The aim of this study was to investigate the factors associated with illness insight and medication adherence in bipolar disorder (BD). This is a cross-sectional study (with a retrospective evaluation of longitudinal variables) and a secondary analysis of a BD database. The insight of 108 outpatients (age, 48.2 ± 14.1 years, 69% women, 33% euthymic) was measured with three items of the Association of Methodology and Documentation in Psychiatry scale. Their adherence was assessed through patients' and caregivers' reports, plus serum levels. We performed multivariate logistic regression analyses. Full insight was independently and directly associated with adherence, a social support score, and depressive symptoms and inversely associated with intensity of manic symptoms, problems ever with alcohol, and age at onset of the first symptoms. Medication adherence was independently and directly associated with insight, being married, and having had a psychiatric hospitalization and inversely with having suffered a high number of depressive episodes, intensity of manic symptoms, and heavy tobacco smoking.
Research article Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter ph... more Research article Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study
Bipolar Disorders, 2020
Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder (BD). Met... more Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder (BD). Methods: Electronic MEDLINE/PubMed/Cochrane-Library/Scopus/TripDatabase search until 06/30/2019 for studies comparing antioxidant or oxidative stress markers between BD and healthy controls (HCs). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated for ≥3 studies. Results: Forty-four studies (n = 3,767: BD = 1,979; HCs = 1,788) reported on oxidative stress markers malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS), and total nitrites; antioxidants glutathione (GSH), uric acid, and zinc; or antioxidantenhancing enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and GSH-transferase (GST). Compared with HCs, BD was associated with higher GST (P = .01), CAT (P = .02), nitrites (P < .0001), TBARS (P < .0001), MDA (P = .01), uric acid (P < .0001), and lower GSH (P = .006), without differences in SOD, GPX, and zinc. Compared to HCs, levels were higher in BD-mania for TBARS (P < .0001) and uric acid (P < .0001); in BD-depression for TBARS (P = .02); and BD-euthymia for uric acid (P = .03). Uric acid levels were higher in BD-mania vs BD-depression (P = .002), but not vs BD euthymia. TBARS did not differ between BD-mania and BD-depression. Medication-free BD-mania patients had higher SOD (P = .02) and lower GPX (P < .0001) than HCs. After treatment, BD did not differ from HCs regarding SOD and GPX. Conclusions: Beyond a single biomarker of oxidative stress, the combination of several parameters appears to be more informative for BD in general and taking into account illness polarity. BD is associated with an imbalance in oxidative stress with some phase-specificity for uric acid and TBARS and possible treatment benefits for SOD and GPX. Future studies should take into account confounding factors that can modify oxidative stress status and simultaneously measure oxidative stress markers and antioxidants including different blood sources. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Frontiers in Psychiatry, 2020
The aim of this study is to determine the prevalence of three possible diagnostic specifiers, nam... more The aim of this study is to determine the prevalence of three possible diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their association with important socio-demographic, clinical and course-of-illness variables. Methods: A retrospective and naturalistic study on 108 BD outpatients, who were classified according to the PP, polarity of the first episode and early age at onset (≤20 years) [vs. late (>20 years)] and were characterized by their demographics, clinical data, functionality and social support, among others features. After bivariate analyses, those variables showing certain association (P value < 0.25) with the three dependent variables were entered in logistic regression backward selection procedures to identify the variables independently associated with the PP, polarity of the first episode and early age at onset. Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26% with type II. Around 70% had depressive PP, onset with a depressive episode and onset after age 20. Depressive PP was independently associated with depressive onset, higher score on the CGI severity scale and work disability. Onset with depressive episode was associated with type II BD, longer diagnostic delay and higher score on family disability. Early age at onset (≤20 years) was associate with younger age, longer diagnostic delay, presence of ever psychotic symptoms, current use of antipsychotic drugs and higher social support score. Conclusions: The results of this study show that BD patients with depressive PP, onset with depression and early age at onset may represent greater severity, because they are frequently associated with variables that worsen the prognosis. Our findings match up with the conclusions of two systematic reviews and we also include a disability factor (at family and work) that has not been previously reported. This work contributes to the use of polarity and age at onset in BD patients, as it can become a useful instrument in the prognostic and therapeutic applications.
Archivos de neurobiologiá
Cuadernos de bioética : revista oficial de la Asociación Española de Bioética y Ética Médica
The psychiatric consequences of induced abortion continue to be the object of controversy. The re... more The psychiatric consequences of induced abortion continue to be the object of controversy. The reactions of women when they became aware of conception are very variable. Pregnancy, whether initially intended or unintended, may provoke stress; and miscarriage may bring about feelings of loss and grief reaction. Therefore, induced abortion, with its emotional implications (of relief, shame and guilt) not surprisingly is a stressful adverse life event. METHODOLOGICAL CONSIDERATIONS: There is agreement among researchers on the need to compare the mental health outcomes (or the psychiatric complications) with appropriate groups, including women with unintended pregnancies ending in live births and women with miscarriages. There is also agreement on the need to control for the potential confounding effects of multiple variables: demographic, contextual, personal development, previous or current traumatic experiences, and mental health prior to the obstetric event. Any psychiatric outcome ...
Schizophrenia Research, 2015
Right click to open a feedback form in a new tab to let us know how this document benefits you.
Neurología (English Edition), 2012
(C. Carnero-Pardo). ♦ En el anexo 1 se relacionan los integrantes del grupo FOTOTRANS.
Schizophrenia Research, 2008
psychiatric diagnosis other than non-affective psychosis, being 14.1% CR. Among subjects without ... more psychiatric diagnosis other than non-affective psychosis, being 14.1% CR. Among subjects without any lifetime diagnosis, 31.7% presented psychotic symptoms, being 3.9% CR. Individuals with any psychiatric diagnosis were nine times more likely to present CR delusion (OR: 9.3; 95% CI: 4.9-17.5), and around 4 time to report CR hallucination (OR: 3.8; 95% CI: 2.3-6.4), compared to those without any lifetime diagnosis. Conclusions: These data clearly point out that psychotic symptoms are widely present in the general population, and also shows us that they are spread among all other psychiatric diagnoses other than psychotic diagnosis. The existence of a symptomatic continuum between subjects from the general population and subjects with clinical psychosis with respect to the occurrence of psychotic experiences support the dimensional model of psychosis.
Schizophrenia Research, 2006
According to the literature, there is an association between schizophrenia and caffeine consumpti... more According to the literature, there is an association between schizophrenia and caffeine consumption, but it is not clear whether schizophrenia is associated with either higher prevalence of daily caffeine intake or the amount consumed. In this study we compared our previously published schizophrenia patients (n = 250) with a control sample (n = 290) after controlling for demographic variables and tobacco and alcohol consumption. Current caffeine intake was less frequent in schizophrenia patients (59%, 147/250) than in controls (70%, 204/290). In the multivariate analyses, caffeine intake was less frequent at an older age and in schizophrenia patients, and more frequent in smokers and alcohol users. Among caffeine consumers, heavy caffeine intake (≥ 200 mg/day) was significantly associated with schizophrenia (64%, 94/147 in schizophrenia versus 36%, 73/204 in controls), as well as older age and smoking. Daily amount of caffeine intake and smoked cigarettes correlated significantly in the schizophrenia group but not in the control group; the correlation of caffeine intake with nicotine dependence was low and non-significant in both groups. The association between current smoking and heavy caffeine intake may be partly explained by a pharmacokinetic effect: tobacco smoke compounds induce caffeine metabolism by the cytochrome P450 1A2. Although schizophrenia by itself may be associated with heavy caffeine intake in caffeine users, part of this association was explained by the association between schizophrenia and smoking. The relationship between caffeine and alcohol intake appeared to be more complex; alcohol and caffeine use were significantly associated, but within caffeine users alcohol was associated with less frequent heavy caffeine consumption among smokers. In future studies, the measurement of plasma caffeine levels will help both to better define heavy caffeine intake and to control for smoking pharmacokinetic effects.
Psychiatry Research, 2012
We examined sex differences in the distribution of psychiatric diagnoses among hospitalized patie... more We examined sex differences in the distribution of psychiatric diagnoses among hospitalized patients, controlling for socio-demographic variables. The sample included 1865 psychiatric inpatients consecutively admitted during a 9-year period. The finding of a higher proportion of men among patients hospitalized for schizophrenia or substance use disorder and a higher proportion of women among those admitted for affective disorders, including bipolar disorder, was stable over time. A better understanding of these differences may help to establish more effective treatment strategies.
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008
Objective: As an indication of potential psychopathology, our aim was to compare, in a non-psychi... more Objective: As an indication of potential psychopathology, our aim was to compare, in a non-psychiatric sample, the variables associated to daily smoking with those associated to nicotine dependence. We also compared dependent and non-dependent smokers on these variables and on the age of onset of daily smoking (AODS). Method: A sample of 290 persons aged 18 or older, recruited in a family medical clinic, were interviewed to inquire about their tobacco, caffeine, alcohol, and illegal drugs consumption, and on their practice of physical exercise. Psychiatric morbidity was assessed with the General Health Questionnaire (GHQ-28) and defined by a score N 6. They also were questioned on their use of psychotropic medication and previous suicide attempt. The smokers answered the Fagerström Test for Nicotine Dependence (FTND) and the question on their age of onset of daily smoking (AODS). Results: In comparison with non-dependent smoking, nicotine dependence was associated with current use of psychotropic medication, psychiatric morbidity, previous suicide attempt, and earlier AODS. Logistic regression analyses showed that nicotine dependence was associated with antecedents of suicide attempt and primary or lower education as well as with high caffeine use and the regular use of illegal drugs; in contrast, daily smoking showed a significant association with high caffeine use, the regular use of illegal drugs and lack of physical exercise. Conclusions: In terms of psychopathology or behavioral disturbance-particularly attempting suicidenicotine dependence adds significant information as opposed to the simple daily smoking, with important implications in clinical and epidemiological psychiatric studies.
Journal of Psychiatric Research, 2013
Objective: Low serum phosphate level is considered one of the metabolic adaptations to the respir... more Objective: Low serum phosphate level is considered one of the metabolic adaptations to the respiratory alkalosis induced by hyperventilation associated with panic disorder. The aim of this study was to assess phosphatemia as a possible state marker for panic disorder. Methods: Sixteen panic disorder patients underwent clinical assessment with a semi-structured interview, a set of rating scales and the self-rated State and Trait Anxiety Inventory (STAI), as well as extraction of venous blood samples at baseline and after 12 weeks of pharmacological treatment. Ten healthy volunteers of similar sex, age and educational level filled out the STAI and gave blood samples at baseline and 12 weeks later. Results: The median (25the75th percentiles) of phosphate levels (mg/dl) was 2.68 (2.22e3.18) among patients and 4.13 (3.74e4.70) among healthy volunteers respectively (P < 0.001). Seven (44%) patients and no healthy volunteers presented low serum phosphate (<2.50 mg/dl) at baseline; this patient abnormality was corrected in all cases after successful treatment. At baseline, the age-adjusted correlation between phosphate levels and state-anxiety was À0.66 (P < 0.001) among all 26 participants and À0.51 (P ¼ 0.05) among the 16 panic disorder patients. Conclusions: Measurement of phosphate levels could be easily introduced into clinical practice as a possible marker for chronic hyperventilation in panic disorder, although further investigations with larger sample sizes are necessary to characterize panic disorder patients with low versus normal phosphate levels.
Journal of Affective Disorders, 2009
Background: Psychopathological vulnerability may be related to certain personality traits. The ai... more Background: Psychopathological vulnerability may be related to certain personality traits. The aim of this study was to explore the association of minor affective psychopathology and the regular use of psychotropic medication with temperament and character profiles from Cloninger's personality model, in a sample of active professional people. Methods: This cross-sectional study included 498 non-clinical subjects, teachers in a local school system. Instruments used included the self-administered General Health Questionnaire (GHQ-28) to measure psychiatric morbidity; the Center for Epidemiologic Studies Depression scale (CES-D) to measure depressive symptoms; documentation of regular use of psychotropic medication; and the Temperament and Character Inventory (TCI-125) for personality traits self-assessment. Results: The proportion of subjects presenting psychiatric morbidity (GHQ-28 N 6) or depressive symptoms (CES-D N 20) was significantly higher among explosive, passive-aggressive, and obsessional temperament profiles, and among schizotypal, moody, melancholic and dependent character profiles. Similar results were observed with the scores on each of the four GHQ-28 subscales (depression, anxiety, social dysfunction, and somatic symptoms). The regular use of psychotropic medications was significantly higher among the passive-aggressive and explosive temperament types, and among the schizoptypal and moody character types. Limitations: Being a cross-sectional study, no causal attributions can be inferred. Subjects on sick leave were excluded, so the sample was not representative of the general population. The data were collected using self-reporting questionnaires, and no specific psychiatric diagnoses were obtained. Conclusions: It is possible to identify certain personality configurations associated with minor psychopathology and concomitant use of psychotropics, among active professional people.
International Clinical Psychopharmacology, 2011
The impact of medication adherence on relapse was assessed in an observational study of patients ... more The impact of medication adherence on relapse was assessed in an observational study of patients with an acute manic or mixed episode who were follow up over 2 years. Adherence was associated with a lower risk of relapse in these patients independent of differences in baseline characteristics. This study was sponsored by Eli Lilly & Company.
International Clinical Psychopharmacology, 2011
We analyzed the presence of work, social life and family life disability in 108 outpatients with ... more We analyzed the presence of work, social life and family life disability in 108 outpatients with a Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) diagnosis of bipolar disorder and their association with previous course-of-illness variables and current psychopathology. Work disability was pragmatically defined as being on a disability pension or in the process of obtaining it; social life or family life disability was defined by a score ≥ 7 in the respective subscales of the Sheehan Disability Scale. At least one type of disability (for work, social life or family life) affected 52-54% of the patients; and two types, 37%. By logistic regression and multiple linear regression analyses we determined the variables independently associated with each type of disability: 1) Work disability was significantly associated with previous repeated manic episodes, three or more hospitalizations, with current depressive symptoms and inversely with the educational attainment. 2) Social life disability significantly increased with the number of hospitalizations and was associated with previous repeated depressive episodes and current depressive symptoms. In alternative models, nicotine dependence and lack of social support were significantly associated with work and social life disability respectively. And 3) family life disability significantly increased with number of hospitalizations, CAGE questionnaire score and age; and was associated with previous repeated manic episodes and current depressive symptoms. In conclusion, previous course-of-illness variables, particularly a high number of manic episodes, and current psychopathologyas indicated by the presence of nicotine dependence or depressive symptomsmay be indicators of disability; previous manic episodes appear to affect disability at work or at family life whereas previous depressive episodes seem to be related with social life disability.
European Psychiatry, 2000
306s FC 12. Schizophrenia III Twin studies constitute a good adequate strategy to evaluate the "e... more 306s FC 12. Schizophrenia III Twin studies constitute a good adequate strategy to evaluate the "endophenotype" present through the schizophrenic spectrum, inimportance of genetic and environmental effects. dependent of its syndromatic presentation. Method: RD and APFC were studied in three independent samples of MZ twins discordant and concordant for psychosis. Samples were: i) 24 pairs with one or two affected twins (10 pairs and 14 pairs respectively) and 13 pairs of well control twins held in the Department of Genetics at the Institute of Psychiatry; ii) 19 MZ pairs concordant, 3 1 pairs discordant drawn from the recent NLMH twin sample; iii) 27 pairs of MZ twins concordant and discordant for psychosis grid related disorders (17 and 10 pairs, respectively) and 10 pairs of well control MZ twins from the ongoing Maudsley twin study. FC12.05 SMOKING IN SCHIZOPHRENIA: PREVALENCE AND ASSOCIATED FEATURES M. Gurpegui l. M.C. Aguilar, J. de Leon'. Dept. qfPs.vchiuf~v and lnsrirure of Neurosciences. Uniue,si(v qf Granuda. Spain 'Dept. qf P.~ychiat~, Uniuer.si~~ r!/ Kenlrrch~! Lexington. USA Dermatoglyphic analysis was conducted blind to concordance and diagnostic status in all the cases. Results: The first study reported higher risk of APFC and RD in MZ affected compared to non-affected twins (0.R = 6.8, 95% CI: 2-23.5) (Van Oi et al. Biol. Psychiafty, 1997). These results have been replicated again in the NIMH twin sample (0.R = 2.4, 95%
European Psychiatry, 2007
Poor diet habits and a more sedentary life may contribute to a worse physical health outcome of p... more Poor diet habits and a more sedentary life may contribute to a worse physical health outcome of persons with schizophrenia, who are subjected to an increased risk of diabetes mellitus and other metabolic complications. These patients report greater euphoria and stimulatory effects in response to alcohol that may contribute to the increased risk for alcohol use disorders, which complicate the functional outcome of schizophrenia. Among subjects in this diagnostic group, those exposed to caffeine consumption tend to drink heavier amount of it, although the psychobiological implication of this finding has not been elucidated. Finally, there is worldwide a greater prevalence of tobacco smoking, heavy smoking and high nicotine dependence; and the available date support a theory of shared vulnerability to both smoking and schizophrenia rather than a self-medication hypothesis. The authors, all of whom have been contributors in this area, will discuss each other presentations