Global brain asymmetry is increased in schizophrenia and related to avolition.

OBJECTIVE: Schizophrenia may be the result of a failure of the normal lateralization process of the brain. However, whole-brain asymmetry has not been assessed up to date. Here, we propose a novel measure of global brain asymmetry based on the Dice coefficient to quantify similarity between brain hemispheres. METHOD: Global gray and white matter asymmetry was calculated from high-resolution T1 structural images acquired from 24 patients with schizophrenia and 26 healthy controls, age- and sex-matched. Some of the analyses were replicated in a much larger sample (n = 759) obtained from open-access online databases. RESULTS: Patients with schizophrenia had more global gray matter asymmetry than controls. Additionally, increased gray matter asymmetry was associated with avolition, whereas the inverse relationship was found for anxiety at a trend level. These analyses were replicated in a larger sample and confirmed previous results. CONCLUSION: Our findings suggest that global gray matter asymmetry is related to the concept of developmental stability and is a useful indicator of perturbations during neurodevelopment.

The relationship between wearable-derived sleep features and relapse in Major Depressive Disorder.

BACKGROUND: Changes in sleep and circadian function are leading candidate markers for the detection of relapse in Major Depressive Disorder (MDD). Consumer-grade wearable devices may enable remote and real-time examination of dynamic changes in sleep. Fitbit data from individuals with recurrent MDD were used to describe the longitudinal effects of sleep duration, quality, and regularity on subsequent depression relapse and severity. METHODS: Data were collected as part of a longitudinal observational mobile Health (mHealth) cohort study in people with recurrent MDD. Participants wore a Fitbit device and completed regular outcome assessments via email for a median follow-up of 541 days. We used multivariable regression models to test the effects of sleep features on depression outcomes. We considered respondents with at least one assessment of relapse (n = 218) or at least one assessment of depression severity (n = 393). RESULTS: Increased intra-individual variability in total sleep time, greater sleep fragmentation, lower sleep efficiency, and more variable sleep midpoints were associated with worse depression outcomes. Adjusted Population Attributable Fractions suggested that an intervention to increase sleep consistency in adults with MDD could reduce the population risk for depression relapse by up to 22 %. LIMITATIONS: Limitations include a potentially underpowered primary outcome due to the smaller number of relapses identified than expected. CONCLUSION: Our study demonstrates a role for consumer-grade activity trackers in estimating relapse risk and depression severity in people with recurrent MDD. Variability in sleep duration and midpoint may be useful targets for stratified interventions.

Predictors of engagement with remote sensing technologies for symptom measurement in Major Depressive Disorder.

BACKGROUND: Remote sensing for the measurement and management of long-term conditions such as Major Depressive Disorder (MDD) is becoming more prevalent. User-engagement is essential to yield any benefits. We tested three hypotheses examining associations between clinical characteristics, perceptions of remote sensing, and objective user engagement metrics. METHODS: The Remote Assessment of Disease and Relapse - Major Depressive Disorder (RADAR-MDD) study is a multicentre longitudinal observational cohort study in people with recurrent MDD. Participants wore a FitBit and completed app-based assessments every two weeks for a median of 18 months. Multivariable random effects regression models pooling data across timepoints were used to examine associations between variables. RESULTS: A total of 547 participants (87.8% of the total sample) were included in the current analysis. Higher levels of anxiety were associated with lower levels of perceived technology ease of use; increased functional disability was associated with small differences in perceptions of technology usefulness and usability. Participants who reported higher system ease of use, usefulness, and acceptability subsequently completed more app-based questionnaires and tended to wear their FitBit activity tracker for longer. All effect sizes were small and unlikely to be of practical significance. LIMITATIONS: Symptoms of depression, anxiety, functional disability, and perceptions of system usability are measured at the same time. These therefore represent cross-sectional associations rather than predictions of future perceptions. CONCLUSIONS: These findings suggest that perceived usability and actual use of remote measurement technologies in people with MDD are robust across differences in severity of depression, anxiety, and functional impairment.

[Two cases of acute pulmonary edema secondary to laryngospasm]. / Dos casos de edema agudo de pulmón secundario a laringospasmo.

We report two cases of acute pulmonary edema attributable to episodes of postextubation laryngospasm appearing when two young patients awoke after appendectomies under general anesthesia. Both patients improved in less than 48 hours with diuretics, oxygen therapy and liquid restriction, making tracheal intubation unnecessary. The pathophysiology and clinical and radiological signs of pulmonary edema are reviewed.

[Alert! We are responsible for the health of our spine]. / Alerta! Somos responsables de la salud de nuestra espalda.

The author stresses the importance of keeping our spine in good shape, both for our physical welfare as for our socio-economic. To this end, this article starts off with a study of the spine and an analysis of the basic principles of body mechanics. Next, the author points out exercise as the fundamental therapeutic factor for alleviating back pain. She describes some of the most common exercises recommended to alleviate back pain as well as a few practical suggestions for daily activities. If followed, one will be on one's way to a correct posture which will better the health of one's spine.

Fomentando la resiliencia en las familias con enfermedad mental parental: los talleres Kidstime / Encouraging resilience in families with parental mental illness: KidsTime workshops / Fomentant la resiliència en famìlies amb malaltia mental parental: els tallers Kidstime

Tener un progenitor con enfermedad mental aumenta el riesgo de presentar problemas sociales y de conducta en la infancia y de salud mental en la adolescencia. A menudo estos niños y niñas presentan estrés asociado con el hecho de tener que asumir el rol de cuidador de sus padres. Es frecuente que estas familias no pidan ayuda por temor, culpa o estigma ante la enfermedad mental. En el presente artículo describimos un programa de intervención multifamiliar Kidstime que busca desarrollar y fomentar actitudes resilientes en toda la familia, especialmente en los hijos e hijas de padres y madres que sufren un trastorno mental grave, con el objetivo de prevenir posibles trastornos entre la población infantil de este grupo de rie Resultados de la psicoterapia psicoanalítica infanto-juvenil focal en una unidad de tratamientos especializados en la red pública de salud mental

Having a parent with mental illness increases the risk for social and behavioral problems in childhood and adolescent mental health. Often these children have stress associated with having to assume the role of caregiver of their parents. Often these families don’t ask for due to fear, guilt and the stigma against mental illness. In this article we describe a Kidstime multifamily intervention program that tries to develop and promote resilient attitudes in the family, especially with the children of parents who suffer from a serious mental disorder, in order to avoid possible disorders among children in this at-risk group (AU)

Fomentant la resiliència en famílies amb malaltia mental parental: els tallers Kidstime. Tenir un progenitor amb malaltia mental augmenta el risc de presentar problemes socials i de conducta a la infància i de salut mental a l’adolescència. Sovint, aquests nens i nenes presenten estrès associat pel fet d’haver d’assumir el rol de cuidador dels seus pares. És freqüent que aquestes famílies no demanin ajuda per temor, culpa o estigma davant la malaltia mental. En el present article descrivim un programa d’intervenció multifamiliar Kidstime que busca desenvolupar i fomentar actituds resilients en tota la família, especialment en els fills i filles de pares i mares que pateixen un trastorn mental greu, amb l’objectiu de prevenir possibles trastorns entre la població infantil d’aquest grup de risc