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Redox imbalance accompanies loss of viability in seeds of two cacti species buried in situ
- David A. Guzmán-Hernández, Claudia Barbosa-Martínez, Juan M. Villa-Hernández, Laura J. Pérez-Flores
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- Seed Science Research , First View
- Published online by Cambridge University Press:
- 15 April 2024, pp. 1-9
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This work provides insights into the deterioration of cacti seeds of Escontria chiotilla (F.A.C. Weber ex K. Schum) and Stenocereus pruinosus (Otto ex Pfeiff.) Buxbaum stored ex situ at 25 °C, under dry and dark conditions or buried in situ conditions in a xerophytic shrubland. Viability, germination speed, electrolyte leakage and indicators of the redox balance including glutathione content, glutathione half-cell reduction potential (EGSSG/2GSH) and malondialdehyde (MDA), oxidized protein content, together with water-soluble antioxidant enzyme activity were assessed. Over a period of two years of storage, viability was maintained when seeds were stored ex situ at 7–9% water content compared to seeds buried in the soil. A second burial experiment showed that seeds of E. chiotilla maintained viability during a year of storage that included a rainy season followed by a dry season. Thereafter, they died rapidly during the second rainy season. In contrast, those of S. pruinosus started to lose viability after 6 months of burial at the end of the rainy season and were mostly dead at the end of the dry season. This difference in persistence between species was related to a difference in the glutathione content and antioxidant enzyme activities. In both storage experiments, the loss of viability of both species was associated to a EGSSG/2GSH shift to a more oxidative state during burial. Yet, contents in MDA and oxidized soluble proteins were not related to redox imbalance and loss of viability, indicating that these compounds are not good markers of oxidative stress in cacti seeds during storage.
The occurrence of two opecoeliid digeneans in Mullus barbatus and M. surmuletus
- A. Martínez-Vicaria, J. Martín-Sánchez, P. Illescas, A.M. Lara, M. Jiménez-Albarrán, A. Valero
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- Journal of Helminthology / Volume 74 / Issue 2 / June 2000
- Published online by Cambridge University Press:
- 12 April 2024, pp. 161-164
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The infection by Opecoeloides furcatus and Poracanthium furcatum (Opecoeliidae) was studied in 121 Mullus barbatus and 113 M. surmuletus collected from the Spanish south-eastern Mediterranean. The prevalence of infection was most frequent in M. surmuletus with values of 81.42% for O. furcatus and 38.05% for P. furcatum. In M. barbatus the prevalences of O. furcatus and P. furcatum were 54.54% and 14.88% respectively. Statistically significant differences were found between the infection of the two hosts with P. furcatum. No significant differences in worm burdens could be attributable to host size or to seasonal changes, although a lower infection of M. barbatus by O. furcatus occurred in the autumn. Furthermore, the electrophoretic mobility of the enzyme malic dehydrogenase (MDH) was also studied and both digeneans presented different patterns, corresponding in both cases to homozygotic genotypes.
Nematocide activity of 6,7-diarylpteridines in three experimental models
- C. Ochoa, M. Rodríguez, L. Domínguez, J. Saldaña, R. Di Maio, P. Alonso-Villalobos, M.M. Martínez Grueiro
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- Journal:
- Journal of Helminthology / Volume 73 / Issue 4 / April 1999
- Published online by Cambridge University Press:
- 11 April 2024, pp. 333-336
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The in vitro nematocide activity of seventeen 6,7-diarylpteridines has been tested using three different experimental models, Caenorhabditis elegans, Nippostrongylus brasiliensis and Heligmosomoides polygyrus. The method of evaluation of inhibition in the secretion of acetylcholinesterase by H. polygyrus seems to be the most indicated to avoid false positives. The in vivo activities, against Trichinella spiralis, of the most in vitro active pteridines have been assayed. All pteridine derivatives bearing 6,7-di-p-bromophenyl substituents have shown in vitronematocide activites in the three experimental models used. Amongst all the pteridines tested in vivo, only 2,4-pteridinedithione derivatives exhibited moderate activity.
Longitudinal study of peer victimization, social support, and mental health during early adolescence
- Matías Martínez, Katherine S. Damme, Teresa Vargas, Beiming Yang, D. J. Rompilla, Jacquelyn Stephens, Yang Qu, Vijay A. Mittal, Claudia M. Haase
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- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 05 February 2024, pp. 1-16
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Background
Peer victimization predicts the development of mental health symptoms in the transition to adolescence, but it is unclear whether and how parents and school environments can buffer this link.
MethodsWe analyzed two-year longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, involving a diverse sample of 11 844 children across the United States (average at baseline = 9.91 years; standard deviation = 0.63; range = 8.92–11.08; complete case sample = 8385). Longitudinal associations between peer victimization and two-year changes in mental health symptoms of major depression disorder (MDD), separation anxiety (SA), prodromal psychosis (PP), and attention-deficit/hyperactivity disorder (ADHD) were examined including a wide range of covariates. Mixed linear models were used to test for the moderating effects of parental warmth and prosocial school environment.
Results20% of children experienced peer victimization. Higher exposure to peer victimization was associated with increases in MDD, SA, and ADHD symptoms. Parental warmth was associated with decreases in MDD symptoms but did not robustly buffer the link between peer victimization and mental health symptoms. Prosocial school environment predicted decreases in PP symptoms and buffered the link between peer victimization and MDD symptoms but amplified the link between peer victimization and SA and ADHD symptoms.
ConclusionsPeer victimization is associated with increases in mental health symptoms during the transition to adolescence. Parental warmth and prosocial school environments might not be enough to counter the negative consequences of peer victimization on all mental health outcomes.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
4 Urinary Fluoride Levels and Metal Co-Exposures Among Pregnant Women in Los Angeles, California
- Ashley J Malin, Howard Hu, E. Angeles Martinez-Mier, Sandrah P Eckel, Shohreh Farzan, Rima Habre, Theresa M Bastain, Carrie V Breton
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 867-868
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Objective:
Approximately 73% of the United States (US) population on public water systems receives fluoridated water for tooth decay prevention. In Los Angeles (LA) County, 89% of cities are at least partially fluoridated. Drinking water is the primary source of fluoride exposure in the US. Studies conducted in Mexico and Canada suggest that prenatal fluoride exposure, at levels relevant to the US, may contribute to poorer neurodevelopment in offspring. However, data on biomarkers and patterns of fluoride exposure among US pregnant women are scarce. This study examined urinary fluoride levels according to sociodemographic factors and metal co-exposures among pregnant women in the US.
Participants and Methods:Participants were from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort based in Los Angeles, California. There were 293 and 490 women with urine fluoride measured during the first and third trimesters of pregnancy, respectively. An intra-class correlation coefficient examined consistency of specific gravity-adjusted maternal urinary fluoride (MUFsg) between trimesters. Kruskal-Wallis and Mann-Whitney U tests examined associations of MUFsg with sociodemographic variables. Spearman correlations examined associations of MUFsg with blood and urine metals within and between trimesters. A False Discovery Rate (FDR) correction accounted for multiple comparisons. The criterion for statistical significance was an alpha of 0.05.
Results:Participants were approximately 29 years old on average, and 80% were Hispanic or Latina. Median (IQR) MUFsg during trimesters one and three was 0.65 (0.5) mg/L and 0.8 (0.59) mg/L, respectively. MUFsg levels were moderately consistent between trimesters (N=292, ICC = 0.46, 95%CI: 0.32,0.57). Maternal age was positively associated with MUFsg during first (p = 0.16, p = 0.006) and third (p = 0.18, p < 0.001) trimesters. MUFsg differed by race/ethnicity during first and third trimesters (N = 293, H (3) = 7.99, p = 0.046; N = 486, H (3) = 25.31, p < 0.001, respectively). Specifically, MUFsg was higher for White, Non-Hispanic participants (first trimester Median (IQR) =1.03 (1.31) mg/L; third trimester Median (IQR) = 1.32 (1.24) mg/L) than for Hispanic participants in both trimesters (first trimester Median (IQR) =0.64 (0.48) mg/L; third trimester Median (IQR) = 0.76 (0.55) mg/L). Additionally, during trimester three, MUFsg was higher for White, Non-Hispanic participants than for Black Non-Hispanic participants (Median (IQR) = 0.82 (0.49) mg/L). MUFsg also differed by education during trimester one (N = 293, H (4) = 10.61, p = 0.031), and was higher for participants with some graduate training than for those with high school or some college/technical school education (ps = 0.03 and 0.04, respectively). After FDR correction, MUFsg was associated with blood lead (N =91, p = 0.29, p = 0.024) and urinary cadmium (N =279, p = 0.19, p = 0.042), copper (N=279, p = 0.16, p = 0.042), and tungsten (N=279, p = 0.16, p = 0.049) during trimester three.
Conclusions:Consistent with studies conducted in Canada and Mexico, MUFsg increased across pregnancy. Lower MUFsg among Hispanic and Non-Hispanic Black participants may reflect lower tap water consumption. Metal co-exposures are important to consider when examining potential neurodevelopmental impacts of fluoride.
68 Preliminary Evidence of a Therapeutic Effect of Electrical Neuromodulation on Cognitive Deficits in Patients with Mild Cognitive Impairment
- Christian LoBue, Didehbani Nyaz, Hsueh-Sheng Chiang, John Hart, Jessica Helphrey, Michael Conley, Eric Smernoff, Laura Lacritz, Caitlin Reese, C M Cullum, Cindy Marshall, Trung Nguyen, Brendan J Kelley, Alka Khera, Alex Frolov, Natalie Martinez, Rebecca Logan
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 475
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Objective:
Episodic memory functioning is distributed across two brain circuits, one of which courses through the dorsal anterior cingulate cortex (dACC). Thus, delivering non-invasive neuromodulation technology to the dACC may improve episodic memory functioning in patients with memory problems such as in amnestic mild cognitive impairment (aMCI). This preliminary study is a randomized, double-blinded, sham-controlled clinical trial to examine if high definition transcranial direct current stimulation (HD-tDCS) can be a viable treatment in aMCI.
Participants and Methods:Eleven aMCI participants, of whom 9 had multidomain deficits, were randomized to receive 1 mA HD-tDCS (N=7) or sham (N=4) stimulation. HD-tDCS was applied over ten 20-minute sessions targeting the dACC. Neuropsychological measures of episodic memory, verbal fluency, and executive function were completed at baseline and after the last HD-tDCS session. Changes in composite scores for memory and language/executive function tests were compared between groups (one-tailed t-tests with a = 0.10 for significance). Clinically significant change, defined as > 1 SD improvement on at least one test in the memory and non-memory domains, was compared between active and sham stimulation based on the frequency of participants in each.
Results:No statistical or clinically significant change (N-1 X2; p = 0.62) was seen in episodic memory for the active HD-tDCS (MDiff = 4.4; SD = 17.1) or sham groups (MDiff = -0.5; SD = 9.7). However, the language and executive function composite showed statistically significant improvement (p = 0.04; MDiff = -15.3; SD = 18.4) for the active HD-tDCS group only (Sham MDiff = -5.8; SD = 10.7). Multiple participants (N=4) in the active group had clinically significant enhancement in language and executive functioning tests, while nobody in the sham group did (p = 0.04).
Conclusions:HD-tDCS targeting the dACC had no direct benefit for episodic memory deficits in aMCI based on preliminary findings for this ongoing clinical trial. However, significant improvement in language and executive function skills occurred in response to HD-tDCS, suggesting HD-tDCS in this configuration has promising potential as an intervention for language and executive function deficits in MCI.
Ten new insights in climate science 2023
- Mercedes Bustamante, Joyashree Roy, Daniel Ospina, Ploy Achakulwisut, Anubha Aggarwal, Ana Bastos, Wendy Broadgate, Josep G. Canadell, Edward R. Carr, Deliang Chen, Helen A. Cleugh, Kristie L. Ebi, Clea Edwards, Carol Farbotko, Marcos Fernández-Martínez, Thomas L. Frölicher, Sabine Fuss, Oliver Geden, Nicolas Gruber, Luke J. Harrington, Judith Hauck, Zeke Hausfather, Sophie Hebden, Aniek Hebinck, Saleemul Huq, Matthias Huss, M. Laurice P. Jamero, Sirkku Juhola, Nilushi Kumarasinghe, Shuaib Lwasa, Bishawjit Mallick, Maria Martin, Steven McGreevy, Paula Mirazo, Aditi Mukherji, Greg Muttitt, Gregory F. Nemet, David Obura, Chukwumerije Okereke, Tom Oliver, Ben Orlove, Nadia S. Ouedraogo, Prabir K. Patra, Mark Pelling, Laura M. Pereira, Åsa Persson, Julia Pongratz, Anjal Prakash, Anja Rammig, Colin Raymond, Aaron Redman, Cristobal Reveco, Johan Rockström, Regina Rodrigues, David R. Rounce, E. Lisa F. Schipper, Peter Schlosser, Odirilwe Selomane, Gregor Semieniuk, Yunne-Jai Shin, Tasneem A. Siddiqui, Vartika Singh, Giles B. Sioen, Youba Sokona, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Vikki Thompson, Gregory Trencher, Kees van der Geest, Saskia E. Werners, Thea Wübbelmann, Nico Wunderling, Jiabo Yin, Kirsten Zickfeld, Jakob Zscheischler
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- Journal:
- Global Sustainability / Volume 7 / 2024
- Published online by Cambridge University Press:
- 01 December 2023, e19
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Non-technical summary
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summaryThe Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summaryWe highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
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- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
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Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Assessment of executive functions through a virtual reality task in euthymic patients with bipolar disorder and influence in psychosocial functioning
- J. Andreu Martínez, D. Beltrán Cristancho, P. Navalón, P. Sierra San Miguel, A. García Blanco, A. Chicchi Glioli, S. Cervera Torres, M. Alcañiz Raya, Y. Cañada Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S700
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Introduction
Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia in in patients with bipolar disorder (BD) and that those are associated with an impairment of psychosocial functioning. The assessment of executive functions (EFs) is normally carried out using laboratory tests. Novel methodologies such as virtual reality (VR) allow the creation of immersive environments, to evaluate executive performance with greater potential for ecological validity than evaluations with standard tasks.
ObjectivesThe objectives of this project are to evaluate executive performance in euthymic patients with BD with a novel virtual reality task compared to standard computerized tasks, and to find predictors of functioning associated with cognitive performance.
MethodsThis is a cross sectional study in which 46 euthymic patients with BD treated at La Fe University and Polytechnic Hospital were assessed with a battery of standard computerized tasks (ST) (TMT/Stroop,/Go-No-Go/TOL/DOT) and with the Cooking Task virtual reality task. The Cooking Task presents 4 tasks of increasing difficulty in which you must cook food in a specific time. It records total time to complete the task, whether food is cooled or burned, the simultaneous use of two fires, the proper use of seasonings and the time to set the table.
Functioning was assessed with the Functioning Assessment Short Test (FAST) that evaluates the overall functioning of patients with a mental illness in 6 subscales.
Correlation analyses between cognitive performance variables and clinical variables were done. Multiple linear regression was performed with the FAST score as a dependent variable and cognitive performance variables and relevant clinical variables to executive functioning (months of euthymia, age, and number of total episodes) were included as independent variables.
ResultsA worse psychosocial functioning was significantly associated with a worse performance in standard tasks (TMTA, TMTB, STROOP, and TOL) and cooking task (total time spent on task 2, burning time and total time spent on task 3, and total time spent on task 4). In the regression analysis, the correct simultaneous use of the two fires was the best predictor of a better psychosocial functioning in BD patient. This implies the preserved ability of planning and performing dual tasks.
ConclusionsOur findings suggest that euthymic patients with BD present deficits in executive functions related with a worse psychosocial functioning. Among the tasks, the cooking task may have a greater sensitivity than standards task to predict real functioning. This in an opportunity to design virtual applications for diagnostic and therapeutic purposes.
Disclosure of InterestNone Declared
The impact of the COVID-19 pandemic on health outcomes in delusional disorder: A systematic review
- E. Román, M. Natividad, M. V. Seeman, E. Izquierdo, E. Martínez, E. Rial, A. Alvarez, A. Guàrdia, J. A. Monreal, A. González-Rodríguez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S790
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Introduction
The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health. Relatively little attention has been paid to patients with delusional disorder (DD).
ObjectivesOur goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with DD.
MethodsA systematic review was carried out using the PubMed and Scopus database (2019-October 2022) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Search terms: “delusional disorder” or “delusional disorder” AND “COVID-19 OR SARS-CoV2.” Inclusion criteria: 1)DD according to DSM/ICD, 2)languages: English, French, German and Spanish, 3)studies reporting health consequences of COVID-19 pandemic. From a total of 615 records, 6 were included: meta-analysis (n=1), cross-sectional studies (n=2), retrospective study (n=1), case reports (n=2).
ResultsA full third of patients with psychosis (including DD) presented with increased psychiatric symptom severity, reportedly activated by increased daily life stress. Suicidal behavior was reported in a previously undiagnosed DD patient in association with a worsening clinical picture. Perhaps surprisingly, admissions for DD in 2020 were lower than in 2019. The duration of hospitalization was, however, longer. There was a report of new onset DD with delusional material centred on COVID. There was also a report of COVID-19 symptoms being more severe in DD patients than in the larger community.
ConclusionsHealth emergencies affect the seriously mentally ill more than other community members. Awareness and outreach can help to maintain treatment adherence and minimize risk of psychotic exacerbation.
Disclosure of InterestNone Declared
TRANVIA: A program for continuum mental health assistance in transition period
- L. Pérez Gómez, A. González Álvarez, M. A. Reyes Cortina, E. Lanza Quintana, N. Álvarez Alvargonzález, C. Rodríguez Turiel, E. Lago Machado, J. J. Martínez Jambrina
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S728
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Introduction
Transition between adolescence and adulthood represents the most important challenge for personal development and involves several transformations: physical, psychological and social. It is a complex age bracket, concurring the transition from youth psychiatric units to adult ones, with an increased risk for the appearance of mental disorders and risky behaviours. TRANVIA program, developed in Avilés, provides psychiatric assistance to patients between 15 and 25 years old, diagnosed with a severe psychiatric disorder or with an increased risk of having one.
ObjectivesOur objectives are: ensuring clinical continuity assistance, promoting communication among professionals and the empowerment of our patients to improve their functionality and quality of life.
MethodsDescriptive study including patients involved in TRANVIA program from November 2019 to November 2021.
ResultsDuring this two-years period there have been 44 referrals to the program, 11 of them were rejected for failure to comply with diagnostic criteria. In November 2021 there were 33 patients included in the TRANVIA program with an average age of 17 years old (range: 15-22). 70% of them were men and 30% women. All of them had psychiatric assistance from different sources: youth mental health units, neuropediatrics… About 75% of the patients were diagnosed with autistic spectrum disorder and approximately three-quarters of the sample needed pharmacological treatment. Risperidone was the most prescribed drug. We have also developed other assistance alternatives as home-based care, relaxation sessions, social worker interventions and coordination with schools.
ConclusionsTRANVIA program has allowed us to provide continual attention to vulnerable patients that shift from youth psychiatric units to adult ones. Patients that meet inclusion criteria were enrolled independently the type of assistance they have previously received. Accessibility and flexibility were our priority. During the described period there was only one dropout, three patients required psychiatric hospitalization and two others visited the emergency department. There have been no cases of completed suicide.
Disclosure of InterestNone Declared
Positive relationships and academic stressors in the post-pandemic context of covid-19 in adolescents from a school in Córdoba, Colombia.
- E. P. Ruiz Gonzalez, M. F. Martinez Burgos, V. Contrera Montiel, M. N. Muñoz Argel, J. J. Diaz Muñoz
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S214
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Introduction
Berscheid (1999), taken from Lacunza & Contini (2016), indicated that social relations were the foundation of the human condition. From positive psychology, Park et al. (2013) point out good relationships as a factor that contributes to a good psychological life, since they provide emotional and instrumental support in times of stress and challenge, indicating, in turn, normal evolutionary development and the avoidance of psychopathological problems.
ObjectivesTo establish the relationship between positive relationships and the presence of stressors in adolescents.
MethodsA cross-sectional, descriptive-correlational study was carried out in 109 (N= 109) adolescents. The SISCO Inventory was used to study academic stress as well as the Ryff Psychological Well-Being Scale.
ResultsA negative magnitude correlation was found between positive relationships and stressors. ( Table 1).
As a secondary result, 60.6% of the evaluated adolescents presented life purpos as the factor with the highest score in the psychological well-being variable. This points to authors such as Erikson (1988, p. 96), who define adolescence as a space characterized by feelings of creativity, productivity, new ideas, and a period of cognitive and social maturation, which leads to a definitive commitment to life itself. (Graph 1).
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ConclusionsPositive relationships in adolescents decrease the presence of stimuli considered stressors.
Disclosure of InterestNone Declared
Use and experience with six-monthly paliperidone in the Campo de Gibraltar area. Descriptive study.
- C. M. Gil Sánchez, J. A. Salomón Martínez, E. Corbacho Navarro
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1005-S1006
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Introduction
Long-acting injectable antipsychotics have demonstrated advantages over therapeutic adherence and can reduce the rates of relapses and due to treatment discontinuation. The novel presentation of paliperidone palmitate six-month (PP6M) can simplify the treatment to two injections per year.
ObjectivesThe purpose of the present research is to describe the profile of patients receiving this novel treatment in our area. For this, a descriptive study has been carried out.
MethodsWe have collected and analyzed data from a total of 8 patients from the global long-acting injectable nursing registry in our area. The data collection was from May 2022 to October 2022.
ResultsID Patient Age Gender Medical comorbidities Social support Adherence to previous LAI EP001AGC 52 M No - Yes EP002EGA 53 M No Low No EP003ESL 45 F Yes HIV, HCV, dyslipidemia, Enough Yes EP004ACG 60 M Yes Hypertension, dyslipidemia Good Yes EP005DCP 52 M Yes COPD Enough Yes EP006ATT 47 M No Enough / Low Yes EP007AH 40 F Yes Tension headache Enough Yes EP008IAR 66 F Yes Type 2 diabetes mellitus, hypertension, hyperuricemia Enough Yes ID Patient Diagnosis Refractory positive symptoms Last H. Polypharmacy Previous injection Injection date / Dose H. / Side Effects EP001AGC Paranoid schizophrenia - 08/03/2014 No PP3M 525mg 17/05/22 1.000 mg No EP002EGA Schizoaffective disorder Yes 19/08/2022 Yes Valproic acid 1.000mg PP1M 150mg (once) 13/09/22 1.000mg No EP003ESL Paranoid schizophrenia No 17/04/2019 Yes Olanzapine 10mg BZD PP3M 525mg 10/08/22 1.000mg Sedation (low) EP004ACG Paranoid schizophrenia No - Yes Quetiapine 50mg PP3M 525mg 16/09/22 1.000mg No EP005DCP Paranoid schizophrenia No 16/01/2004 Yes Olanzapine 20mg BZD PP3M 525mg 11/10/22 1.000mg No EP006ATT Persistent delusional disorder Yes - No PP3M 525mg 19/09/22 1.000mg No EP007AH Paranoid schizophrenia No 2017 No PP3M 525mg 03/08/22 1.000mg No EP008IAR Persistent delusional disorder Yes - Yes BZD Paliperidone oral 9mg and later PP3M 350mg (twice) 18/10/22 1.000mg No Fig. 1: Sociodemographic characteristics and Fig. 2: Clinical characteristics.
ConclusionsNone of the patients required hospitalization at the time of the study, although this work team considers that it is early to make conclusions in this regard. No serious or minor adverse effects were reported in any of the cases during the time of the investigation, apart from one case of mild sedation.
The clinical characteristics of most patients were psychopathological stability and good adherence to previous treatment. Although this study shows that the drug was also used in patients who did not meet these characteristics, specially one case of poor social support. The data collected show that the profile of the patient in whom the drug has been prescribed can be varied and broad.
Disclosure of InterestNone Declared
Efficacy of maintenance electroconvulsive therapy in recurrent depression: a case series
- G. Guerra Valera, Ó. Martín Santiago, M. Esperesate Pajares, Q. D. L. de la Viuda, A. A. Gonzaga Ramírez, C. Vallecillo Adame, C. de Andrés Lobo, T. Jiménez Aparicio, N. Navarro Barriga, B. Rodríguez Rodríguez, M. Fernández Lozano, M. J. Mateos Sexmero, A. Aparicio Parras, M. Calvo Valcárcel, M. A. Andreo Vidal, P. Martínez Gimeno, M. P. Pando Fernández, M. D. L. Á. Guillén Soto
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S832
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Introduction
Maintenance electroconvulsive therapy (mECT) is an option in the treatment of affective disorders which progress is not satisfactory. It is certainly neglected and underused during the clinical practice.
ObjectivesTo evaluate the efficacy of mECT in reducing recurrence and relapse in recurrent depression within a sample of three patients.
MethodsWe followed up these patients among two years since they received the first set of electroconvulsive sessions. We applied the Beck Depression Inventory (BDI) in the succesives consultations for evaluating the progress.
ResultsThe three patients were diagnosed with Recurrent Depressive Disorder (RDD). One of them is a 60 year old man that received initially a cycle of 12 sessions; since then he received 10 maintenance sessions. Other one is a 70 year old woman that received initially a cycle of 10 sessions; since then she received 6 maintenance sessions. The last one is a 55 year old woman that received initially a cycle of 14 sessions; since then she received 20 maintenance sessions.
All of them showed a significant reduction in depressive symptoms evaluated through BDI and clinical examination. In the first case, we found a reduction in the BDI from the first consultation to the last that goes from 60 to 12 points; in the second case, from 58 to 8 points; and in the last case, from 55 to 10 points. The main sections that improved were emotional, physical and delusional.
As side-effects of the treatment, we found anterograde amnesia, lack of concentration and loss of focus at all of them.
ConclusionsWe find mECT as a very useful treatment for resistant cases of affective disorders like RDD.
It should be considered as a real therapeutic option when the first option drugs have been proved without success.
Disclosure of InterestNone Declared
Gut permeability and low-grade inflammation in bipolar disorder
- M. Couce, G. Paniagua, L. González-Blanco, A. García-Fernández, C. Martínez-Cao, P. Sáiz, J. Bobes, M. P. García-Portilla
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S385-S386
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Introduction
Systemic inflammation has been increasingly related to bipolar disorder -BD- (Tanaka et al. Neurosci Res 2017;115 59-63). Intestinal bacterial translocation has been postulated as one of the causes of this inflammation (Nguyen et al. J Psychiatr Res 2018;99 50-61). A possible pathway is through the lipopolysaccharide, which is presented to CD14 through lipopolysaccharide binding protein (LBP) leading to a release of systemic inflammatory markers like C-reactive protein (CPR) (Funda et al. Infect Immun 2001;69 3772-81).
Objectives1) Describe gut permeability in patients with BD through the determination of intestinal inflammatory markers (LBP, sCD14) in plasma; 2) Analyze variables associated with intestinal inflammation.
MethodsCross-sectional study of 38 patients with BD [mean age=45.50 (SD=10.93; range 23-68); males=15 (39.5%)], recruited from mental health outpatient clinics in Oviedo (Spain).
Assessment: Pro-inflammation biomarkers [CRP (mg/dL), Erythrocyte Sedimentation Rate (ESR) (mm/h), Neutrophil/Lymphocyte, Monocyte/Lymphocyte, Platelet/Lymphocyte and Systemic Immune Inflammation Indexes]. Indirect markers of intestinal bacterial translocation [LBP, soluble CD14 (sCD14)]. Dichotomous variables were created for LBP, considering LBP ≥15 μg/dL as increased gut permeability; and for CPR, considering CRP≥0.3 as systemic inflammation. Metabolic syndrome [ATPIII criteria: glucose, HDL, triglycerides (mg/dl), arterial pressure (mmHg), abdominal circumference (cm)], body mass index (BMI) (kg/m2), smoking, cannabis or alcohol use.
Statistical analyses: t-Student test, multiple linear regression analyses.
ResultsAverage LBP was 14.60 μg/dL (SD=6.4) and 15 patients (39.5%) had increased gut permeability. Moreover, average CPR was 0.40 mg/dL (SD=0.58) and 16 patients (47.1%) showed systemic inflammation. There were no patients with increased levels of sCD14.
Associations were found between LBP and CPR (r=0.357; p=0.032), cannabis use in the last month (t=-2.293; p=0.029), BMI (r=0.433; p=0.008) and abdominal obesity (t=3.006; p=0.005); but no with age or sex.
Subsequently, a multiple linear regression model for LBP was calculated with variables previously mentioned, and age (based on expert criteria). The overall regression was statistically significant (R2=0.49, F=9.273, p<0.001). It was found that CPR, abdominal obesity, and cannabis use in the last month significantly predicted LBP levels (table 1).
Table 1. Multiple linear regression analyses to LBP B SE β t p CPR 4.842 1.529 0.439 3.167 0.004 Abdominal obesity 4.810 1.849 0.362 2.601 0.014 Cannabis use -5.048 2.273 -0.296 -2.221 0.034 ConclusionsMore than one third of patients with BD had increased gut permeability. Almost 50% had systemic inflammation. Intestinal permeability was directly related to abdominal obesity and systemic inflammation, but inversely related to cannabis use.
Disclosure of InterestNone Declared
UNTIL IT BURSTS OR ALL OF US BURST. A SCHIZOTYPICAL CASE.
- B. Rodríguez Rodríguez, N. Navarro Barriga, M. Fernández Lozano, M. J. Mateos Sexmero, M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, M. P. Pando Fernández, A. Aparicio Parras, M. D. L. Á. Guillén Soto, T. Jiménez Aparicio, M. D. C. Vallecillo Adame, C. de Andrés Lobo, A. A. Gonzaga Ramírez, G. Guerra Valera, M. Queipo de Llano de la Viuda, M. Esperesate Pajares
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S967
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Introduction
Schizotypal disorder is conceptualized as a stable personality pathology (Cluster A) and as a latent manifestation of schizophrenia. It can be understood as an attenuated form of psychosis or high-risk mental state, which may precede the onset of schizophrenia or represent a more stable form of psychopathology that doesn’t necessarily progress to psychosis.
ObjectivesTo exemplify the continuum of psychosis
MethodsReview of scientific literature based on a relevant clinical case.
Results39-year-old male living with his parents. He started studying philosophy. He is a regular cannabis user and has an aunt with schizophrenia. He’s admitted to psychiatry for behavioral disturbance in public. He refers to having been hearing a beeping noise in his street for months, what he interprets as a possible way of being watched due to his past ideology. Without specifying who and why, he sometimes shouts “until it bursts” to stop the noise and he thinks that his neighbours alerted the police about his behavior. During the interview he alludes to Milgram’s experiment, saying that throughout history there have been crimes against humanity and those who pointed them out were labeled “crazy”. His father refers that he has always been “strange” and with certain extravagant revolutionary ideas and thoughts. He doesn’t maintain social relationships and dedicates himself to reading and writing.
ConclusionsIt’s important to understand psychosis as a continuum to advance the understanding of etiology, pathophysiology and resilience of psychotic disorders and to develop strategies for prevention and early intervention
Disclosure of InterestNone Declared
Use of psychotropic medications during pregnancy and the postpartum period: Review on Recent Works and Clinical Scenarios
- E. Román, M. Natividad, J. Cobo, R. Ayesa, H. Cachinero, I. Figueras, E. Izquierdo, E. Martínez, J. P. Paolini San Miguel, J. A. Monreal, A. González-Rodríguez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1125-S1126
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Introduction
The effects of antidepressant and antipsychotic medications in the perinatal period in both mothers and children have been a subject of interest for many decades. Risks and benefits should be considered according to the illness stage, trimester of pregnancy/ postpartum period, and neonatal outcomes.
ObjectivesOur goal was to summarize the knowledge about the use of antidepressants and antipsychotics in the perinatal period. To illustrate the complexity of treatment decisions with clinical reports.
MethodsReview: A narrative review was carried out using the PubMed database including papers published in 2022. Evidence about the risks and benefits of using antidepressants and antipsychotics in the perinatal period is presented. Search terms: antidepressants OR antipsychotics AND (perinatal OR pregnancy OR postpartum).
Case reports (5 clinical scenarios): (1) pre-pregnancy counselling, (2-4) first-, second- and third-trimester of pregnancy, and (5)postpartum/breastfeeding.
ResultsReview: (1)Depression/antidepressants. Treating maternal depressive symptoms is associated with a lower risk of pregnancy complications. Although placental passage of sertraline is low, drug monitoring is recommended. Antidepressant use in pregnancy is associated with preterm delivery and low weight at birth. (2)Psychosis/Antipsychotics. Antipsychotic intrauterine exposure is not significantly associated with increased risk of major congenital malformations. Minimum effective doses are recommended.
Case reports. (1)Pre-pregnancy counselling. Schizoaffective disorder receiving perphenazine, quetiapine and lithium. (2)First-trimester pregnancy. Discontinuation of treatment in major depressive disorder. (3-4)Second/third trimester. Occurrence of anxiety symptoms in posttraumatic stress disorder. (5)Postpartum/Breastfeeding. Discontinuation of antidepressants.
ConclusionsShared decision-making models for antidepressants and antipsychotics prescription represent patient-centered approaches to be recommended in perinatal period.
Disclosure of InterestNone Declared
Delirious episode secondary to rotigotine: the psychotic patch
- M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, P. Pando Fernández, B. Rodríguez Rodríguez, N. Navarro Barriga, M. Fernández Lozano, M. J. Mateos Sexmero, T. Jiménez Aparicio, M. D. C. Valdecillo Adame, C. de Andrés Lobo, G. Guerra Valera, M. Queipo de Llano de la Viuda, A. A. Gonzaga Ramirez, M. D. L. Á. Guillén Soto, A. Aparicio Parras, M. Esperesate Pajares
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S626
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Introduction
There is a fine line separating psychiatry and neurology. Most movement disorders can have psychiatric symptoms, not only those caused by the disease itself, but also those induced by the drugs used to treat them.
ObjectivesPresentation of a clinical case about a patient diagnosed with Parkinson’s disease presenting a several-month-long delirious episode due to dopaminergic drugs.
MethodsLiterature review on drug-induced psychosis episodes in Parkinson’s disease.
ResultsA 57-year-old patient with diagnosis of Parkinson’s disease for six years, who went to the emergency room accompanied by his wife due to delirious ideation. He was being treated with levodopa, carbidopa and rasagiline for years, and rotigotine patches whose dosage was being increased over the last few months.
His wife reported celotypical clinical manifestations and multiple interpretations of different circumstances occurring around her. He chased her on the street, had downloaded an app to look for a second cell phone because he believed she was cheating on him, and was obsessed with sex. He had no psychiatric background. It was decided to prescribe quetiapine.
The following day, he returned because he refused to take the medication since he thought he was going to be put to sleep or poisoned. It was decided to admit him to Psychiatry.
During the stay, rasagiline and rotigotine were suspended. Olanzapine and clozapine were introduced, with behavioral improvement and distancing from the psychotic symptoms which motivated the admission. The patient was also motorically stable. Although levodopa is best known for causing psychotic episodes, the symptons were attributed to rotigotine patches for temporally overlapping the dose increase.
ConclusionsPsychiatric symptoms are the third most frequent group of complications in Parkinson’s disease after gastrointestinal complications and abnormal movements. All medication used to control motor disorders can lead to psychosis, not only dopaminergics, but also selegiline, amantadine and anticholinergics.
Excessive stimulation of mesocortical and mesolimbic dopaminergic pathways can lead to psychosis, which is the most common psychiatric problem related to dopaminergic treatment.
In the face of a psychotic episode, antiparkinsonian drugs which are not strictly necessary for motor control should be withdrawn. If this is not sufficient, levodopa dose should be reduced, considering the side effects that may occur. When the adjustment of antiparkinsonian treatment is not effective, neuroleptics, especially quetiapine or clozapine, should be administered. In a recent study, pimavanserin, a serotonin 5-HT2 antagonist, was associated with approximately 35% lower mortality than atypical antipsychotic use during the first 180 days of treatment in community-dwelling patients.
Medication should always be tailor-made to suit each patient and we usually have to resort to lowering or withdrawing the dopaminergic medication.
Disclosure of InterestNone Declared
Bipolar disorder and substance use: Risk factors and prognosis
- M. Fernández Lozano, B. Rodríguez Rodríguez, M. J. Mateos Sexmero, N. Navarro Barriga, C. Vallecillo Adame, C. de Andrés Lobo, T. Jimenez Aparicio, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramírez, M. P. Pando Fernández, M. Calvo Valcárcel, M. A. Andreo Vidal, P. Martínez Gimeno
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S704
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Introduction
Bipolar disorder comorbidity rates are the highest among the major mental disorders. In addition to other intoxicants, alcohol is the most abused substance because it is socially accepted and can be legally bought and consumed. Estimates are between 40-70% with male predominance, which further influences the severity with a more complicated course of both disorders.
ObjectivesThe objective of this article is to highlight the impact of substance use on the course and prognosis of bipolar disorder, as well as to make a differential diagnosis of a manic episode in this context.
MethodsBibliographic review of scientific literature based on a relevant clinical case.
ResultsWe present the case of a 45-year-old male patient. Single with no children. Unemployed. History of drug use since he was young: alcohol, cannabis and amphetamines. Diagnosed with bipolar disorder in 2012 after a manic episode that required hospital admission. During his evolution he presented two depressive episodes that required psychopharmacological treatment and follow-up by his psychiatrist of reference. Since then, he has been consuming alcohol and amphetamines occasionally, with a gradual increase until it became daily in the last month. He went to the emergency department for psychomotor agitation after being found in the street. He reported feeling threatened by a racial group presenting accelerated speech, insomnia and increased activity.
ConclusionsThe presence of substance abuse complicates the clinical presentation, treatment and development of bipolar disorder. It is associated with a worse prognosis with multiple negative consequences including worsening symptom severity, increased risk of suicide and hospitalization, increased medical morbidity and complication of social problems. In addition, this comorbidity delays both the diagnosis and treatment, by masking the symptoms, and making more difficult an adequate differential diagnosis.
Disclosure of InterestNone Declared