Neuropsychological profile of a patient with multiple sclerosis and psychiatric symptoms that masked and delayed the diagnosis. A case report using teleneuropsychology.

Objective: Multiple sclerosis (MS) may include not only severe neurological signs and symptoms, but also cognitive and psychiatric disturbances. When psychiatric symptoms precede or are comorbid with MS, it poses a clinical challenge, because it may lead to a mistaken diagnosis of MS as a psychiatric disorder, delaying proper treatment. We describe the neuropsychological profile of a female patient with MS whose diagnosis was delayed due to neuropsychiatric symptoms. Method: A comprehensive analysis of the medical history and the results of a teleneuropsychological assessment of a 36-year-old Mexican woman with a diagnosis of relapsing--remitting MS (RRMS) was performed. Results: The patient indicates a long history of psychotic, anxious, and depressive features years before the first neurological symptom that led to MS going unnoticed for several years. Language, attentional, perceptual, motor, and learning skills were found to be preserved. Short-term memory and spatial orientation problems were identified, with decreased processing speed and executive dysfunction, including working memory and planning deficits. Conclusions: The patient has a non-typical presentation of neuropsychological alterations with cognitive and behavioral symptoms that resemble dorsolateral frontal lobe syndrome. This case study highlights the importance of considering MS in differential diagnosis of patients with psychiatric symptoms, even in the absence of obvious neurological signs.

Health-Related Quality of Life in Mexican Children and Adolescents with Non-Syndromic Craniosynostosis.

OBJECTIVE: Assess the Health-Related Quality of Life in children and adolescents with non-syndromic craniosynostosis and compare it with participants without craniosynostosis. DESIGN: Non-experimental, cross-sectional design. SETTING: The assessment was done remotely and the instrument was sent via chat or email. PATIENTS/PARTICIPANTS: Participants (ages 8-17) with non-syndromic craniosynostosis (n = 27) and without craniosynostosis (n = 26). MAIN OUTCOME MEASURE(S): We used an adapted version for the Mexican population of the Health-Related Quality of Life Questionnaire for Children and Adolescents -KIDSCREEN-52. RESULTS: All scores were in the average clinical range and both groups scored similarly in all domains except those with craniosynostosis were significantly lower in the Social Support and Peers domain (rpb = 0.48). CONCLUSIONS: Children and adolescents with non-syndromic craniosynostosis reported similar Health-Related Quality of Life as the control group, except for the Social Support domain, which should be investigated in future studies.

Exploratory study of the prevalence of food addiction and its relationship with executive functioning, depression, and reinforcement sensitivity in a sample of Mexican adults.

Introduction: The study of food addiction (FA) has become relevant due to its high prevalence, the negative impact on quality of life, and its association with neuropsychological and psychiatric symptoms. Several studies have provided scientific support for these associations, however, the results are contradictory. Additionally, studies have unsuccessfully elucidated the true nature of the failures in executive functioning in people with FA symptomatology, particularly when it comes to executive deficits. Therefore, the purpose of this research was to establish whether the presence of executive dysfunction, depressive symptoms and binge eating problems, as well as high reward sensitivity entails a greater severity in FA traits and high body mass index (BMI) in a sample of Mexican adults. Methods: The sample consisted of Mexican men and women between 21-59 years (n = 36); who completed self-report questionnaires and performance tests to measure the study variables. Additionally, BMI was estimated with self-reported height and weight. Results: Our results showed that a high number of FA symptoms were associated with higher executive dysfunction scores, greater reward sensitivity, and more severe depressive and binge eating problems. Furthermore, factors that are more strongly associated with higher scores of FA include severe executive deficits, greater activation of the punishment avoidance system, and persistence in the search for reward when the depressive symptoms increased. The factors that best explained changes in the estimated BMI of women were a decreased crystallized intellectual capacity and the inability to control food intake as the number of FA symptoms increased. Discussion: In summary, the cognitive functioning profile characterized by general failure of the executive functioning, as well as a greater activation of the Punishment Avoidance System and persistence in the search for reward, were associated with greater severity of FA symptoms, especially when the depressive symptomatology was severe. In parallel, the psychopathology in participants associated with FA confirms the contribution of anxious and depressive symptomatology and borderline personality traits which could facilitate the expression of clinically relevant FA symptoms in women. Finally, we found that decreased crystallized intellectual capacity and inability to control food intake were linked to higher BMI when the number of FA symptoms increased.

Regulación Emocional En Pacientes Con Esquizofrenia: Un Estudio Piloto / Emotion Regulation In Schizophrenia Patients: A Pilot Study

RESUMEN Antecedentes: Se ha reportado que los pacientes con esquizofrenia presentan alteraciones en el procesamiento emocional, específicamente en la percepción de emociones. Sin embargo, poco se sabe sobre otros aspectos de este proceso, como la regulación emocional. Objetivo: Evaluar y comparar la regulación emocional y neurocognición en pacientes con esquizofrenia y sujetos control, así como identificar correlaciones entre regulación emocional, neurocognición y datos demográficos. Método: Se evaluaron nueve pacientes (GE) y nueve controles (GC). Se obtuvieron datos demográficos, para evaluar regulación emocional se utilizó la Prueba de Inteligencia Emocional Mayer-Salovey Caruso, sección Manejo de Emociones y se realizó una breve evaluación neurocognitiva. Resultados: El GE tuvo un desempeño significativamente inferior que el GC en la prueba de regulación emocional y en neurocognición (p<.05). No se encontraron correlaciones entre regulación emocional, neurocognición, datos demográficos y clínicos. Discusión y conclusión: Los pacientes con esquizofrenia presentan menor capacidad de regulación emocional y alteraciones en la neurocognición. Estos resultados son consistentes con lo descrito en la literatura.

ABSTRACT Background: It has been reported that schizophrenia patients display emotional processing impairments, specifically in the emotion perception domain. However, less is known about other domains of emotional processing, like emotion regulation. Objective: The aim of this study was to assess and compare emotion regulation abilities and neurocognition in schizophrenia patients and healthy controls, as well as to identify correlations between emotion regulation, neurocognition and demographic data. Methods: 9 patients (GE) and 9 controls (GC) were recruited. Demographic data was obtained. To assess emotion regulation, the Mayer-Salovey-Caruso Emotional Intelligence Test -Managing Emotions section- was administered. Finally, a brief neurocognitive assessment was conducted. Results: The GE showed significant poorer performance than the GC in the emotion regulation test as well as in the neurocognitive assessment (p < .05). No correlations were identified between emotion regulation, neurocognition, demographic and clinical data. Discussion and conclusion: Schizophrenia patients show emotion regulation impairment, as well as neurocognitive deficits. Our results are consistent with other studies.

Funcionamiento cognoscitivo en la diabetes tipo 2: una revisión / Cognitive function in type 2 diabetes: a review

The aim of this work is to offer an updated review of the major cognitive difficulties that appear in Type 2 Diabetes Mellitus (T2DM), and its association with the patient compliance related factors proposed by the Panamerican Health Organization (PAHO), such as characteristics of patient, of the disease and of treatment. The review included electronic databases search (PubMed, Psy-cINFO and SpringerLink) from January 2000 to December 2011, predominating research from the United States, Canada, Holland, UK, Japan, Mexico and Germany. Most of the reviewed articles identified that factors which have shown to be associated with cognitive functioning in T2DM include: glycemic fluctuations, disease duration and pharmacological treatment. As for the changes that occur in the Central Nervous System (CNS), to date there is no consensus as to whether these are purely degenerative, vascular or a combination of both. Most affected cognitive abilities are: verbal memory, working memory, verbal fluency, attention, mental planning and psychomotor speed. The latter have been related with frontal, temporal and hyppo-campal structure functioning, which are also compromised on T2DM. In the cognitive aspect, it is reported that T2DM is a risk factor for developing mild cognitive impairment. Also, chronicity of this condition associated with hypertension, inadequate glycemic control, and macrovascular complications increases the odds for vascular dementia to occur. It is concluded that even though some risk factors of the cognitive deficiencies have been identified on T2DM, it is important to determine how they interact, and to what degree they affect overall cognitive performance, and specific functions in this population.

El objetivo de este trabajo es ofrecer una revisión actualizada de las principales dificultades cognoscitivas que se presentan en la Diabetes mellitus tipo 2 (DM2) y su asociación con factores relacionados con la adherencia terapéutica propuestos por la Organización Panamericana de la Salud para las enfermedades crónicas como: las características del paciente, de la enfermedad y del tratamiento. La revisión se basó en una búsqueda en las bases de datos PubMed, PsycINFO y SpringerLink. Se abarcó el periodo de enero de 2000 hasta diciembre de 2011, y predominaron las investigaciones procedentes de los Estados Unidos de América, Canadá, Holanda, Inglaterra, el Japón, México y Alemania. En la mayoría de los estudios consultados se identificó que las fluctuaciones glicémicas, la duración de la enfermedad y el tipo de tratamiento farmacológico son los factores que más se han asociado con el funcionamiento cognoscitivo en la DM2. En cuanto a los cambios que se producen en el Sistema Nervioso Central (SNC), hasta la fecha no hay consenso en cuanto a si estos son exclusivamente degenerativos, vasculares o si son una combinación entre ambos. En el aspecto cognoscitivo, se ha reportado que la DM2 es un factor de riesgo para desarrollar deterioro cognoscitivo leve y que la cronicidad de esta condición, asociada a hipertensión, a un control glicémico inadecuado y a complicaciones macrovasculares aumenta la posibilidad de desarrollar demencia vascular. Las habilidades cognoscitivas más referidas como afectadas son memoria verbal y de trabajo, fluidez verbal, atención, planificación mental y velocidad psicomotora, las cuales se han relacionado con el funcionamiento de estructuras frontales, temporales e hipocámpicas, que en la DM2 también se encuentran comprometidas. Se concluye que a pesar de que se han identificado algunos factores de riesgo de las deficiencias cognoscitivas en la DM2, es importante que se determine cómo interactúan y en qué grado influyen estos factores en el rendimiento cognoscitivo global y en funciones específicas en esta población.