Psiquiatria Biologica最新文献

英文中文

The MCOSUL cohort: Lethality, recurrence, and mortality in suicide attempts in the Lérida Region, Spain—Rationale, objectives, and preliminary findings

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-26 DOI: 10.1016/j.psiq.2024.100548

María Irigoyen-Otiñano , Vicent Llorca-Bofí , Marina Adrados-Pérez , Laura Arenas-Pijoan , Eugènia Nicolau-Subires , Carla Albert-Porcar , Lucía Ibarra-Pertusa , Margarita Puigdevall-Ruestes

Background and objectives

Suicide is a major global health issue with profound impacts on individuals, families, and societies. Understanding the factors that influence the lethality of suicide attempts, the frequency of reattempts, ultimate causes of death, and associated immune biomarkers is crucial for developing effective prevention strategies. This article outlines the rationale, objectives, and protocol of a new cohort study, presenting preliminary descriptive results.

Methods

We designed a prospective, naturalistic cohort study involving patients from the Arnau de Vilanova and Santa Maria University Hospitals in Lleida, Spain. Participants are recruited following a suicide attempt and are monitored over time. Data on clinical assessments, suicidal methods, somatic lethality, immune biomarkers, reattempts, and causes of death are collected and analyzed. The cohort continues to recruit patients and update follow-up data.

Results

Currently, the cohort includes 1918 patients. The majority of participants are females (62.8%) with an average age of 41.2 years. The average follow-up period is 77.6 months. Sedative poisoning is the most common method of suicide attempt (57.3%). High lethality attempts predominate (76.7%), and 43.4% of patients have reattempted suicide. During follow-up, 5.5% of patients died, with 2.1% of deaths attributed to suicide.

Conclusion

The findings from this study are expected to enhance our understanding of the relationships between suicide lethality, reattempts, mortality, and immune biomarkers. This knowledge may help to personalize interventions aimed at reducing suicide rates and improving outcomes for individuals at high risk.

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引用次数: 0

Effect of stimulant medications on immunity in the treatment of attention deficit hyperactivity disorder

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-23 DOI: 10.1016/j.psiq.2024.100546

Alberto Rodríguez-Quiroga , Miriam Akasbi Montalvo , Miguel Ángel Álvarez-Mon González , Fernando Mora Mínguez , Javier Quintero Gutiérrez del Álamo

Background

Research suggests a potential link between attention deficit hyperactivity disorder (ADHD) and the immune system, with higher rates of allergic conditions observed in ADHD patients. Altered levels of cytokines, crucial immune signaling molecules, are also associated with ADHD, and stimulant medications may modulate immune activity.

Objective

The objective is to raise awareness of the intricate relationship between ADHD and the immune system, shedding light on its potential implications for treatment and management strategies.

Material and methods

Descriptive study of the case report type based on the case report guidelines.

Case description

A 41-year-old male with systemic lupus erythematosus (SLE) was referred for anxiety symptoms. His medical history included SLE diagnosis and chronic steroid therapy. He reported inconsistent attention, difficulty in task planning and organization, restlessness, and impulsivity. Comprehensive assessment confirmed ADHD diagnosis. He was prescribed melatonin, vortioxetine, and methylphenidate, which significantly improved his symptoms. SLE antibody levels decreased with treatment.

Conclusion

The detection of ADHD and specific treatment with stimulants not only improved his symptoms but also led to a decrease in SLE antibodies and an enhancement in quality of life for the patient.

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引用次数: 0

First experiences with esketamine nasal spray in patients with moderate and severe treatment-resistant depression

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-23 DOI: 10.1016/j.psiq.2024.100547

José Miguel Meca García, María Teresa Perní Lasala, María Beret Trancón, Ricardo Jesús Lara Mellado, Antonio José Ureña Caballero, Raquel Fernández Villalobos, José Enrique Romero Baca

We report 4 cases of female patients with treatment-resistant depression treated with intranasal esketamine. The age of 2 patients were over 50, with only 1 patient in their 20s. The time course of the disease episode ranged from 2 to 4 years, 2 of the cases had psychiatric comorbidity, the time of administration in the patients who completed treatment ranged from 31 to 41 weeks with a discontinuation of treatment due to non-serious but intolerable side effects for one of the patients at 12 weeks. Oral treatment was not substantially modified, with the only notable change being the almost complete withdrawal of benzodiazepines in some cases. The results were satisfactory, with clinical improvement evident in the clinical assessment and in the scales, with 2 patients in complete remission and another in partial remission. Two of these patients returned to work.

引用次数: 0

Tamizaje del trastorno por déficit de atención e hiperactividad (TDAH) en pacientes hospitalizados por farmacodependencia en una unidad de salud mental en Barranquilla, Colombia

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-21 DOI: 10.1016/j.psiq.2024.100544

Natalia Gutierrez-Marchena , Anderson David Padilla-Menco , Dania Lucía Ruiz-Plaza

Attention Deficit Hyperactivity Disorder (ADHD) is considered a neurodevelopmental disorder that typically presents in childhood and can continue into adulthood. Mainly affects three areas given by attention, impulse control, and hyperactivity, which end up affecting the psychosocial development, interpersonal relationships, and academic level of the subject. The prevalence varies depending on age group, sex, and location; however, it is estimated at 7% overall in the pediatric population and 4.5% in adults. ADHD symptoms have been found to predict tobacco, alcohol, and cannabis use; and additionally, if left untreated, it is estimated that up to 50% of people with ADHD will manifest a substance use disorder at some point in their lives, however there are no data on such comorbidity in our population, so we consider necessary to determine the prevalence of ADHD in the population hospitalized for Substance Use Disorder (SUD) in the mental health institution through screening with self-report scales. Here we report the sociodemographic characterization, drug use pattern and comorbidities of this population, as well as the result of screening with the Wender Utah Scale (WURS-25) and Adult ADHD Self Report Scale (ASRS V1.1). The study included a total of 74 subjects who were hospitalized in a mental health institution located in Barranquilla, Colombia, with a diagnosis of SUD. It was found that 50% of patients scored positive for ADHD diagnosis according to the ASRS scale, probable diagnosis 20.3% and unlikely 29.7%, with 44.6% positive on the WURS-25 scale. The results of the present study suggest that screening for ADHD is a useful tool to detect comorbidity in patients with SUD, who could benefit from comprehensive treatment for both pathologies and thus impact the course and prognosis of the disease, as well as their functionality and quality of life.

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引用次数: 0

Diagnóstico diferencial del mutismo selectivo a través de un caso clínico

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-19 DOI: 10.1016/j.psiq.2024.100543

Sandra Puyal González , Carlos-Luis Ortiz Sánchez-Expósito , Almudena Escudero González

Selective mutism consists of a consistent failure to speak in specific social conditions in which there is an expectation to communicate. It produces a decrease in functionality in several areas of life.

The case of a 26-year-old woman with mutist symptoms since childhood is presented. The main objective of this article is to carry out a review of selective mutism and the different disorders that can encompass these symptoms, presenting the different diagnosis between anxiety disorder including social anxiety or social phobia, avoidant personality disorder or autism spectrum disorder.

引用次数: 0

Encefalitis autoinmune por anticuerpos antirreceptor de NMDA: a propósito de un caso

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-16 DOI: 10.1016/j.psiq.2024.100541

Vanessa Gladys Velasquez Acebey, Maite Sellart Altisent

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common form of autoimmune encephalitis. It usually begins with psychiatric symptoms and heterogeneous manifestations that make diagnosis challenging, thereby delaying appropriate treatment. It is crucial to be aware of this condition and to consider it for exclusion in cases of atypical first psychotic episodes.

Clinical findings and diagnosis

We present the case of a 28-year-old woman who visited the emergency room five times over 12 days due to generalized tonic–clonic seizures, accompanied by psychotic symptoms. She was initially diagnosed with a conversion disorder at two general hospitals before being referred for urgent psychiatric admission. A neurology consultation revealed positive anti-NMDA antibodies (1:16) in cerebrospinal fluid (CSF), leading to the diagnosis of anti-NMDAR encephalitis. A gynecology consultation subsequently detected a left ovarian teratoma.

Conclusions

In the event of a first psychotic episode with additional neurological symptoms or poor evolution, encephalitis should be excluded. In some cases, magnetic resonance imaging (MRI) and electroencephalographic (EEG) patterns may be normal, making CSF analysis essential. Given the strong association of tumors with anti-NMDAR encephalitis, particularly ovarian teratomas in young women, good coordination between services is critical for early diagnosis and treatment.

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引用次数: 0

Influencia de la gripe materna en la esquizofrenia. Estudio epidemiológico en Galicia (España), de 1999 a 2007

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-16 DOI: 10.1016/j.psiq.2024.100545

María José Durán-Maseda , María Vidal-Millares , Vicente Álvarez Pérez

The etiology of schizophrenia remains unknown. From the late eighties onwards, a range of theories has been put forward identifying various possible risk factors. One of these was the flu infection (Influenza A virus) during pregnancy, which argues, as a result of an increased incidence being detected in those born in the winter and spring months, that it can affect fetal neurodevelopment. However, the findings which correlate the two are contradictory.

The aim of this study is to link the fluctuations between the distribution of the dates of birth of patients diagnosed with schizophrenia and the distribution of the incidence dates of flu in the general population.

Between 1999 and 2007, a total of 5,911 new diagnoses of schizophrenia were recorded in Galicia, an autonomous region of Spain with a total population of 2,699,499. Furthermore, we have the week-by-week incidence of flu in the general population from 1964 to 2011. On average, the incidence of flu is concentrated in the final 15 weeks and the first 15 weeks of each year, with a higher number of cases registered in the years 1973, 1975 and 2000.

To corroborate the causal hypothesis, the dates of birth of the patients diagnosed with schizophrenia were offset in order to determine the approximate week of conception. Subsequently, this was compared against the 48-weekly distribution of flu, one for each year recorded, by means of the 2 tests. The result of this test rejects the possible causality between the incidence of flu in the mother and the development of schizophrenia in her child.

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引用次数: 0

Cuando el saber juega en contra: insight y depresión pospsicótica 当知识起反作用时：洞察力和后精神病抑郁症

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-14 DOI: 10.1016/j.psiq.2024.100524

Julia Rodríguez Martín, Lucianna Ifarraguirre Mello, Onorina Stoicev Stefoglo, Maria Antonia Marti Femenías, Teresa Jimeno Beltran, Javier Eduardo Gonzalez Lucha

引用次数: 0

Caso clínico: asociación de tianeptina en un paciente anciano con trastorno depresivo 病例报告：一名老年抑郁症患者与噻奈普汀的关系

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-08 DOI: 10.1016/j.psiq.2024.100528

Juan José De Frutos Guijarro, Borja Macías Gamo, Nuria Esther Chinchurreta De Lora, Cristina Merino Del Villar

引用次数: 0

Persistence of ADHD into adulthood and associated factors: A prospective study ADHD持续进入成年期及其相关因素：一项前瞻性研究

Q4 Medicine

Psiquiatria Biologica

Pub Date : 2024-11-07 DOI: 10.1016/j.psiq.2024.100529

Laura Jiménez-Muñoz , Olatz Lopez-Fernandez , Inmaculada Peñuelas-Calvo , David Delgado-Gómez , Carolina Miguélez-Fernández , Sara López-González , Cristina González-Garrido , Enrique Baca-García , Juan José Carballo , Alejandro Porras-Segovia

Background

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in child and adolescent psychiatry. The aims of this study are to describe the persistence of ADHD into adulthood and to explore factors associated with persistence.

Methods

This is a prospective study conducted in a clinical sample of Spanish children and adolescents diagnosed with ADHD. After a baseline interview in which a battery of standardized scales was administered (e.g., Strengths and Difficulties Questionnaire (SDQ). A review of the digital medical history was carried out 10 years after recruitment. The persistence of the ADHD diagnosis into adulthood and the end-point diagnoses were described. We carried out logistic regression to explore the factors associated with ADHD persistence.

Results

Most of the patients (87.5%) kept the ADHD diagnosis into adulthood. Factors associated with ADHD persistence was high SDQ hyperactivity/inattention subscale scores at baseline (OR = 1.197), high scores on the SDQ peer relationship problems subscale (OR = 0.823), number of diagnoses at baseline (OR = 0.490).

Conclusions

Our findings show that ADHD diagnosed in children often persists into adulthood. An appropriate transition between child and adolescent mental health services and adult services needs to be mapped out, as a large proportion of children with ADHD will continue to need mental health care during their adulthood.

背景注意缺陷多动障碍（ADHD）是儿童和青少年精神病学中最常见的疾病之一。本研究的目的是描述ADHD在成年后的持续性，并探索与持续性相关的因素。方法：这是一项前瞻性研究，在西班牙诊断为多动症的儿童和青少年的临床样本中进行。经过基线访谈，其中使用了一系列标准化量表（例如，优势和困难问卷（SDQ））。招募10年后，对数字病史进行了审查。描述了ADHD诊断进入成年期的持续性和终点诊断。我们进行了逻辑回归来探讨ADHD持续存在的相关因素。结果大多数患者（87.5%）保持ADHD诊断至成年。与ADHD持续性相关的因素是SDQ多动/注意力不集中量表基线得分高（OR = 1.197），SDQ同伴关系问题量表得分高（OR = 0.823），基线诊断次数多（OR = 0.490）。结论我们的研究结果表明，儿童诊断的ADHD通常会持续到成年。儿童和青少年心理健康服务与成人服务之间的适当过渡需要制定，因为很大一部分患有多动症的儿童在成年后将继续需要心理健康护理。

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引用次数: 0

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