Association between heroin dependence and 5-HT2A receptor gene polymorphisms.

OBJECTIVE: To investigate the association between four polymorphisms of the 5-HT(2A) receptor and 5-HT transporter genes and heroin dependence. METHODS: 113 heroin- dependent patients (DSM-IV criteria) and 420 unrelated healthy controls from Asturias (Northern Spain) were genotyped using standard methods. RESULTS: There was an apparent difference in the distribution of genotypes for A-1438G polymorphisms (p = 0.024, not significant after Bonferroni correction). The 5-HT(2A) -1438A allele was significantly more common in patients than controls [0.55 and 0.45, respectively; corrected p = 0.042, OR = 1.51 (95% CI = 1.13-2.03)]. An interaction was observed between A-1438G of 5-HT(2A) and 5-HTT polymorphisms. The association between the -1438AA vs. AG/GG genotypes and heroin dependence was enhanced in the presence of 12-repeat 5-HTT VNTR and short 5-HTTLPR alleles [24.8% in heroin-dependent patients vs. 12.6% in controls; corrected p = 0.045, OR = 2.28 (95% CI = 1.36-3.82)]. CONCLUSIONS: Our findings support a contribution of the 5-HT(2A) gene to susceptibility to heroin dependence, as well as a possible synergistic effect of 5-HT(2A) and 5-HTT genes on susceptibility to heroin dependence.

La depresión en el anciano en una zona rural y su interacción con otros factores / Depression in the elderly living in a rural area and other related factors

Introducción. Se quiere determinar la prevalencia de depresión en población anciana (≥ 65 años) rural, libre de deterioro cognitivo y examinar las características que presentan los ancianos con probable depresión. Pacientes y método. Un total de 265 personas (edad media [DE]: 76,2 [6,7] años; 60,4 % mujeres) residentes en los concejos rurales de Proaza, Quirós y Santo Adriano (Asturias) fueron entrevistados. Se registraron variables sociodemográficas y clínicas y se administraron los siguientes cuestionarios: Mini-Examen Cognoscitivo (MEC), Escala de Depresión Geriátrica de Yesavage (GDS), Cuestionario Oviedo de Sueño (COS), Cuestionario de alcoholismo CAGE, Cuestionario de Salud General de Goldberg (GHQ-28) y el Instrumento de Evaluación de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF). Resultados. Se excluyeron a 23 personas por puntuar <18 puntos en el MEC. La muestra final incluye 242 sujetos (edad media [DE]: 75,59 [6,2] años; 60,3 % mujeres). Presentaban probable depresión el 23,1 % (30,1 % mujeres frente a 12,5 % hombres; p=0,002), las prevalencias más elevadas de depresión se obtuvieron en aquellos que padecían mayor número de enfermedades físicas (p = 0,012), presentaban comorbilidad psiquiátrica (p = 0,031), puntuaban menos en el MEC (p = 0,019), presentaban mayor prevalencia de problemas de sueño (p ≤ 0,050), puntuaban más en el GHQ-28 (p=0,000) y menos en el WHOQOL-BREF (p=0,000). Conclusiones. La prevalencia de depresión es moderadamente elevada, siendo más frecuente en mujeres, en los que viven solos, carecen de estudios, pertenecen al sector primario, padecen patología física o psíquica, presentan mayor deterioro cognitivo, peor salud general y tienen una peor percepción de su calidad de vida

Introduction. We want to determine the prevalence of depression in a rural population (65 years and over) free from cognitive impairment and to evaluate related factors of late life depression. Patients and method. A total of 265 persons (mean age [SD]: 76.2 [6.7] years; 60.4 % females) residing in the towns of Proaza, Quiros and Santo Adriano (Asturias) were interviewed. The evaluation included sociodemographical and clinical aspects as well as the Mini-Mental State Examination Spanish version (MMSE), the Geriatric Depression Scale (GDS), the Oviedo Sleep Questionnaire (OSQ), the CAGE Questionnaire, the Goldberg General Health Questionnaire (GHQ-28), and the World Health Organization Quality of Life Instrument (WHOQOL-BREF). Results. A total of 23 subjects out of the total sample were excluded from the study due to scoring less than 18 points on the MMSE. The final sample included 242 subjects (mean age [SD]: 75.59 (6.2) years; 60.3 % females). Prevalence of probable depression was 23.1 % [30.1 % females vs 12.5 % males; p = 0.002]. Depression was statistically associated with a higher number of physical diseases (p=0.012), higher psychiatric comorbidity (p=0.031), less cognitive impairment measured by MMSE (p=0.019), higher prevalence of sleep disorders (p ≤ 0.050), higher score in the GHQ-28 (p = 0.000), and worse quality of life evaluated by the WHOQOL-BREF (p=0.000). Conclusions. Depression is moderately prevalent in this population. Depression is more frequent in females, those living alone, without studies, working in agricultural sector, with physical or psychiatric comorbidity, with higher cognitive impairment, and with a worse health status and quality of life perception

[Depression in the elderly living in a rural area and other related factors]. / La depresión en el anciano en una zona rural y su interacción con otros factores.

INTRODUCTION: We want to determine the prevalence of depression in a rural population (65 years and over) free from cognitive impairment and to evaluate related factors of late life depression. PATIENTS AND METHOD: A total of 265 persons (mean age [SD]: 76.2 [6.7] years; 60.4 % females) residing in the towns of Proaza, Quiros and Santo Adriano (Asturias) were interviewed. The evaluation included sociodemographical and clinical aspects as well as the Mini-Mental State Examination Spanish version (MMSE), the Geriatric Depression Scale (GDS), the Oviedo Sleep Questionnaire (OSQ), the CAGE Questionnaire, the Goldberg General Health Questionnaire (GHQ-28), and the World Health Organization Quality of Life Instrument (WHOQOL-BREF). RESULTS: A total of 23 subjects out of the total sample were excluded from the study due to scoring less than 18 points on the MMSE. The final sample included 242 subjects (mean age [SD]: 75.59 (6.2) years; 60.3 % females). Prevalence of probable depression was 23.1 % [30.1 % females vs 12.5 % males; p = 0.002]. Depression was statistically associated with a higher number of physical diseases (p = 0.012), higher psychiatric comorbidity (p = 0.031), less cognitive impairment measured by MMSE (p = 0.019), higher prevalence of sleep disorders (p < or = 0.050), higher score in the GHQ-28 (p = 0.000), and worse quality of life evaluated by the WHOQOL-BREF (p = 0.000). CONCLUSIONS: Depression is moderately prevalent in this population. Depression is more frequent in females, those living alone, without studies, working in agricultural sector, with physical or psychiatric comorbidity, with higher cognitive impairment, and with a worse health status and quality of life perception.

Negative evidences in association between apolipoprotein E polymorphism and panic disorder.

The aim is to investigate the association between apolipoprotein E (ApoE) and panic disorder (PD). Genotyping 92 PD patients [Diagnostic Statistic Manual IV (DSM IV) criteria] and 174 controls no differences were found between both groups. Variation in the ApoE-gene was not associated with the development of PD.

Polimorfismos serotoninérgicos en pacientes con trastorno de angustia / Serotonin gene polymorphisms in patients with panic disorder

Introducción. El objetivo es determinar la posible asociación entre cuatro polimorfismos de genes serotoninérgicos (T102C, A-1438G, 5-HTTLPR y VNTR-5HTT) y el trastorno de angustia (TA). Pacientes y método. El estudio incluye 92 pacientes ambulatorios diagnosticados de TA (criterios DSM-IV) 174 voluntarios sanos de Asturias (grupo control). Los polimorfismos se determinaron tras la amplificación de los genes mediante reacción en cadena de la polimerasa y su posterior digestión con enzimas de restricción y electroforesis en gel de agarosa. Resultados. Ambos polimorfismos 5-HT2A (T102C y A- 1438G) se encuentran en desequilibrio de ligamiento completo en nuestra población. No se encontraron diferencias estadísticamente significativas en las frecuencias genotípicas de los polimorfismos genéticos serotoninérgicos estudiados (T102C, A-1438G, 5HTTLPR y VNTR-5HTT) entre el grupo de pacientes y el grupo control. Las frecuencias alélicas tampoco diferían entre ambos grupos. El análisis en función del sexo tampoco aportó diferencias estadísticamente significativas. Conclusiones. Los polimorfismos estudiados no se asociaron con TA en nuestra población. No obstante, son necesarios estudios con mayor número de pacientes para poder confirmar o rechazar estos hallazgos

Introduction. The objetive is to investigate the possible association between four serotonin gene polymorphisms (T102C, A-1438G, 5-HTTLPR and VNTR-5HTT) and panic disorder (PD). Patients and method. 92 PD outpatients (DSM-IV criteria) and 174 healthy volunteers from Asturias (control group) were included. Polymorphisms were determined after polymerase chain reaction amplification followed by digestion with restriction enzymes and electrophoresis on an agarose gel. Results. Both 5-HT2A polymorphisms are in complete linkage disequilibrium in our population. No statistically significant differences in genotype frequencies of serotonin gene polymorphisms (T102C, A-1438G, 5HTTLPR and VNTR-5HTT) were found between patients and control subjects. Allele frequencies did not differ between both groups. No differences were found according to gender. Conclusions. The polymorphisms studied were not associated with PD in our population. However, larger patient samples are necessary to confirm or reject these findings

Serotonin gene polymorphisms in patients with panic disorder.

INTRODUCTION: The objective is to investigate the possible association between four serotonin gene polymorphisms (T102C, A-1438G, 5-HTTLPR and VNTR-5HTT) and panic disorder (PD). PATIENTS AND METHOD: 92 PD outpatients (DSM-IV criteria) and 174 healthy volunteers from Asturias (control group) were included. Polymorphisms were determined after polymerase chain reaction amplification followed by digestion with restriction enzymes and electrophoresis on an agarose gel. RESULTS: Both 5-HT2A polymorphisms are in complete linkage disequilibrium in our population. No statistically significant differences in genotype frequencies of serotonin gene polymorphisms (T102C, A-1438G, 5HTTLPR and VNTR-5HTT) were found between patients and control subjects. Allele frequencies did not differ between both groups. No differences were found according to gender. CONCLUSIONS: The polymorphisms studied were not associated with PD in our population. However, larger patient samples are necessary to confirm or reject these findings.

Consumo de MDMA (extasis) en estudiantes de secundaria / MDMA (ecstasy) consumption in secondary school students

Objetivos: Describir la prevalencia de consumo de MDMA y el perfil toxicológico y psicológico en una muestra de estudiantes de secundaria.Sujetos y Método: Durante el curso académico 1998-99 se evaluó una muestra compuesta por 2.862 jóvenes de ambos sexos [edad media (SD): 15.87 (1.48); 50.6 por ciento hombres], estudiantes de secundaria de Oviedo (Asturias) Evaluación: Cuestionario de la OMS de consumo de alcohol y drogas, cuestionario de personalidad de Eysenck versión adultos (EPQ-A) y, la escala de búsqueda de sensaciones de Zuckerman (EBS).Resultados: Las prevalencias vida, último año y último mes, de consumo de MDMA fueron 3.8 por ciento, 2.7 por ciento y 1.6 por ciento, ocupando la MDMA la 7ª posición entre las drogas ilegales consumidas alguna vez. Los hombres mostraron mayores prevalencias de consumo, vida, último año y último mes, que las mujeres (p< .05). Comparados con los estudiantes que nunca han consumido MDMA (pero que pueden haber consumido otras drogas ilegales), los usuarios de MDMA refieren una historia más extensa de uso de drogas. La MDMA es, tras la heroína, la droga asociada a un mayor índice de policonsumo. Los jóvenes que han usado MDMA alguna vez obtuvieron puntuaciones más elevadas en la subescala de psicoticismo del EPQ-A y refirieron niveles más elevados de búsqueda de sensaciones.Conclusiones: Los consumidores de MDMA son policonsumidores de otras sustancias legales e ilegales. Aquellos que consumen MDMA tienen un perfil psicológico diferente, caracterizado por elevados niveles de búsqueda de sensaciones y psicoticismo. (AU)

Aproximacion terapeutica del uso y abuso de MDMA (extasis) / Therapeutic approach in the use-abuse of MDMA (Ecstasy)

El uso de éstasis (MDMA), una anfetamina sintética, se ha ido popularizando tanto en España como en Europa durante los últimos 10 años, siendo considerada como una sustancia "segura". A pesar de ello, en la literatura científica, se han descrito un no desdeñable número de muertes y reacciones adversas de tipo físico y psíquico relacionadas con su consumo. El tratamiento del uso-abuso de MDMA está mucho menos desarrollado que el tratamiento de otros tipos de drogas. No obstante, desde la perspectiva del uso-abuso de sustancias, la mejor aproximación terapeútica consistiría en combinar los "tres pilares del tratamiento": biológico, social y psicológico. Finalmente, se hace referencia al manejo de las reacciones adversas severas, tanto de tipo físico como de tipo psíquico (AU)