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Biomedical subjects

C Gastó

Publications and source records attributed to C Gastó.

45 records · Page 3Linked to original sources
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

Deficit in schizophrenia: the relationship between negative symptoms and neurocognition.

The aim of the study was to analyze the role of clinical and neuropsychological variables in the psychosocial functioning and evolution of negative schizophrenia. We examined a sample of 49 negative schizophrenic outpatients who were pharmacologically stabilized. The subjects were evaluated clinically with the Positive and Negative Syndrome Scale (PANSS) and the Schedule for Affective Disorders and Schizophrenia (SADS), and neuropsychologically with a broad neuropsychological test battery. The correlations between all of the variables were studied and their predictive capacity assessed by linear regression methods. When the neuropsychological impairment criterion was established, we were able to distinguish two groups of patients with similar psychopathologies, but different neuropsychological and prognostic characteristics. Schizophrenic patients with neuropsychological impairment showed worse prognosis, worse evolution, and worse psychosocial adaptation than nonneuropsychologically impaired schizophrenics. Cognitive variables are statistically good predictors of evolution, prognosis, and adaptation. In conclusion, the negative syndrome of schizophrenia is neuropsychologically heterogeneous. Although negative patients present a similar clinical profile, their neuropsychological and prognostic characteristics may differ.

Adult↗
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

[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

[Serotonin receptor changes in depression: evidences and limitations].

Serotonin and serotonin receptors might be involved in the pathophysiology of depression. In the following, research data supporting the general hypothesis of adaptatives changes in density and functioning of serotonergic receptors in depression are review. Binding assays, platelet and neuroendocrine studies supports this theory. The density of 5-HT2A binding sites in postmortem brain tissue of depressed patients and suicide victims, as well as in platelets of drug-free depressed patients has been found to be increased by several authors. The reduce hormonal response to fenfluramine challenge test in depression appears to indicate a sub-normal functioning of 5-HT2A receptors, however studies evaluating physiologic platelet 5-HT2A receptor-mediated responses have produced conflicting results. On the other hand, neuroendocrine challenges tests with 5-HT1A agonists suggest that presynaptic and postsynaptic 5-HT1A receptors may be also desensitized in depression. To date, postmorten receptor 5-HT1A studies in suicide victims have not yielded consistent. Taken together, these findings provide support for hypotheses of amine receptor abnormalities in depression, and indicate the need for expanded studies of amine receptor density and function in depression. Nevertheless, the role of these changes in the pathophysiology of depression has not been proved.

Blood Platelets↗
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

[The 5-HT1A receptors: from molecular biology to neuropsychiatric symptoms].

Among the multiple serotonin receptors identified to date, the 5-hydroxytryptamine (5-HT)1A subtype is among the best known because selective ligands have been available for more than 15 years. Radioactive derivatives of these ligands make it possible to demonstrate the presence of 5-HT1A binding sites mainly in the limbic areas and in the raphe nuclei in the brain, where they correspond to post-synaptic receptors and pre-synaptic autoreceptors respectively. On stimulation of 5-HT1A autoreceptors, they regulate serotonin release in the distal regions of the neuron by inhibitory firing activity. In this way, they help to maintain the serotonin in the terminal regions at physiological levels, which favors correct neuronal functioning. This review article summarizes key data on localization, study technique, molecular biology, signal transduction, differential functional properties of pre-synaptic versus post-synaptic 5-HT1A receptors, and behavioral effects and clinical correlates of their activation, especially cognitive and emotional responses. Mention is made about the role of these receptors in the neurogenesis process of certain brain areas and of the possible clinical and therapeutic implications of these processes.

Affect↗
PubMedDate not supplied

[Bipolar II disorder: course and suicidal behavior].

INTRODUCTION: Bipolar II disorder seems to be more than a mild form of classic manic-depressive illness. Differences with bipolar I concern genetic, biological, clinical and pharmacological aspects. Nevertheless, studies on suicidal behavior in both groups have resulted in inconsistent results PATIENTS AND METHOD: Twenty-two patients fulfilling Research Diagnostic Criteria for the diagnosis of bipolar II disorder and 38 bipolar I were evaluated with the Schedule for Affective Disorders and Schizophrenia by two independent interviewers, and compared. RESULTS: Bipolar II patients had significantly more previous episodes (p = 0.001), including both depressive (p = 0.003) and hypomanic switches (p = 0.006), but had been hospitalized (p = 0.001) and presented psychotic symptoms (p < 0.001) less frequently. CONCLUSIONS: There were no significant differences between both groups regarding suicidal behavior variables. These results suggest that bipolar II disorder is less severe than bipolar I regarding symptoms intensity, but more severe with respect to episodes frequency, and that suicide attempts rates are not useful to discriminate between both groups.

Adolescent↗