ABSTRACT
AIM: We analyzed the association between SLC6A4, DRD2, COMT and MAOA genes and suicide attempt (SA) in Mexican adolescent patients with major depressive disorder (MDD). METHODS: The sample included 197 adolescents (127 females and 70 males) with principal diagnosis of MDD. Among them, 63 patients had SA at least once and 134 had not SA. The mean age of patients with and without SA was 15 ± 1.4 and 14 ± 1.5 years, respectively. We analyzed the genotype and allele distribution between patients with and without SA of SLC6A4 (5HTTLPR/rs25531), DRD2 (rs6275), COMT (rs4680), and MAOA (uVNTR). RESULTS: We did not find genotype or allele association between SA and SLC6A4 (χ2=0.67, p = 0.71; χ2=0.07, p = 0.77, respectively), DRD2 (χ2=0.05, p = 0.97; χ2=0.003, p = 0.95), and MAOA (females: χ2=0.86, p = 0.64; χ2=0, p = 1/males: χ2=0.008, p = 0.92) genes. However, there were differences in genotype frequencies of COMT/rs4680 between patients with SA and without SA (χ2=11.17, p = 0.003). Also, we observed a high frequency of Met158 allele showing an increased risk of having presented at least one SA (χ2=10.6, p = 0.001; OR = 1.43; 95% CI, 1.17-1.74). CONCLUSIONS: Our findings showed an association between low activity genotype and allele of Val158Met polymorphism of COMT gene and SA in Mexican adolescents with MDD.
Subject(s)
Catechol O-Methyltransferase , Depressive Disorder, Major , Suicide, Attempted , Adolescent , Catechol O-Methyltransferase/genetics , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/genetics , Female , Genetic Predisposition to Disease , Genotype , Humans , Male , Monoamine Oxidase/genetics , Polymorphism, Single Nucleotide , Receptors, Dopamine D2/genetics , Serotonin Plasma Membrane Transport Proteins/geneticsABSTRACT
There is a paucity of follow-up studies of neurological, endocrine, and metabolic adverse effects of antipsychotics in adolescents from low-income and middle-income countries, who have a higher prevalence of obesity and overweight, and could present increased morbidity. A Mexican sample of 86 adolescents with schizophrenia was examined during a 6-month follow-up using the Simpson-Angus, abnormal involuntary movement and Barnes Akathisia rating scales, in addition to a side effects score sheet and other laboratory measures. Binary logistic regression models were used to identify specific variables as predictors of weight gain. Sleep difficulties, restlessness, drowsiness, changes in thyroid hormones, and a linear increase in weight gain were observed. A baseline positive and negative syndrome scale score greater than 97 predicted a 5 kg increase at month 3 (odds ratio: 4.52, 95% confidence interval: 1.5-13.2). The absence of a plateau in weight gain in the present study across the 6-month treatment period and its relationship with illness severity suggests that even longer follow-up time should be examined in future studies in these patient populations.
Subject(s)
Antipsychotic Agents/adverse effects , Schizophrenia/drug therapy , Weight Gain/drug effects , Adolescent , Antipsychotic Agents/therapeutic use , Child , Female , Humans , Logistic Models , Male , Mexico , Prospective Studies , Psychiatric Status Rating Scales , Severity of Illness Index , Sleep/drug effects , Thyroid Hormones/metabolismABSTRACT
BACKGROUND: There are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation. METHODS: K-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients. RESULTS: A total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders. CONCLUSIONS: The factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.
Subject(s)
Interview, Psychological/methods , Mental Status Schedule/standards , Mood Disorders/diagnosis , Schizophrenia/diagnosis , Adolescent , Child , Child Behavior Disorders/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Population , Reproducibility of Results , SpainABSTRACT
Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America. The Spanish version of the K-SADS-PL was modified to integrate changes made to the DSM-5. Clinicians received training in the K-SADS-PL-5 and 90% agreement between raters was obtained. A total of 80 patients were recruited in four different countries in Latin America. All items from each of the six disorders were included in a factor analysis. Parent-child agreement was calculated for every item of the six disorders, including the effect of sex and age. The factor analysis revealed 6 factors separately grouping the items defining each of the new or modified disorders, with Eigenvalues greater than 2. Very good parent-child agreements (r>0.8) were found for the large majority of the items (93%), even when considering the sex or age of the patient. This independent grouping of disorders suggests that the manner in which the disorders were included into the K-SADS-PL-5 reflects robustly the DSM-5 constructs and displayed a significant inter-informant reliability. These findings support the use of K-SADS-PL-5 as a clinical and research tool to evaluate these new or modified diagnoses.
Subject(s)
Anxiety Disorders/diagnosis , Autism Spectrum Disorder/diagnosis , Child Behavior Disorders/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Feeding and Eating Disorders/diagnosis , Mood Disorders/diagnosis , Parents , Psychiatric Status Rating Scales/standards , Self Report/standards , Adolescent , Child , Chile , Colombia , Female , Humans , Male , Mexico , Reproducibility of Results , Schizophrenia/diagnosis , UruguayABSTRACT
INTRODUCTION: In this study we evaluated a recently developed test, the Ball Search Field Task (BSFT) as a neuropsychological tool for measuring cognitive and behavioral performance of individuals with disorders such as attention-deficit/hyperactivity disorder (ADHD), which are frequently accompanied by cognitive deficits and a lack of behavioral inhibition. The task provides a complementary method of assessment that attempts ecological validity by drawing on challenges faced in real-world situations. In this task, energetic costs and gross sensorimotor feedback are involved, as participants are required to search for targets in a large open area. METHOD: We compared performance on the BSFT in a clinical sample of children and adolescents with a diagnosis of ADHD with their scores on two widely used neuropsychological tools, the Tower of London (ToLo) and the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: We found no correlations between scores on the BRIEF and those on either the BSFT or ToLo. However, we found moderate correlations between rule violations on ToLo and several BSFT variables, suggesting the capacity of these tests to detect common aspects of executive dysfunction. CONCLUSIONS: These findings, although modest, encourage further study of tasks like the BSFT, which may help assess cognitive dysfunction found in neurodevelopmental disorders such as ADHD in ecologically valid situations.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Neuropsychological Tests , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Child , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Cognition Disorders/psychology , Executive Function , Feedback, Sensory , Female , Humans , Male , Principal Component Analysis , Psychomotor PerformanceABSTRACT
Searching, defined for the purpose of the present study as the displacement of an individual to locate resources, is a fundamental behavior of all mobile organisms. In humans this behavior underlies many aspects of everyday life, involving cognitive processes such as sustained attention, memory and inhibition. We explored the performance of 36 treatment-free children diagnosed with attention-deficit hyperactivity disorder (ADHD) and 132 children from a control school sample on the ecologically based ball-search field task (BSFT), which required them to locate and collect golf balls in a large outdoor area. Children of both groups enjoyed the task and were motivated to participate in it. However, performance showed that ADHD-diagnosed subjects were significantly less efficient in their searching. We suggest that the BSFT provides a promising basis for developing more complex ecologically-derived tests that might help to better identify particular cognitive processes and impairments associated with ADHD.
Subject(s)
Attention Deficit Disorder with Hyperactivity/physiopathology , Attention/physiology , Cognitive Dysfunction/physiopathology , Memory/physiology , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Child, Preschool , Cognitive Dysfunction/diagnosis , Female , Humans , Male , Motivation/physiologyABSTRACT
OBJECTIVE: Stereotaxic lesions of the orbitofrontal-thalamic system, specifically the thalamic reticular nucleus (TRN), could be helpful to prevent perseverative behavior in rats produced by 8-OH-DPAT. METHODS: Fifty rats were conditioned in a T-maze to measure the number of perseverations. Habituation was performed on days 1 and 2, baseline scores were obtained on day 3 and the final test was done on day 4 (chemical induction). Group I only received saline solution injection; group II was only submitted to 8-OH-DPAT; group III received pharmacological treatment with chlorimipramine (CMI) before 8-OH-DPAT administration; group IV and group V were submitted to stereotaxic bilateral lesions, one week before T-maze evaluation, in the TRN and orbitofrontal cortex (OFC), respectively and received 8-OH-DPAT administration. RESULTS: No differences between groups were found at baseline on day 3 (p<0.05). Significant differences were found between days 3 and 4 of evaluation only in group II (p<0.01) and group V (p<0.001). Differences between groups on day 4 were significant (p<0.01). CONCLUSIONS: TRN lesions were as effective as CMI administration to prevent the 8-OH-DPAT action. OFC lesions failed to prevent the perseverative behavior.
Subject(s)
Frontal Lobe/physiology , Maze Learning/physiology , Memory/physiology , Thalamic Nuclei/physiology , 8-Hydroxy-2-(di-n-propylamino)tetralin/toxicity , Animals , Clomipramine/pharmacology , Frontal Lobe/drug effects , Male , Maze Learning/drug effects , Memory/drug effects , Rats , Rats, Wistar , Serotonin Receptor Agonists/toxicity , Selective Serotonin Reuptake Inhibitors/pharmacology , Thalamic Nuclei/drug effects , Time FactorsABSTRACT
La evaluación de los síntomas somáticos y el registro de los efectos colaterales es fundamental en la evaluación psicopatológica de los adolescentes, pues es común que esta población presente algunos de los síntomas somáticos que acompañan a los trastornos mentales, y que se confunden con los efectos colaterales que producen los psicofármacos. Esta investigación describe el RECA, y su objetivo fue lograr la validez de constructo en una población clínica. Se evaluaron 150 adolescentes, de los cuales se analizaron los reportes completos de 135. El análisis factorial integró tres factores que se denominaron; somático, gastrointestinal y misceláneo. El alfa de Cronbach obtuvo un valor de 0.91. Este es el primer estudio sobre síntomas somáticos y de un registro de efectos colaterales en español, útil en la evaluación clínica de los adolescentes
