Assessment of cognitive impairment and depressive signs in patients with type 2 diabetes treated with metformin from Southeast Mexico: A cross-sectional study.

Multiple factors associate diabetes with cognitive impairment and depression. Antidiabetic drugs have reported antidepressant and pro-cognitive effects in diabetic and non-diabetic subjects. Antidepressant and pro-cognitive effects of metformin are reported in various studies; however, these effects are not consistent among researches. We designed a cross-sectional study. We recruited patients with T2D diagnosis from the Diabetes Clinic of the Regional Hospital of High Specialty "Dr. Gustavo A. Rovirosa Pérez" from January 2019 to May 2022. We included 431 subjects with T2D, 374 patients with metformin treatment and 57 subjects without metformin. These patients were on intensive therapies and had not a previous diagnosis of cognitive impairment or depression. We applied Mini-Mental State Examination (MMSE) to evaluate cognitive impairment, and Hamilton Depression Rating Scale (HAM-D) to assess depressive signs. Our sample had a mean age of 53.77 ± 13.43 years. Metformin users were 374 individuals, and 57 subjects didn't use metformin. MMSE found cognitive impairment in 8.3% (n = 31) of metformin users, and 14.8% (n = 8) of patients without metformin. HAM-D scale showed that 39.5% (n = 147) of patients with metformin had depression signs, subjects without metformin and depressive signs were 44.6% (n = 25). We found no differences between groups for cognitive impairment and depression grades. We did not find associations between metformin treatment, cognitive impairment measures and depression sign measures. However, chronic metformin treatment, insulin use, glycemic control and age could influence our results.

Exploring the association between BDNF Val66Met polymorphism and suicidal behavior: Meta-analysis and systematic review.

Suicide is a serious worldwide health problem of critical consequences. Nowadays genetic factors are considered to be an important cause of suicide. The association between Val66Met (rs6265) polymorphism of the BDNF gene and suicide behavior has been increasingly studied. The aim of this study was to perform a meta-analysis in order to unravel the possible association between BDNF gene Val66Met polymorphism and suicide behavior. These meta-analysis and systematic review were performed using 23 articles that searched for a genetic association between Val66Met and suicide behavior, including 4532 cases and 5364 control subjects. The association was analyzed following the models: allelic, homozygous, heterozygous, dominant and recessive. Also, analyses by ethnicity (Caucasian and Asian populations) were done following the same four models. When the overall population was evaluated, we found no evidence of association between the polymorphism Val66Met of BDNF (rs6265) and suicide behavior (Met vs. Val: OR: 1.01; 95% CI = 0.92-1.10). However, a significant increased risk was found in the subgroup analysis by ethnicity in Caucasian populations (Met-Met vs. Met-Val + Val-Val: OR: 1.96; 95% CI = 1.58-2.43) and Asian populations (Val-Val vs. Val-Met + Met: OR: 1.36; 95% CI = 1.04-1.78). Our results suggest there is no association between the BDNF gene Val66Met (rs6265) and suicide behavior in the overall population. However, ethnic differences can be observed and the BDNF Val66Met might increase the risk for suicide behavior in Asian and Caucasian populations. Further studies with larger samples are necessary in order to have conclusive outcomes.

Assessing the reliability, predictive and construct validity of historical, clinical and risk management-20 (HCR-20) in Mexican psychiatric inpatients.

INTRODUCTION: Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20). OBJECTIVE: To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population. METHOD: In total, 225 patients diagnosed with psychotic, affective or personality disorders were included. The HCR-20 was applied at hospital admission and violent behaviours were assessed during psychiatric hospitalization using the Overt Aggression Scale (OAS). Construct validity, predictive validity and internal consistency were determined. RESULTS: Violent behaviour remains more severe in patients classified in the high-risk group during hospitalization. Fifteen items displayed adequate communalities in the original designated domains of the HCR-20 and internal consistency of the instruments was high. CONCLUSION: The HCR-20 is a suitable instrument for predicting violence risk in Mexican psychiatric inpatients.

Evaluación psicológica de la agresividad impulsiva/predeterminada y factores asociados: Un estudio transversal en usuarios de los servicios de salud en Tabasco, México / Psychological evaluation of impulsive/premeditated aggression and associated factors: a cross-sectional study in users of health services in Tabasco, Mexico

Resumen: INTRODUCCIÓN: La conducta suicida es un problema de salud pública. Se sugiere que la personalidad impulsiva o predeterminada participa en los actos de agresividad como el suicidio. OBJETIVO: En este estudio se identificaron diferencias sociodemográficas, de intento de suicidio y la presencia de depresión entre individuos con característica de agresividad impulsiva o predeterminada. MÉTODOS: Se realizó un estudio de tipo transversal que incluyó a 200 residentes de Villahermosa, Tab., México, usuarios de los servicios de salud en ese Estado. La agresividad predeterminada o impulsiva se caracterizó usando la Escala de Agresión Impulsiva/Predeterminada (IPAS). Las características sociodemográficas, de intento de suicidio y de depresión fueron divididas de acuerdo al tipo de agresividad. Subsecuentemente fueron comparadas las características entre los dos grupos. RESULTADOS: Los resultados psicológicos revelaron que la agresividad impulsiva está presente en 62.71 % de la población. Estar desempleado y ser mujer fueron asociadas con la agresividad predeterminada. De igual forma, la mayor proporción de personas con depresión se observó en el grupo de personas predeterminadas (x2 = 18.29, gl = 1, p = 0.001). La proporción de personas con por lo menos un intento de suicidio a lo largo de la vida es similar en las impulsivas y las predeterminadas (6.06% y 6.30%, respectivamente). DISCUSIÓN Y CONCLUSIÓN: El presente estudio no muestra relación entre la personalidad y la proporción del intento de suicidio en los usuarios de los servicios de salud en Tabasco. Sin embargo, el estado de ánimo podría estar asociado con la toma de decisiones.

Abstract: INTRODUCTION: Suicidal behaviour is a public health problem. It has been suggested that impulsive or premeditated personality interferes with aggressive acts such as suicide. OBJECTIVE: In this study, we identified the socio-demographic differences when attempting suicide, as well as the concomitant depression among individuals characterized by impulsive or premeditated aggression. METHODS: We performed a transversal study that included 200 residents of Villahermosa, Tabasco, Mexico, who regularly use the city's General Health Services. The premeditated or impulsive aggression was evaluated using the Impulsive/Premeditated Aggression scale (IPAS). The sample was divided in two groups: impulsive and premeditator individuals. Suicidal attempt, presence of depression and socio-demographic characteristics were evaluated after wards and compared between groups. RESULTS: The psychological evaluation revealed that impulsive aggression is present in 62.71% of the population. We observed that being unemployed and/or being a woman were characteristics associated with premeditated aggression. The premeditators group had the higher proportion of concomitant depression (x2 = 18.29, gl = 1, p = 0.001). The proportion of people that had attempted suicide at least once during their lives was similar in both groups (impulsive = 6.06%, premeditators = 6.30%). DISCUSSION AND CONCLUSION: This study does not show any association between the personality (impulsive or premeditative) and the frequency of suicide attempts in the Tabascan General Health Services users. Nevertheless, the frame of mind (depression) could be associated with taking decisions when attempting suicide.

Differences Between Patients that Made an Impulsive or Premeditated Suicide Attempt in a Mexican Population.

OBJECTIVE: We performed a study to identify differences between patients with impulsive suicide attempt and those with premeditated suicide attempt in a Mexican population. METHOD: We studied 144 patients who recently attempted suicide. Impulsive and premeditated suicide attempts were evaluated with the Suicide Intent Scale. These data were divided according to the type of attempt. Subsequently, the characteristics between the two groups were compared. RESULTS: The rate of patients that made an impulsive attempt was 61.8% and only 9.7% of the patients carried out a premeditated suicide attempt. More years of schooling/education and less severity of the attempt were observed in patients that carried out an impulsive suicide attempt (p < 0.001). Alcohol consumption (0.003) and use of cannabis (0.002) were present in patients who premeditated a suicide attempt. CONCLUSIONS: Our findings demonstrate that there are clinical differences among the individuals who carried out an impulsive suicide attempt from those who premeditated an attempt in a Mexican population. As a result, when planning interventions and prevention efforts it may be helpful to consider these clinical differences and demographic characteristics.