10 research outputs found
Rostral Middle Frontal Volumetric Differences in Bipolar Offspring versus Community Controls Offspring
Neuroanatomical findings in the anterior limbic network in bipolar disorder (BD) adults have not been replicated in other populations such as bipolar offspring (BO). The aim of this study was to compare some brain areas volumes between BO with and without a lifetime affective disorder (AD) to a group of community control offspring (CCO). Methods: A descriptive observational cross-sectional study was carried out, with multiple comparison groups. Seven subjects (11-17 years old) from the BO with AD group were compared to seven subjects from the BO without AD group and seven subjects from the CCO group (match by age, gender and Tanner stage). Magnetic resonance imaging was performed with a Philips 3 Teslas device and volumetric segmentation was performed with the Freesurfer image analysis suite. Results: A larger size was found in the right middle frontal rostral region in the BO with AD group compared to the other two groups (p = 0.041). A higher volume was also found in BO with AD group in the left pars opercularis (Cohen d = 0.63) and in the right cingulate isthmus (d = 0.53) when compared with BO without AD group, and in the right hippocampus (d = 0.53) when compared to CCO group. A smaller volume was found in the BO without AD group versus CCO group in the left anterior caudate (d = 0.6). The BO groups (with and without AD) compared to CCO have a higher volume in the right frontal pole (d = 0.52). These volumetric differences can be attributed to the condition of BO with AD
Vitamin B12 deficiency in psychiatric practice
RESUMEN: Es com煤n la solicitud de los niveles de vitamina B12 en pacientes evaluados por psiquiatr铆a y espec铆ficamente en las unidades de pacientes agudos, pero, a pesar de la creciente literatura disponible sobre la correlaci贸n entre esta hipovitaminosis y los s铆ntomas neuropsiqui谩tricos, a煤n existen muchas dudas sobre los grupos poblacionales de riesgo que se deben tamizar, el tipo de examen que se debe solicitar, la forma de hacer el tratamiento y la utilidad real de la reposici贸n vitam铆nica en la resoluci贸n de los s铆ntomas afectivos, cognitivos o psic贸ticos. Este art铆culo es una revisi贸n narrativa de la literatura disponible con el objetivo de poder evaluar de forma cr铆tica los interrogantes te贸ricos y pr谩cticos m谩s relevantes para el psiquiatra actual, con 茅nfasis en la evidencia sobre la correlaci贸n entre niveles bajos de vitamina B12 y d茅ficit cognitivo, depresi贸n y algunos trastornos psic贸ticos.ABSTRACT: Levels of vitamin B12 are commonly requested in psychiatric patients, specifically in units for acute patients. Despite the abundant literature available about the correlation between this hypovitaminosis and neuro-psychiatric symptoms, there are still many doubts about the risk groups that should be screened, the tests that should be applied, how to treat, and the real usefulness of vitamin supplementation in the resolution of affective, cognitive or psychotic symptoms. This article presents a narrative review of the available literature, and summarizes the main recommendations about theoretical and practical questions concerning this subject matter, with emphasis on the correlation between low levels of vitamin B12 and cognitive impairment, depression and psychotic disorders
Neuroimagen estructural y polaridad predominante en pacientes con trastorno afectivo bipolar tipo I de Antioquia
RESUMEN: Introducci贸n: La Polaridad Predominante (PP) se ha propuesto como un especificador del trastorno afectivo bipolar (TAB) por su relaci贸n con variables cl铆nica y pron贸sticas. Es posible que esto se deba a una neurobiolog铆a subyacente distinta de tal manera que los cambios encontrados por Resonancia Magn茅tica Nuclear estructural (RMNe) en el TAB sean diferentes y espec铆ficos. Objetivos: Explorar hallazgos de neuroimagen estructural en pacientes con TAB tipo I (TAB-I) de acuerdo con la PP. Materiales y m茅todos: Estudio de corte transversal que evalu贸 77 pacientes con TAB-I usando la entrevista DIGS. Se estableci贸 la PP utilizando la definici贸n operativa de los dos tercios de todos los episodios afectivos a lo largo de la vida para clasificar la PP en maniaca (PPM), depresiva (PPD) o indeterminada (PPI). Se les realiz贸 RMNe durante la fase de eutimia para medir estructuras intracraneales, Los datos obtenidos se analizaron mediante un modelo de regresi贸n lineal ajustado por variables de confusi贸n (consumo de medicamentos, consumo de alcohol, consumo de sustancias psicoactivas) y se compararon entre los tres grupos hallando la diferencia de medias estandarizada (DME). Resultados: Se encontraron diferencias con adecuado tama帽o de efecto en tres estructuras cerebrales tras ajustar por variables de confusi贸n. Espec铆ficamente en el giro fusiforme derecho y el giro lingual izquierdo, que fueron mayores en el grupo PPD en comparaci贸n con PPM (DME = 0,92; IC%95 = 0,34 a 1,49 y DME = 0,78; IC95% = 0,21 a 1,35) Respectivamente. Igualmente, en el t谩lamo derecho, que mostr贸 ser mayor en el grupo PPI frente a PPM (DME0,89; IC95% = 0,31 a 1,46). Conclusiones: Se observ贸 una reducci贸n del espesor del giro fusiforme derecho y el giro lingual izquierdo, as铆 como del volumen tal谩mico derecho en pacientes con TAB-I con PPM, lo que soporte la hip贸tesis de que la PP cuenta con un correlato neurobiol贸gico plausible y pudiera tener potencial utilidad como especificador del TABABSTRACT: Introduction: Predominant Polarity (PP) has been proposed as a specifier of bipolar disorder (BD) due to its relationship with clinical and prognostic variables. It is possible that this is due to a different underlying neurobiology such that the changes found by structural Nuclear Magnetic Resonance (sNMR) in BD are different and specific. Objectives: To explore findings of structural neuroimaging in patients with BD type I (BD-I) according to PP. Materials and Methods: Cross-sectional study that evaluated 77 patients with BD-I using the DIGS interview. PP was established using the operative definition of two thirds of all affective episodes throughout life to classify PP as manic (PPM), depressive (PPD) or indeterminate (PPI). NMR was performed during the euthymia phase to measure intracranial structures. The data obtained was analyzed using a linear regression model adjusted for confounding variables (drug use, alcohol use, psychoactive substance use) and were compared between the three groups finding the standardized mean difference (SMD). Results: Differences with adequate effect size were found in three brain structures after adjusting for confounding variables. Specifically, in the right fusiform gyrus and the left lingual gyrus, which were higher in the PPD group compared to PPM (SMD = 0.92; 95% CI = 0.34 to 1.49 and SMD = 0.78; 95% CI = 0.21 to 1.35) respectively. Likewise, in the right thalamus, it was shown to be higher in the PPI group compared to PPM (SMD 0.89, 95% CI = 0.31 to 1.46). Conclusions: A reduction in the thickness of the right fusiform gyrus and the left lingual gyrus, as well as the right thalamic volume was observed in patients with BD-I with PPM, which supports the hypothesis that PP has a plausible neurobiological correlate and could have potential utility as a BD specifie
2.2 A Comparison Study of Psychopathological and Neuroanatomical Characteristics: Among Colombian Offspring With Bipolar Disorder Versus Offspring of Community Control Parents
2.19 NEUROANATOMICAL CHARACTERIZATION OF AFFECTED AND UNAFFECTED ADOLESCENTS OF BIPOLAR PARENTS AND CONTROLS
Rostral Middle Frontal Volumetric Differences in Bipolar Offspring versus Community Controls Offspring
Neuroanatomical findings in the anterior limbic network in bipolar disorder (BD) adults have not been replicated in other populations such as bipolar offspring (BO). The aim of this study was to compare some brain areas volumes between BO with and without a lifetime affective disorder (AD) to a group of community control offspring (CCO). Methods: A descriptive observational cross-sectional study was carried out, with multiple comparison groups. Seven subjects (11-17 years old) from the BO with AD group were compared to seven subjects from the BO without AD group and seven subjects from the CCO group (match by age, gender and Tanner stage). Magnetic resonance imaging was performed with a Philips 3 Teslas device and volumetric segmentation was performed with the Freesurfer image analysis suite. Results: A larger size was found in the right middle frontal rostral region in the BO with AD group compared to the other two groups (p = 0.041). A higher volume was also found in BO with AD group in the left pars opercularis (Cohen d = 0.63) and in the right cingulate isthmus (d = 0.53) when compared with BO without AD group, and in the right hippocampus (d = 0.53) when compared to CCO group. A smaller volume was found in the BO without AD group versus CCO group in the left anterior caudate (d = 0.6). The BO groups (with and without AD) compared to CCO have a higher volume in the right frontal pole (d = 0.52). These volumetric differences can be attributed to the condition of BO with AD.Los hallazgos neuroanat贸micos en la red l铆mbica anterior en el trastorno bipolar (TB) en adultos no se han replicado en otras poblaciones, como en los hijos de pacientes con trastorno bipolar (HPTB). El objetivo de este estudio fue comparar los vol煤menes de 谩reas del cerebro entre HPTB, con y sin alg煤n trastorno afectivo (TA) a lo largo de la vida, con un grupo de hijos de padres control de la comunidad (HPC). M茅todos: Se realiz贸 un estudio observacional, descriptivo y transversal, con m煤ltiples grupos de comparaci贸n. Siete sujetos (11-17 a帽os) del grupo HPTB con TA se compararon con siete sujetos del grupo HPTB sin TA y siete sujetos del grupo HPC (pareados por edad, sexo y estadio Tanner). La resonancia magn茅tica nuclear se realiz贸 con un resonador Philips 3 Teslas y la segmentaci贸n volum茅trica se realiz贸 con el conjunto de an谩lisis de imagen Freesurfer. Resultados: Se encontr贸 un tama帽o mayor en la regi贸n frontal rostral medial derecha en el grupo HPTB con TA en comparaci贸n con los otros dos grupos (p = 0.041). Tambi茅n se encontr贸 un mayor volumen en el grupo HPTB con TA en el op茅rculo frontal izquierdo (Cohen d = 0,63) y en el istmo del giro del c铆ngulo derecho (d = 0,53) cuando se compar贸 con el grupo sin TA, y en el hipocampo derecho (d = 0,53) en comparaci贸n con el grupo HPC. Se encontr贸 un volumen m谩s peque帽o en el grupo HPTB sin TA versus grupo HPC en el caudado anterior izquierdo (d = 0,6). Los grupos HPTB (con y sin TA) en comparaci贸n con HPC tienen un volumen mayor en el polo frontal derecho (d = 0.52). Estas diferencias volum茅tricas pueden atribuirse a la condici贸n de HPTB con TA
DISTINCT AND SHARED CONTRIBUTIONS OF DIAGNOSIS AND SYMPTOM DOMAINS TO COGNITIVE PERFORMANCE IN SEVERE MENTAL ILLNESS
Gender, age and geographical representation over the past 50 years of schizophrenia research
Previous studies have suggested that subjects participating in schizophrenia research are not representative of the demographics of the global population of people with schizophrenia, particularly in terms of gender and geographical location. We here explored if this has evolved throughout the decades, examining changes in geographical location, gender and age of participants in studies of schizophrenia published in the last 50 years. We examined this using a meta-analytical approach on an existing database including over 3,000 studies collated for another project. We found that the proportion of studies and participants from low-and-middle income countries has significantly increased over time, with considerable input from studies from China. However, it is still low when compared to the global population they represent. Women have been historically under-represented in studies, and still are in high-income countries. However, a significantly higher proportion of female participants have been included in studies over time. The age of participants included has not changed significantly over time. Overall, there have been improvements in the geographical and gender representation of people with schizophrenia. However, there is still a long way to go so research can be representative of the global population of people with schizophrenia, particularly in geographical terms
The enduring gap in educational attainment in schizophrenia according to the last 50 years of published research: a meta-analysis
Background. Educational attainment is associated with well-being and health. Unfortunately, patients with schizophrenia achieve lower levels of education. Several effective interventions can ameliorate this. However, the magnitude of the education gap in schizophrenia and changes over time are unclear. Methods. We performed a systematic review and meta-analysis including all studies reporting on patients with schizophrenia and describing their years of education, with or without healthy controls. There were no other design constraints on studies. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (January 1st, 1970, to November 24th, 2020). We estimated the birth date of participants from their mean age and publication date, and metaanalyzed these data, focusing on educational attainment, the education gap, and changes over time. The protocol was registered in PROSPERO (CRD42020220546). Outcomes. From 32,593 initial references, we included 3,321 studies reporting on 318,632 patients alongside 138,675 healthy controls (170,941 women and 275,821 men from studies describing gender; ethnicity was not collected). Patients educational attainment increased over time mirroring the controls.聽 However, patients achieved 19 months less than patients, and this remained unchanged throughout the decades. Studies were biased to include more educated patients and controls than their respective larger population, but results were unchanged in studies with groups with similar parental education. Interpretation. Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes
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Distinct and shared contributions of diagnosis and symptom domains to cognitive performance in severe mental illness in the Paisa population: a case-control study
BackgroundSevere mental illness diagnoses have overlapping symptomatology and shared genetic risk, motivating cross-diagnostic investigations of disease-relevant quantitative measures. We analysed relationships between neurocognitive performance, symptom domains, and diagnoses in a large sample of people with severe mental illness not ascertained for a specific diagnosis (cases), and people without mental illness (controls) from a single, homogeneous population.MethodsIn this case-control study, cases with severe mental illness were ascertained through electronic medical records at Cl铆nica San Juan de Dios de Manizales (Manizales, Caldas, Colombia) and the Hospital Universitario San Vicente Fundaci贸n (Medell铆n, Antioqu铆a, Colombia). Participants were assessed for speed and accuracy using the Penn Computerized Neurocognitive Battery (CNB). Cases had structured interview-based diagnoses of schizophrenia, bipolar 1, bipolar 2, or major depressive disorder. Linear mixed models, using CNB tests as repeated measures, modelled neurocognition as a function of diagnosis, sex, and all interactions. Follow-up analyses in cases included symptom factor scores obtained from exploratory factor analysis of symptom data as main effects.FindingsBetween Oct 1, 2017, and Nov 1, 2019, 2406 participants (1689 cases [schizophrenia n=160; bipolar 1 disorder n=519; bipolar 2 disorder n=204; and major depressive disorder n=806] and 717 controls; mean age 39 years (SD 14); and 1533 female) were assessed. Participants with bipolar 1 disorder and schizophrenia had similar impairments in accuracy and speed across cognitive domains. Participants with bipolar 2 disorder and major depressive disorder performed similarly to controls, with subtle deficits in executive and social cognition. A three-factor model (psychosis, mania, and depression) best represented symptom data. Controlling for diagnosis, premorbid IQ, and disease severity, high lifetime psychosis scores were associated with reduced accuracy and speed across cognitive domains, whereas high depression scores were associated with increased social cognition accuracy.InterpretationCross-diagnostic investigations showed that neurocognitive function in severe mental illness is characterised by two distinct profiles (bipolar 1 disorder and schizophrenia, and bipolar 2 disorder and major depressive disorder), and is associated with specific symptom domains. These results suggest the utility of this design for elucidating severe mental illness causes and trajectories.FundingUS National Institute of Mental Health