María Paz García‐Portilla

Universidad de Oviedo

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Julio Bobes

Centro de Investigación Biomédica en Red de Salud Mental

350

Pilar A. Sáiz

Instituto de Investigación Sanitaria del Principado de Asturias

294

Leticia García-Álvarez

Universidad de Oviedo

109

Leticia González-Blanco

Gobierno del Principado de Asturias

Lorena de la Fuente-Tomás

Universidad de Oviedo

Miquel Bernardo

Centro de Investigación Biomédica en Red de Salud Mental

Celso Arango

Hospital General Universitario Gregorio Marañón

Eduard Vieta

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

Teresa Bobes-Bascarán

Universidad de Oviedo

M.T. Bascarán

Azerbaijan Medical University

Cooperative Institutions

Centro de Investigación Biomédica en Red de Salud Mental

497

Instituto de Salud Carlos III

281

Universitat de Barcelona

225

Universidad de Oviedo

205

Centro de Investigación Biomédica en Red

160

Hospital Clínic de Barcelona

120

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

111

Universidad Complutense de Madrid

107

Centre for Biomedical Network Research on Rare Diseases

Universitat Autònoma de Barcelona

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Functional recovery in patients with schizophrenia: recommendations from a panel of experts

BMC Psychiatry (2018)

Guillermo Lahera J. L. Gálvez Sanchez Pedro Sánchez M. Martínez-Roig J. V. Pérez-Fuster

The management of schizophrenia is evolving towards a more comprehensive model based on functional recovery. The concept of functional recovery goes beyond clinical remission and encompasses multiple aspects of the patient's life, making it difficult to settle on a definition and to develop reliable assessment criteria. In this consensus process based on a panel of experts in schizophrenia, we aimed to provide useful insights on functional recovery and its involvement in clinical practice and clinical research. After a literature review of functional recovery in schizophrenia, a scientific committee of 8 members prepared a 75-item questionnaire, including 6 sections: (I) the concept of functional recovery (9 items), (II) assessment of functional recovery (23 items), (III) factors influencing functional recovery (16 items), (IV) psychosocial interventions and functional recovery (8 items), (V) pharmacological treatment and functional recovery (14 items), and (VI) the perspective of patients and their relatives on functional recovery (5 items). The questionnaire was sent to a panel of 53 experts, who rated each item on a 9-point Likert scale. Consensus was achieved in a 2-round Delphi dynamics, using the median (interquartile range) scores to consider consensus in either agreement (scores 7–9) or disagreement (scores 1–3). Items not achieving consensus in the first round were sent back to the experts for a second consideration. After the two recursive rounds, consensus was achieved in 64 items (85.3%): 61 items (81.3%) in agreement and 3 (4.0%) in disagreement, all of them from section II (assessment of functional recovery). Items not reaching consensus were related to the concepts of functional recovery (1 item, 1.3%), functional assessment (5 items, 6.7%), factors influencing functional recovery (3 items, 4.0%), and psychosocial interventions (2 items, 5.6%). Despite the lack of a well-defined concept of functional recovery, we identified a trend towards a common archetype of the definition and factors associated with functional recovery, as well as its applicability in clinical practice and clinical research.

Functional impairment

Delphi Method

10.1186/s12888-018-1755-2

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Citations (57)

Ante el nuevo reto de identificar el síndrome negativo de la esquizofrenia

Revista de Psiquiatría y Salud Mental (2013)

María Paz García‐Portilla Julio Bobes

10.1016/j.rpsm.2013.09.002

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Citations (17)

Trastornos de personalidad en patología dual

Julio Bobes Pilar A. Sáiz María Paz García‐Portilla

EL Manual Diagnostico y Estadistico de los Trastornos Mentales IV-Texto Revisado (DSM-IV-TR)1, reconoce 11 tipos de trastornos de la personalidad (TP) diferentes que define como un patron permanente e inflexible de experiencia interna y de comportamiento que se aparta acusadamente de las expectativas de la cultura del sujeto, de inicio en la adolescencia o principio de la edad adulta, con un patron de estabilidad a lo largo del tiempo y que comporta malestar o perjuicios.

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COVID-19 psychological impact in patients with depressive disorder: Differences based on their age

European Psychiatry (2021)

Eunha Gil M. Valtueña-García Leticia González-Blanco Francesco Dal Santo C. Moya-Lacasa

Introduction COVID-19 pandemic and lockdown have provoked a considerable psychological impact in Spain. Some studies have reported greater psychological impact in the younger population. To date, no previous study has focused on depressive disorder (DD) patients based on their age. Objectives To describe the psychological impact on DD according to age. Methods Cross-sectional study of an online survey available from 19 to 26 March 2020. Out of a total of 21207 respondents, 608 (2.9%) reported suffering from DD (mean age ±SD = 41.2 years±14.07 [18-82], 80.6% women). The subsample (608) was divided according to age, “youngsters” <45 (57.4%)/ “elders” ≥45. DASS-21 and IES scales were employed. Statistical analyses: Chi-square, t-Student test. Results Both groups did not differ (p>0.05) in sex, having COVID-19 symptoms, having family/friends infected, or income changes. While youngsters were single more frequently (68.8% vs 14.3%, χ² = 179.7, p<0.001), elders had somatic illness more frequently (64.8% vs 39.7% χ² =30.401, p<0.001). Youngsters obtained higher scores in depression (4.69 vs 4.1, T=5.413, p<0.001), anxiety (2.86 vs 1.97, T=5.249, p<0.001) and stress (4.48 vs 3.17, T=6.355, p<0.001) DASS-21 subscales, as in intrusive (3.42 vs 3.05, T=1.984, p=0.048) and avoidant (4.64 vs 4.11, T=3.056, p=0.002) IES scores. Conclusions Despite the group of elders with depression being more vulnerable to severe COVID-19 disease and presenting more frequently somatic comorbidities, younger depressive patients suffered more from depressive, anxiety, stress and avoidant symptoms and intrusive thoughts, in line with previous reports in the general population. Disclosure No significant relationships.

Depression

10.1192/j.eurpsy.2021.1790

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Cognitive impairment and C-reactive protein in clinically stable schizophrenia outpatients: a focus on sex differences

Scientific Reports (2020)

Francesco Dal Santo Leticia González-Blanco Leticia García-Álvarez Lorena de la Fuente-Tomás Ángela Velasco

Although previous findings identified an association between C-reactive protein (CRP) levels, and impaired cognitive functions in patients with schizophrenia (SZ), little is currently known about the relationship between inflammation, cognition, and sex in SZ. The current study aimed to explore the association between peripheral inflammation and cognitive impairment in SZ as a function of sex. The sample included 132 clinically stable patients with SZ, of whom 82 were males (62.1%) and 50 females (37.9%). Sociodemographic data were collected, an accurate assessment was performed using the Positive and Negative Syndrome (PANSS), Clinical Assessment Interview for Negative Symptoms (CAINS), and Calgary Depression (CDS) scales, and the MATRICS Consensus Cognitive Battery (MCCB), and CRP levels were tested. A Pearson correlation and multiple regression analyses, including potential confounding factors, were performed. We found an inverse association between CRP levels and performance on visual learning (r = - 0.386, p = 0.006) domain in female patients only, whereas no correlations were found in males. The regression model for women retained age (β = - 0.319, p = 0.017), the CAINS-MAP score (β = - 0.247, p = 0.070), and the CRP (β = - 0.321, p = 0.013) as predictors of visual learning. Our results suggest the possible existence of sex-specific modulation of the association between systemic inflammation and the cognitive features of the illness.

10.1038/s41598-020-73043-x

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Función sexual en pacientes deprimidos: relación entre síntomas depresivos y disfunción sexual.

Revista de Neuro-Psiquiatría (2014)

Pedro Marina María Paz García‐Portilla Luis Jiménez Leandro Palicioc Pedro Trabajo

Introducción: La prevalencia de disfunción sexual es mayor en los pacientes con depresión que en la población general.Además la relación entre depresión y disfunción sexual parece ser bidireccional, en el sentido que la presencia de una de ellas puede desencadenar o exacerbar la otra, y el tratamiento de una puede mejorar la otra.Por otro lado, el deseo y el funcionamiento sexual se pueden ver afectados por los efectos secundarios de los fármacos antidepresivos.Métodos: A 50 pacientes deprimidos (según criterios CIE-10 de episodio depresivo o trastorno depresivo recurrente) con una vida sexual activa, se les administró en una visita basal y a los 3 meses la Escala de Depresión de Hamilton (HDRS), la Impresión Clínica Global (ICG) y el Inventario de Motivación y Energía (MEI).Además, cumplimentan en ambas ocasiones la Escala visual analógica de satisfacción con el funcionamiento sexual (VAS-SFS).Resultados: En la visita basal, el 52% de las mujeres y el 63% de los hombres cumplían criterios DSM IV-TR de alguna disfunción sexual siendo la más frecuente el trastorno orgásmico en ambos sexos.En la misma visita las puntuaciones media de la HDRS, MEI e ICG fueron 24,3, 46,4 y 4

10.20453/rnp.2013.1183

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M176. INTESTINAL PERMEABILITY AND LOW-GRADE CHRONIC INFLAMMATION IN SCHIZOPHRENIA: DO THEY INFLUENCE COGNITION AND COGNITIVE RESERVE?

Schizophrenia Bulletin (2020)

Gerard Anmella Sílvia Amoretti Miqueu Alfonso O. Cuñat Gemma Safont

Abstract Background Higher intestinal-permeability is known to cause low-grade chronic inflammation, which seems to participate in the development and worsening of psychotic disorders both in first-episode psychosis (FEP) and schizophrenia (SCZ) patients. Moreover, in psychotic disorders, inflammation has been linked to cognition and cognitive reserve (CR). The aim of this study is to assess the relation between intestinal-permeability, low-grade chronic inflammation, cognition and cognitive reserve in psychotic disorders. Methods Observational, cross-sectional and multisite study including four centers in Spain (Grant from Fondo de Investigación Sanitaria, PI17/00246). A total of 500 adult patients with DSM-5 SCZ-spectrum disorder at any stage of the disease were recruited. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Disease severity was assessed using the Clinical Global Impression (CGI) scale and functioning was assessed using the Global Assessment of Functioning (GAF) scale. The intestinal-permeability was estimated with the “Permeable-Intestine-syndrome questionnaire”. The diet was assessed with the “Mediterranean-diet-adherence questionnaire”. Exercise was measured with the “International Physical Activity Questionnaire (IPAQ)”. Cognition was measured with the SCIP-S scale. CR was assessed with the Cognitive Reserve Assessment Scale in Health (CRASH), which is a scale developed to measure CR specifically for patients with severe mental illness. Correlations between CRASH scores and the remainder variables were performed. Results For the present study we included only the subjects who had CRASH score, a total of 112 patients, 42.7% female, aged 40.61±12.4 (mean±SD). Substance use was present in 44.3%. The CRASH score was 33.30±15.72 (mean±SD) and was associated with negative (but not positive) psychotic symptoms assessed by PANSS (PANSS negative; rp=-3.98; p=0.001, PANSS general; rp=-2.13; p=0.038, GAF; rp=0.410; p<0.0001, CGI; rp=-0.30; p=0.002, IPAQ; rs=0.224; p=0.025 and the permeability-scale; rs=-0.266; p=0.008. All cognitive domains (assessed by SCIP-S) were associated to CRASH: verbal learning immediate (rp=0.584; p<0.0001) and differed (rp=0.515; p<0.0001), working memory (rp=0.539; p<0.0001), verbal fluency (rs=0.485; p<0.0001) and processing speed (rp=0.584; p<0.0001). No significant associations were found with Mediterranean-diet scale (rs=0.195; p=0.056), IMC (rs=-0.192; p=0.063), C-reactive protein (rs=-0.104; p=0.278) and the IPAQ-resting scale and permeability-scale (rs=0.119; p=0.244). Discussion

Cognitive reserve

10.1093/schbul/sbaa030.488

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Association of cannabinoid receptor genes (CNR1 and CNR2) polymorphisms and panic disorder

Anxiety Stress & Coping (2020)

Ana M. Peiró María S. García‐Gutiérrez Beatriz Planelles Teresa Femenía C. Mingote

Background and objectives: Panic disorder (PD) is an anxiety disorder characterized by recurrent and unexpected panic attacks along with sudden onset of apprehension, fear or terror. The endocannabinoid system (ECS) has a role in stress recovery, regulating anxiety. The aim of this study was to analyze potential genetic alterations in key ECS targets in patients suffering from panic disorders.Design and methods: We analyzed single nucleotide polymorphisms (SNPs) of the cannabinoid receptors (CNR1; CNR2) and the endocannabinoid hydrolytic enzyme fatty acid amide hydrolase (FAAH) genes in 164 Spanish PD patients and 320 matched controls.Results: No significant differences were observed in the SNPs of the CNR2 and FAAH genes tested. However, when analyzing genotype-by-sex interaction at A592G (rs2501431) and C315T (rs2501432) in the CNR2 gene, the presence of the G-allele in males was associated with a protective haplotype. Genotyping analysis revealed that variants in CNR1 confer vulnerability to PD, with a significantly increased risk associated with the G-allele (rs12720071) and C-allele (rs806368). This finding was consistent when analyzing genotype-by-sex interaction, where females presented a greater PD risk.Conclusions: Polymorphisms at the CNR1 gene may be a risk factor for PD contributing to sex-specific dysfunction in females.

Linkage Disequilibrium

10.1080/10615806.2020.1732358

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[SPECT-identified hypoperfusion of the left temporomesial structures in a Kleine-Levin syndrome].

PubMed (2002)

María Paz García‐Portilla Éric Durand A. Chalvon Marie‐Odile Habert Y Navelet

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P.683 First episode psychosis outcome trajectories: The role of functioning and neurocognition

European Neuropsychopharmacology (2019)

Alexandra Roldán A. Keymer Iluminada Corripio B. Cabrera António Lobo

10.1016/j.euroneuro.2019.09.652

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