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1.
J Eat Disord ; 12(1): 135, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39242598

RESUMEN

BACKGROUND: Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental factors have been proposed to explain the connection between ED, OCD, and CTE. This study explores the link between CTE and the comorbidity of ED and OCD, with the hypothesis that specific types of CTE may increase the risk of developing OCD in individuals with ED. METHODS: Participants (N = 562) were enrolled at an eating disorder unit in Montpellier, France, between March 2013 and January 2020. The Childhood Trauma Questionnaire (CTQ), Eating Disorder Examination Questionnaire (EDE-Q), and Mini International Neuropsychiatric Interview (MINI) were used to evaluate childhood maltreatment, assess clinical characteristics associated with ED, and categorize participants into two groups: patients with and without OCD. RESULTS: Bivariate analysis revealed that patients with comorbid ED and OCD had higher EDE-Q scores (p < 0.001), more anxiety disorders (p < 0.001), depressive disorders (p = 0.02), post-traumatic stress disorder (PTSD) (p < 0.001), and a higher incidence of sexual abuse (p < 0.001) and physical neglect (p = 0.04) compared to those without OCD. Multivariate analysis showed that the association between CTE and OCD was influenced by the presence of an anxiety disorder (p = 0.01) and a higher EDE-Q total score (p = 0.03), with a significant association with a history of sexual abuse (p = 0.04). CONCLUSIONS: This demonstrates that CTE increases the risk of comorbid OCD in ED patients, correlating with more clinically severe ED and a higher likelihood of anxiety disorders.


This study looked at the link between childhood trauma and the occurrence of both obsessive-compulsive disorder (OCD) and eating disorders (ED). We studied 562 participants who were being treated for eating disorders in Montpellier, France, over a seven-year period. We used various questionnaires to evaluate their childhood experiences, eating disorder symptoms, and the presence of OCD. We found that people with comorbid OCD and ED had more severe eating disorder symptoms and higher rates of anxiety, depression, and PTSD compared to those with just an eating disorder. These individuals were also more likely to have experienced sexual abuse and physical neglect during childhood. Our analysis showed that the connection between childhood trauma and OCD in patients with eating disorders was influenced by the presence of anxiety disorders and more severe eating disorder symptoms. Specifically, a history of sexual abuse was a significant factor. In summary, childhood trauma, especially sexual abuse, increases the risk of having both OCD and an eating disorder. This highlights the importance of screening for OCD and addressing past traumas in patients with eating disorders to provide better, more personalized care.

2.
Biomarkers ; 26(8): 752-759, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34664533

RESUMEN

Despite research advances, recently identified biological markers for depression are either non-specific or impractical in daily clinical practice. Hence, we aim to identify a novel biomarker: δEPCD, the electrophysiologic coefficient of depressiveness. δEPCD must be sensitive and specific to the vulnerability towards depression. It should also detect the presence of a depressive clinical state and be able to quantify its severity. Moreover, it should be easily accessible and cost-effective. Accordingly, combining high-frequency heart rate variability (HF-HRV), which reflects a reduction in vagal tone, and tryptophan metabolism, which influences serotonin synthesis pathway, may have a good diagnostic and prognostic accuracy in depression. δEPCD is the multiplication of the intrinsic difference between state 0 (rest) and state 1 (exposure to stress) of HF-HRV and the plasma concentration ratio between quinolinic acid and kynurenine. δEPCD theoretically fluctuates between -1000 and 0 where being closer to 0 signifies no vulnerability to depression. Individuals with a score between -16.7 and -167 have a high vulnerability to depression. Finally, individuals with a δEPCD closer to -1000 have the most severe forms of depression. δEPCD is theoretically conceived to be easy to assess and monitor which makes it a candidate for further evaluation of reliability and validity.CLINICAL SIGNIFICANCEDepression is currently diagnosed based on emotional and behavioural symptoms; however there is currently a rising interest in the field of neurobiological markers that could improve diagnostic accuracy.Many current biological approaches are primarily based on single neurobiological markers that are either non-specific or impractical in daily clinical practice.Among other neurological effects, depression may modify the parasympathetic nervous system tone and disturb the tryptophan metabolism.The electrophysiological coefficient of depressiveness δEPCD combines heart rate variability (HRV) and tryptophan metabolism to reflect the intrinsic individual vulnerability towards depression and the inherent severity of an index depressive disorder.δEPCD is the intrinsic difference between state 0 (without stress) and state 1 (exposed to a stressful task) of the high-frequency heart rate variability multiplied by the intrinsic difference between both states, e.g. state 0 and 1, of the plasma concentration ratio of quinolinic acid over kynurenine.


Asunto(s)
Trastorno Depresivo Mayor/sangre , Frecuencia Cardíaca/fisiología , Quinurenina/sangre , Ácido Quinolínico/sangre , Triptófano/sangre , Biomarcadores/sangre , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/fisiopatología , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estrés Fisiológico/fisiología
3.
Med Hypotheses ; 144: 110047, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32758885

RESUMEN

Atypical dysgeusia such as having the sensation of a sweet tooth is an uncommon clinical presentation in severe depression. First, we present the case of a 67 year-old-man admitted to the psychiatric ward for depression after a suicide attempt by drug ingestion. The patient manifested a sweet taste sensation in the upper and lower gums that increased with mood swings and notably with severe depressive symptoms. Blood tests showed an elevated serum creatinine level (115 µmol/L), a normocytic anemia (hemoglobin 6.5 mmol/L; MCV 96 fL) and a deficit in vitamin B12 (122.4 pmol/L). The patient received vitamin B12 supplementation and was treated with clomipramine, lithium, mirtazapine, modafinil, and olanzapine. He was discharged after improvement of his depressive symptoms and decrease in the sweet taste. On follow-up, the patient's dysgeusia had subsided. Second, we hypothesize that the atypical dysgeusia may have been induced by vitamin B12 deficiency and medical comorbidities, leading to deafferentation (development of erroneous mouth mucosae sensations felt by the patient). This could have been increased by depression. Dysgeusia in elederly patients with depression should be extensively investigated in order to elucidate somatic contributing factors but it may not resolve until improvement of the depressive symptoms.


Asunto(s)
Anemia , Disgeusia , Anciano , Depresión , Disgeusia/etiología , Humanos , Masculino , Olanzapina , Vitamina B 12
4.
J Psychiatr Pract ; 26(4): 320-323, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32692129

RESUMEN

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal syndrome classically encountered in patients receiving typical antipsychotic agents. However, many physicians have also reported the occurrence of NMS with atypical antipsychotics, notably with atypical presentations. In this report, we present a case in which a patient's antipsychotic regimen during a psychotic episode (which involved both typical and atypical antipsychotics) subsequently led to NMS. During his stay, the patient developed an altered level of consciousness, elevation of creatine phosphokinase, hemodynamic instability, and a fever. However, the patient did not have signs of rigidity, the cardinal sign of this syndrome. The authors concluded that patients could develop NMS without rigidity while receiving an antipsychotic. Given this presentation, the authors suggest that clinicians have a high level of suspicion for NMS to avoid misdiagnosis and subsequent adverse consequences. Hence, clinicians must be vigilant about atypical presentations of NMS without rigidity.


Asunto(s)
Antipsicóticos/efectos adversos , Síndrome Neuroléptico Maligno/diagnóstico , Síndrome Neuroléptico Maligno/etiología , Adulto , Antipsicóticos/uso terapéutico , Creatina Quinasa/metabolismo , Errores Diagnósticos/prevención & control , Humanos , Masculino , Síndrome Neuroléptico Maligno/tratamiento farmacológico , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/tratamiento farmacológico
5.
PLoS One ; 15(6): e0233681, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32579560

RESUMEN

BACKGROUND: There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region. OBJECTIVES: To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region. METHODS: Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis. RESULTS: 100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7).


Asunto(s)
Depresión/epidemiología , Salud Mental/etnología , Refugiados/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Adolescente , Adulto , Anciano , Cristianismo/psicología , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Pueblos Indígenas/psicología , Pueblos Indígenas/estadística & datos numéricos , Irak/epidemiología , Islamismo/psicología , Masculino , Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Refugiados/psicología , Autoinforme/estadística & datos numéricos , Trastornos por Estrés Postraumático/psicología , Adulto Joven
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