The neuroanatomical basis of panic disorder and social phobia in schizophrenia: a voxel based morphometric study

[eng] Objective: It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods: Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results: Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions: Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions

High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample

Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients

High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample

Background: Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. Objective: (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. Methods: This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (https://clinicaltrials.gov; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. Results: The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. Conclusion: Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients

Plan Integral de Residuos Sólidos Urbanos : Segundo informe parcial

Contenido: - Capítulo 1: La actividad de recuperación y reciclado de materiales desde los RSU. El caso del partido de La Plata - Capítulo 2: Sistema biohidrometalúrgico para la recuperación de pilas agotadas - Capítulo 3: Reciclado de polímeros plásticos - Capítulo 4: Estado actual y potencialidades de la recuperación de materiales celulósicos en el partido de La Plata - Referencias - Anexo I: Proyecto de ley para el tratamiento y disposición final de pilas y baterías - Anexo II: Detalles técnicos de funcionamiento de planta piloto de biolixiviación de pilas agotadas (PlaPiMu-CIC-UNLP)Facultad de Ciencias Exacta

Síntomas neuropsiquiátricos como factor de confusión en la detección de la demencia

Valorar si los síntomas neuropsiquiátricos interfieren en la detección de deterioro cognitivo por los médicos de familia en atención primaria, así como describir cuáles generan más confusión. Estudio observacional y descriptivo. Equipo de psiquiatría de intervención en domicilio en colaboración con la red de atención primaria de Barcelona. Un total de 104 pacientes mayores de 65 años derivados desde atención primaria por sus médicos de familia solicitando valoración psiquiátrica en el domicilio por sospecha de enfermedad mental. Todos los casos recibieron un diagnóstico según criterios DSM--TR. Se incluyeron en el estudio el Mini Mental State Examination (MMSE), el Inventario Neuropsiquiátrico de Cummings, la escala de Gravedad de Enfermedad Psiquiátrica, la escala de Evaluación de la Actividad Global, la escala de Impresión Clínica Global y el Cuestionario de Evaluación de la Discapacidad de la Organización Mundial de la Salud. El 55,8% de los pacientes derivados desde atención primaria tenían el MMSE alterado. Los síntomas neuropsiquiátricos más frecuentemente asociados a la sospecha de deterioro cognitivo fueron los delirios, las alucinaciones, la agitación, la desinhibición, la irritabilidad y la conducta motora sin finalidad. Cuando se detecten síntomas psiquiátricos propios de trastorno mental severo (TMS) en individuos de edad avanzada sin antecedentes de TMS hay que sospechar un deterioro cognitivo y se debería administrar una prueba de cribado

Comorbilidad entre depresión y conductas impulsivas: Un caso de urgencia negativa

Depression is one of the most frequent pathologies being consulted. Includes a wide range of symptoms such as sadness, anhedonia, loss or gain of weight, insomnia or hypersomnia, feelings of excessive guilt or loss of energy. Many patients suffer at once both depression or symptoms of discomfort and uncontrolled impulses.There is data that shows a high prevalence between the two pathologies. For example, of up to 76% between depression and pathological gambling or 50% between depression and addiction to substances.Even so, there are not enough studies attempting to explain this association and comorbidity.The high prevalence of comorbidity is due both, to common risk factors (biological bases and neuroanatomical correlates) and to a causal relationship between both mental pathologies. In general depression (or subjective discomfort) precedes impulsive behaviors.Cyders and Smith's Negative Urgency model provides a framework to some of the issues raised. The authors describe the negative urgency as a factor that predisposes the person to act impulsively when facing an emotion that causes discomfort.The case is presented on a 32-year old patientwith depressive disorder and impulse control disorders. It allows us to exemplify the comorbidity between these two pathologies and to propose the negative urgency as a predisposing factor for the patient to develop themLa depresión es una de las patologías más frecuentes por la que se consulta e incluye una amplia manifestación de síntomas, como la tristeza, anhedonia, pérdida o aumento de peso, insomnio o hipersomnia, sentimientos de culpa excesiva o pérdida de energía.  La depresión o síntomas de malestar y el descontrol de los impulsos en muchos pacientes se dan a la vez. Hay datos que anuncian una alta prevalencia entre las dos patologías, por ejemplo de hasta un 76% entre depresión y juego patológico o de un 50% entre depresión y adicciones a sustancias. Aún así, no hay suficientes estudios que intenten explicar esta asociación y comorbilidad. La alta prevalencia de la comorbilidad obedece tanto a factores de riesgo comunes (bases biológicas y correlatos neuroanatómicos) como a una relación causal entre ambas patologías mentales, precediendo generalmente la depresión (o malestar subjetivo) a las conductas impulsivas. El modelo de Cyders y Smith sobre la Urgencia negativa da salida a algunas cuestiones planteadas.  Los autores describen la urgencia negativa como un factor que predispone a la persona a actuar impulsivamente ante una emoción que provoque malestar. En este artículo se presenta un caso de un joven de 32 años diagnosticado de trastorno depresivo y trastornos de control de impulsos, que nos permite ejemplificar la comorbilidad entre estas dos patologías y proponer la urgencia negativa como factor de predisposición del paciente para desarrollarlas

The neuroanatomical basis of panic disorder and social phobia in schizophrenia: a voxel based morphometric study.

OBJECTIVE: It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. METHODS: Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. RESULTS: Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. CONCLUSIONS: Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions.Funding was provided by the Fondo deInvestigación Sanitaria (Pi052381). MP is supportedby a FI grant of the Agencia de Gestió d’AjutsUniversitaris i de Recerc