5 research outputs found
Association of depression phenotypes and antidepressant treatment with mortality due to cancer and other causes: a community-based cohort study
Fà rmac antidepressiu; Cà ncer; SÃndrome depressiuFármaco antidepresivo; Cáncer; SÃndrome depresivoAntidepressant drug; Cancer; Depressive syndromeObjective: This study aimed to assess the association of somatic depressive symptoms (SDS), cognitive/emotional depressive symptoms (C-EDS), and antidepressant treatment on mortality due to cancer and other causes in a community cohort.Methods: A community-based sample recruited in 1995, 2000, and 2005 aged between 35 and 75 years was examined in two waves and followed for a median of 6.7 years. SDS and C-EDS phenotypes were assessed using the Patient Health Questionnaire-9. Medication used by participants was collected. Deaths and their causes were registered during follow-up. Cox proportional hazard models stratified by sex were performed to determine the association between depressive phenotypes and mortality.Results: The cohort consisted of 5,646 individuals (53.9% women) with a mean age of 64 years (SD = 11.89). During the follow-up, 392 deaths were recorded, of which 27.8% were due to cancer. C-EDS phenotype was associated with an increased risk of cancer mortality in both men (HR = 2.23; 95% CI = 1.11–4.44) and women (HR = 3.69; 95% CI = 1.69–8.09), and SDS was significantly associated with non-cancer mortality in men (HR = 2.16; 95 CI % = 1.46–3.18). Selective serotonin reuptake inhibitors (SSRIs) were significantly associated with both cancer (HR = 2.78; 95% CI = 1.10–6.98) and non-cancer mortality (HR = 2.94; 95% CI = 1.76–4.90) only in the male population.Conclusion: C-EDS phenotype was related to an increased risk of cancer mortality at 6 years. In addition, the use of SSRIs in the male population was associated with cancer and all-cause mortality.Objectiu: aquest estudi pretenia avaluar l'associació de sÃmptomes depressius somà tics (SDS), sÃmptomes depressius cognitius/emocionals (C-EDS) i tractament antidepressiu sobre la mortalitat per cà ncer i altres causes en una cohort comunità ria.
Mètodes: una mostra basada en la comunitat reclutada el 1995, 2000 i 2005 d'entre 35 i 75 anys es va examinar en dues onades i es va seguir durant una mitjana de 6,7 anys. Els fenotips SDS i C-EDS es van avaluar mitjançant el Patient Health Questionnaire-9. Es van recollir els medicaments utilitzats pels participants. Durant el seguiment es van registrar les morts i les seves causes. Es van realitzar models de risc proporcional de Cox estratificats per sexe per determinar l'associació entre fenotips depressius i mortalitat.
Resultats: La cohort estava formada per 5.646 individus (53,9% dones) amb una edat mitjana de 64 anys (DE = 11,89). Durant el seguiment es van registrar 392 defuncions, de les quals el 27,8% van ser per cà ncer. El fenotip C-EDS es va associar amb un augment del risc de mortalitat per cà ncer tant en homes (HR = 2,23; IC 95% = 1,11-4,44) com en dones (HR = 3,69; IC 95% = 1,69-8,09), i el SDS es va associar significativament. amb mortalitat no per cà ncer en homes (HR = 2,16; IC 95 % = 1,46–3,18). Els inhibidors selectius de la recaptació de serotonina (ISRS) es van associar significativament tant amb el cà ncer (HR = 2,78; IC 95% = 1,10-6,98) com amb la mortalitat no per cà ncer (HR = 2,94; IC 95% = 1,76-4,90) només a la població masculina.
Conclusió: el fenotip C-EDS es va relacionar amb un augment del risc de mortalitat per cà ncer als 6 anys. A més, l'ús d'ISRS a la població masculina es va associar amb cà ncer i mortalitat per totes les causes.This study was supported by the research grant STL006/17/00234 from the Strategic Plan for Health Research and Innovation (PERIS) 2016–2020 of the Department of Health, Government of Catalonia. The funding sources played no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, nor in the preparation, review, or approval of the manuscript
Gender analysis of the frequency and course of depressive disorders and relationship with personality traits in general population: a prospective cohort study
Depressió; Epidemiologia; PersonalitatDepresión; EpidemiologÃa; PersonalidadDepression; Epidemiology; PersonalityBackground: We aimed to determine the prevalence and course of subthreshold depressive symptomatology (sDS) and probable major depressive episode (MDE) and to examine their association with personality traits among men and women.
Methods: A community-based sample aged 35 years or older was examined in two waves (median follow-up of 6.9 years). The Patient Health Questionnaire-9 (PHQ-9) was used to assess sDS and MDE. The 10-item version of the Big Five Inventory was used to assess personality traits. Prevalence was assessed at baseline (n=5,557) and incidence and persistence-recurrence rates were computed at follow up (n=3,102). Logistic regression models were adjusted to explore the association of personality traits with prevalence and course of depressive disorders.
Results: The prevalence of sDS and MDE was 14.04% (95% CI = 17.04-19.08) and 8.54 (95% CI=7.82-9.31), the incidence was 14.30 per 1,000 person-years (95% CI=12.49-16.31) and 4.34 per 1,000 person-years (95% CI=3.46-5.36), and the persistence-recurrence was 35.04 per 1,000 person-years (95% CI=29.00-41.96) and 28.8 per 1,000 person-years (95% CI=20.49-38.14). The gender gap was higher for MDE. Personality traits were differentially associated with the prevalence and course of depressive disorders between men and women.
Limitations: Because this study used questionnaires to assess depressive disorders and personality traits, information bias could not be ruled out.
Conclusions: The gender gap was higher for the prevalence and course of the probable MDE. There were more personality traits related with the course of the sDS and they had a major role in the course of the probable MDE in women.This study was supported by research grant STL006/17/00234 from the Strategic Plan for Health Research and Innovation (PERIS) 2016-2020 of the Department of Health. Government of Catalunya
Fenotips delirants en pacients amb esquizofrènia: caracterització clÃnica i evolució als 6 mesos
L’esquizofrènia és un trastorn psiquià tric caracteritzat per la presència de deliris i al·lucinacions a banda d’altres sÃmptomes de tipus emocional i cognitiu, que sembla tenir una base causal relacionada amb el neurodesenvolupament. A nivell fenomenològic s’ha pogut caracteritzar l’esquizofrènia a través dels sÃmptomes observables, que són descrits com a simptomatologia positiva, negativa i cognitiva, representant una à mplia heterogeneïtat en la seva presentació clÃnica. Fins ara hi hagut diferents intents de definir subgrups especÃfics dins del trastorn per tal d’aconseguir una caracterització aproximada en termes d’etiologia i fisiopatogènia i del possible substrat anatòmic, i aquestes caracteritzacions han estat bà sicament sempre realitzades a partir d’aquests grans grups sindròmics però no a través dels sÃmptomes per separat. És possible que l’estudi individualitzat dels diferents sÃmptomes presents en el trastorn puguin aportar també una informació và lida pel que fa al seu correlat fisiopatogènic i anatòmic cerebral, donant peu a un coneixement més ampli dels mecanismes etiopatogènics del trastorn. Objectiu: Agafant com a base els continguts de la simptomatologia delirant d’un grup de pacients amb esquizofrènia, caracteritzar-ne els fenotips fenomenològics de presentació i estudiar-ne les caracterÃstiques clÃniques i evolutives diferenciades, aixà com el seu possible correlat neuropsicològic. Metodologia: Estudi de cohort prospectiu a sis mesos sobre una mostra de pacients amb diagnòstic d’esquizofrènia hospitalitzats en una unitat d’aguts, de qui es recullen les dades sociodemogrà fiques, les dades clÃniques rellevants referides a la gravetat dels sÃmptomes psicòtics aixà com al contingut dels sÃmptomes delirants i les dades neuropsicològiques obtingudes a través de les diferents subescales de la Escala d’Intel·ligència per adults de Weschler (WAIS). Resultats: Després d’una anà lisi factorial del contingut dels deliris, s’observa que aquests s’agrupen en tres factors que permeten caracteritzar tres fenotips especÃfics que anomenem fenotip paranoide, fenotip afectiu/estrany i fenotip alienació. Aquest darrer, com a subgrup ben definit, que caracterÃsticament presenta una associació amb els sÃmptomes de primer rang de Kurt Schneider, s’agafa com a grup d’estudi, comparant-lo amb aquells que no presenten aquest fenotip. Aquest fenotip delirant presenta unes caracterÃstiques clÃniques, neuropsicològiques i evolutives diferenciades respecte el grup comparador (absència del fenotip). Es relaciona el fenotip delirant, a través de les proves neuropsicològiques, amb possibles alteracions a nivell frontoparietal esquerres i compensacions amb hiperactivació hemisfèrica dreta. Conclusions: Un estudi basat en el sÃmptoma en concret, més que en l’agrupació de diferents sÃmptomes, permet caracteritzar subgrups fenotÃpics de pacients amb unes caracterÃstiques fenomenològiques similars i amb un substrat fisiopatogènic i neurobiològic especÃfic.Schizophrenia is a psychiatric disorder characterized by the presence of delusions and hallucinations, in addition to other emotional and cognitive symptoms, and it seems to have a causal basis related to the neurodevelopment. At a phenomenological level, schizophrenia has been characterized using clinical symptoms, constituting what has been designated as positive, negative and cognitive symptomatology. These syndromic groups however, have a very heterogeneous clinical presentation. To date, several attempts to classify schizophrenia into specific subgroups have been performed with the aim of obtaining a rough classification in terms of etiology, physiopathology, and anatomy. However, these classifications have always been performed using the three big syndromic groups, and a classification using individual symptoms has been never attempted. The study of specific symptoms may shed some light on the physiopathogenic and anatomic brain correlates, which may lead to a broader knowledge on the etiological mechanisms of schizophrenia.
Objective: to use the contents of the delusional symptomatology of a sample of patients with schizophrenia to characterize their phenomenological phenotypes and to study the clinical characteristics and evolution, as well as the existence and characteristics of a possible specific neuropsychological correlate.
Methods: Six-month prospective cohort study using a sample of patients with a diagnosis of schizophrenia hospitalized in a Psychiatric Unit. Sociodemographic information was collected, as well as clinical information on the severity of psychotic symptoms, and on the contents of delusional symptoms. Neuropsychological data were obtained through the administration of several subscales of the Weschler Adult Intelligence Scale (WAIS).
Results: A factor analysis of the delusions’ contents yielded three separate factors which constitute three distinct phenotypes: a paranoid phenotype, an affective/strange phenotype, and an alienation phenotype. The latter is a clear-cut group that has a distinctive association with Kurt Schneider’s first-rank symptoms. We selected the group of patients presenting with this phenotype, and compared them with the other patients. The results indicate that the clinical and neuropsychological characteristics, as well as the course of the disease of the alienation phenotype are distinct and separate from those of the other phenotypes. Neuropsychological tests indicate that the delusional phenotype is probably related to possible changes in the left frontoparietal regions, compensated by the hyperactivation of the right hemisphere.
Conclusion: A study based on a specific symptom rather than on a cluster of symptoms has allowed describing a phenotypic subgroup of patients with similar phenomenological characteristics and with a specific physiopathogenic and neurobiological background
Fenotips delirants en pacients amb esquizofrènia: caracterització clÃnica i evolució als 6 mesos
L'esquizofrènia és un trastorn psiquià tric caracteritzat per la presència de deliris i al·lucinacions a banda d'altres sÃmptomes de tipus emocional i cognitiu, que sembla tenir una base causal relacionada amb el neurodesenvolupament. A nivell fenomenològic s'ha pogut caracteritzar l'esquizofrènia a través dels sÃmptomes observables, que són descrits com a simptomatologia positiva, negativa i cognitiva, representant una à mplia heterogeneïtat en la seva presentació clÃnica. Fins ara hi hagut diferents intents de definir subgrups especÃfics dins del trastorn per tal d'aconseguir una caracterització aproximada en termes d'etiologia i fisiopatogènia i del possible substrat anatòmic, i aquestes caracteritzacions han estat bà sicament sempre realitzades a partir d'aquests grans grups sindròmics però no a través dels sÃmptomes per separat. És possible que l'estudi individualitzat dels diferents sÃmptomes presents en el trastorn puguin aportar també una informació và lida pel que fa al seu correlat fisiopatogènic i anatòmic cerebral, donant peu a un coneixement més ampli dels mecanismes etiopatogènics del trastorn. Objectiu: Agafant com a base els continguts de la simptomatologia delirant d'un grup de pacients amb esquizofrènia, caracteritzar-ne els fenotips fenomenològics de presentació i estudiar-ne les caracterÃstiques clÃniques i evolutives diferenciades, aixà com el seu possible correlat neuropsicològic. Metodologia: Estudi de cohort prospectiu a sis mesos sobre una mostra de pacients amb diagnòstic d'esquizofrènia hospitalitzats en una unitat d'aguts, de qui es recullen les dades sociodemogrà fiques, les dades clÃniques rellevants referides a la gravetat dels sÃmptomes psicòtics aixà com al contingut dels sÃmptomes delirants i les dades neuropsicològiques obtingudes a través de les diferents subescales de la Escala d'Intel·ligència per adults de Weschler (WAIS). Resultats: Després d'una anà lisi factorial del contingut dels deliris, s'observa que aquests s'agrupen en tres factors que permeten caracteritzar tres fenotips especÃfics que anomenem fenotip paranoide, fenotip afectiu/estrany i fenotip alienació. Aquest darrer, com a subgrup ben definit, que caracterÃsticament presenta una associació amb els sÃmptomes de primer rang de Kurt Schneider, s'agafa com a grup d'estudi, comparant-lo amb aquells que no presenten aquest fenotip. Aquest fenotip delirant presenta unes caracterÃstiques clÃniques, neuropsicològiques i evolutives diferenciades respecte el grup comparador (absència del fenotip). Es relaciona el fenotip delirant, a través de les proves neuropsicològiques, amb possibles alteracions a nivell frontoparietal esquerres i compensacions amb hiperactivació hemisfèrica dreta. Conclusions: Un estudi basat en el sÃmptoma en concret, més que en l'agrupació de diferents sÃmptomes, permet caracteritzar subgrups fenotÃpics de pacients amb unes caracterÃstiques fenomenològiques similars i amb un substrat fisiopatogènic i neurobiològic especÃfic.Schizophrenia is a psychiatric disorder characterized by the presence of delusions and hallucinations, in addition to other emotional and cognitive symptoms, and it seems to have a causal basis related to the neurodevelopment. At a phenomenological level, schizophrenia has been characterized using clinical symptoms, constituting what has been designated as positive, negative and cognitive symptomatology. These syndromic groups however, have a very heterogeneous clinical presentation. To date, several attempts to classify schizophrenia into specific subgroups have been performed with the aim of obtaining a rough classification in terms of etiology, physiopathology, and anatomy. However, these classifications have always been performed using the three big syndromic groups, and a classification using individual symptoms has been never attempted. The study of specific symptoms may shed some light on the physiopathogenic and anatomic brain correlates, which may lead to a broader knowledge on the etiological mechanisms of schizophrenia. Objective: to use the contents of the delusional symptomatology of a sample of patients with schizophrenia to characterize their phenomenological phenotypes and to study the clinical characteristics and evolution, as well as the existence and characteristics of a possible specific neuropsychological correlate. Methods: Six-month prospective cohort study using a sample of patients with a diagnosis of schizophrenia hospitalized in a Psychiatric Unit. Sociodemographic information was collected, as well as clinical information on the severity of psychotic symptoms, and on the contents of delusional symptoms. Neuropsychological data were obtained through the administration of several subscales of the Weschler Adult Intelligence Scale (WAIS). Results: A factor analysis of the delusions' contents yielded three separate factors which constitute three distinct phenotypes: a paranoid phenotype, an affective/strange phenotype, and an alienation phenotype. The latter is a clear-cut group that has a distinctive association with Kurt Schneider's first-rank symptoms. We selected the group of patients presenting with this phenotype, and compared them with the other patients. The results indicate that the clinical and neuropsychological characteristics, as well as the course of the disease of the alienation phenotype are distinct and separate from those of the other phenotypes. Neuropsychological tests indicate that the delusional phenotype is probably related to possible changes in the left frontoparietal regions, compensated by the hyperactivation of the right hemisphere. Conclusion: A study based on a specific symptom rather than on a cluster of symptoms has allowed describing a phenotypic subgroup of patients with similar phenomenological characteristics and with a specific physiopathogenic and neurobiological background
Changes in lifestyle resulting from confinement due to COVID-19 and depressive symptomatology: A cross-sectional a population-based study
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Depressió; Aïllament social; QuarantenaCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Depression; Social isolation; QuarantineCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Depresión; Aislamiento social; CuarentenaThe measures adopted to control the spread of the COVID-19 pandemic in several countries included mobility and social restrictions that produced an immediate impact on the lifestyle of their inhabitants. Methods: We assessed the association between the consequences of these measures and depressive symptomatology using a population-based sample of 692 individuals aged 18 or over from an ongoing study in the province of Girona (Catalonia, Spain). Participants responded to a telephone-based survey that included questionsrelated to the consequences of confinement and the Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptomatology. Multivariate logistic and linear regressions were used to identify which changes in lifestyle resulting from confinement were independently associated with a possible depression episode and depressive symptomatologyThe Girona Healthy Region Study is funded by the Girona, Health LivingLab operation, which is granted by the Projectes d'Especialització i Competitivitat Territorial (PECT) of the RIS3Cat and the Operative Programme of the European Regional Development Fund of Catalonia 2014–2020