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Biomedical subjects

S Cervera

Publications and source records attributed to S Cervera.

17 recordsLinked to original sources

[Prevalence of eating disorders in a representative sample of female adolescents from Navarra (Spain)].

BACKGROUND: In spite of the social concern about eating disorders (ED), information of its prevalence in Spain is limited. Further studies in communities are needed to estimate the frequency of this problem in representative samples of the population. SUBJECTS AND METHODS: To estimate the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), and partial syndromes of the "non specified eating disorders" (NOSED) type, a representative sample of the female population of Navarre was selected using a random multistage sampling scheme. A sample of 2862 participants aged 12 to 21 was studied. The screening procedure was performed using the Eating Attitudes Test (EAT) (values over 30 as the cutoff point) and each diagnosis was confirmed using a semi-structured interview performed by a psychiatry according to DSM-IV criteria. RESULTS: The overall prevalence of ED in this female population was 4.1% (95% CI: 3.45-4.95). The disorder specific prevalences being NOSED 3.1% (95% CI: 2.5-3.8), BN 0.8 (95% CI: 0.5-1.2) and AN 0.3 (95% CI: 0.1-0.6). CONCLUSIONS: Our results show a slight lower prevalence than what other Spanish authors have reported, although we found higher prevalences of incomplete syndromes and suggest that a high social burden does exist and primary prevention strategies are needed.

Adolescent↗

Tianeptine therapy for depression in the elderly.

1. Depression is frequent in the elderly but difficult both to diagnose and treat due to a number of distinctive features. 2. Tianeptine is a novel antidepressant with a reverse mode of action to that of the selective serotonin reuptake inhibitors yet with proven efficacy and safety. 3. 63 elderly patients (mean age:68.8 years; range:65-80 years) with depressive symptoms (major depression:55.6%; dysthymia:44.4%) were included in a 3-month open multicenter study with tianeptine (25 mg daily). 4. 43 patients (68.2%) completed the study. There were no drop-outs due to side-effects. Total Montgomery and Asberg Depression Rating Scale scores were significantly decreased (p < 0.01) on day 14, with a response rate of 76.7%. 5. Improvements were also observed in anxiety and cognitive performance. Side-effects were seen in only 11.7% of patients, with no changes in laboratory or ancillary safety parameters. Tianeptine is thus effective and well tolerated in this category of patient.

Aged↗

Moclobemide versus clomipramine in the treatment of depression: a multicentre trial in Spain.

The efficacy, tolerability and safety of moclobemide were compared with those of clomipramine in a double-blind, randomized parallel group study over 4 weeks. Patients were suffering from various forms of depression: 33 received moclobemide and 31 clomipramine. The mean score on the Hamilton Rating Scale for Depression decreased gradually in both groups, with no significant differences between them; the final scores showed an improvement of 57% in the moclobemide group and 60% in the clomipramine group, compared with baseline. The investigators' assessment of efficacy at the end of treatment was good or very good for 60% of moclobemide patients and 50% of clomipramine patients, and tolerance was good or very good for 31 patients on moclobemide and 26 on clomipramine. The drugs thus showed comparable antidepressant efficacy, and both were mostly well tolerated, although adverse events were more prevalent in patients treated with clomipramine.

Adult↗

[Usefulness of neuroendocrine function tests in the differential diagnosis of depression].

In order to find the correlation between dexamethasone suppression test (DST) and TSH response to TRH in the differential diagnosis of subtypes of depression, and to evaluate the possible relationship between Hypothalamic-Pituitary-Adreno-cortisol axis, Hypothalamic-Pituitary-Thyroid axis function, psychopathological symptoms, and the possible influence of age and sex, 107 depressed patients were studied. The relationship between both tests (DST and THS response to TRH) and the subtypes of depression was unspecific. The results did not show psychopathologic differences between depression subgroups. DST appeared to be a good marker for the "state" of illness, whereas TSH was better as a predictor for the outcome.

Adolescent↗

[Anorexia nervosa: study method and sleep analysis].

By studying anorexia nervosa with an Integrated Inventory and the quality and the quantity of sleep applying Hauri's scale for the analysis of dream contents, the sleeping habits of 50 anorexic patients who were under treatment have been studied. The results show that sleep in these patients is similar and sometimes better in quantity and quality than those in the control group. Their dreams are characterized by an almost total absence of sexual, aggressive and alimentary contents, and that reality, active participation, unpleasant feelings and sensory-perceptive elements are predominant.

Adolescent↗

Clinical and neuroendocrine features of endogenous unipolar and bipolar depression.

A group of 19 patients suffering from endogenous unipolar depression was compared with another group of eight patients with bipolar depression. Comparisons were based on psychopathological features together with results of the dexamethasone suppression test and the thyrotropin releasing hormone stimulation test. Unipolar patients showed more frequent loss of weight, reduced appetite, autonomic disturbances, muscular tension, sadness, and reduced sexual interest, whereas bipolar patients showed more frequent hostile feelings. Each neuroendocrine test identified at least 50% of the patients in each group. The combined use of both tests identified about 75% of the patients. The bipolar depressives obtained slightly but not significantly higher rates of positive results in each test and a more frequent association of abnormality in both tests.

Adult↗

[Seville Quality of Life Questionnaire: historic outlook of its establishment].

We describe how we developed a new instrument for measuring quality of life, the Seville Quality of Life Questionnaire (SQCQ), and the results we obtained when we applied it to a group of schizophrenic patients. The questionnaire was designed by a group of researchers who set out from the premise that the quality of life of schizophrenic patients is perceived differently from that of healthy people, and tried first of all to demarcate the kind of area which is abnormal in these patients. We then devised a set of items which were assessed for clarity and pertinence by a series of experts, and the questionnaire was assembled in the form of a set of statements, response to which is in the form of a Lickert-type 5-stage scale. The finished questionnaire was administered to 279 schizophrenic patients. At the same time, these patients were also evaluated using the AMDP Psychopathology Scale, the positive and negative symptoms evaluation scale (PANS), Lehman's structured quality of life interview (QOLY), Ruiz and Baca's quality of life questionnaire (QLQ), Camberwell's scale of needs analysis (CANr) and the WHO's handicap assessment scale (DDS). These questionnaires were used to judge the different types of validity of the Seville Questionnaire. The reliability of the questionnaire was measured using Cronbach's alpha coefficient (internal consistency: 0,85 scale of favourable aspects, 0,96 scale of unfavourable aspects). As far as validity was concerned, both scales of the questionnaire were found to have a high level of validity. We also examined the extent to which the psychopathological disorders affected the quality of the schizophrenic person's life, the extent to which his/her needs were being met by the health services, and the patient's degree of disability. From the results obtained, we can say that the SQCQ is a reliable and valid instrument, which is sufficiently sensitive to the clinical changes produced in the course of the natural history of the disease. The SQCQ stands out from the other quality of life questionnaires in that it takes into account aspects of the disease which the patient him/herself is aware of as affecting his/her quality of life.

Humans↗

[Differential features of SSRIs].

The goal of this study is to review the pharmacologic profiles of the selective serotonin reuptake inhibitors (SSRIs) presently available, with particular emphasis placed on therapeutically relevant distinctions.

Animals↗

[Subjective experience and quality of life in schizophrenia].

The term quality of life has been gradually introduced in the field of Psychiatry. This term tries to integrate not only the symptoms in Psychiatric patients, but also other aspects, like individual perceptions, personal expectations, degree of independence, etc., in order to achieve a global understanding of the patient. The are few studies on quality of life in schizophrenia, especially there is a lack of self assessment scales that the patients can fill out about themselves and their psychological environment. The Seville Quality of Life Questionnaire tries to evaluate the subjective experience of patients with schizophrenia about their illness. The Seville Quality of Life Questionnaire also checks the presence or absence of groups of patients with schizophrenia with a better or worst quality of life. We have assessed 222 subjects that meet ICD-10 criteria diagnostic for schizophrenia, with the Seville Quality of Life Questionnaire, the Positive and Negative Symptom Scale specific psychopathology scale and the AMDP system general psychopathology scale. Our results show two clearly differentiate groups: one with better (Group 2: 108 patients) and one with worse (Group 1: 81 patients) quality of life. However, 33 patients could not be included in any of the two groups. In the worse quality of life group the most prominent factors were: lack of cognitive grasp, perplexity, fear of loss of control, and contained hostility. These four factors have a great influence on the worse quality of life. When we compare the Seville Quality of Life Questionnaire data with several the Positive and Negative Symptom Scale scores, we saw that the group of worse quality of life presents higher scores on both Negative and Positive Symptoms of schizophrenia, and also in the Positive and Negative Symptom Scale general psychopathology scale. In the AMDP system general psychopathology scale we saw three groups of significant symptoms in the Seville Quality of Life Questionnaire: 1. Difficult relationships with the external world, 2. Difficulty to understand what it happening (loss of associations); and 3. Affective alterations (ambivalence).Finally, these data suggests that it is probable that the Seville Quality of Life Questionnaire could be able to build a typology of patients with schizophrenia more centred in their pathology that in their psychophatology.

Adult↗

[A mid-term clinical and hemodynamic evaluation of the Wessex and Hancock II bioprostheses].

The purpose of this study is to compare clinically and hemodynamically the Wessex and Hancock II porcine bioprostheses. We compared functional class and data from echo-Doppler in 34 Wessex bioprostheses (group A) with those in 42 Hancock II bioprostheses (group B). We subdivided group A into A1 and A2. A1 was made up of 23 Wessex manufactured since 1986. A2 constituted 11 Wessex made before 1986 which belonged to a series with some variations in the manufacturing process, and in which some early dysfunctions have been described. We compared data from these sub-groups between each other as well as with those of group B. The groups were homogeneous in age, sex, patients body surface and the time elapsed since the prosthetic implant. The mean mitral gradient, the mitral area, the peak aortic gradient and the regurgitation incidence were similar in groups A and B. In A2 the mean mitral gradient was significantly superior to that of group B (7.1 +/- 1.1 mmHg vs 5.4 +/- 1.4 mmHg; p less than 0.01), and the mitral area showed a tendency to be inferior, although with no statistical significance. The functional class of the patients was similar in all the groups. We conclude that the Wessex bioprosthesis presents hemodynamic data and functional class similar to those of the Hancock II, with the exception of a sub-group of Wessex manufactured before 1986 which presents mean mitral gradients superior to the others and which would warrant further studies.

Bioprosthesis↗

[Treatment with tianeptine for depressive disorders in the elderly].

Depression is frequent in the elderly but difficult both to diagnose and treat due to a number of distinctive features. Tianeptine is a novel antidepressant with a reverse mode of action to that of the selective serotonin reuptake inhibitors yet with proven efficacy and safety. 63 elderly patients (mean age: 68.8 years; range: 65-80 years) with depressive symptoms (major depression: 55.6%; dysthymia: 44.4%) were included in a 3-month open multicenter study with tianeptine (25 mg daily). 43 patients (68.2%) completed the study. There were no drop-outs due to side-effects. Total Montgomery and Asberg depression rating scale scores were significantly decreased (p < 0.01) on day 14, with a response rate of 76.7%. Improvements were also observed in anxiety and cognitive performance. Side-effects were seen in only 11.7% of patients, with no changes in laboratory or ancillary safety parameters. Tianeptine is thus effective and well tolerated in this category o patient.

Aged↗