Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children: a multicenter study protocol.

Background: More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods: A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion: This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].

Conservation of Green and White Ash Germplasm Using the Cryopreservation of Embryogenic Cultures.

Green ash (Fraxinus pennsylvanica) and white ash (F. americana) populations are currently experiencing major declines across their native ranges in North America due to infestation by the exotic insect pest emerald ash borer (Agrilus planipennis). The development of a reliable method for the long-term storage of green and white ash germplasm in the form of embryogenic cultures using cryopreservation would be a considerable aid to ash conservation efforts. We compared recovery percentages of cryopreserved green and white ash embryogenic cultures using vitrification versus slow cooling methods. Three Plant Vitrification Solution 2 (PVS2) exposure durations (40, 60, and 80 min) for vitrification and three DMSO concentrations (5%, 10%, and 15%) for slow cooling were tested for their effects on the percentage of cultures that regrew following cryostorage. Vitrification resulted in a higher overall culture recovery percentage (91%) compared to cultures that were cryostored using the slow cooling approach (39%), and a more rapid initiation of regrowth (5 days versus 2-3 weeks) resulted. Recovery from cryostorage by cultures using the slow cooling approach varied significantly (p < 0.05) between experiments and with genotype (p < 0.05). The recovery of vitrified tissue from cryostorage did not vary with genotype, species, or PVS2 exposure duration (p > 0.05). The vitrification cryopreservation protocol provides a reliable and versatile alternative to the traditional slow cooling method, strengthening our ability to preserve valuable ash germplasm for conservation and restoration.

BDNF and Cognitive Function in Chilean Schizophrenic Patients.

Despite cognitive symptoms being very important in schizophrenia, not every schizophrenic patient has a significant cognitive deficit. The molecular mechanisms underlying the different degrees of cognitive functioning in schizophrenic patients are not sufficiently understood. We studied the relation between brain-derived neurotrophic factor (BDNF) and cognitive functioning in two groups of schizophrenic patients with different cognitive statuses. According to the Montreal Cognitive Assessment (MoCA) results, the schizophrenic patients were classified into two subgroups: normal cognition (26 or more) and cognitive deficit (25 or less). We measured their plasma BDNF levels using ELISAs. The statistical analyses were performed using Spearman's Rho and Kruskal-Wallis tests. We found a statistically significant positive correlation between the plasma BDNF levels and MoCA score (p = 0.04) in the subgroup of schizophrenic patients with a cognitive deficit (n = 29). However, this correlation was not observed in the patients with normal cognition (n = 11) and was not observed in the total patient group (n = 40). These results support a significant role for BDNF in the cognitive functioning of schizophrenics with some degree of cognitive deficit, but suggest that BDNF may not be crucial in patients with a normal cognitive status. These findings provide information about the molecular basis underlying cognitive deficits in this illness.

Disasters collide at the intersection of extreme weather and infectious diseases.

Natural disasters interact to affect the resilience and prosperity of communities and disproportionately affect low income families and communities of colour. However, due to lack of a common theoretical framework, these are rarely quantified. Observing severe weather events (e.g. hurricanes and tornadoes) and epidemics (e.g. COVID-19) unfolding in southeastern US communities led us to conjecture that interactions among catastrophic disturbances might be much more considerable than previously recognized. For instance, hurricane evacuations increase human aggregation, a factor that affects the transmission of acute infections like SARS-CoV-2. Similarly, weather damage to health infrastructure can reduce a community's ability to provide services to people who are ill. As globalization and human population and movement continue to increase and weather events are becoming more intense, such complex interactions are expected to magnify and significantly impact environmental and human health.

Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects.

BACKGROUND: Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS: We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS: Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS: Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.

Beyond the Categorical Distinction Between Borderline Personality Disorder and Bipolar II Disorder Through the Identification of Personality Traits Profiles.

BACKGROUND: The relationship between borderline personality disorder (BPD) and type-II bipolar disorder (BDII) is not clearly understood. Nevertheless, in clinical practice and research, most efforts focus on establishing a categorical distinction between the two. We propose using personality traits as a more informative strategy to describe them. METHODS: Five-Factor Model personality traits were measured in 73 individuals with either BPD or BDII. Latent class cluster analysis was applied to the sample. RESULTS: A three-cluster model resulted the best fit to the data, where all clusters had high neuroticism and low extraversion scores but differed widely on the other traits. The clusters' boundaries did not match the categorical diagnosis. CONCLUSIONS: Our sample showed significant heterogeneity on personality traits, which can have a relevant effect on the outcome of each disorder and that was not captured by the categorical diagnosis. Thus, we advocate for a multivariate approach as a better way to understand the relationship between BPD and BDII.

SERT and BDNF polymorphisms interplay on neuroticism in borderline personality disorder.

OBJECTIVE: Genetic factors underlying different personality traits are not entirely understood, particularly how genes interact to modulate their effect. We studied 76 patients diagnosed with borderline personality disorder (BPD), characterized by extreme levels of personality traits, especially neuroticism (N), in which we genotyped two polymorphisms, the 5HTTLPR of the Serotonin transporter (SERT) gene, and the Val66Met of the Brain-derived neurotrophic factor (BDNF) gene. RESULTS: We found an association with SERT, where S-allele carriers had significantly higher levels of N than L-homozygous. Furthermore, we found that the protective effect of L-homozygosity is only evident on A-allele carriers of the BDNF Val66Met polymorphism. Genetic constitution in SERT and BDNF seems to be important in neuroticism, the most relevant personality trait on BPD.

Estudio exploratorio-descriptivo acerca de las relaciones entre trastornos depresivos y características de personalidad / Explorative-descriptive study of the relationschip between depressive disorders and personality traits

Objetivo. Evaluar y relacionar variables referidas a trastornos depresivos y variables de personalidad. Método. Se administraron el Inventario de Depresión de Beck (BDI), la forma abreviada del Examen Internacional de los trastornos de Personalidad (IPDE) y el Test de Rorschach a una muestra de 37 pacientes adultos de ambos géneros, con diagnóstico de depresión (CIE 10), pertenecientes al Programa de Detección, diagnóstico y Tratamiento de la Depresión, que consultaron en el Servicio de Psiquiatría de Complejo Hospitalario San Borja Arriarán (HSBA) durante el año 2004. Resultados. Los puntajes obtenidos a través del BDI indicaron que la mayor parte de la muestra se ubicó en los rangos de depresión moderada y grave (32,4 y 40,5 por ciento respectivamente) los datos arrojados por el IPDE señalaron que los rasgos de personalidad menos presentes en la muestra son: Antisocial (24,3 por ciento) e Histriónico (48,6 por ciento). Al relacionar los resultados del test IPDE y BDI se encontró una correlación significativamente poisitiva entre los rasgos de personalidad dependiente y las puntuaciones elevadas de depresión. Los resultados del test de Rorschach mostraron una baja incidencia respecto a indicadores de depresividad, así como predominio de indicadores de rasgos dependientes y pasivos de la personalidad. Conclusiones. La prueba de Rorschach arrojó resultados discrepantes con el BDI respecto a la presencia de depresividad en la medida en que el test de Roschach refleja una baja en los indicadores que corroboraran la manifestación de índices de depresión. Por lo tanto, este estudio nos llevaría a condiderar la incidencia de variables de personalidad en el proceso diagnóstico, cuestión que adquiere relevancia en la medida que la muestra presentó indicadores elevados de dependencia y pasividad.

Estudio comparativo de la prueba de Rey-Osterrieth en trastorno límite versus controles sanos / Comparative study of the Rey-Osterrieth test in bordeline personality disorders versus healthy controls

Objetivo. Comparar los resultados de la prueba de Rey-Osterrieth en pacientes con trastorno límite de personalidad versus controles sanos. Método. Se administró la prueba de Rey-Osterrieth a 23 pacientes con trastorno límite de personalidad de acuerdo al International Personality Disorder Examination (IPDE), sin patología del Eje I del DSM IV y que no recibían fármacos. El grupo control estaba constituido por 23 sujetos sanos, comparables en género, edad y nivel educacional. Resultados. Los pacientes con trastorno límite tuvieron puntajes menores en las fases. Estas diferencias no alcanzaron significación estadística. Conclusiones. No se encontraron diferencias significativas en la prueba de Rey-Osterrieth entre los pacientes con trastorno límite de personalidad y los controles sanos, aunque los resultados fueron peores en los pacientes con trastorno límite. Este resultado difiere de otras publicaciones en las que se encuentran rendimientos significativamente menores en los sujetos con trastorno límite. Estas diferencias pueden deberse al tipo de pacientes estudiados que, a diferencia de otros trabajos eran más leves, no tenían patologías comórbidas y no recibían fármacos.

Prueba Torre de Londres-Drexel en trastorno límite de personalidad: resultados preliminares / Tower of London-Drexel task in borderline personality disorder: preliminary report

La Torre de Londres-Drexel(TDL-DX) es una prueba neuropsicológica destinada a evaluar funciones ejecutivas. Anormalidades en esta prueba pueden reflejar daño o disfunción frontal. Objetivo evaluar funciones ejecutivas en pacientes con trastorno límite de personalidad mediante la prueba TDL-DX, Método 14 pacientes (4 hombres y 10 mujeres) con trastorno límite de personalidad de acuerdo al International Personality Disorder Examination (IPDE), sin patología del eje 1 del DSM IV y que no recibían fármacos, fueron evaluados con la prueba TDL-DX. Resultados Los pacientes con trastorno límite de personalidad estudiados cometieron más errores y ejecutaron un mayor número de movimientos que lo normal en la prueba TDL-DX. Conclusiones. Los resultados sugieren que existen alteraciones de las funciones ejecutivas en el grupo de pacientes con trastorno límite de personalidad estudiados, las que se asocian a disfunción del lóbulo frontal.

Efecto diferencial de fluoxetina en psicopatología de personalidad límite / Differential effect of fluoxetine on psychopathology of borderline personality disorders

Introducción. Tanto la depresión como la impulsividad han sido asociadas a disfunciones del sistema serotoninérgico y ambas responden al tratamiento con inhibidores selectivos de la recaptura de serotonina. En este trabajo se estudia el efecto diferencial de fluoxetina sobre la impulsividad y los síntomas depresivos en pacientes con trastorno límite de personalidad. Sujetos y método. A 38 pacientes con trastorno límite de personalidad y sin patología del Eje I, se les administró fluoxetina en dosis flexibles por siete semanas. Fueron evaluados semanalmente mediante BPRS, GAF, escala de depresión de Hamilton y una escala de impulsividad. Se estudió la variación temporal del puntaje de estas escalas en dos grupos de pacientes: uno con elevada impulsividad y otro con baja impulsividad. Resultados. Hubo una mejoría de la sintomatología global y de los síntomas depresivos y la impulsividad en el grupo total de pacientes. En el grupo de sujetos más impulsivo hubo una mayor reducción de la impulsividad en las dos primeras semanas de tratamiento. En cambio, en los pacientes menos impulsivos hubo una mayor reducción de los síntomas depresivos a partir de la tercera semana de tratamiento. Ambas diferencias fueron estadísticamente significativas. Conclusiones. La fluoxetina tuvo un efecto diferencial sobre los síntomas depresivos y la impulsividad en los pacientes con trastorno límite de personalidad estudiados. Estos resultados concuerdan con los de otros autores y sugieren que los ISRS actúan por diferentes mecanismos neurobiológicos en ambos tipos de síntomas.

Estudio de personalidad en una población clínica mediante el International Personality Disorder Examination (IPDE) / Personality assessment of a clinical population with the International Personality Disorder Examination (IPDE)

El empleo de instrumentos de diagnóstico confiables para los trastornos de personalidad es un área de activa investigación. En este trabajo se presentan los resultados de la aplicación del International Personality Disorder Examination (IPDE) a una población clínica de pacientes ambulatorios. Sujetos y Métodos: 48 pacientes (41 mujeres y 7 hombres) participantes en un estudio clínico en curso en la Clínica Psiquiátrica Universitaria, sin patología psiquiátrica del Eje 1 del DSM-IV según el structural Clinical Interview for DSM-IV (SCID), fueron evaluados mediante el IPDE. Resultados: el diagnóstico más frecuente fue trastorno límite de personalidad, que se formuló en el 24,5 por ciento de los pacientes. El promedio de diagnósticos por paciente fue 2,12 oscilando entre 1 y 7. Conclusiones: la mayor prevalencia del trastorno límite en este estudio concuerda con lo encontrado por otros autores en poblaciones clínicas y establecimientos de salud mental. En cambio, en estudios efectuados en la comunidad, son más prevalentes otros trastornos de personalidad.

Programa de transtornos de personalidad de la clínica psiquiátrica universitaria: un enfoque multidisciplinario / Personality disorder program at a university psychiatric clinic: a multidisciplinary approach

Se comunica la creación y puesta en marcha de una unidad destinada al estudio y tratamiento de kos transtornos de personalidad en la Clínica Psiquiátrica de la Universidad de Chile. Un equipo profesional, multidisciplinario, compuesto por psiquiatras, psicólogos, terapeutas ocupacional y enfermera, desarrolla una labor asistencial, docente y de la investigación en el campo de los transtornos de personalidad. Se describe la forma de funcionamiento y las dificultades y desafíos que ha enfrentado en sus tres años de funcionamiento. Se propone un enfoque multidisciplinario, que integra terapéuticas y psicosociales en el tratamiento de los pacientes con transtornos de personalidad