Search PubMed⌕ Search

Biomedical subjects

E Vieta

Publications and source records attributed to E Vieta.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Psychiatric morbidity in elderly patients admitted to a general hospital. A day-prevalence study].

BACKGROUND: The most common psychiatric diseases in the geriatric population are depression, the acute confusional state or delirium and dementia. METHODS: A prevalence-day study of psychopathology was carried out in the elderly population admitted to the hospital for several medical and surgical conditions. The semistructured psychiatric interview (CIS), cognoscitive miniexamination (MEC) and Zung's depression scale (SDS) were administered. When appropriate, a diagnosis was established following the DSM-III-R criteria. 15% of the overall number of elderly patients were excluded because of severe medical disease or surgical operation on the study day. RESULTS: A 43% prevalence of psychiatric disorders was found. 21% of them had depression and 18% a mental organic disorder with cognitive deficit in the form of dementia (6%), delirium (10%), or both (2%). The depression symptoms were more marked with greater cognitive deterioration, and both were greater with increasing age. In only 10% of the patients considered as psychiatric cases the cooperation of the psychiatric interconsultation team had been requested. CONCLUSIONS: The diagnosis of these diseases (depression, delirium and dementia) is very important because in the elderly population with these disorders a higher morbidity and mortality due to medical causes is found.

Aged↗
PubMedDate not supplied

Suicide attempts of high medical seriousness in schizophrenic patients.

A retrospective study was conducted that included all patients who in the previous 6 years had required admission to our hospital for medical reasons following attempted suicide (N = 253). Those diagnosed as schizophrenic (n = 43) in accordance with DSM-III-R criteria were compared with the other nonschizophrenic suicide attempters. Schizophrenic patients were significantly different in that they were younger and generally unmarried, usually used violent methods, made more attempts while in a psychiatric center, and presented a lower incidence of concurrent organic illness than the nonschizophrenics; almost all of them were chronic. A large majority (80%) showed delusional and hallucinatory symptoms at the time of the attempt. In contrast, depressive symptoms were noted in an appreciably lower percentage of subjects than that in other studies of suicidal behavior in schizophrenics.

Adult↗
PubMedDate not supplied

Recall and recognition confabulation in psychotic and bipolar disorders: evidence for two different types without unitary mechanisms.

Several forms of confabulation have been identified recently in schizophrenic patients, but it has not yet been investigated whether these forms are specific to schizophrenia. Furthermore, the origin of confabulation is unclear. The present study investigated recall and recognition confabulation and their relations with symptomatology, cognitive domains (abstraction and flexibility, verbal fluency, verbal memory, motor activity, and visual-motor processing/attention), computed tomographic (CT) measures (ventricular, cerebral, and Sylvian fissure size), and auditory event-related potentials (amplitudes and latencies of peak components in oddball paradigms) in 33 schizophrenic patients, 35 bipolar I patients, eight schizoaffective patients, and seven patients with other psychotic disorders. We found that neither type of confabulation was specific of any diagnostic group. Recall confabulation was mainly predicted by the predominance of positive symptoms, while recognition confabulation was predicted by a delay in P300 latency and the doses of antipsychotics used. Our results suggest two different mechanisms for both types of confabulation based on interference with the adequate retrieval of information and slowness in early stimulus detection.

Adolescent↗
PubMedDate not supplied

Differential features between bipolar I and bipolar II disorder.

Although bipolar II disorder is generally viewed as a mild form of classic manic-depressive illness, recent investigations suggest that it could be a valid diagnostic category different from bipolar I in genetic, biological, clinical, and pharmacological aspects. Twenty-two patients fulfilling Research Diagnostic Criteria for the diagnosis of bipolar II disorder and 38 bipolar I patients were evaluated with the Schedule for Affective Disorders and Schizophrenia by two independent interviewers and compared. Bipolar II patients had significantly more previous episodes (P = .001), including both depressive (P = .003) and hypomanic (P = .006) switches, but had been hospitalized (P = .001) and presented psychotic symptoms (P < .001) less frequently. These results suggest that bipolar II disorder is less severe than bipolar I with regard to symptom intensity, but is more severe with respect to episode frequency.

Adult↗
PubMedDate not supplied

Bipolar II disorder and comorbidity.

The validity and reliability of the diagnosis of bipolar II disorder has been questioned by means of comorbidity with nonaffective disorders, including substance abuse, personality disorders, and anxiety disorders. This study examined the comorbid diagnosis of a sample of bipolar II patients, comparing patients with comorbidity and those with "pure" bipolar II disorder. Forty Research Diagnostic Criteria (RDC) bipolar II patients were assessed by means of the Schedule for Affective Disorders and Schizophrenia, Lifetime Version (SADS-L) and Structured Clinical Interview for DSM-III-R axis I (SCID-II) for personality disorders. Patients fulfilling RDC criteria for any psychiatric disorder (except personality disorders) or DSM-IV criteria for any personality disorder were compared with patients without comorbidity. For practical reasons, cyclothymia was not considered as a comorbid diagnosis. Half of the sample had lifetime comorbidity with other psychiatric disorders, mainly personality disorders (33%), substance abuse or dependence (21%), and anxiety disorders (8%). However, only the rates of suicidal ideation (74% v 24%, chi square [chi2] = 9.03, P = .003) and suicide attempts (45% v 5%, chi2 = 8.53, P = .003) were significantly different between patients with and without comorbidity. In summary, although the rates of comorbidity are relatively high in bipolar II disorder, most clinical and course variables are strikingly similar in patients with and without comorbidity except for suicidal behavior, suggesting that comorbidity does not reduce the validity of the diagnosis of bipolar II disorder.

Adult↗
PubMedDate not supplied

Therapeutic interventions focused on the family of bipolar patients.

BACKGROUND: Although genetic and biological factors are crucial in the pathophysiology of bipolar disorder, the importance of psychosocial and familial factors in triggering or mitigating relapses warrants the implementation of psychotherapeutic interventions. The authors review and criticize the role of family intervention in bipolar disorder. METHODS: The main computerized databases (Medline, Psychological Abstracts, Current Contents) have been searched for the terms 'family intervention', 'family management', 'family therapy', 'psychotherapy', 'psychoeducation' and 'bipolar disorder'. RESULTS: Some studies have associated high expressed emotion in relatives and poorer outcome in bipolar disorder. Studies on families of bipolar patients seem to support that family intervention as adjunctive therapy to pharmacological treatment may reduce the number of relapses and hospitalizations, improving familial, occupational and social functioning. However, controlled studies are scarce and most of them have a great number of methodological pitfalls such as small sample size, uncontrolled pharmacological treatment, absence of long follow-up and biased populations, among others. CONCLUSIONS: Both bipolar patients and their relatives could benefit from family intervention as adjunctive treatment to pharmacotherapy. Nevertheless, it would be necessary to design further investigations avoiding some of the limitations listed above, and controlling additionally for psychopathology in family members, and the influence of life events. It would be important to distinguish between causes and effects, studying which factors are involved in family attitudes and determining whether the interactive patterns are variable or stable according to the clinical state of the patient. Finally, it would be useful to design viable, effective and measurable interventions for the accurate delimitation of the role of family intervention in the treatment of bipolar disorder.

Antimanic Agents↗
PubMedDate not supplied

Executive function in patients with remitted bipolar disorder and schizophrenia and its relationship with functional outcome.

BACKGROUND: Recent studies have reported that differences in cognitive performance between schizophrenic and bipolar patients seem to be smaller than expected. Patients with schizophrenia have consistently shown frontal executive dysfunctions, but studies regarding executive abilities in bipolar patients are scarce and discrepant. As executive function has been associated with psychosocial functioning in schizophrenia, we wanted to investigate if such a relationship is also present in bipolar disorder and the differences between the two groups. METHODS: Executive function was assessed in 49 euthymic (at least 6 months in remission, Hamilton Depression Rating Scale < or = 8 and Young Mania Rating Scale < or = 6) bipolar and in 49 schizophrenic, residual-type (with at least 1 year without acute exacerbation and predominant negative symptomatology) patients, by the Wisconsin Card Sorting Test (WCST), FAS Test (COWAT) and Trail Making Test. Baseline clinical and psychosocial variables were controlled and psychopathology evaluated by means of the Positive and Negative Syndrome Scale (PANSS). RESULTS: The two groups showed a similar pattern of cognitive deficits in tests of executive function, except for the number of categories achieved in the WCST, which was significantly lower in the schizophrenic group (F = 7.26; p = 0.009). Functional outcome was predicted by the negative syndrome (PANSSN) and perseverative errors (WCST) in schizophrenic patients, and general psychopathology (PANSSG) was the best predictor of functional outcome in the bipolar group. CONCLUSION: Executive function was a good predictor of functional outcome in the schizophrenic group, whereas clinical variables were more predictive of the bipolar one. Patterns of cognitive disturbances in tasks of executive function are similar in both groups but quantitatively more marked in schizophrenia.

Adult↗
PubMedDate not supplied

The somatics of psyche: structural neuromorphometry of bipolar disorder.

Many neuroimaging investigations report structural differences in subjects with bipolar disorder; however, conflicting results are common in the limited number of available investigations. Thus, the structural correlates of bipolar disorders remain poorly understood. The authors reviewed the early investigations using computed tomography and examined gross structural differences, such as cerebral atrophy, ventricular enlargement, or cerebellar atrophy. Many of these investigations report significant differences in these features compared with controls, whereas others found no such differences. More recent magnetic resonance imaging (MRI) investigations have employed increasingly sophisticated imaging and research methodologies, allowing for the quantitative examination of specific brain regions. Because neuropsychological and functional studies suggest abnormalities in frontal, temporal and subcortical regions, many investigators have focused their MRI neuromorphometric studies on these temporal limbic structures. However, the number of investigations examining each of these regions remains small, and conflicting results continue to be reported. It seems clear that for many brain regions, the structural changes from normal may be subtle, and that the differences in the reported studies may be due to differences in research methodologies between studies and across centers.

Amygdala↗
PubMedDate not supplied

Impact of a psychoeducational family intervention on caregivers of stabilized bipolar patients.

BACKGROUND: Environmental stress has an important role in the course of bipolar disorder. Some findings have shown that family beliefs about the illness could predict family burden, and this burden could influence the outcome of bipolar disorder. To the best of our knowledge, there is scant information about the effects of family intervention on the caregiver's burden in bipolar disorder. The aim of this study was to assess the effects of psychoeducational family intervention on bipolar patients' caregivers, including the assessment of the caregiver's burden. METHODS: 45 medicated euthymic bipolar outpatients were randomized into an experimental and a control group. Relatives of patients from the experimental group received 12 psychoeducational, 90-min sessions about bipolar disorder and coping skills. The caregivers' knowledge of bipolar disorder, the relationship subscales of the Family Environment Scale, and the family burden subscales from an adapted version of the Social Behavior Assessment Schedule were assessed for both caregiver groups before and after the intervention. RESULTS: Psycho-educated caregivers significantly improved their knowledge of bipolar disorder and reduced both the subjective burden and the caregiver's belief about the link between the objective burden and the patient. No significant differences were found in the objective burden nor in the family relationship subscales. CONCLUSIONS: These preliminary results suggest that psychoeducational intervention on caregivers of bipolar patients may improve the caregiver's knowledge of the illness, reduce their distress or subjective burden and alter their beliefs about the link between the disruptions in their life and the patient's illness.

Adaptation, Psychological↗
PubMedDate not supplied

[Long-term effects of the treatment with risperidone versus conventional neuroleptics on the neuropsychological performance of euthymic bipolar patients].

INTRODUCTION: An increasing number of studies point to the persistence of cognitive deficits in a subpopulation of euthymic bipolar disorders. Atypical antipsychotics represent an interesting alternative treatment compared with conventional neuroleptics, because the former might cause lesser affection of cognitive functions. The objective of this study was to establish, for euthymic bipolar patients who need long-term antipsychotic treatment, the neuropsychological and outcome (occupational functioning) differences between the patients treated with risperidone and the patients treated with conventional neuroleptics. SUBJECTS AND METHOD: A sample of twenty RDC bipolar I and II patients were assessed by means of the SADS. All of them were euthymic (HDRS < 8; YMRS < 6) for at least 6 months and treated with antipsychotics. Patients who received risperidone (N = 11) were compared with patients who received conventional neuroleptics (N = 9) with respect to their neuropsychological profile. RESULTS: There were significant differences in Trail Making Test-part B (p = 0.038) and in occupational outcome (p = 0.024), favouring patients who were treated with risperidone. There were no significant differences in other neuropsychological tests, but the patients treated with risperidone tended to score higher in most measures of cognitive performance. CONCLUSIONS: Among bipolar patients who need long-term antipsychotic treatment for preventing relapses, patients who receive risperidone show more cognitive flexibility and better occupational adaptation than patients treated with conventional neuroleptics.

Adult↗
PubMedDate not supplied

[Functional neuroimaging of emotions and bipolar disorder].

In this review we comment the results of functional neuroimaging works of emotions on normal population and some parallelisms with the emotional changes of bipolar disorder correlated with their functional neuroimaging. Initially we refer the emotional ontogenetical development of human brain based on regional cerebral sanguineous flow evolution (FSC). Secondly we describe the differences of FSC between the externally generated emotions versus internally; between positive versus negative emotions and the correlation between FSC and some facial expressions. When FSC of bipolar disorder is compared with normal emotions on general population, we observe that temporal cortex, the prefrontal medial and insular anterior cortex, change their perfusion with the switch or the change of emotional expression. It is possible to determine if the findings obtained in samples of healthy subjects and bipolar patients converge in a dimensional model, or if on the contrary they support the categorical hypotheses, moving the emotional aspects to a second term on bipolar disorder.

Bipolar Disorder↗
PubMedDate not supplied

[Effectiveness and safety of topiramate in treatment-resistant bipolar disorder].

INTRODUCTION: This study was conducted to evaluate the effectiveness and safety of topiramate as add-on therapy for treatment-resistant bipolar disorder. METHODS: Twenty-one DSM-IV bipolar patients, considered resistant to treatment with lithium, carbamazepine or valproate, gave informed consent to receive increasing doses of the novel anticonvulsant topiramate as adjunctive therapy for their manic (n= 9), depressive (n= 6), hypomanic (n= 3), mixed (n= 2) or schizoaffective manic (n= 1) symptoms. The dosage of other mood stabilizer drugs remained unchanged throughout the 6-week follow-up. Outcome measures included the YMRS, HDRS-17, and CGI scales. Fifteen out of 21 patients completed the 6-week follow-up. RESULTS: Six patients (40% of completers, 29% by intention-to-treat) were considered responders to topiramate (> 50% reduction in YMRS or HDRS-17 and a decrease of 2 points in CGI). The drug was less effective in intially depressed patients. Topiramate was well tolerated and only one patient discontinued due to side-effects. The most common adverse effect was paresthesia (n= 2). Ten patients experienced moderate weight loss during the follow-up. The mean topiramate dose at endpoint was 158 mg/day. CONCLUSIONS: These preliminary results suggest that topiramate may be a useful therapy for bipolar disorders, with promising results even in the most treatment-refractory patients.

Adult↗
PubMedDate not supplied

[Treatment of bipolar II disorder with lamotrigine].

INTRODUCTION: This study analyzes the effectiveness and safety of lamotrigine in the treatment of bipolar II disorder. Patients and methods. Seventeen patients with DSM-IV bipolar II disorder with a history of poor response to lithium or other mood-stabilizers gave their consent to be treated with lamotrigine. Th ey we re followed-up for 6 months and assessed with the Young Mania Scale (YMRS), Hamilton Depression Rating Scale (HDRS-17) and the modified version of the Global Clinic Impresion Scale for Bipolar Disorder ( CG I-BP-M). RESULTS: Twelve patients completed the study. Three patients dropped out due to side effects (two because of mild rash, which vanished after treatment was discontinued and one because of vomiting) and two due to lack of efficacy. The mean dose of lamotrigine for patients completing the study was 202.1 64.4 mg/day. There was a significant improvement in HDRS-17 scores (p= 0.004) and the depressive (p=0.002) and overall (p= 0.002) subscales of the CGI-BP-M. CONCLUSIONS: This study confirms previous findings concerning the antidepressant profile of lamotrigine and its potential effectiveness in bipolar II disorder.

Adult↗
PubMedDate not supplied

[Spanish adaptation of the Seasonal Pattern Assessment Questionnaire (SPAQ) in the adult and children-adolescent versions].

INTRODUCTION: In 1984, Rosenthal et al. described the seasonal affective disorder as a cyclic pattern of depressive episodes appearing in autumn and winter, showing atypical symptoms as hypersomnia, overeating, and carbohydrate craving. They also introduced the self-applied Seasonal Pattern Assessment Questionnaire, which includes a seasonality index. A children and adolescent version was also introduced later too. In this paper the test retest reliability and internal consistency of both the adult and the children and adolescent SPQA version are presented. METHODS: 30 adults y 30 adolescents filled out the corresponding questionnaires in an interval of one week. Kappa and intraclass correlation coefficients were applied. Internal consistency was measured with Cronbach alpha. RESULTS: The adult version obtained coefficients between 0.47 y 0.81, and a Cronbach alpha of 0.85 for the seasonality index. The children and adolescent version included several items with low reliability, which were then rewritten. The renewed version was tested again in a new 30 subjects sample. Coefficients ranged from 0.50 to 0.83, with a Cronbach's alpha of 0.69 for the seasonality index. CONCLUSIONS: The Spanish version of the SPAQ (Both Adult and Children-Adolescent) showed good reliability values and also appropriate internal consistency coefficients. Therefore, they are ready to be used in clinical and epidemiological research.

Adolescent↗
PubMedDate not supplied

[Barcelona Bipolar Eating Disorder Scale (BEDS): a self-administered scale for eating disturbances in bipolar patients].

INTRODUCTION: The presence of eating disorders in bipolar population is not rare, with rates over 10 %, according to the few available epidemiologic studies, however the literature on this issue is still scarce. An even higher percentage of bipolar individuals suffer from serious problems related to eating behavior without fulfilling criteria for DSM-IV eating disorder. METHODS: The Bipolar Eating Disorders Scale (BEDS) was designed on the basis of the existing eating scales, adjusted to the characteristics of bipolar disorders from the complaints of our sample of patients (n=350). Subsequently, a group of experts made the selection of the most representative and independent items in order to obtain a short, 10-item scale, aimed at assessing the intensity and frequency of eating dysfunctions in the bipolar population and not at diagnosis. We administered the scale to a healthy control group (n=55) to evaluate feasibility and to determine the cut-off score. RESULTS: The BEDS is a 10-item simple, self-administered scale. Average time of completing this scale is about 1.13 min (1 min, 21 seconds) +/-26 seconds. Median score was 6 and the mean score was 6.6 with a standard deviation of 3.7, this being the reason why the cut-off point was found to be around 13 points. Patients receiving scores over 13 may require an individualized intervention to evaluate which were the main difficulties and to propose treatment. CONCLUSIONS: The BEDS allows for a rapid and effective evaluation of both the intensity and the frequency of eating dysfunctions in bipolar patients in order to perform an adequate intervention for the specific needs of each one of the patients.

Bipolar Disorder↗
PubMedDate not supplied

Process of adaptation to Spanish of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Scale. Self applied version (TEMPS-A).

INTRODUCTION: Investigation of the predisposing factors for affective disorders has shown that measures to assess affective temperament are necessary. The TEMPS-A is a self-evaluation measure to assess four affective temperaments (hyperthymic, depressive, cyclothymic and irritable) and anxious temperament. METHOD: The TEMPS-A questionnaire version that includes 110 questions has been adapted following the translation-backtranslation methodology, including two translations to Spanish and the classification of equivalence to English by an independent author. RESULTS: The study results indicated that a satisfactory translation was obtained, as indicated by the validation of equivalence by the bilingual consultant. All the items showed a perfect (A) or satisfactory equivalence (B). CONCLUSIONS: The TEMPS-A, Spanish version, is an understandable questionnaire that is equivalent to the original version in English, that allows for the evaluation of affective temperaments.

Bipolar Disorder↗