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Biomedical subjects

J Seguí

Publications and source records attributed to J Seguí.

33 records · Page 2Linked to original sources
PubMed1991

[The prevalence of buprenorphine consumption in a sample of outpatient drug abusers].

We studied 184 patients with DSM III-R diagnostic criteria for opioid dependence who attended the Sta. Eulalia's CAS (outpatients facility) during 18 months in order to measure the buprenorphine use. We collected the data from the patient's reports on the present buprenorphine use. The period prevalence was 79% (43.5% of them were occasional users and 35.5% habitual; whereas the point prevalence was 16.8% (6.5% occasional users and 10.3% habitual). The average of buprenorphine use was 6.1 +/- 9.9 months. Main method of consume is crushing the pill then dilute it and then injecting the solution e.v. The usual way of getting the substance is from illegal market (about 65% of patients get it in this way). About the third of our patients have been involved in the illegal traffic of in this drug anytime. From the data presented above we conclude that a more strict control of buprenorphine in highly recommended.

Buprenorphine↗
PubMedDate not supplied

Depersonalization in panic disorder: a clinical study.

Panic disorder (PD) has been hypothesized to be a heterogeneous entity, with distinct clinical subgroups. The presence of depersonalization during panic attacks may distinguish a specific subgroup of PD. We sought to analyze the differential features of a subgroup of PD patients with depersonalization. A total of 274 patients with PD were assessed and divided into 2 groups according to the presence or absence of depersonalization. The Structured Clinical Interview for DSM-III-R (SCID-UP-R) was used to assess PD and comorbid disorders. The clinical scales administered included the Hamilton Anxiety and Depression Rating Scale (HARS and HDRS), the Marks and Mathews Fears and Phobia Scale, Panic-Associated Symptom Scale (PASS), and a panic attack symptoms inventory. A total of 66 patients (24.1%) exhibited depersonalization during the attacks. Patients with depersonalization appeared to be younger and had an earlier age at onset. PD was more severe in the depersonalization group (greater number of attacks, worse level of functioning, and higher scores on most self-rating scales). Also, depersonalization patients showed more comorbidity with specific phobia. Our results support the view that PD with depersonalization may be considered a distinct and more severe subcategory of PD.

Adolescent↗
PubMedDate not supplied

Differential clinical features of late-onset panic disorder.

OBJECTIVES: The aim was to analyse the sociodemographic and clinical characteristics of panic disorder (PD) in patients with a PD onset after 60 years of age, at two outpatient psychiatric clinics in Barcelona (northeastern Spain). MATERIAL AND METHODS: All patients presenting with PD at two outpatient clinics over a 4-year period were assessed by the same team. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with an earlier onset. The instruments administered to the sample were: Global Assessment of Functioning scale, Panic-Associated Symptom Scale, Hamilton's Depression and Anxiety Scales and Marks-Matthews' Fear and Phobia scale. RESULTS: Of 5301 patients attended over a 4-year period, 64 (1.2%) were PD patients aged 60 or above. Age at PD onset was over 60 in 27 cases (0.4% of the total population, and 6.1% of all PD patients). The mean age in the late-onset group was 67.0+/-4.9 years. Late-onset PD patients were less likely to report family history of PD. They scored lower on most scales assessing clinical severity (excepting GAF and agoraphobia scores), and they exhibited fewer and milder panic symptoms during the attacks. However, dysthymic disorder, but not major depressive disorder, was more common among late-onset PD patients (P<0.05). COMMENTS: The most notable findings in our late-onset PD subgroup of patients were: lesser severity of the disorder, greater comorbidity with dysthymia, and less family history of PD. Prevalence rates of late-onset PD in our sample appeared to be rather high. Physical illness and less severe panic symptoms may contribute to underdiagnosing PD in this particular subpopulation.

Age of Onset↗
PubMedDate not supplied

[Validation of the Panic Attack Symptoms Scale].

INTRODUCTION AND METHOD: The ESAP is a self-rating scale based on the panic attack with 0 to 3 scoring and the total score is obtained by adding the 14 scores- the highest score thus being 42. Forty patients were included for the study, and the were assessed at their first visit, after one week and after one month in the treatment. RESULTS: The items at the first basal assessment followed a normal distribution (Test Shapiro-Wilk w: 0.97, p< 0.57). The mean score was 18.5 with a SD of 7.43. The scale's internal consistency was measured by Cronbach's alpha, which was 0.66 at the first visit, 0.60 at the second one and 0.90 at the third one. Test-retest reliability was good in most cases, with values greater than 0.7 (p< 0.001). The correlation between the first visit total score and the second one was 0.89 (p< 0.001). The correlation with other scales (concurrent validity was highly significant with Hamilton's anxiety scale, total PASS and most of the PASS sub-scales (unexpected panic, limited and anticipatory anxiety) and slightly significant with the number of crises in past month. Four factors accounting for 65% of variance were identified in the factor analysis.

Adult↗
PubMedDate not supplied

[Causes of failure in psychopharmacological treatment of anxiety disorder].

OBJECTIVE AND METHODS: A comprehensive review of literature on the causes of failure in pharmacologic treatment of panic disorder (PD). RESULTS: PD has high rates of response to psychopharmacological treatment, reaching up to 80-90%. However, in a small percentage of cases (10-20%), the disorder is refractory to the combination of drugs and psychotherapy, at correct dosages and during adequate time periods. Refractoriness in PD is not a well-known issue as few studies have addressed this question. Intolerance to psychotropic drugs is usually reported to be the commonest cause, especially to antidepressants. Other causes are: comorbidity (especially with depressive disorders, personality disorders, and alcohol abuse, as well as with medical conditions); severe panic attacks; severe agoraphobia; and long illness duration. < > PD is to be ruled out, since incorrect diagnosis, incorrect treatment, or bad compliance are common causes of a poor response. We review treatment approaches for PD when no response is achieved with antidepressants (TCA, SSRI, MAOI), alprazolam and cognitive-behaviour therapy. Two recommended strategies are drug potentiation and use of clonazepam.

Antidepressive Agents↗
PubMedDate not supplied

[Buprenorphine use, a bad prognostic indicator in drug dependence].

We studied 184 patients with DSM III-R diagnostic criteria for opiate dependence and classified them in order of their buprenorphine use: those who never used it (21%), others who used it from time to time (43.5%), and those who use it habitually (35.5%). The patients who use buprenorphine habitually have a poorer social functioning and are more disturbed clinically. They present too: more unemployment (p less than 0.05), longer time of opioid dependence (p less than 0.05), they offend usually (p less than 0.001), they traffic in drugs more than the other patients (p less than 0.001), mostly buprenorphine (p less than 0.001) and they are usually polydrug-addicts (p less than 0.001).

Adult↗
PubMedDate not supplied

[Psychiatric evaluation of organic diseases].

The psychiatric assessment of the patients with organic illnesses is very difficult because of the bias related to physical symptoms (asthenia, anorexia). This could produce an over-diagnosis of the psychiatric disorders. The use of the specific psychiatric diagnosis criteria in the organic illnesses avoids this kind of problems and allows an improvement of their clinical assessment.

Humans↗
PubMedDate not supplied

[Comorbidity of panic disorder and social phobia].

Among 83 patients presenting panic disorder 24% have comorbid social phobia. Its age of onset was earlier than the one for panic disorder, in 95% of social phobics appeared first. Patient comorbid with social phobia and panic disorder: a) have an earlier panic disorder age of onset (p < 0.05); b) have more major depressive disorders (p < 0.01); c) more obsessive compulsive disorders (p < 0.05); d) higher scores in all SCL-90 subscales, except for phobias; e) more severity in the social phobia scale from the Fear Questionnaire of Marks & Mathews. The clinical significance of these findings is discussed.

Adult↗
PubMedDate not supplied

[Clinical subgroups of anxiety disorders: from phenomenology to cluster diagnosis].

The panic disorder is heterogeneous. The factorial study of the phenomenology of panic crisis suggests the existence of different subtypes: the cardio-respiratory, the vestibular, the despersonalization, the gastrointestinal and others. We review the clinical and biological data which suggest the display of these subtypes.

Adult↗
PubMedDate not supplied

[Panic disorder in the elderly].

UNLABELLED: The existence of panic disorder (PD) in old population is a source of debate. OBJECTIVES: This study is aimed at studying the sociodemographic and clinical characteristics of panic disorder in patients over 60 years of age seen in two outpatient psychiatric clinics. METHOD: All consecutive cases of PD (DSM-III-R) who contacted with two outpatient clinics in a three-year period were assessed by the same team. Those patients aged 60 or more at the time of interview were grouped and compared with a young and adult group. PASS and Marks-Matthews' Phobia Scale were administered to the sample. RESULTS: Fifty-three (15.6%) out of 341 PD patients were over 60 years of age. Elderly patients reported less frequency and severity of symptoms, less comorbidity with social phobia (p < 0.01) and alcoholism disorders (p < 0.01) and more with dysthymia (p < 0.05). The elderly patients with PD reported fewer family histories of alcoholism (p < 0.05), depression (p < 0.05) and PD (p < 0.05). CONCLUSIONS: The rate of PD patients over 60 years of age who get in touch with outpatient psychiatric clinics is variable but not uncommon. Some clinical characteristics of PD in the elderly such as medical comorbidity and less symptom severity may enhance misdiagnosis in clinical settings.

Adolescent↗
PubMedDate not supplied

[Separation anxiety and panic disorder].

History od separation anxiety was investigated in several psychiatryc disorders and in 150 patients with panic disorder following DSM III-R criteria. Separation anxiety was reported by 15.3% of patients with panic disorder, 3.3% of the healthy control group, 13.3% of patients with major depression, 16.7% with dystymia, 13.3% with generalized anxiety and 33.3% with social phobia (p < 0.001). Separation anxiety is thus considered a common predisposing factor of anxiety and depressive disorders. Panic disorder patients with a history of separation anxiety had an earlier age at panic onset and greater comorbidity with social phobia and agoraphobia.

Adult↗