Lifetime cannabis use and cognition in patients with schizophrenia spectrum disorders and their unaffected siblings.

The relationship between cannabis and cognitive performance is controversial. While both acute administration and long-term cannabis use impair cognitive performance in healthy subjects, several studies have shown improved cognitive outcomes in patients with schizophrenia spectrum disorders who use cannabis. The aim of this study was to determine the relationship between lifetime cannabis use, as assessed longitudinally over 10 years of follow-up in a sample of 42 patients and 35 of their unaffected siblings, and current cognitive performance. Forty-two healthy control subjects were assessed at follow-up with the same instruments. Stepwise linear regression revealed a negative effect of longitudinal cannabis use on performance in a social cognition task in the patient group. In the sibling group, lifetime cannabis use had a negative effect on processing speed and declarative memory performance. In the control group, cannabis use per se did not predict cognitive performance; however, when adding lifetime tobacco use to the model, we found a negative association between lifetime cannabis and tobacco use and processing speed and social cognition performance. Moreover, a lower IQ associated with current cannabis use predicted worse attentional performance in the control group. The differential pattern of associations between cannabis use and cognitive performance in patients compared with siblings and controls can be explained by the negative impact of illness on cognition.

Characterization of spontaneous Parkinsonism in drug-naive patients with nonaffective psychotic disorders.

Spontaneous Parkinsonism (SP) in schizophrenia-related disorders is poorly characterized. The objective of this study was to examine the concordance and clinical validity of alternative definitions of SP in patients with nonaffective psychotic disorders. Two-hundred drug-naive patients with nonaffective psychotic disorders were examined for core parkinsonian signs, including bradykinesia, rigidity, and tremor, and diagnosed of SP according to the Simpson-Angus Scale (SAS) cutoff criterion, the UK Parkinson's disease brain bank (UKPDBB) criteria, the National Institute of Neurological Disorders and Stroke (NINDS) criteria, and criteria requiring the presence of all three core features (full syndrome criteria). Parkinsonian signs and criteria were examined in relation to a number of relevant clinical variables. The most frequent sign was rigidity (33.5%) followed by bradykinesia (16%) and tremor (12%). The prevalence rate of SP according to the SAS cutoff criterion, the UKPDBB criteria, the NINDS criteria for possible and probable SP, and the full syndrome criteria were 20.5, 13, 25.5, 18.5, and 4%, respectively. Bradykinesia was specifically related to negative symptoms, rigidity to neurological soft signs, and tremor to dyskinetic movements. The set of criteria showing more associations with clinical variables were the NINDS criteria for probable SP. Patients fulfilling these criteria had higher ratings for poor premorbid adjustment, negative symptoms, dyskinesia, neurological soft signs, and poor global treatment response than those without that diagnosis. The NINDS criteria for probable SP, i.e., presence of any two of the three core parkinsonian signs, seem to be the most suitable for clinical and research purposes.

[Prevalence trends of high risk of mental disorders in the Spanish adult population: 2006-2012]. / Evolución de la prevalencia de alto riesgo de trastornos mentales en población adulta española: 2006-2012.

OBJECTIVE: To evaluate the prevalence of high risk of psychiatric morbidity in the Spanish adult population and its changes between 2006 and 2012. METHODS: Data from 47,905 participants obtained from the National Health Surveys in 2006 and 2012 were used. Mental health status was assessed with the General Health Questionnaire score. Adjusted logistic regression models were fitted. RESULTS: The prevalence of high risk of psychiatric morbidity was 20.5% in 2012 and 21.3% in 2006. Using 2006 as the reference, the odds ratio (OR) for these problems in 2012 was 0.84 (0.79-0.89) in women and 1.10 (1.02-1.18) in men. In women, it decreased for all ages. In men, these ORs were 1.15 (1.04-1.27) in the aged 16-44 group, 1.23 (1.08-1.40) in the aged 45-64 group and 0.81 (0.68-0.96) in the aged ≥ 65 group. CONCLUSIONS: The prevalence of high risk of psychiatric morbidity decreased except in males <65 years of age, who are more sensitive to the economic crisis.

[Percentage of psychoemotional problems in Spanish children and adolescents. Differences between 2006 and 2012]. / Porcentaje de población infantojuvenil española con problemas psicoemocionales y sus diferencias entre 2006 y 2012.

BACKGROUND AND OBJECTIVE: To examine the percentage of psychoemotional problems in Spanish children and adolescents and the difference between 2006 and 2012. MATERIAL AND METHOD: Data from 9,761 participants were taken from the Spanish National Health Survey of 2006 and 2012. The Goodman Strengths and Difficulties Questionnaire was used to assess mental health. The percentage of participants with abnormal scores in the different scales was calculated. Chi-square test and multivariate logistic regression models adjusted for age, sex, social level and adult mental health status were used. RESULTS: In 2012, the percentage of Spanish youths with emotional, conduct, hyperactivity, peer and prosocial problems and abnormal total problem score was 8.5, 6.7, 10.2, 7.7, 0.7 and 4%, respectively. In 2006, these percentages were 11.5, 10.2, 14.7, 10.1, 0.9 and 6.7%. A significant reduction was found for the percentage of children and adolescents with problematic behavior between 2006 and 2012. CONCLUSIONS: Based on the total problem score, about 4% of Spanish youths suffer from psychoemotional problems. This percentage has decreased between 2006 and 2012.

Executive functioning in schizophrenia spectrum disorder patients and their unaffected siblings: a ten-year follow-up study.

Executive dysfunction represents a core deficit that is associated with schizophrenia spectrum disorders (SSDs). However, the longitudinal course of executive deficits in SSDs is still controversial. The aim of this study was to examine the executive performance of 34 SSD patients in relation to 34 of their unaffected siblings over a period of 10 years. Both groups completed psychopathological and executive assessments. Thirteen healthy controls were assessed using the same instruments. At baseline, the SSD patients differed significantly from siblings and controls in their performance on the Trail Making Test-B (TMT-B) and the number of categories in which they succeeded in the Wisconsin Card Sorting Test (WCST). They also differed significantly from the controls in the total number of errors in the WCST. The siblings did not differ in executive functioning from the controls over the follow-up. Longitudinally, the patients demonstrated significant improvement only for the TMT-B. However, only 14.71% of the patients showed reliable and clinically significant improvements for the TMT-B, and 8.82% made more errors on the WCST at the follow-up evaluation. Less than 3% of the patients showed either improved or worse results on the remaining measures of the WCST. A stabilisation pattern for the WCST was observed in the three groups. The patients performed worse than their siblings and controls on both executive tests. Some patients exhibited significant improvements in the TMT-B over time, but this improvement was reliable and clinically significant for less than 15% of the sample. Thus, we conclude that the patients exhibited stable impairments over time in the executive functions assessed.

Evolución de la prevalencia de alto riesgo de trastornos mentales en población adulta española: 2006-2012 / Prevalence trends of high risk of mental disorders in the Spanish adult population: 2006-2012

Objetivo: Evaluar la prevalencia de alto riesgo de morbilidad psiquiátrica en población adulta española y su cambio entre 2006 y 2012. Métodos: Se incluyeron 47.905 participantes de las Encuestas Nacionales de Salud de 2006 y 2012. El estado de salud mental se calculó con la puntuación del Cuestionario de salud general. Se calcularon regresiones logísticas ajustadas. Resultados: La prevalencia de alto riesgo de morbilidad psiquiátrica fue del 20,5% en 2012 y del 21,3% en 2006. Usando 2006 como referencia, la odds ratio (OR) de estos problemas en 2012 fue de 0,84 (0,79-0,89) en las mujeres y de 1,10 (1,02-1,18) en los varones. En las mujeres descendió en todas las edades. En los varones, las OR fueron de 1,15 (1,04-1,27), 1,23 (1,08-1,40) y 0,81 (0,68-0,96), para los grupos de edad de 16-44, 45-64 y ≥65 años, respectivamente. Conclusiones: La prevalencia de alto riesgo de morbilidad psiquiátrica disminuyó, salvo en los varones <65 años, que son más vulnerables a la crisis económica (AU)

Objective: To evaluate the prevalence of high risk of psychiatric morbidity in the Spanish adult population and its changes between 2006 and 2012. Methods: Data from 47,905 participants obtained from the National Health Surveys in 2006 and 2012 were used. Mental health status was assessed with the General Health Questionnaire score. Adjusted logistic regression models were fitted. Results: The prevalence of high risk of psychiatric morbidity was 20.5% in 2012 and 21.3% in 2006. Using 2006 as the reference, the odds ratio (OR) for these problems in 2012 was 0.84 (0.79-0.89) in women and 1.10 (1.02-1.18) in men. In women, it decreased for all ages. In men, these ORs were 1.15 (1.04-1.27) in the aged 16-44 group, 1.23 (1.08-1.40) in the aged 45-64 group and 0.81 (0.68-0.96) in the aged ≥ 65 group. Conclusions: The prevalence of high risk of psychiatric morbidity decreased except in males < 65 years of age, who are more sensitive to the economic crisis (AU)

Influence of genetic variability at the COMT gene on TMT-B performance in psychotic patients and their healthy siblings.

The Val158Met catechol-O-methyl transferase functional polymorphism has been repeatedly associated to differences in performing the Wisconsin Card Sorting Test in both, patients with schizophrenia and healthy individuals. However, this association has not been consistently replicated for the Trail Making Test part-B (TMT-B). In a sample of 89 patients suffering from a functional psychotic disorder and their healthy siblings we aim (i) to explore if there is any difference completing the TMT-B between both groups and among the different psychotic categories, and (ii) to investigate the association between the catechol-O-methyl transferase genotype and the TMT-B performance. Psychotic patients executed the TMT-B worse than the siblings group (P≤0.006). The patients (P=0.001) and the siblings (P=0.006) with the Val/Val genotype used more time to execute the test than those who carried the Met allele.

Demanda asistencial en atención primaria y especializada según la salud mental de población adulta española / Demand for primary and secondary healthcare services according to mental health in the Spanish adult population

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Controversies surrounding the diagnosis of schizophrenia and other psychoses.

The diagnosis of schizophrenia and other psychotic disorders in current psychiatric classifications identifies individuals who are severely ill but who have few clinical characteristics in common. The usual picture of psychotic patients is a mixture of mood and psychotic symptoms. Fortunately, clinicians do not base their therapeutic strategies exclusively on diagnosis, but also on symptom predominance. Thus, clinicians' treatments have been dimensional in nature for years, although, until recently, their psychiatric classifications had been mainly categorical. The main principle in psychosis classification has been the Kraepelinian dichotomy, despite its lack of enduring empirical validation. Without doubt, current psychiatric classifications have made great strides in reliability and clinical utility, although these advantages have not been enough to compensate for their shortcomings concerning validity. It has recently been suggested that the Kraepelinian dichotomy may be hindering progress in neurobiological research within psychosis. Mounting evidence is now fuelling a paradigm shift in the ongoing process of review of psychiatric classifications toward the introduction of complementary dimensional indicators of psychiatric categorical diagnoses. This new approach will allow us to understand psychosis as prototypical extremes of a severity continuum. The gradients of this continuum may begin with subtle expressions in the general population, continue with milder forms in relatives of psychotic patients and subclinical cases and finally reach the prototypical forms of psychosis at the other extreme. Future complementary dimensional indicators will require sound instruments capable of reflecting a multidimensional assessment of psychopathological symptoms, polydiagnostic interviews and the assessment of a wide range of nonsymptomatic domains. These new methods of assessment merging created by the shift toward a dimensional paradigm will be applied in the forthcoming new diagnostic criteria and may allow for a phenome-wide scanning for psychosis.

Porcentaje de población infantojuvenil española con problemas psicoemocionales y sus diferencias entre 2006 y 2012 / Percentage of psychoemotional problems in Spanish children and adolescents. Differences between 2006 and 2012

Fundamento y objetivo: Evaluar el porcentaje de problemas psicoemocionales en niños y adolescentes españoles y su diferencia entre 2006 y 2012. Material y método: Se obtuvieron datos de 9.761 participantes en la Encuesta Nacional de Salud de 2006 y de 2012. Se utilizó el Cuestionario de Fortalezas y Dificultades de Goodman para evaluar la salud mental. Se calculó el porcentaje de participantes con puntuaciones anormales en las diferentes escalas. Se realizaron test de la ji-cuadrado y regresiones logísticas multivariantes para ajustar por edad, sexo, clase social y estado de salud mental del adulto. Resultados: En 2012, el porcentaje de menores con problemas emocionales, conductuales, de hiperactividad, en las relaciones con iguales, la conducta prosocial y en la puntuación total de dificultades fue, respectivamente, del 8,5, 6,7, 10,2, 7,7, 0,7 y 4%. En 2006 dichos porcentajes fueron del 11,5, 10,2, 14,7, 10,1, 0,9 y 6,7%. Se observó una disminución significativa del porcentaje de menores con conductas problemáticas entre 2006 y 2012. Conclusiones: Según la puntuación total de dificultades, alrededor del 4% de la población infantojuvenil española presenta problemas psicoemocionales. Dicho porcentaje ha disminuido de 2006 a 2012 (AU)

Background and objective: To examine the percentage of psychoemotional problems in Spanish children and adolescents and the difference between 2006 and 2012. Material and method: Data from 9,761 participants were taken from the Spanish National Health Survey of 2006 and 2012. The Goodman Strengths and Difficulties Questionnaire was used to assess mental health. The percentage of participants with abnormal scores in the different scales was calculated. Chi-square test and multivariate logistic regression models adjusted for age, sex, social level and adult mental health status were used. Results: In 2012, the percentage of Spanish youths with emotional, conduct, hyperactivity, peer and prosocial problems and abnormal total problem score was 8.5, 6.7, 10.2, 7.7, 0.7 and 4%, respectively. In 2006, these percentages were 11.5, 10.2, 14.7, 10.1, 0.9 and 6.7%. A significant reduction was found for the percentage of children and adolescents with problematic behavior between 2006 and 2012. Conclusions: Based on the total problem score, about 4% of Spanish youths suffer from psychoemotional problems. This percentage has decreased between 2006 and 2012 (AU)

Riesgo de problemas de salud mental en España y distribución por regiones / Risk of mental health problems in Spain and regional distribution

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