23 results
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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- Journal:
- 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.
Does intensive home treatment change treatment trajectories of psychiatric disorders?
- A. Martín-Blanco, A. González-Fernández, A. Farré, S. Vieira, P. Alvaro, C. Isern, D. Giménez, C. Torres, V. de la Cruz, C. Martín, N. Moll, O. Castro, M. Sagué-Vilavella
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S167-S168
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Introduction
Intensive home treatment (IHT) for people experiencing a mental health crisis has been progressively established in many western countries as an alternative to in-ward admission. But is this a real alternative? We previously reported that patients treated in our IHT unit only differ from those voluntarily admitted to hospital in suicidal risk and severe behaviour disorders (not in other factors such as clinical severity) (Martín-Blanco et al., Rev Psiquiatr Salud Ment 2022;15:213-5). Now we are interested in disentangle if those patients who used to require inward management can be successfully treated at home.
ObjectivesTo describe subsequent treatment trajectories of the first 1000 admissions to our IHT unit and to compare clinical characteristics among the different groups of trajectories.
MethodsRetrospective cohort study. Subsequent treatment trajectories were collected from December 2016 to October 2022 and classified: absence, hospital, IHT, and mixed (hospital and IHT). Statistical significance was tested by means of ANOVA or Kruskal-Wallis test for quantitative variables (corrected for multiple comparisons) and chi-square tests for qualitative variables.
ResultsTables 1 shows the characteristics of the whole sample. Of the 1000 IHT admissions, 12.1% needed subsequent hospital admission(s), 12.7% IHT admission(s), and 9.3% mixed admission(s). There were no differences among these groups in median severity at IHT admission, but there were differences in the number of previous admissions (p=0.0001): the group with no subsequent admissions had less previous admissions than the other groups (pBonf<0.0001), and the group with subsequent IHT admissions had less than the group with mixed admissions (pBonf=0.0123). There were differences between groups regarding distribution of diagnoses (p<0.0001) (Fig. 1). When considering subsequent admissions by diagnosis, there were differences in severity at IHT admission (p=0.0068) and in number of previous hospitalizations (p<0.0001) (Fig. 2).
Table 1. Clinical characteristics of the whole sample (N=1000) mean SD Age (years) 47.07 17.02 CGI-s at admission * 5 4-5 N % Sex (female) 548 54.8% Psychotic disorders 463 46.3% Affective disorder 257 25.7% Bipolar disorder 128 12.8% Other disorders 152 15.2% Hospital admission in the previous 5 years 313 31.3% CGI-s: clinical global impression - severity. * median and IQR
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ConclusionsPatients that used to require inward management can now be treated at home when suffering an acute episode. Therefore, IHT has changed treatment trajectories for some patients with psychiatric disorders.
Disclosure of InterestNone Declared
Relationship between dementia and depression: a case series
- A. Izquierdo De La Puente, P. del Sol Calderón, R. Fernández Fernádez, A. Rodríguez Rodriguez, M. Vizcaíno Da Silva, M. Martín García, O. Médez Gonzalez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S825
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Introduction
Four cases are presented who debut with depressive episodes and after close follow-up, are diagnosed and treated for Alzheimer’s disease
ObjectivesThe aim of this case series is to give a brief review of the depressive prodrome of dementia.
MethodsFour women, aged 67-77 years, treated on an outpatient basis, consulted for depressive symptoms. In addition to affective symptoms such as apathy, lack of interest, sadness, increased emotional lability and anhedonia, all three reported cognitive impairment. In their follow-up after two years, they became progressively more dependent on their partners, with more memory lapses, forgetfulness and progressive loss of higher cognitive functions. With the progression of cognitive impairment, anxious symptoms have become increasingly present.
ResultsThe mean age of the patients is 70 years. Two of them had an insidious onset of depressive symptoms, while the other two had a psychotic onset of depression. None of the patients had no previous history of depression. All four were started on antidepressant treatment with little response. Following the diagnosis of cognitive impairment, treatment was started with rivastigmine, with an adequate response.
ConclusionsDementia and depression are very common in the elderly. It appears that up to 40% of patients with dementia have depressive symptoms. It appears that depression in old age may actually be a prodromal symptom of dementia.
Disclosure of InterestNone Declared
Individual and family predictors of ultra-processed food consumption in Spanish children: The SENDO project
- Lorena García-Blanco, Víctor de la O Pascual, Arantxa Berasaluce, Laura Moreno-Galarraga, Miguel Ángel Martínez-González, Nerea Martín-Calvo
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 2 / February 2023
- Published online by Cambridge University Press:
- 27 May 2022, pp. 437-445
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Background:
Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects.
Objective:To identify individual and faGmily factors predicting UPF consumption in childhood.
Design:The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (P < 0·20) in univariate analyses were introduced in a model of generalised estimating equations which accounted for intra-cluster correlations between siblings.
Setting:The SENDO project (Spain), 2015–2021.
Participants:Spanish children are recruited at the age of 4–5 years and followed yearly through online questionnaires completed by parents.
Results:In this sample of 806 participants (49 % girls; mean age 5 years (sd: 0·90)), the mean UPF consumption was 37·64 % of total energy intake (sd: 9·59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children’s dietary recommendations, healthy dietary attitudes towards child’s eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16 % of the variability on the consumption of UPF in childhood.
Conclusion:Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting healthy dietary habits in early life.
Neuroleptic malignant syndrome: Case report and literature review
- R. Martín Gutierrez, R. Medina Blanco, P. Suarez Pinilla, R. Landera Rodriguez, M. Juncal Ruiz, I. Madrazo del Río Hortega, M. Gómez Revuelta, O. Porta Olivares, J. González Gómez, J. Vázquez Bourgon, R. Hernando Fernández
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S564
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Introduction
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal adverse effect of neuroleptic, both classic and atypical drugs.
ObjectiveTo review the incidence, clinical characteristics, diagnosis and treatment of NMS.
AimWe have described the case of a man of 32 years of age diagnosed with bipolar disorder treated with lithium. He precised high-dose corticosteroids after having tonsillitis. Then, he presented manic decompensation requiring neuroleptic treatment (oral risperidone). After 72 hours, he presented an episode characterized by muscular rigidity, fever, altered mental status and autonomic dysfunction. Life support measures and suspension of neuroleptic treatment were required.
MethodsA literature review of the NMS was performed using the PubMed database.
ResultsThe frequency of NMS ranges from 0.02 to 2.4%. The pathophysiology is not clearly understood but the blockade of dopamine receptors seems to be the central mechanism. Some of the main risk factors described are: being a young adult, the concomitant use of lithium and metabolic causes, among others. NMS occurs most often during the first week of treatment or after increasing the dosage of the neuroleptic medication. Some issues of NMS are those related with diagnosis, treatment and reintroduction of antipsychotic treatment or not.
ConclusionsNMS can be difficult to diagnose due to the variability in the clinical symptoms and presentation. Because of it diagnosis is of exclusion, clinicians should always take it into consideration when a patient is treating with neuroleptic, especially when the dosage has been recently increased. NMS is a clinical emergency.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Steroid-induced psychiatric syndromes: A case report and a review of the literature
- R. Martín Gutierrez, P. Suarez Pinilla, R. Medina Blanco, R. Landera Rodriguez, M. Juncal Ruiz, M. Gómez Revuelta, I. Madrazo del Río Hortega, O. Porta Olivares, J. González Gómez, R. Hernando Fernández
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S694
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Introduction
Glucocorticoids are widely prescribed for a variety of diseases and are known to cause neuropsychiatric as well as somatic side effects.
ObjectiveTo review the incidence, clinical characteristics, course and treatment of neuropsychiatric effects of glucocorticoids.
AimWe have described the case of a 86-year-old woman. She had no personal and no psychiatric medical history in her family. She presented wrist arthritis requiring high doses of an oral corticoid treatment (prednisona 20 mg/d). After a week, she started with symptoms characterised by persecutory and surveillance delusions. Organicity was ruled out. The patient got a progressive recovery after starting anti-psychotic medication and progressive reduction of the steroid drugs.
MethodsWe have performed a literature review of the neuropsychiatric complications of glucocorticoids using the PubMed database.
ResultsNeuropsychiatric effects of glucocorticoids involve affective, behavioural, and cognitive manifestations. The incidence is variable, between 2 and 60% of patients who receive steroids. Although the effects of glucocorticoids are unpredictable, the administered dose is the most significant risk factor for the development of neuropsychiatric symptoms. Dosage reduction typically results in clinical recovery. Although the limited data on this subject, it is a problem that clinicians face on their regular basis. The administration of anti-psychotics or mood stabilizers may be beneficial in the prevention and treatment of this syndrome.
ConclusionThe neuropsychiatric effects of glucocorticoids are unpredictable and non-specific. More controlled trials are needed in order to perform evidence-based clinical guidelines for the treatment with glucocorticoids and for the prevention of neuropsychiatric manifestations.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Benzodiazepines abstinence syndrome with psychotic symptoms: Case report
- N.I. Núñez Morales, M. Gómez Revuelta, B. González Hernández, M. Laborde Zufiaurre, A. Aranzabal Itoiz, O. Porta Olivares, G. Montero González, M. Zubia Martín, J. Gaviña Arenaza, A.M. González Pinto Arrillaga
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S482
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Introduction
Several studies point to the importance that the complex formed by GABA and the benzodiazepine receptor play for cerebral dopaminergic transmission and, hence, to the pathophysiology of psychotic symptoms. The decrease in GABA neuratransmisión or the hypofunction of the system in the hippocampus, cortex and other limbic prefrontal or subcortical regions has consequences as emotional dysregulation, cognitive impairment and development of positive psychotic symptoms.
ObjectivesWe intended to show an additional practical example to the limited literature available based on a case linking the emergence of psychotic symptoms due to acute benzodiazepine withdrawal.
MethodsWe present the case of a 21 year old man who was sent to the emergency room of our hospital after an episode of aggressiveness on the street. The patient showed a psychotic schizophrenic syndrome with significant emotional and behavioural impact with aggressive and bizarre movements. In parallel, restlessness, sweating, tremor, increased blood pressure and tachycardia were observed. Symptoms had started abruptly two hours earlier. The patient companion explained that he usually took Alprazolam at an of over 40 mg per day. He had decided to give up this consumption abruptly four days earlier.
DiscussionGABAergic deficits cause the imbalance between excitatory and inhibitory neurotransmission that may relate the pathophysiology of psychotic symptoms. The dysfunction of the GABAergic cortical interneurons could affect to the modulating response from the association cortex, which, could also relate with the appearance of these symptoms.
ConclusionThis case could relate a decrease in GABAergic transmission with the appearance of psychotic symptoms.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Pieces of Me: A Story of Trauma and Dissociation
- L. Garcia Ayala, M. Gómez Revuelta, C. Martin Requena, M. Juncal Ruiz, O. Porta Olivares, E. Saez de Adana García de Acilu, A. Aranzabal Itoiz, B. González Hernández, M. Laborde Zufiaurre, M. Zubia Martín, N. Núñez Morales, M.P. López Peña, A.M. González-Pinto Arrillaga
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S723
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Introduction
Traumatic event related disorders (ASD, PTSD and dissociative disorders) could share a common dissociative psychobiological origin. Patients diagnosed with dissociative identity disorder present a high sexual abuse rate (85–90%), way above the rest of the traumatic spectrum disorders.
ObjectivesThe goal of this study is to analyse the existing relation between different types of trauma, especially sexual abuse, and the onset and continuity of dissociative disorders.
Materials and methodsWe report the case of a 37 years old woman with a long sexual abuse history. The symptoms appear by age 30, in the form of flashbacks, ushering a persistent identity fragmentation in individual differentiated opposed components, shaping a dissociative personality disorder, which was present for years taking a fluctuating and invalidating nature.
DiscussionWhen a traumatic event occurs, acute dissociative reactions frequently appear, usually briefly, disappearing spontaneously afterwards. In this case, we can discern the persistence of the dissociative symptoms and the repercussion they had in the patient's functionality.
ConclusionThe existence of a correlation between the duration of a chronic traumatic event and the persistence of dissociative symptoms in the evolution of a dissociative personality disorder is possible.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Knowledge Takes up Space, a Family Affair
- L. Garcia Ayala, M. Gomez Revuelta, C. Martin Requena, M. Juncal Ruiz, O. Porta Olivares, E. Saez de Adana Garcia de Acilu, A. Aranzabal Itoiz, B. Gonzalez Hernandez, M. Laborde Zufiaurre, M.P. Lopez Peña, N. Nuñez Morales, M. Zubia Martin, A.M. Gonzalez-Pinto Arrillaga
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S641
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Introduction
Previous research suggests that hoarding aggregates in families and is associated with health, safety risks and family problems. Hoarding symptoms appear to be more common among first-degree relatives of people who hoard. A predominance of shared hoarding disorder has been observed among female relatives.
ObjectivesWe present an atypical case report describing hoarding symptoms among first-degree male relatives who present two different subtypes of hoarding disorder.
Materials and methodsWe report the case of a 38 years old male patient, attended for the first time by the mental health services at the age of 22, and being diagnosed of severe OCD at that moment. In the home visit paid by the social services, an excessive object hoarding was observed, including the presence of over 40,000 books.
Moreover, they found a 38 years old man looking severely deteriorated; when they ask him about it, the patient's father admits to having been isolated in the house for almost 14 years. Hoarding history was gathered, through the acquisition of various objects by the patient's father, dating back to over 30 years ago.
DiscussionThe harmonic coexistence for over a decade between two patients affected with a hoarding disorder with two different clinical setting subtypes was only made possible by the complementary nature of their symptoms.
ConclusionThe hoarding disorders amongst more than one person living under the same roof are uncommon, can present themselves in both genders and can exhibit different symptoms.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evolution of diagnostic frequency in schizophrenia spectrum disorders in Acute Psychiatric Unit in Barcelona
- M. Grifell, L. Galindo, M. Campillo, L. Gonzalez, A. Palomo, C. Diez-aja, A. Grau, L. San-Emeterio, M. Ibarra, R. Sanchez, L.M. Martín, L. García, O. Orejas, T. Salvador, H. Manteca, V. Pérez
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- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S363
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Introduction
Several studies have suggested variations in the prevalence of schizophrenia spectrum disorders diagnosis across time. This could be due to a change in diagnostic practice motivated either for changes in DSM criteria as for local culture factors. The aim of this study is to explore the evolution of the schizophrenia spectrum disorders. We hypothesize that we would observe a transference from the schizophrenia diagnosis to psychosis not otherwise specified.
MethodsA retrospective review of all psychiatric discharges in acute unit in the INAD of Parc de Salut Mar of Barcelona, between 2002 and 2014 was performed, relating each discharge to its axis I psychiatric diagnostic. An ANOVA analysis was used to calculate the differences between the months and the frequency of the diagnosis.
ConclusionWe have not been able to observe any transference between diagnoses across years. We observe a decrease of the proportion of schizophrenic spectrum disorders in its prevalence at discharge from 2012 to 2014. The proportion of not otherwise specified psychosis remains quite constant as a third of the schizophrenia diagnoses.
Disclosure of interestThe authors report no conflict of interest in this study. LG is funded by the Instituto.de.Salud.Carlos.III (CM14/00111).
I Don't Recycle! An Organic Hoarding Disorder
- L. Garcia Ayala, M. Gomez Revuelta, C. Martin Requena, E. Saez de Adana Garcia de Acilu, O. Porta Olivares, M. Juncal Ruiz, N. Nuñez Morales, M. Zubia Martin, M. Laborde Zufiaurre, B. Gonzalez Hernandez, A. Aranzabal Itoiz, M.P. Lopez Peña, A.M. Gonzalez-Pinto Arrillaga
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S640-S641
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Introduction
Hoarding often occurs without the presence of obsessive-compulsive disorder (OCD), showing distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Furthermore, it presents itself secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as independent diagnosis in DSM-5.
ObjectivesWe aim to expose the possible organic etiology of a hoarding disorder case with atypical presentation.
Materials and methodsWe present a case of a 48 years old male patient who was brought to the hospital by the police after being reported for unhealthy conditions in his home. In the home visit paid by the Social Services an excessive hoarding of objects and trash was detected. A possible hoarding disorder was diagnosed in the psychiatric assessment. Among other diagnostic test, a brain CT was conducted, in which a frontal meningioma was identified. After surgical treatment, hoarding symptoms diminished significantly.
DiscussionA significant part of the hoarding disorders are attributed to primary psychiatric disorders, resulting in potentially treatable organic pathology going unnoticed.
ConclusionIt's important to rule out organic etiology before proceeding to make a definitive hoarding disorder diagnosis, optimizing that way the treatment options.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Does psychiatry link culture and symptoms?
- L. Garcia Ayala, M. Gomez Revuelta, C. Martin Requena, B. Gonzalez Hernandez, M. Laborde Zufiaurre, E. Saez de Adana Garcia de Acilu, A. Aranzabal Itoiz, O. Porta Olivares, M. Juncal Ruiz, M. Zubia Martin, N. Nuñez Morales, A.M. Gonzalez-Pinto Arrillaga, M.P. López Peña
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S513
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Introduction
Transcultural psychiatry is a branch of psychiatry where cultural context for psychiatric symptoms is studied. It emerged as a consequence of migration of diverse ethnic groups and questions whether international diagnosis classifications fit in different cultures.
ObjectivesThe aim of this review is to make professionals aware of the importance of cultural context for the way mental disorders present themselves depending on the patient's origin.
Materials and methodsWe report the detailed case of a 23-year-old Moroccan woman, attended for the first time by the mental health services when she was 8. Since that moment, she felt herself possessed by a strange being. Auditory hallucinations appeared. It was only when her father or her husband were at home that she felt the “being” was gone. Her husband, as formerly his father, represented a symbol of protection against that evil being and indeed against her mental disorder, which was directly related to her cultural beliefs.
DiscussionEvery country has a different culture and every migration brings with it a new environment. The way people adapt to it may result in mental illness. We want to discuss if symptoms fit international diagnosis classifications.
ConclusionPsychiatrists should become aware of the limitations of the international classifications when used on different ethnic groups. We should have a cultural approach in order to treat the diverse populations from all around the world.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clozapine: Since the very beginning?
- L. Garcia Ayala, M. Gómez Revuelta, C. Martín Requena, E. Saez de Adana Garcia de Acilu, O. Porta Olivares, M. Juncal Ruiz, N. Nuñez Morales, M. Zubia Martín, M. Laborde Zufiaurre, B. González Hernández, A. Aranzabal Itoiz, M.P. López Peña, A.M. González-Pinto Arrillaga
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S752-S753
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Introduction
Psychosis in childhood and adolescence could be defined as having hallucinations, with the hallucinations occurring in the absence of insight. A broader definition includes symptoms such as delirious thoughts, disorganized speech, disorganized behavior, cognitive and mood symptoms and what is called negative symptoms. Several researches have been done focused in the treatment of first episode of psychosis showing clozapine as a keystone in the treatment of psychosis, especially in refractory first episodes.
ObjectivesClozapine has unique efficacy in improving treatment-resistant patients with chronic schizophrenia but the moment of instauration remains unclear. There have always been doubts about the right moment to start clozapine, after two or more previous anti-psychotics or as first option.
Materials and methodsWe report a 18-year- old woman with family history of severe psychosis. Her mum reasserted patient's symptoms contributing to a longer period of non-treating psychosis (about 10 months). Auditory hallucinations, incongruent mood and incoherent language appeared for the first time at the age of 17. High doses of two consecutive anti-psychotics were tried without remission and finally clozapine was initiated with clinical improvement.
DiscussionIn clinical practice, a subgroup of psychotic patients experience, significant ongoing positive symptoms despite of using first line anti-psychotic medication.
ConclusionMost recent research; suggest that clozapine may have an important role in the early treatment of first-episode patients, even becoming a first line option to consider.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neuropsychological Test Performance in Parkinsonism Without Dopaminergic Deficiency on [123I]-FP-CIT SPECT Imaging
- Kathryn A. Wyman-Chick, Phillip K. Martin, Michal Minár, Manuel Menéndez-González, Lauren O. Erickson, Tania Álvarez-Avellón, Ryan W. Schroeder
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- Journal of the International Neuropsychological Society / Volume 24 / Issue 6 / July 2018
- Published online by Cambridge University Press:
- 19 April 2018, pp. 646-651
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Objectives: To examine neuropsychological test performance among individuals clinically diagnosed with Parkinson’s disease (PD) without evidence of dopaminergic deficiency on [123]I-CIT single photon emission computed tomography imaging. Methods: Data were obtained from the Parkinson’s Progression Marker Initiative. The sample included 59 participants with scans without evidence of dopaminergic deficiency (SWEDD), 412 with PD, and 114 healthy controls (HC). Tests included Judgment of Line Orientation, Letter-Number Sequencing, Symbol Digit Modalities, Hopkins Verbal Learning Test-Revised, and Letter and Category Fluency. Multivariate analysis of variance was used to compare standardized scores between the groups. Results: There was a statistically significant difference in performances between the groups, F(14,1155)=5.04; p<.001; partial η2=.058. Pairwise comparisons revealed significant differences in Category Fluency between SWEDD (M=0.22; SD=1.08) and HC (M=0.86; SD=1.15) and in Symbol Digit Modalities Test performance between SWEDD (M=45.09; SD=11.54) and HC (M=51.75; SD=9.79). No significant differences between SWEDD and PD were found. Using established criteria, approximately one in four participants in the SWEDD and PD groups met criteria for mild cognitive impairment (MCI). Conclusions: Individuals with SWEDD demonstrate significantly worse mental processing speed and semantic fluency than HC. The neuropsychological test performances and rates of MCI were similar between the SWEDD group and PD groups, which may reflect a common pathology outside of the nigrostriatal pathway. (JINS, 2018, 24, 646–651)
Elusive Accretion Discs in Low Luminosity AGN
- J.A. Fernández-Ontiveros, M.A. Prieto Escudero, S. Markoff, L. Reb, D. Espada, O. González-Martín
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- Journal:
- Proceedings of the International Astronomical Union / Volume 12 / Issue S324 / September 2016
- Published online by Cambridge University Press:
- 23 June 2017, pp. 192-195
- Print publication:
- September 2016
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Low luminosity AGN (LLAGN) represent the vast majority of the AGN population in the near universe. However, they show intrinsic differences when compared to the Unified Model scenario, i.e. a lack of both the big blue bump and the IR bump in their spectral energy distribution (SED), which are the signatures of an accretion disk and a torus, respectively. In this work we present SED for a sample of six LLAGN in the nearby Universe obtained from subarcsec resolution observations. The nature of the IR continuum emission is discussed in the context of non-thermal radiation powered by compact jets.
X-ray variability of 104 active galactic nuclei
- O. González-Martín, S. Vaughan
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- Journal:
- Proceedings of the International Astronomical Union / Volume 8 / Issue S290 / August 2012
- Published online by Cambridge University Press:
- 21 February 2013, pp. 37-40
- Print publication:
- August 2012
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We have performed a uniform analysis of the power spectrum densities (PSDs) of 104 nearby (z<0.4) active galactic nuclei (AGN) using 209 XMM-Newton/pn observations, including several AGN classes. These PSDs span ≃ 3 decades in temporal frequencies, ranging from minutes to days. We have fitted each PSD to two models: (1) a single power-law model and (2) a bending power-law model. A fraction of 72% show significant variability. The PSD of the majority of the variable AGN was well described by a simple power-law with a mean index of α = 2.01±0.01. In 15 sources we found that the bending power law model was preferred with a mean slope of α = 3.08±0.04 and a mean bend frequency of 〈νb〉 ≃ 2 × 10−4 Hz. Only KUG 1031+398 (RE J1034+396) shows evidence for quasi-periodic oscillations. The ‘fundamental plane’ relating variability timescale, black hole mass, and luminosity is demonstrated using the new X-ray timing results presented here together with a compilation of the previously detected timescales from the literature.
X-Ray Variability in LINERs
- L. Hernández-García, O. González-Martín, J. Masegosa, I Márquez
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- Journal:
- Proceedings of the International Astronomical Union / Volume 8 / Issue S290 / August 2012
- Published online by Cambridge University Press:
- 21 February 2013, pp. 41-44
- Print publication:
- August 2012
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Active galactic nuclei (AGN) are powered by energetic phenomena which cannot be attributed to stars. LINERs appears to be the low power end of the AGN sequence with the lowest Eddington ratios but hosting the most massive black holes (typically 109 M⊙). Whereas variability is common for high Eddington ratio emitting sources, in the low Eddington regime data are not so clear. Recent investigations at UV (Maoz et al. 2005) and X-ray frequencies (Younes et al. 2011, González-Martín et al. 2011) point out to the long term variable nature for some particular LINERs.
In this work we add more evidence about the X-ray variability in LINERs and investigate its nature. The data set comprises X-ray archival spectroscopy from observations taken from Chandra and XMM-Newton, selecting LINERs with several observations at different epochs. Up to now we analysed two LINER 1.9 objects, NGC 1052 and NGC 4278, and checked that variability is due to different mechanisms based on the results of spectral fittings.
Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
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- 11 July 2011, pp xv-xxviii
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. 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Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. 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Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Stellar Populations in Luminous and Ultraluminous Infrared Galaxies
- R. M. González Delgado, R. Cid Fernandes, E. Pérez, J. Rodríguez-Zaurín, C. Tadhunter, O. Dors, V. Muñoz Marín, M. Villar-Martín
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- Journal:
- Proceedings of the International Astronomical Union / Volume 5 / Issue S262 / August 2009
- Published online by Cambridge University Press:
- 13 April 2010, pp. 341-342
- Print publication:
- August 2009
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The goal of this work is to determine the properties of the stellar populations in a sample of LIRGs and ULIRGs. Using the ages as a clock we investigate: a) whether LIRGs-ULIRGs evolve into Radio Galaxies and QSOs; b) whether cool LIRGs-ULIRGs can evolve into warm LIRGs-ULIRGs; c) the merger sequence deduced from the morphological studies is reflected in the properties of the stellar populations. Using evolutionary synthesis models with high spectral resolution stellar libraries we have found that the intermediate age stellar population dominates at optical wavelengths. The stellar population in LIRGs is similar to ULIRGs and ULIRGs-QSOs transition objects.