RESUMEN
BACKGROUND: It has been claimed that the quality of a diet is associated with the incidence of depressive disorders. We sought to investigate the evidence for this claim. METHODS: Systematic searches were performed up to March 6th, 2017 in order to identify prospective cohort studies that reported on exposure to dietary patterns or food groups and the incidence of depression/depressive symptoms. Data from 24 independent cohorts (totalling 1,959,217 person-years) were pooled in random-effects meta-analyses. RESULTS: Adherence to a high-quality diet, regardless of type (i.e., healthy/prudent or Mediterranean), was associated with a lower risk of depressive symptoms over time (odds ratios ranged 0.64-0.78 in a linear dose-response fashion [P < 0.01]). A relatively low dietary inflammatory index was also associated with a somewhat lower incidence of depressive symptom (odds ratio = 0.81), although not in a dose-response fashion. Similar associations were found for the consumption of fish and vegetables (odds ratios 0.86 and 0.82 respectively) but not for other high quality food groups (e.g., fruit). Studies that controlled for depression severity at baseline or that used a formal diagnosis as outcome did not yield statistically significant findings. Adherence to low quality diets and food groups was not associated with higher depression incidence. LIMITATIONS: Our ability to detect confounders was only limited. CONCLUSION: There is evidence that a higher quality of a diet is associated with a lower risk for the onset of depressive symptoms, but not all available results are consistent with the hypothesis that diet influences depression risk. Prospective studies that control for relevant confounders such as obesity incidence and randomized controlled prevention trials are needed to increase the validity of findings in this field.
Asunto(s)
Trastorno Depresivo/epidemiología , Dieta , Fenómenos Fisiológicos de la Nutrición , Femenino , Humanos , Masculino , Estudios ProspectivosRESUMEN
BACKGROUND: The health-related quality of life in stroke patients (HRQOLISP-40, short version) survey was developed in Nigeria and constitutes a 40-item, multidimensional, self-administrated questionnaire. We assessed the validity and reliability of the HRQOLISP-40 Spanish version for stroke patients in Colombia. METHODS: The analysis included factor analysis, confirmatory factor analysis, Rasch analysis, convergent validity, internal consistency (261 stroke patients), test-retest reliability (73 patients assessed at two different times) and sensitivity to change (46 patients assessed before and after a rehabilitation intervention). RESULTS: We found an 8-domain structure. None of the items had a significant impact on the global alpha value in order to be removed. Lin's concordance correlation coefficient indicated test-retest reliability (Rho IC: 0.76 to 0.95), suggesting an adequate stability of the instrument. Regarding sensitivity to change differences, they were only significant in the psychological and eco-social domains (p <0.05). When comparing SF-36 with HRQOLISP-40, all the correlation coefficients values were significantly different from zero, except those related to vitality. The highest scores were found in the physical and physical functioning domains, with a value of 0.722. CONCLUSIONS: The HRQOLISP-40 scale is valid and reliable for assessing patients' quality of life after a stroke. Validating quality of life assessment instruments is necessary in order to improve the effectiveness of rehabilitation programs for Colombian stroke patients.
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Psicometría/instrumentación , Calidad de Vida/psicología , Accidente Cerebrovascular/psicología , Encuestas y Cuestionarios/normas , Adulto , Anciano , Anciano de 80 o más Años , Colombia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación Neurológica , Reproducibilidad de los ResultadosRESUMEN
UNLABELLED: Context processing deficits have been shown to be present in chronic and first episode schizophrenia patients and in their relatives. This cognitive process is linked to frontal functioning and is highly dependent on dopamine levels in the prefrontal cortex (PFC). The catechol-O-methyltransferase (COMT) enzyme plays a prominent role in regulating dopamine levels in PFC. Genotypic variations in the functional polymorphism Val(158)Met COMT appear to have an impact in dopamine signaling in the PFC of healthy subjects and schizophrenia patients. We aimed to explore the effect of the Val(158)Met COMT polymorphism on brain activation during the performance of a context processing task in healthy subjects, schizophrenia spectrum patients and their healthy relatives. METHODS: 56 participants performed the Dot Probe Expectancy task (DPX) during the fMRI session. Subjects were genotyped and only the Val and Met homozygotes participated in the study. RESULTS: Schizophrenia spectrum patients and their relatives showed worse performance on context processing measures than healthy control subjects. The Val allele was associated with more context processing errors in healthy controls and in relatives compared to patients. There was a greater recruitment of frontal areas (supplementary motor area/cingulate gyrus) during context processing in patients relative to healthy controls. Met homozygotes subjects activated more frontal areas than Val homozygotes subjects. CONCLUSIONS: The Val(158)Met COMT polymorphism influences context processing and on its underlying brain activation, showing less recruitment of frontal areas in the subjects with the genotype associated to lower dopamine availability in PFC.
Asunto(s)
Catecol O-Metiltransferasa/genética , Familia , Polimorfismo de Nucleótido Simple/genética , Corteza Prefrontal/diagnóstico por imagen , Esquizofrenia/genética , Adulto , Anciano , Análisis de Varianza , Señales (Psicología) , Femenino , Genotipo , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Metionina/genética , Persona de Mediana Edad , Estimulación Luminosa , Tiempo de Reacción/genética , Esquizofrenia/diagnóstico por imagen , Aprendizaje Seriado , Valina/genética , Adulto JovenRESUMEN
Antecedentes. La medición de calidad de vida en pacientes con accidente cerebrovascular es importante, ya que puede orientar el manejo de los procesos de rehabilitación. En Colombia no existen instrumentos de medición de calidad de vida validados para pacientes con este tipo de afección. Objetivo. Realizar la adaptación transcultural de la escala Health-Related Quality of Life In Stroke Patients HRQOLISP-40 para su uso en Colombia. Materiales y métodos. Se siguieron las recomendaciones metodológicas del grupo de calidad de vida EORTC: traducción inicial, traducción inversa y estudio piloto. Resultados. Las traducciones directas fueron similares en 24/40 ítems; en 12 ítems hubo variaciones en redacción sin cambio de palabras; en las instrucciones, una opción de respuesta y en 4 ítems se requirió escoger la mejor opción de traducción de una palabra. Las traducciones inversas fueron similares entre sí y a la versión original de la escala. Por otra parte, en la prueba piloto se observó cierta dificultad de comprensión en 3 ítems, se adoptaron las sugerencias del autor respecto a las inquietudes de los pacientes, no hubo dificultades por molestia ni se sugirió un nuevo parafraseo. Conclusión. Al terminar esta fase se cuenta con la versión en español (de Colombia) de la escala HRQOLISP-40 para ser sometida a una validación previa a su uso en la evaluación de calidad de vida en pacientes con accidente cerebrovascular.
Background. The measurement of quality of life in patients with stroke is important because it can guide the management of rehabilitation processes. In Colombia there are no instruments for measuring quality of life in stroke patients. The objective was to perform the cross-cultural adaptation of Health-Related Quality of Life In Stroke Patients HRQLISP-40 scale for use in Colombia. Objective. To make a transcultural adaptation to the Health-Related Quality of Life In Stroke Patients HRQOLISP-40 scale in order to use it in Colombia. Materials and Methods. The methodological recommendations by EORTC quality of life group were taken: initial translation, back translation and pilot study. Results. Direct translations were similar in 24/40 items; in 12 items there were variations in writing without changing the words; in the instructions, an option of choices and 4 items were required to choose the best translation of a word. The reverse translations were similar to each other and with the original version of the scale; in the pilot test there were difficulty in comprehension understanding 3 items and were adopted the author's suggestions concerns the patients, there was no trouble or non-comfortableness nor any paraphrase were suggested. Conclusion. To finish this phase it is the Colombian Spanish version of HRQLISP-40 scale to be submitted for validation prior to use in assessing quality of life in stroke patients.
RESUMEN
Cognitive impairment in schizophrenia is a core feature and seems to be related mainly to dopaminergic dysfunction in the prefrontal cortex (PFC). The functional polymorphism Val158Met of the COMT (catechol-O-methyltransferase) gene could mediate the relationship between cognition and dopamine activity in PFC. The present study tested the influence of this polymorphism on the cognitive performance of schizophrenia spectrum patients and their relatives, using some subtests of the neuropsychological battery, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and evaluated the impact of this polymorphism on a specific prefrontal cognitive function using a cognitive neuroscience paradigm. A Group of 74 schizophrenia spectrum disorder patients, 48 relatives and 67 controls performed some subtests of the MATRICS Consensus Cognitive Battery. In addition, 40 schizophrenia spectrum disorder patients, 26 relatives and 63 controls performed the Dot Pattern Expectancy Task (DPX) to study context processing. For the neuropsychological battery, no differences in any of the cognitive domains were found according to genotype. The DPX task was sensitive to genotype effects in patients as well as in relatives. Context processing deficits in schizophrenia patients and their relatives may be mediated by COMT genotype. The influence of the COMT genotype on cognition is more relevant in specific cognitive tasks related to prefrontal function. These results should be replicated in larger samples.