Hiponatremia recurrente secundaria a ISRS.

El objetivo del presente trabajo es presentar l caso de un varón de 88 años que ha presentado en los últimos tres años tres episodios de hiponatremia por SIADH en relación con el uso fármacos inhibidores de la recaptación de serotonina (ISRS) que han requerido de ingreso hospitalario. En dos de estos episodios el paciente estaba en tratamiento concomitante con diuréticos tiazídicos, siendo la sertralina el fármaco antidepresivo implicado, y en uno de los tres episodios el paciente estaba en tratamiento con citalopram sin que existiera tratamiento diurético concomitante alguno. Se revisan los factores de riesgo para esta complicación, se revisa la literatura al respecto y se establecen recomendaciones de contro

Hiponatremia recurrente secundaria a ISRS

El objetivo del presente trabajo es presentar l caso de un varón de 88 años que ha presentado en los últimos tres años tres episodios de hiponatremia por SIADH en relación con el uso fármacos inhibidores de la recaptación de serotonina (ISRS) que han requerido de ingreso hospitalario. En dos de estos episodios el paciente estaba en tratamiento concomitante con diuréticos tiazídicos, siendo la sertralina el fármaco antidepresivo implicado, y en uno de los tres episodios el paciente estaba en tratamiento con citalopram sin que existiera tratamiento diurético concomitante alguno. Se revisan los factores de riesgo para esta complicación, se revisa la literatura al respecto y se establecen recomendaciones de contro

How does neighbourhood socio-economic status affect the interrelationships between functioning dimensions in first episode of psychosis? A network analysis approach

The links between psychosis and socio-economic disadvantage have been widely studied. No previous study has analysed the interrelationships and mutual influences between functioning dimensions in first episode of psychosis (FEP) according to their neighbourhood household income, using a multidimensional and transdiagnostic perspective. 170 patients and 129 controls, participants in an observational study (AGES-CM), comprised the study sample. The WHO Disability Assessment Schedule (WHODAS 2.0) was used to assess functioning, whereas participants' postcodes were used to obtain the average household income for each neighbourhood, collected by the Spanish National Statistics Institute (INE). Network analyses were conducted with the aim of defining the interrelationships between the different dimensions of functioning according to the neighbourhood household income. Our results show that lower neighbourhood socioeconomic level is associated with lower functioning in patients with FEP. Moreover, our findings suggest that “household responsibilities” plays a central role in the disability of patients who live in low-income neighbourhoods, whereas “dealing with strangers” is the most important node in the network of patients who live in high-income neighbourhoods. These results could help to personalize treatments, by allowing the identification of potential functioning areas to be prioritized in the treatment of FEP according to the patient's neighbourhood characteristic

The interplay between functioning problems and symptoms in first episode of psychosis: an approach from network analysis

The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were “conceptual disorganization”, “emotional withdrawal”, “lack of spontaneity and flow of conversation”, “delusions”, “unusual thought content”, “dealing with strangers” and “poor rapport”. Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this populationThis work was supported by the Madrid Regional Government (R&D activities in Biomedicine (grant number S2017/BMD-3740 - AGES-CM 2-CM)) and Structural Funds of the European Union. Ana Izquierdo’s work is supported by the PFIS predoctoral program (FI17/00138) from the Instituto de Salud Carlos III (Spain) and co-funded by the European Union (ERDF/ESF, "A way to make Europe”/ “Investing in your future”) and The Biomedical Research Foundation of La Princesa University Hospital. Angela Ib´a˜nez thanks the support of CIBERSAM and of the Spanish Ministry of Science, Innovation and Universities. Instituto de Salud Carlos III (PI16/00834 and PI19/01295) co-financed by ERDF Funds from the European Commission. Covadonga M. Díaz-Caneja holds a Juan Rod´es Grant from Instituto de Salud Carlos III (JR19/00024). Celso Arango was supported by the Spanish Ministry of Science and Innovation. Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/ 024), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM. Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds. European Union Seventh Framework Program under grant agreements FP7-4-HEALTH-2009-2.2.1-2-241909 (Project EU-GEI), FP7- HEALTH- 2013-2.2.1-2-603196 (Project PSYSCAN) and FP7- HEALTH-2013- 2.2.1-2-602478 (Project METSY); and European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No 115916, Project PRISM, and grant agreement No 777394, Project AIMS-2-TRIALS), Fundaci´on Familia Alonso, Fundaci´on Alicia Koplowitz and Fundaci´on Mutua Madrile˜n

Hiponatremia recurrente secundaria a ISRS.

El objetivo del presente trabajo es presentar l caso de un varón de 88 años que ha presentado en los últimos tres años tres episodios de hiponatremia por SIADH en relación con el uso fármacos inhibidores de la recaptación de serotonina (ISRS) que han requerido de ingreso hospitalario. En dos de estos episodios el paciente estaba en tratamiento concomitante con diuréticos tiazídicos, siendo la sertralina el fármaco antidepresivo implicado, y en uno de los tres episodios el paciente estaba en tratamiento con citalopram sin que existiera tratamiento diurético concomitante alguno. Se revisan los factores de riesgo para esta complicación, se revisa la literatura al respecto y se establecen recomendaciones de contro

Hiponatremia recurrente secundaria a ISRS.

El objetivo del presente trabajo es presentar l caso de un varón de 88 años que ha presentado en los últimos tres años tres episodios de hiponatremia por SIADH en relación con el uso fármacos inhibidores de la recaptación de serotonina (ISRS) que han requerido de ingreso hospitalario. En dos de estos episodios el paciente estaba en tratamiento concomitante con diuréticos tiazídicos, siendo la sertralina el fármaco antidepresivo implicado, y en uno de los tres episodios el paciente estaba en tratamiento con citalopram sin que existiera tratamiento diurético concomitante alguno. Se revisan los factores de riesgo para esta complicación, se revisa la literatura al respecto y se establecen recomendaciones de contro

Smartphone-based Ecological Momentary Intervention for secondary prevention of suicidal thoughts and behaviour: protocol for the SmartCrisis V.2.0 randomised clinical trial

Auteurs : MEmind Study GroupInternational audienceSuicide is one of the leading public health issues worldwide. Mobile health can help us to combat suicide through monitoring and treatment. The SmartCrisis V.2.0 randomised clinical trial aims to evaluate the effectiveness of a smartphone-based Ecological Momentary Intervention to prevent suicidal thoughts and behaviour. Methods and analysis: the SmartCrisis V.2.0 study is a randomised clinical trial with two parallel groups, conducted among patients with a history of suicidal behaviour treated at five sites in France and Spain. The intervention group will be monitored using Ecological Momentary Assessment (EMA) and will receive an Ecological Momentary Intervention called ‘SmartSafe’ in addition to their treatment as usual (TAU). TAU will consist of mental health follow-up of the patient (scheduled appointments with a psychiatrist) in an outpatient Suicide Prevention programme, with predetermined clinical appointments according to the Brief Intervention Contact recommendations (1, 2, 4, 7 and 11 weeks and 4, 6, 9 and 12 months). The control group would receive TAU and be monitored using EMA. Ethics and dissemination: this study has been approved by the Ethics Committee of the University Hospital Fundación Jiménez Díaz. It is expected that, in the near future, our mobile health intervention and monitoring system can be implemented in routine clinical practice. Results will be disseminated through peer-reviewed journals and psychiatric congresses. Reference number EC005-21_FJD. Participants gave informed consent to participate in the study before taking part. Trial registration number NCT04775160

The interplay between functioning problems and symptoms in first episode of psychosis: An approach from network analysis

The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were “conceptual disorganization”, “emotional withdrawal”, “lack of spontaneity and flow of conversation”, “delusions”, “unusual thought content”, “dealing with strangers” and “poor rapport”. Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this population.Depto. de Psicobiología y Metodología en Ciencias del ComportamientoFac. de PsicologíaTRUEpu