Pilar Alejandra Saiz Martínez

The role of genetic variability in the GABRA6, 5-HTT and BDNF genes in anxiety-related traits

Arias B, Aguilera M, Moya J, Sáiz PA, Villa H, Ibáñez MI, García‐Portillo MP, Bobes J, Ortet G, Fañanás L. The role of genetic variability in the SLC6A4, BDNF and GABRA6 genes in anxiety‐related traits.

Biomarcadores sanguíneos diferenciales de las dimensiones psicopatológicas de la esquizofrenia

Symptomatology of schizophrenia is heterogeneous, there is not any pathognomonic symptom. Moreover, the diagnosis is difficult, since it is based on subjective information, instead of markers. The purpose of this study is to provide a review of the current status of blood-based biomarkers of psychopathological dimensions of schizophrenia. Inflammatory, hormonal or metabolic dysfunctions have been identified in patients with schizophrenia and it has attempted to establish biomarkers responsible for these dysfunctions. The identification of these biomarkers could contribute to the diagnosis and treatment of schizophrenia.

It is feasible and effective to help patients with severe mental disorders to quit smoking: An ecological pragmatic clinical trial with transdermal nicotine patches and varenicline

Despite the proven association between smoking and high rates of medical morbidity and reduced life expectancy in people with severe mental disorders (SMD), their smoking rates do not decline as they do in the general population. We carried out a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to investigate the clinical efficacy, safety and tolerability of a 12-week smoking cessation programme for patients with SMD in the community under real-world clinical conditions. Eighty-two adult outpatients with schizophrenic/bipolar disorder smoking ≥15 cigarettes/day were assigned by shared decision between doctors and patients to transdermal nicotine patches (TNP) [36(46.2%)] or varenicline [39(50%)]. Short-term efficacy: The 12-week 7-day smoking cessation (self-reported cigarettes/day=0 and breath carbon monoxide levels≤9ppm) prevalence was 49.3%, without statistically significant differences between medications (TNP 50.0% vs varenicline 48.6%, chi-square=0.015, p=1.000). Long-term efficacy: At weeks 24 and 36, 41.3 and 37.3% of patients were abstinent, with no statistically significant differences between treatments. Safety and Tolerability: no patients made suicide attempts/required hospitalization. There was no worsening on the psychometric scales. Patients significantly increased weight [TNP 1.1(2.8) vs varenicline 2.5(3.3), p=0.063], without significant changes in vital signs/laboratory results, except significant decreases in alkaline phosphatase and low-density lipoprotein-cholesterol levels in the varenicline group. Patients under varenicline more frequently presented nausea/vomiting (p<0.0005), patients under TNP experienced skin reactions more frequently (p=0.002). Three patients under varenicline had elevated liver enzymes. In conclusion, we have demonstrated that in real-world clinical settings it is feasible and safe to help patients with stabilized severe mental disorders to quit smoking.

Evolución de la prevalencia administrativa de los trastornos mentales durante 13 años en Asturias (norte de España)

INTRODUCTION The study of administrative prevalence from cumulative psychiatric case registers allows the mental health state of the studied region and the functioning of its Health Services to be estimated. METHODS Data were extracted from the Asturias Cumulative Psychiatric Case Register (RACPAS) between January 1st 1998 and December 3 th 2010. Characteristics of the population of the catchment area were studied, and their relationship with the administrative prevalence was analyzed. RESULTS The mean population in the studied period was 1,078,406 inhabitants. The Fritz index and the Youth and replacement indices of the active population decreased throughout the period. There was no significant increase in the prevalence of organic mental disorders, psychosis, mood disorders, and substance use in males, or behavioral disorders associated with somatic factors and physiological dysfunctions in females. There were significant gender differences in the prevalence of all disorders, except for personality disorders and organic mental disorders. Population ageing had a significant influence on the increase in the prevalence of most mental disorders in both males and females. CONCLUSIONS A slight general increase in the administrative prevalence of mental disorders is observed during the studied period, and it was influenced by population ageing.

Estadificación clínica en los trastornos mentales graves: trastorno bipolar, depresión y esquizofrenia

Clinical staging is a diagnostic tool used in other medical specialties, which has resulted from the combination of a categorical and dimensional approach. In the last 2decades, the usefulness of its application in the field of psychiatry has been suggested, mainly as a tool for diagnostic help, and therapeutic and prognostic orientation. In this paper we review the clinical staging models that have been proposed to date for bipolar disorder, depression and schizophrenia. A literature search was performed in PubMed and Medline databases. A total of 15 studies were selected according to inclusion and exclusion criteria. Models were grouped according to the type of disorder for which staging was proposed (bipolar disorder: 4, depression: 5, schizophrenia: 6), and their characteristics were described. As a conclusion, we identify the need to empirically validate these models to demonstrate that staging is a useful tool for clinical practice.

A Review of Quality-of-Life Assessment Measures in Schizophrenia: Limitations and Future Developments

The assessment of quality of life (QoL) in patients with schizophrenia is an area of growing concern since it is considered an essential distal outcome for clinical trials and patient management (Auquier et al. 2003; Awad and Voruganti 2012) according to the patient-reported outcome (PRO) movement in medicine (see Fig. 5.1). Its evaluation is founded on the notion that every patient has a right to self-determination in health-care decisions and his/her subjective perspective should be considered in both diagnosis and care planning processes (Awad and Voruganti 2012; Badia et al. 1999; Bilker et al. 2003).