Biomedical subjects

José M Menchón

Publications and source records attributed to José M Menchón.

3 recordsLinked to original sources

PubMed2004

Perceived parental rearing style in obsessive-compulsive disorder: relation to symptom dimensions.

Obsessive-compulsive disorder (OCD) runs in families, but the specific contribution of genetic and environmental factors to its development is not well understood. The aim of this study was to assess whether there are differences in perceived parental child-rearing practices between OCD patients and healthy controls, and whether any relationship exists between parental characteristics, depressive symptoms and the expression of particular OCD symptom dimensions. A group of 40 OCD outpatients and 40 matched healthy controls received the EMBU (Own Memories of Parental Rearing Experiences in Childhood), a self-report measure of perceived parental child-rearing style. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HDRS) were used to assess the severity of obsessive-compulsive and depressive symptoms. The Y-BOCS Symptom Checklist was used to assess the nature of obsessive-compulsive symptoms, considering the following five symptom dimensions: contamination/cleaning, aggressive/checking, symmetry/ordering, sexual/religious and hoarding. Logistic and multiple linear regression analyses were conducted to study the relationship between parental style of upbringing, depressive symptoms and OCD symptom dimensions. Severe OCD (Y-BOCS: 27.0+/-7.4) and mild to moderate depressive symptoms (HDRS: 14.0+/-5.4) were detected in our sample. Compared with healthy controls, OCD patients perceived higher levels of rejection from their fathers. No differences between the groups with respect to perceived levels of overprotection were detected. The seventy of depressive symptoms could not be predicted by scores on any perceived parental characteristics. Hoarding was the only OCD symptom dimension that could be partially predicted by parental traits, specifically low parental emotional warmth. Social/cultural variables such as parental child-rearing patterns, in interaction with biological and genetic factors, may contribute to the expression of the OCD phenotype.

Adolescent↗

PubMed2004

Mapping structural brain alterations in obsessive-compulsive disorder.

BACKGROUND: Recent technical developments have made it feasible to comprehensively assess brain anatomy in psychiatric populations. OBJECTIVE: To describe the structural brain alterations detected in the magnetic resonance images of a large series of patients with obsessive-compulsive disorder (OCD) using imaging procedures that allow the evaluation of volume changes throughout the brain. DESIGN: Case-control study. SETTING: Referral OCD unit in a tertiary hospital. PARTICIPANTS: A consecutive sample of 72 outpatients with OCD and 72 age- and sex-matched control subjects. INTERVENTIONS: Three-dimensional sequences were obtained in all participants. A statistical parametric mapping approach was used to delineate possible anatomical alterations in the entire brain. To preserve volumetric information, voxel values were modulated by the Jacobian determinants (volume change measurement) derived from spatial normalization. MAIN OUTCOME MEASURES: Voxelwise brain volumes. RESULTS: The brains of patients with OCD showed reduced gray matter volume in the medial frontal gyrus, the medial orbitofrontal cortex, and the left insulo-opercular region. A relative increase in gray matter volume was observed bilaterally in the ventral part of the putamen and in the anterior cerebellum. All these brain alterations were abnormally correlated in patients with OCD, and age statistically significantly contributed to the relative enlargement observed in the striatal areas. Disease severity, the nature of symptoms, and comorbidities were not related to the changes described. Nevertheless, patients with prominent aggressive obsessions and checking compulsions showed reduced amygdala volume in the right hemisphere. CONCLUSIONS: The pattern of anatomical features depicted by this voxelwise approach is consistent with data from functional studies. The reported anatomical maps identified the specific parts of the frontostriatal system that were altered in patients with OCD and detected changes in anatomically connected distant regions. These data further define the structural brain alterations in OCD and may contribute to constraining the prevailing biological models of this psychiatric process.

Adolescent↗

PubMed2003

Enlargement of brain cerebrospinal fluid spaces as a predictor of poor clinical outcome in melancholia.

BACKGROUND: A number of recent neuroimaging findings in depression have provided new insight into the biological substratum of depressive illness. The question now is what particular relevance the structural brain alteration described may have within the clinical context of depressive patients. We investigated a possible relationship between brain cerebrospinal fluid (CSF) space changes and patient prognosis in melancholic depression. METHOD: Fifty-five patients who met DSM-IV criteria for major depressive disorder with melancholic features were examined with 3-dimensional magnetic resonance imaging, and CSF volumes were measured for global brain CSF and for lateral ventricles and left and right sylvian fissure regions. Clinical outcome was prospectively assessed during a 6-month standardized antidepressive treatment period (Phase I) and in a 2-year follow-up (Phase II) of recovered patients. The outcome measurements were total days to symptom remission (Phase I) and to eventual symptom relapse or recurrence (Phase II). The study took place from July 1998 to Dec. 2001. RESULTS: Phase I: Enlargement of CSF spaces in the left sylvian fissure region predicted poor treatment response. Volume measurements from this region accounted for 35% of remission time variance. Median time to full clinical remission was 82 days in patients with severe changes, 51 days in the case of mild-to-moderate CSF enlargement, and 35 days in patients with no left sylvian fissure region alterations. Phase II: Severe enlargement of global cortical CSF spaces was associated with increased risk of depression relapse or recurrence. Patients with severe cortical CSF changes showed a 7.8-fold excess risk of depression relapse/recurrence compared with patients with no cortical CSF space alteration. CONCLUSION: Our data suggest that MRI-detected CSF space enlargement may be an important neuroimaging marker for poor prognosis in melancholic depression.

Adult↗