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Biomedical subjects

M Gurpegui

Publications and source records attributed to M Gurpegui.

15 recordsLinked to original sources
PubMed2002

Cannabis-induced psychosis: a cross-sectional comparison with acute schizophrenia.

OBJECTIVE: The existence of cannabis-induced psychosis (CP) remains controversial, partly because of methodological problems. We hypothesize that acute schizophrenia (AS) and CP can have distinct demographic, premorbid and clinical features. METHOD: We compared 26 patients with CP to 35 with AS, after their cannabis-consumption status was confirmed by repeated urine screens. Patients with CP were assessed after at least 1 week but not more than 1 month of abstinence. Symptoms were evaluated with the Present State Examination (PSE). RESULTS: In group CP, male gender, expansive mood and ideation, derealization/depersonalization, visual hallucinations, and disturbances of sensorium were more frequent than in group AS. Premorbid schizoid personality traits were more frequently associated to AS and antisocial personality traits to CP. CONCLUSION: The continuous heavy use of cannabis can induce a psychotic disorder distinct from AS. These two clinical entities share some features but they differ in others.

Acute Disease↗
PubMed1999

Emotional distress and occupational burnout in health care professionals serving HIV-infected patients: A comparison with oncology and internal medicine services.

BACKGROUND: The present paper examines the levels of emotional distress and professional burnout among health care professionals working with HIV patients in two different settings, Infectious Disease (ID) Units and a Haemophilia (H) Unit, and compares them with those of professionals working in Oncology (O) or General Internal Medicine (IM) Units, all at public hospitals. METHODS: Cross-sectional anonymous survey assessing their psychological condition, occupational stress, work and social adjustment, and providing information about stressors, supports and coping methods, using the General Health Questionnaire, the Maslach Burnout Inventory, the Modified Social Adjustment Scale, and other self-administered instruments. RESULTS: Perceived stress was higher in both O and IM, and the number of stressful circumstances was especially higher in O. No significant differences in psychological morbidity were found among the groups, with these exceptions: a better status among the H staff, who also showed less overall burnout; emotional exhaustion was lower in both ID and H than in the two other groups; the ID staff showed less personal accomplishment. Using a multiple regression model, a series of variables - including work adjustment, social/leisure adjustment, and having chosen to work in their position - was able to predict outcome. CONCLUSIONS: Our results highlight the presence of substantial levels of emotional distress and work-related difficulties in a significant number of health care workers. The mental health services could play an important role in conducting further research in this field and in providing practical help to deal with staff's difficulties.

Adult↗
PubMed1998

Opioid peptides and immunodysfunction in patients with major depression and anxiety disorders.

To assess cell-mediated immunity in depression and anxiety disorders and to elucidate whether immunodysfunction might be related to a high opioid activity, a prospective study of patients with major depression (n = 34) or anxiety disorders (n = 21) was performed. Cellular immunity tests, the in vitro effects of naloxone on monocytes, and beta-endorphin plasma levels were investigated. Peripheral blood mononuclear cells and some monocyte parameters were determined by flow cytometry. Natural killer (NK) cell activity was studied by cytotoxicity, gamma-interferon production by a standard bioassay, monocytic phagocytosis by ingestion of Candida albicans and latex, and blastogenesis by stimulation with phytohaemaglutinin. In major depression and anxiety: 1) a marked reduction in the number of monocytes that ingested particles and expressed cytoskeletal intermediate filaments and surface structures (CR1 receptors and HLA-DR antigens); 2) a monocytosis that was not able to normalize the count of functioning monocytes; 3) an in vitro correction of the monocyte dysfunction by naloxone; 4) a decrease in NK cell number and activity; and 6) an anergy to candidin and tuberculin and a diminished lectin-induced blastogenesis were observed. Some of these immune changes correlated closely with plasma beta-endorphin abnormally high in all the cases. In conclusion, a naloxone-reversible monocyte dysfunction, associated to decreased NK activity and cell-mediated hypersensitivity, was found together with high of beta-endorphin plasma levels. In addition, results suggest that these immunological alterations may be useful in the clinical management of patients with these psychiatric diseases.

Adolescent↗
PubMed1997

Olanzapine in treatment-refractory schizophrenia: results of an open-label study. The Spanish Group for the Study of Olanzapine in Treatment-Refractory Schizophrenia.

BACKGROUND: Clozapine is currently the treatment of choice for neuroleptic-resistant schizophrenia. Olanzapine is a new antipsychotic drug that has shown efficacy against positive and negative symptoms of schizophrenia, with minimal extrapyramidal side effects. However, the effectiveness of olanzapine has not yet been reported among treatment-refractory schizophrenic patients. METHOD: A total of 25 schizophrenic patients (DSM-IV criteria) with documented lack of response to two conventional antipsychotic drugs entered this 6-week prospective, open-label treatment trial with olanzapine 15 to 25 mg/day. An optional extension up to 6 months was provided. RESULTS: As a group, the olanzapine-treated patients showed statistically significant improvement (p < .05) in both positive and negative symptoms by the end of 6 weeks of therapy. Overall, 9 of the patients (36%) met the a priori criteria for treatment-response (> or = 35% decrease in Brief Psychiatric Rating Scale [BPRS] total score, plus posttreatment Clinical Global Impression-Severity < or = 3 or BPRS total < 18). Only one patient discontinued treatment because of an adverse event during the study. Despite the relatively high dosages of olanzapine used, there were no reports of parkinsonism, akathisia, or dystonia, and no patients required anticholinergic medication. CONCLUSION: This open study suggests that olanzapine may be effective and well tolerated for a substantial number of neuroleptic-resistant schizophrenic patients. Further blinded, controlled trials are needed to confirm our results.

Adult↗
PubMed1985

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↗
PubMed1981

Selectivity of an indole-hydrazide derivative as inhibitor of mouse brain type A monoamine oxidase.

The first indole-hydrazide, 1-[2,-(3-methyl)-5-benzyloxyindolyl]carbonyl-2-isopropyl hydrazide (IH-3), that irreversibly inhibits mouse brain type A monoamine oxidase is measured by 5-hydroxytryptamine deamination. The concentration required in vitro to inhibit this isoenzyme is about 7 X 10(-8) mol/l. Other biochemical and pharmacological features of this potential antidepressant are presented.

Animals↗
PubMedDate not supplied

[Psychiatric morbidity associated to enuresis in children].

AIMS: The objective of the study was to know the clinical and epidemiological features, including associated psychiatric morbidity, of the children seeking help for enuresis in a public child and adolescent mental health unit. SUBJECTS AND METHOD: Within an exploratory, retrospective, and observational study, we reviewed the clinical charts of all the children (N= 2,315) attending the unit during a five-year period (January 1992-December 1997), collecting information on gender, age, type of enuresis, associated psychiatric morbidity, and social and family characteristics. Both the enuresis and the associated psychiatric disorders were diagnosed according to the DSM-IV criteria. RESULTS: Enuresis was the reason for admission in 230 children (9.9%), whose mean (+/- SD) age was 9.0 (+/- 2.9) years (range: 5-18). The condition of single-parent family, the perception of economic difficulties, and a poor academic achievement were not associated to any type of enuresis. A 19.5 per cent of the patients with enuresis presented a co-morbid psychiatric disorder, which was significantly associated to both male gender in subjects younger than 9 and enuresis of the type secondary or mixed. DISCUSSION: Most children with enuresis referred for psychiatric consultation do not present an associated psychiatric disorder. Our results on children with enuresis, in a clinical sample, are similar to those of previous studies conducted in the general population. This may mean that these patients are sent to child psychiatry services for reasons of traditional health delivery uses rather than for their psychopathological characteristics.

Child↗
PubMedDate not supplied

[Visuo-perceptual processing in patients with schizophrenia treated with typical or atypical antipsychotics].

OBJECTIVE: This is a pilot study exploring the possible association between a particular antipsychotic (AP) medication regime and both clinical and visuo-perceptual features. SUBJECTS AND METHOD: A series of 32 patients (25 males; mean age+/- SD = 28.1+/- 5.1 years, range 20-39) suffering from schizophrenia for at least two years (mean+/- SD duration of illness = 6.0+/- 3.6 years), and maintained on the same antipsychotic medication for at least one year, were divided into four groups according to their maintenance medication. Their assessment included the Positive and Negative Syndrome Scale (PANSS), the Rey's Complex Figure test (visual perception and memory), and Leff's BELS scale (skills of daily living). RESULTS: There were not significant differences in demographic features or daily living skills. The patients on oral classical APs scored significantly higher on the disorganization factor than those on clozapine. In general, patients on atypical APs did better on the visual perception and memory tasks, with those on fluphenazine decanoate being the poorest. In the whole series of the 32 patients, the copy time increased with age, with higher scores on the negative and the depressive factors, and with lower scores in visual memory. On multiple linear regression, only visual memory score and age remained significant. CONCLUSIONS: In spite of the small sample size, patients on atypical APs seem to be in a better condition, both in symptoms and in visuo-spatial abilities. Visual reproduction is influenced by both visual memory and age.

Activities of Daily Living↗