Pub Date : 2023-01-01DOI: 10.1016/j.rpsm.2022.08.001
Manuel Canal-Rivero , Cristian Montes-García , Nathalia Garrido-Torres , Amanda Moreno-Mellado , Pablo Reguera-Pozuelo , Miguel Ruiz-Veguilla , Benedicto Crespo-Facorro
Introduction
Health care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW.
Materials and methods
One thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods.
Results
HCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors.
Conclusions
Somatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.
{"title":"The impact of COVID-19 pandemic on the psychological well-being among health care workers: A 6-month cohort longitudinal survey study","authors":"Manuel Canal-Rivero , Cristian Montes-García , Nathalia Garrido-Torres , Amanda Moreno-Mellado , Pablo Reguera-Pozuelo , Miguel Ruiz-Veguilla , Benedicto Crespo-Facorro","doi":"10.1016/j.rpsm.2022.08.001","DOIUrl":"10.1016/j.rpsm.2022.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Health care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW.</p></div><div><h3>Materials and methods</h3><p>One thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods.</p></div><div><h3>Results</h3><p>HCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors.</p></div><div><h3>Conclusions</h3><p>Somatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"16 ","pages":"Pages 25-37"},"PeriodicalIF":9.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9416651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1016/j.rpsm.2022.12.002
Ana Viejo Casas , Marcos Gómez-Revuelta , Urko Merino Garay , Francisco Ruiz Guerrero , Mario Ruiz Núñez , Patricia Fernández Solla , Roberto Garrastazu López , Juan Carlos López Caro , Elsa García Rumayor , Laura Boada Antón , María Juncal Ruiz , Víctor Ortiz-García de la Foz , Javier Vázquez-Bourgon
Background
COVID-19 pandemic has affected the mental health of the general population, and in particular of health professionals. Primary care personnel are at greater risk due to being highly exposed to the disease and working regularly in direct contact with patients suffering COVID-19. However, there is not sufficient evidence on the long-term psychological impact these professionals may suffer. We aimed to explore the long-term psychological impact of COVID-19 on primary care professionals.
Methods
We applied a two-phase design; a self-reported psychopathology screening (PHQ-9, GAD-7, ISI and IES-R) in phase-1, and a specialised psychiatric evaluation (MINI, HDRS and STAI) in phase-2 to confirm phase-1 results. Evaluations were carried at the beginning of the pandemic (May–June 2020) (n = 410) and one year later (n = 339). Chi-square, ANOVA and logistic regression tests were used for statistical analyses.
Results
Primary care professionals presented high rates of depression, anxiety and psychological distress, measured by PHQ-9, GAD-7 and IES-R respectively, during the pandemic. Depressive symptoms’ severity (PHQ-9: 7.5 vs 8.4, p = 0.013) increased after one year of COVID-19 pandemic. After one year nearly 40% of subjects presented depression. Being women, having suffered COVID-19 or a relative with COVID-19, and being a front-line professional were risk factors for presenting depression and anxiety.
Conclusion
Primary Care professionals in Cantabria present a poor mental health during COVID-19 pandemic, which has even worsened at long-term, presenting a greater psychopathology severity one year after. Thus, it is critical implementing prevention and early-treatment programmes to help these essential professionals to cope with the pandemic.
背景新冠肺炎疫情影响了普通人群的心理健康，尤其是卫生专业人员的心理健康。初级保健人员面临更大的风险，因为他们高度接触这种疾病，并定期与新冠肺炎患者直接接触。然而，没有足够的证据表明这些专业人员可能会遭受长期的心理影响。我们旨在探讨新冠肺炎对初级保健专业人员的长期心理影响。方法采用两阶段设计；在第一阶段进行自我报告的精神病理学筛查（PHQ-9、GAD-7、ISI和IES-R），在第二阶段进行专门的精神病学评估（MINI、HDRS和STAI），以确认第一阶段的结果。在大流行开始时（2020年5月至6月）（n=410）和一年后（n=339）进行了评估。采用卡方检验、方差分析和逻辑回归检验进行统计分析。结果在疫情期间，初级保健专业人员的抑郁、焦虑和心理困扰发生率较高，PHQ-9、GAD-7和IES-R分别测定。新冠肺炎大流行一年后，抑郁症状的严重程度（PHQ-9:7.5 vs 8.4，p=0.013）增加。一年后，近40%的受试者出现抑郁症。女性、患有新冠肺炎或患有新冠肺炎的亲属以及一线专业人员是出现抑郁和焦虑的危险因素。结论新冠肺炎大流行期间，坎塔布里亚初级保健专业人员的心理健康状况较差，长期来看甚至恶化，一年后表现出更严重的精神病理学。因此，至关重要的是实施预防和早期治疗方案，以帮助这些重要的专业人员应对疫情。
{"title":"Long-term mental health impact of COVID-19 on primary care health workers in northern Spain: Results from a two-phase longitudinal study","authors":"Ana Viejo Casas , Marcos Gómez-Revuelta , Urko Merino Garay , Francisco Ruiz Guerrero , Mario Ruiz Núñez , Patricia Fernández Solla , Roberto Garrastazu López , Juan Carlos López Caro , Elsa García Rumayor , Laura Boada Antón , María Juncal Ruiz , Víctor Ortiz-García de la Foz , Javier Vázquez-Bourgon","doi":"10.1016/j.rpsm.2022.12.002","DOIUrl":"10.1016/j.rpsm.2022.12.002","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 pandemic has affected the mental health of the general population, and in particular of health professionals. Primary care personnel are at greater risk due to being highly exposed to the disease and working regularly in direct contact with patients suffering COVID-19. However, there is not sufficient evidence on the long-term psychological impact these professionals may suffer. We aimed to explore the long-term psychological impact of COVID-19 on primary care professionals.</p></div><div><h3>Methods</h3><p>We applied a two-phase design; a self-reported psychopathology screening (PHQ-9, GAD-7, ISI and IES-R) in phase-1, and a specialised psychiatric evaluation (MINI, HDRS and STAI) in phase-2 to confirm phase-1 results. Evaluations were carried at the beginning of the pandemic (May–June 2020) (<em>n</em> <!-->=<!--> <!-->410) and one year later (<em>n</em> <!-->=<!--> <!-->339). Chi-square, ANOVA and logistic regression tests were used for statistical analyses.</p></div><div><h3>Results</h3><p>Primary care professionals presented high rates of depression, anxiety and psychological distress, measured by PHQ-9, GAD-7 and IES-R respectively, during the pandemic. Depressive symptoms’ severity (PHQ-9: 7.5 vs 8.4, <em>p</em> <!-->=<!--> <!-->0.013) increased after one year of COVID-19 pandemic. After one year nearly 40% of subjects presented depression. Being women, having suffered COVID-19 or a relative with COVID-19, and being a front-line professional were risk factors for presenting depression and anxiety.</p></div><div><h3>Conclusion</h3><p>Primary Care professionals in Cantabria present a poor mental health during COVID-19 pandemic, which has even worsened at long-term, presenting a greater psychopathology severity one year after. Thus, it is critical implementing prevention and early-treatment programmes to help these essential professionals to cope with the pandemic.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"16 ","pages":"Pages 1-10"},"PeriodicalIF":9.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9495064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1016/j.rpsm.2022.03.004
María Irigoyen-Otiñano , Eugènia Nicolau-Subires , Ana González-Pinto , Marina Adrados-Pérez , Esther Buil-Reiné , Lucía Ibarra-Pertusa , Carla Albert-Porcar , Laura Arenas-Pijoan , Marta Sánchez-Cazalilla , Giovanni Torterolo , Margarita Puigdevall-Ruestes , Vicent Llorca-Bofí
Introduction
Different studies have suggested that psychological, social and economic factors could contribute to an increase in the suicide. That is why the scientific community fear an epidemic of suicides secondary to this crisis. The objective is to evaluate the variables related to suicidal behavior during the two states of alarm and to review if there were sociodemographic or clinical differences with respect to periods prior to the COVID-19 pandemic.
Material and methods
We compared visits to the emergency room and their characteristics of all patients with suicidal behavior before and after the pandemic in Lérida. Information on sociodemographic status, reason for consultation, diagnosis and characteristics of suicidal behavior was obtained from the electronic medical record.
Results
No differences were observed in the percentage of suicidal ideation or attempts in the three periods (p = 0.201). The characteristics in the multiple logistic regression associated with suicidal behavior are: being a woman (OR: 1.81 [1.27–2.56]), living with relatives (OR: 1.55 [1.05–2.32]) and have a diagnosis of non-alcohol related substance use disorder (OR: 1.94 [1.09–3.42]). As protective factors, being visited in the emergency room during the second state of alarm (OR: 0.68 [0.48–0.96]) and having depression (OR: 0.67 [0.47–0.96]).
Conclusions
Emergency care for suicidal behavior did not increase during the pandemic and, in fact, in 2020 completed suicides decreased by almost half in the province. Risk factors for suicide attempt were female gender, living with relatives, and having a substance use disorder diagnosis. Instead, depression was a protective factor.
{"title":"Characteristics of patients treated for suicidal behavior during the pandemic in a psychiatric emergency department in a Spanish province","authors":"María Irigoyen-Otiñano , Eugènia Nicolau-Subires , Ana González-Pinto , Marina Adrados-Pérez , Esther Buil-Reiné , Lucía Ibarra-Pertusa , Carla Albert-Porcar , Laura Arenas-Pijoan , Marta Sánchez-Cazalilla , Giovanni Torterolo , Margarita Puigdevall-Ruestes , Vicent Llorca-Bofí","doi":"10.1016/j.rpsm.2022.03.004","DOIUrl":"10.1016/j.rpsm.2022.03.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Different studies have suggested that psychological, social and economic factors could contribute to an increase in the suicide. That is why the scientific community fear an epidemic of suicides secondary to this crisis. The objective is to evaluate the variables related to suicidal behavior during the two states of alarm and to review if there were sociodemographic or clinical differences with respect to periods prior to the COVID-19 pandemic.</p></div><div><h3>Material and methods</h3><p>We compared visits to the emergency room and their characteristics of all patients with suicidal behavior before and after the pandemic in Lérida. Information on sociodemographic status, reason for consultation, diagnosis and characteristics of suicidal behavior was obtained from the electronic medical record.</p></div><div><h3>Results</h3><p>No differences were observed in the percentage of suicidal ideation or attempts in the three periods (<em>p</em> <!-->=<!--> <!-->0.201). The characteristics in the multiple logistic regression associated with suicidal behavior are: being a woman (OR: 1.81 [1.27–2.56]), living with relatives (OR: 1.55 [1.05–2.32]) and have a diagnosis of non-alcohol related substance use disorder (OR: 1.94 [1.09–3.42]). As protective factors, being visited in the emergency room during the second state of alarm (OR: 0.68 [0.48–0.96]) and having depression (OR: 0.67 [0.47–0.96]).</p></div><div><h3>Conclusions</h3><p>Emergency care for suicidal behavior did not increase during the pandemic and, in fact, in 2020 completed suicides decreased by almost half in the province. Risk factors for suicide attempt were female gender, living with relatives, and having a substance use disorder diagnosis. Instead, depression was a protective factor.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"16 ","pages":"Pages 68-75"},"PeriodicalIF":9.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-14DOI: 10.1016/j.rpsm.2022.12.001
Gerard Anmella, Miriam Sanabra, Mireia Primé-Tous, Xavier Segú, Aleix Solanes, Victoria Ruíz, Ivette Morilla, Antonieta Also Fontanet, Elisenda Sant, Sandra Murgui, Mireia Sans-Corrales, Anabel Martínez-Aran, Giovanna Fico, Michele De Prisco, Vincenzo Oliva, Andrea Murru, Roland Zahn, Allan H Young, Victor Vicens, Clara Viñas-Bardolet, Vicenç Aparicio-Nogué, Juan Francisco Martínez-Cerdá, Ariadna Mas, Bernat Carreras, Jordi Blanch, Joaquim Radua, Miquel A Fullana, Myriam Cavero, Eduard Vieta, Diego Hidalgo-Mazzei
Introduction: There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.
Methods: We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.
Results: Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD.
Conclusions: Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.
{"title":"Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia.","authors":"Gerard Anmella, Miriam Sanabra, Mireia Primé-Tous, Xavier Segú, Aleix Solanes, Victoria Ruíz, Ivette Morilla, Antonieta Also Fontanet, Elisenda Sant, Sandra Murgui, Mireia Sans-Corrales, Anabel Martínez-Aran, Giovanna Fico, Michele De Prisco, Vincenzo Oliva, Andrea Murru, Roland Zahn, Allan H Young, Victor Vicens, Clara Viñas-Bardolet, Vicenç Aparicio-Nogué, Juan Francisco Martínez-Cerdá, Ariadna Mas, Bernat Carreras, Jordi Blanch, Joaquim Radua, Miquel A Fullana, Myriam Cavero, Eduard Vieta, Diego Hidalgo-Mazzei","doi":"10.1016/j.rpsm.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.</p><p><strong>Methods: </strong>We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.</p><p><strong>Results: </strong>Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD.</p><p><strong>Conclusions: </strong>Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.</p>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.1016/j.rpsm.2022.09.005
Roberto Mediavilla, Gonzalo Martínez-Alés, Jorge Andreo-Jover, Iker Louzao-Rojas, Susana Cebolla-Lorenzo, Ainoa Muñoz-San-José, Eduardo Fernández-Jiménez, Pablo Aguirre, José Luis Ayuso-Mateos, María Fe Bravo-Ortiz, Carmen Bayón-Pérez
{"title":"Mental health service requirements after COVID-19 hospitalization: a 1-year follow-up cohort study using electronic health records.","authors":"Roberto Mediavilla, Gonzalo Martínez-Alés, Jorge Andreo-Jover, Iker Louzao-Rojas, Susana Cebolla-Lorenzo, Ainoa Muñoz-San-José, Eduardo Fernández-Jiménez, Pablo Aguirre, José Luis Ayuso-Mateos, María Fe Bravo-Ortiz, Carmen Bayón-Pérez","doi":"10.1016/j.rpsm.2022.09.005","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.09.005","url":null,"abstract":"","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.rpsm.2022.05.005
Agnieszka Cyran , Patryk Piotrowski , Jerzy Samochowiec , Tomasz Grąźlewski , Błażej Misiak
Aim
It has been observed that deficit and non-deficit schizophrenia (SCZ-D and SCZ-ND) might be characterized by different risk factors. Therefore, the present study aimed to assess as to whether previously reported risk factors of schizophrenia are specifically associated with SCZ-D and SCZ-ND.
Method
This study was based on a cohort of 118 stable outpatients with schizophrenia. A diagnosis of SCZ-D was established using the Schedule for the Deficit Syndrome (SDS). Risk factors were recorded using structured interview, the Operational Criteria for Psychotic Illness (OPCRIT) checklist and the Traumatic Experience Checklist (TEC). The following risk factors were explored: male sex, a history of schizophrenia in first-degree relatives, seasonality of birth, birth weight <3000g, delivery by cesarean section, a history of childhood trauma (emotional abuse, emotional neglect, physical abuse and sexual abuse) as well as substance abuse (other than nicotine) and cigarette smoking at psychosis onset.
Results
Individuals with SCZ-D were more likely to be males as well as reported higher rates of birth weight <3000 g and any categories of childhood trauma. In turn, substance abuse (other than nicotine) at psychosis onset was significantly more frequent in patients with SCZ-ND. Binary logistic regression, controlling for multiple comparisons, revealed similar findings, except for the association with any categories of childhood trauma that appeared to be not significant.
Conclusion
Our findings partially replicate differential patterns of risk factors for SCZ-D (male sex and birth weight <3000 g) and SCZ-ND (substance abuse at psychosis onset), likely attributable to the effects of timing of exposure.
{"title":"Risk factors of deficit and non-deficit schizophrenia: Results from a cross-sectional study","authors":"Agnieszka Cyran , Patryk Piotrowski , Jerzy Samochowiec , Tomasz Grąźlewski , Błażej Misiak","doi":"10.1016/j.rpsm.2022.05.005","DOIUrl":"https://doi.org/10.1016/j.rpsm.2022.05.005","url":null,"abstract":"<div><h3>Aim</h3><p>It has been observed that deficit and non-deficit schizophrenia (SCZ-D and SCZ-ND) might be characterized by different risk factors. Therefore, the present study aimed to assess as to whether previously reported risk factors of schizophrenia are specifically associated with SCZ-D and SCZ-ND.</p></div><div><h3>Method</h3><p><span>This study was based on a cohort of 118 stable outpatients with schizophrenia. A diagnosis of SCZ-D was established using the Schedule for the Deficit Syndrome (SDS). Risk factors were recorded using structured interview, the Operational Criteria for Psychotic Illness (OPCRIT) checklist and the Traumatic Experience<span> Checklist (TEC). The following risk factors were explored: male sex, a history of schizophrenia in first-degree relatives, seasonality of birth, birth weight <3000</span></span> <span><span>g, delivery by cesarean section, a history of childhood trauma (emotional abuse, </span>emotional neglect, physical abuse and sexual abuse) as well as substance abuse (other than nicotine) and cigarette smoking at psychosis onset.</span></p></div><div><h3>Results</h3><p>Individuals with SCZ-D were more likely to be males as well as reported higher rates of birth weight <3000<!--> <span><span>g and any categories of childhood trauma. In turn, substance abuse (other than nicotine) at psychosis onset was significantly more frequent in patients with SCZ-ND. Binary </span>logistic regression, controlling for multiple comparisons, revealed similar findings, except for the association with any categories of childhood trauma that appeared to be not significant.</span></p></div><div><h3>Conclusion</h3><p>Our findings partially replicate differential patterns of risk factors for SCZ-D (male sex and birth weight <3000<!--> <!-->g) and SCZ-ND (substance abuse at psychosis onset), likely attributable to the effects of timing of exposure.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 223-229"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136704537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.rpsm.2022.04.002
Miguel Bernardo , Gisela Mezquida , Paula Ferré , Bibiana Cabrera , Mercè Torra , Ana Maria Lizana , Mercè Brunet
Introduction
Therapeutic Drug Monitoring (TDM) of antipsychotics in schizophrenia is a powerful tool that allows tailoring the treatment in an individualized approach. Our goals are to develop and validate a Dried Blood Spot (DBS) method for monitoring some commonly used antipsychotics (aripiprazole, clozapine, and paliperidone) and to evaluate its usefulness as a compliance biomarker, as well as in drug-dose adjustment to personalize the antipsychotic treatment to improve its efficacy and safety.
Methods
31 first-psychotic episode (FEP) and schizophrenia patients were included; 5 refer to naïve FEP who started antipsychotic treatment; 26, to patients with more than one episode and under antipsychotic treatment: aripiprazole (7 cases), clozapine (17), paliperidone (11). For DBS sample collection, 25 μl of capillary blood were placed in the spot of a FTA™DMPK-C-card. After completely dryness, antipsychotics were extracted and analyzed by a validated UHPLC-MS/MS-method. DBS antipsychotic results were compared with those obtained in venous blood/plasma.
Results
Aripiprazole, paliperidone and clozapine showed from good to excellent correlations between concentrations in venous blood and DBS capillary blood (r2, from 0.500 to 0.721). The correlation between conventional plasma and DBS concentrations for paliperidone, aripiprazole, clozapine, and their metabolites were moderate, suggesting that optimal drug target concentrations should be established for DBS.
Conclusions
In this study, for aripiprazole, dehydroaripiprazole, paliperidone, clozapine and desmethylclozapine, DBS has provided good analytical performance for TDM. Thus, DBS sampling can offer a great alternative over conventional sampling for plasma measurement. The assay provides good analytical performances for TDM and clinical research applicability, suggesting that DBS is a promising clinical application in TDM in psychiatry.
{"title":"Dried Blood Spot (DBS) as a useful tool to improve clozapine, aripiprazole and paliperidone treatment: From adherence to efficiency","authors":"Miguel Bernardo , Gisela Mezquida , Paula Ferré , Bibiana Cabrera , Mercè Torra , Ana Maria Lizana , Mercè Brunet","doi":"10.1016/j.rpsm.2022.04.002","DOIUrl":"10.1016/j.rpsm.2022.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Therapeutic Drug Monitoring<span> (TDM) of antipsychotics in schizophrenia is a powerful tool that allows tailoring the treatment in an individualized approach. Our goals are to develop and validate a Dried Blood Spot (DBS) method for monitoring some commonly used antipsychotics (aripiprazole, clozapine, and paliperidone) and to evaluate its usefulness as a compliance biomarker, as well as in drug-dose adjustment to personalize the antipsychotic treatment to improve its efficacy and safety.</span></p></div><div><h3>Methods</h3><p>31 first-psychotic episode (FEP) and schizophrenia patients were included; 5 refer to naïve FEP who started antipsychotic treatment; 26, to patients with more than one episode and under antipsychotic treatment: aripiprazole (7 cases), clozapine (17), paliperidone (11). For DBS sample collection, 25<!--> <!-->μl of capillary blood were placed in the spot of a FTA™DMPK-C-card. After completely dryness, antipsychotics were extracted and analyzed by a validated UHPLC-MS/MS-method. DBS antipsychotic results were compared with those obtained in venous blood/plasma.</p></div><div><h3>Results</h3><p>Aripiprazole, paliperidone and clozapine showed from good to excellent correlations between concentrations in venous blood and DBS capillary blood (<em>r</em><sup>2</sup>, from 0.500 to 0.721). The correlation between conventional plasma and DBS concentrations for paliperidone, aripiprazole, clozapine, and their metabolites were moderate, suggesting that optimal drug target concentrations should be established for DBS.</p></div><div><h3>Conclusions</h3><p>In this study, for aripiprazole, dehydroaripiprazole, paliperidone, clozapine and desmethylclozapine, DBS has provided good analytical performance for TDM. Thus, DBS sampling can offer a great alternative over conventional sampling for plasma measurement. The assay provides good analytical performances for TDM and clinical research applicability, suggesting that DBS is a promising clinical application in TDM in psychiatry.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 230-237"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83061022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse but persists for days and weeks with no substance use. There is as yet little knowledge about the longitudinal course of this psychosis, which suggests that significant numbers go on to be diagnosed with a severe mental disorder (SMD). The objective of this study was to analyse the progression of SIP to SMD in our environment and the possible factors that may be involved in that conversion.
Material and methods
We used a retrospective cohort follow-up design. We reviewed all diagnoses of patients discharged from the psychiatric hospitalisation unit of the University Hospital of Basurto from January 2002 to December 2015 inclusively. In addition to sociodemographic and clinical data, information was collected on the consumption of cannabinoids, opioids, amphetamines, cocaine and alcohol. The data were analysed using descriptive analysis, Kaplan-Meier survival curves and Cox regression.
Results
Of the 116 patients, 78.4% were male, had an average age of 33.0 (SD: 8.9) years and 44.0% were single; 31.0% had a psychiatric family history; the most commonly used substance was cannabis (60.3%), followed by cocaine (40.5%). The cumulative risk of diagnostic conversion to an SMD in 16 years was 41.6% (95% CI: 32.2-52.2) over a mean 36.43 months.
Conclusions
In interventions in episodes of SIP we must bear in mind that a significant proportion will progress to an SMD in the first three years.
{"title":"Estabilidad diagnóstica en la psicosis inducida por sustancias","authors":"Lucía Inchausti , Iñigo Gorostiza , Miguel Angel Gonzalez Torres , Rodrigo Oraa","doi":"10.1016/j.rpsm.2019.10.005","DOIUrl":"10.1016/j.rpsm.2019.10.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse but persists for days and weeks with no substance use. There is as yet little knowledge about the longitudinal course of this psychosis, which suggests that significant numbers go on to be diagnosed with a severe mental disorder (SMD). The objective of this study was to analyse the progression of SIP to SMD in our environment and the possible factors that may be involved in that conversion.</p></div><div><h3>Material and methods</h3><p>We used a retrospective cohort follow-up design. We reviewed all diagnoses of patients discharged from the psychiatric hospitalisation unit of the University Hospital of Basurto from January 2002 to December 2015 inclusively. In addition to sociodemographic and clinical data, information was collected on the consumption of cannabinoids, opioids, amphetamines, cocaine and alcohol. The data were analysed using descriptive analysis, Kaplan-Meier survival curves and Cox regression.</p></div><div><h3>Results</h3><p>Of the 116 patients, 78.4% were male, had an average age of 33.0 (SD: 8.9) years and 44.0% were single; 31.0% had a psychiatric family history; the most commonly used substance was cannabis (60.3%), followed by cocaine (40.5%). The cumulative risk of diagnostic conversion to an SMD in 16<!--> <!-->years was 41.6% (95%<!--> <!-->CI: 32.2-52.2) over a mean 36.43<!--> <!-->months.</p></div><div><h3>Conclusions</h3><p>In interventions in episodes of SIP we must bear in mind that a significant proportion will progress to an SMD in the first three years.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 272-280"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37578273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.rpsm.2021.07.004
Carlos De las Cuevas , Emilio J. Sanz , Can-Jun Ruan , Jose de Leon
Introduction
The incidence of clozapine-associated myocarditis varies by country. These variations were explored in VigiBase, the World Health Organization's global database which has >25 million spontaneously reported adverse drug reaction (ADR) reports from 145 national drug agencies.
Methods
On January 15, 2021, a search of VigiBase since inception focused on myocarditis in clozapine patients. The 3572 individual reports were studied using the standard VigiBase logarithmic measure of disproportionality called information component (IC). The IC measures the disproportionality between the expected and the reported rates. After duplicates were eliminated there were 3274 different patients with myocarditis studied in logistic regression models.
Results
The first case was published in 1980 but since 1993 the VigiBase clozapine-myocarditis IC has been significant; moreover, currently it is very strong (IC = 6.0, IC005–IC995 = 5.9–6.1) and statistically significantly different from other antipsychotics. Of the 3274 different patients with myocarditis, 43.4% were non-serious cases, 51.8% were serious but non-fatal, and 4.8% were fatal. More than half (1621/3274) of the reports came from Australia, of which 69.2% were non-serious, 27.7% serious but non-fatal, and 3.1% fatal. Asian countries contributed only 41 cases.
Conclusions
In pharmacovigilance studies, confounding factors may explain statistical associations, but the strength and robustness of these results are compatible with the hypothesis that myocarditis is definitively associated with early clozapine treatment (84% [1309/1560] and 5% [82/1560] in the first and second months). Myocarditis reports from Australia are over-represented to a major degree. Asian countries may be underreporting myocarditis to their drug agencies.
{"title":"Clozapine-associated myocarditis in the World Health Organization's pharmacovigilance database: Focus on reports from various countries","authors":"Carlos De las Cuevas , Emilio J. Sanz , Can-Jun Ruan , Jose de Leon","doi":"10.1016/j.rpsm.2021.07.004","DOIUrl":"10.1016/j.rpsm.2021.07.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of clozapine-associated myocarditis varies by country. These variations were explored in VigiBase, the World Health Organization's global database which has >25 million spontaneously reported adverse drug reaction (ADR) reports from 145 national drug agencies.</p></div><div><h3>Methods</h3><p>On January 15, 2021, a search of VigiBase since inception focused on myocarditis in clozapine patients. The 3572 individual reports were studied using the standard VigiBase logarithmic measure of disproportionality called information component (IC). The IC measures the disproportionality between the expected and the reported rates. After duplicates were eliminated there were 3274 different patients with myocarditis studied in logistic regression models.</p></div><div><h3>Results</h3><p>The first case was published in 1980 but since 1993 the VigiBase clozapine-myocarditis IC has been significant; moreover, currently it is very strong (IC<!--> <!-->=<!--> <!-->6.0, IC<sub>005</sub>–IC<sub>995</sub> <!-->=<!--> <!-->5.9–6.1) and statistically significantly different from other antipsychotics. Of the 3274 different patients with myocarditis, 43.4% were non-serious cases, 51.8% were serious but non-fatal, and 4.8% were fatal. More than half (1621/3274) of the reports came from Australia, of which 69.2% were non-serious, 27.7% serious but non-fatal, and 3.1% fatal. Asian countries contributed only 41 cases.</p></div><div><h3>Conclusions</h3><p>In pharmacovigilance studies, confounding factors may explain statistical associations, but the strength and robustness of these results are compatible with the hypothesis that myocarditis is definitively associated with early clozapine treatment (84% [1309/1560] and 5% [82/1560] in the first and second months). Myocarditis reports from Australia are over-represented to a major degree. Asian countries may be underreporting myocarditis to their drug agencies.</p></div>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 238-250"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39217047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1016/j.rpsm.2022.06.003
Sara Jiménez-Fernández , Manuel Gurpegui , Jose de Leon , Luis Gutiérrez-Rojas
{"title":"Clozapine for the treatment of pediatric encephalopathy associated with nonketotic hyperglycinemia","authors":"Sara Jiménez-Fernández , Manuel Gurpegui , Jose de Leon , Luis Gutiérrez-Rojas","doi":"10.1016/j.rpsm.2022.06.003","DOIUrl":"10.1016/j.rpsm.2022.06.003","url":null,"abstract":"","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":"15 4","pages":"Pages 287-289"},"PeriodicalIF":9.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86163217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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