SENTIA: a systematic online monitoring registry for children and adolescents treated with antipsychotics.

INTRODUCTION: Despite drastic increases in antipsychotic prescribing in youth, data are still limited regarding their safety in this vulnerable population, necessitating additional tools for capturing long-term, real world data. METHODS: We present SENTIA (SafEty of NeurolepTics in Infancy and Adolescence; https://SENTIA.es), an online registry created in 2010 to track antipsychotic adverse effects in Spanish youth <18 years old currently taking or initiating with any antipsychotic treatment. SENTIA collects information on sociodemographic, diagnostic and treatment characteristics, past personal medical/psychiatric history, healthy lifestyle habits and treatment adherence. Additionally, efficacy and adverse effect data are recorded including the Children's Global Assessment Scale; Clinical Global Impressions scale for Severity and Improvement, the Safety Monitoring Uniform Report Form, Simpson-Angus Scale, Abnormal Involuntary Movement Scale, vital signs, blood pressure, and EKG. Finally, fasting blood is drawn for hematology, electrolytes, renal, liver and thyroid function, glucose, insulin, lipid, prolactin and sex hormone levels. Initially, a diagnostic interview and several psychopathology scales were also included. Patients are assessed regularly and followed even beyond stopping antipsychotics. RESULTS: Since 01/17/2011, 85 youth (11.5 ± 2.9 (range = 4-17) years old, 70.6% male) have been included at one inaugural center. After a mean duration of 17 ± 11 (range = 1-34) months, 78.8% are still actively followed. For feasibility reasons, the diagnostic interview and detailed psychopathology scales were dropped. The remaining data can be entered in <30 minutes. Several additional centers are currently being added to SENTIA. CONCLUSIONS: Implementation of a systematic online pharmacovigilance system for antipsychotic adverse effects in youth is feasible and promises to generate important information.

Are major repeater patients addicted to suicidal behavior?

The literature provides support for the hypothesis that some major repeaters (individuals with >=5 lifetime suicide attempts) are addicted to suicidal behavior (SB). This study explores whether major repeaters are addicted to SB or not using 7 criteria: tolerance (Criterion 1), withdrawal (Criterion 2), loss of control (Criterion 3), problems in quitting/cutting down (Criterion 4), much time spent using (Criterion 5), substantial reduction in activities (Criterion 6), and adverse physiological/physical consequences (Criterion 7). Total dependence on SB was indicated by the presence of 3 or more of the 7 criteria in the last 12 months. This cross-sectional study at Puerta de Hierro University Hospital (Madrid, Spain) recruited 118 suicide attempters including 8 major repeaters (7%, 8/118), who were all females. The association between each SB addiction criterion, physiological dependence and total dependence with major repeater status was tested for significance and for effect size with odds ratios (ORs) and their 95% confidence intervals. As hypothesized, major repeaters met significantly higher frequency of criteria for total dependence on SB, OR=62.9 (6.4-615). A backward stepwise logistic regression model was used to provide an OR between major repeater status and total dependence status corrected by confounding variables. Age, panic disorder without agoraphobia, borderline personality disorder, history of psychiatric inpatient admission, and total dependence on SB were introduced as independent variables with major repeater status as the dependent variable. The model selected total dependence and age as the remaining significant variables in the last step. Accordingly, major repeaters appear to be addicted to SB.

Are major repeater patients addicted to suicidal behavior? / ¿Están los grandes repetidores adictos a los comportamientos suicidas?

The literature provides support for the hypothesis that some major repeaters (individuals with ≥5 lifetime suicide attempts) are addicted to suicidal behavior (SB). This study explores whether major repeaters are addicted to SB or not using 7 criteria: tolerance (Criterion 1), withdrawal (Criterion 2), loss of control (Criterion 3), problems in quitting/cutting down (Criterion 4), much time spent using (Criterion 5), substantial reduction in activities (Criterion 6), and adverse physiological/physical consequences (Criterion 7). Total dependence on SB was indicated by the presence of 3 or more of the 7 criteria in the last 12 months. This cross-sectional study at Puerta de Hierro University Hospital (Madrid, Spain) recruited 118 suicide attempters including 8 major repeaters (7%, 8/118), who were all females. The association between each SB addiction criterion, physiological dependence and total dependence with major repeater status was tested for significance and for effect size with odds ratios (ORs) and their 95% confidence intervals. As hypothesized, major repeaters met significantly higher frequency of criteria for total dependence on SB, OR=62.9 (6.4-615). A backward stepwise logistic regression model was used to provide an OR between major repeater status and total dependence status corrected by confounding variables. Age, panic disorder without agoraphobia, borderline personality disorder, history of psychiatric inpatient admission, and total dependence on SB were introduced as independent variables with major repeater status as the dependent variable. The model selected total dependence and age as the remaining significant variables in the last step. Accordingly, major repeaters appear to be addicted to SB

La escasa literatura existente sugiere que los «grandes repetidores» (individuos con 5 intentos de suicidio a lo largo de la vida) pueden ser considerados «adictos» a los comportamientos suicidas. Este estudio explora si los grandes repetidores sufren una adicción a los comportamientos suicidas usando 7 criterios: tolerancia (Criterio 1), abstinencia (Criterio 2), pérdida de control (Criterio 3), problemas para dejar de tener o disminuir esos comportamientos (Criterio 4), uso de tiempo excesivo (Criterio 5), reducción importante de actividades (Criterio 6), y consecuencias físicas adversas (Criterio 7). La dependencia total a los comportamientos suicidas era diagnosticada si el sujeto cumplía 3 o más de los 7 criterios en los últimos 12 meses. Se trata de un estudio transversal realizado íntegramente en el Hospital Universitario Puerta de Hierro (Madrid, Spain) , donde fueron reclutados 118 individuos que se presentaron en los servicios de urgencia por un intento de suicidio, incluyendo 8 grandes repetidores (7%, 8/118), siendo todos ellos mujeres. Se estimó si había asociaciones estadísticamente significativas y el tamaño del efecto con la razón de oportunidades y los intervalos de confianza (95%)entre cada uno de los criterios de adicción a los comportamientos suicidas, la dependencia fisiológica, y la dependencia total. Nuestra hipótesis se verificó, ya que los grandes repetidores presentaron con mayor frecuencia criterios para la dependencia a las conductas suicidas, OR=62.9 (6.4-615). Usamos un modelo de regresión logística para estamiar el riesgo de la asociación entre ser un gran repetidor y la dependencia total corregido por diferentes variables. La edad, el trastorno de pánico sin agorafobia, el trastorno de personalidad límite, la historia de ingresos previos en unidad de hospitalización psiquiátrica, y la dependencia total a los comportamientos suicidas fueron introducidos como variables independientes y la categoría de grandes repetidores como variable dependiente. El modelo final seleccionó la dependencia total y la edad como las variables estadísticamente significativas en el último paso. En conclusión, nuestro estudio sugiere que los grandes repetidores podrían ser individuos adictos a los comportamientos suicidas

Síndrome confusional tras interrupción brusca de consumo de nicotina / delirium after interruption of nicotine consumption

No disponible