A Snapshot of Female Representation in Twelve Academic Psychiatry Institutions Around the World.

The study presented here aims at bringing a global perspective to the phenomenon of unequal representation of females in science by offering empirical data of female representation in neuroscience/schizophrenia academic or clinical departments in several institutions around the world. We took advantage of a budding network of scientists and colleagues from different countries to bring the data together. The data presented are related to sex, that is the biological distinction between males and females, based on genetics and reproductive anatomy, while gender, considered a cultural concept was harder to determine. We report data from two clinical/academic departments in Nigeria, Africa; 2 clinical/academic departments from Sudan, Africa; 1 clinical/academic department from South Africa, Africa; 3 academic institutions from Ireland, Europe; 1 clinical/academic institution from Spain, Europe; 2 academic institutions from Buenos Aires University, Argentina; and the Psychiatry Departments at Harvard Medical School, Boston, USA.

The history of multiple adverse childhood experiences in patients with schizophrenia is associated with more severe symptomatology and suicidal behavior with gender-specific characteristics.

The current study aims to compare the prevalence of adverse childhood experiences (ACEs) between patients with schizophrenia and non-psychiatric control group, and to analyze the association of having suffered multiple ACEs with clinical symptoms of schizophrenia and suicidal behavior. A multicenter, cross-sectional study was conducted across three facilities in Buenos Aires, Argentina. One-hundred patients with schizophrenia and 50 healthy subjects were assessed with the Adverse Childhood Experiences questionnaire (ACE-Q), the Positive and Negative Syndrome Scale (PANSS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). We observed that the prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the non-psychiatric control group. Multiple ACEs were associated with persistent auditory hallucinations and lower negative symptoms in both sexes. Higher frequency of death ideation and a higher number of suicide attempts were reported among women. The strength of this study is the possibility of comparing the presence of ACEs between schizophrenic patients and non-psychiatric control using the same questionnaire in an under-reported sample of low socio-economic patients assisted in public hospitals. A limitation is that the history of ACEs relied on the retrospective assessment of childhood experiences, and adults could over-report ACEs because of recall bias.

[Psychological effects during the COVID-19 outbreak in Argentina]. / Efectos psicológicos de la pandemia COVID-19 en la población general de Argentina.

Introduction: After the World Health Organization (WHO) declared the COVID-19 outbreak, global measures were implemented with the aim of containing its progression. On March 20, 2020, the mandatory preventive quarantine began in Argentina. As a result of these events, previous studies conducted in the framework of this pandemic in China, have shown psychological consequences. Methods: The aim of this study is to explore, through a self-administered electronic survey, attitudes and fears regarding COVID-19, the development of depressive symptoms and the pattern of alcohol consumption among the argentinian population during quarantine (n = 759). Results: As a result, we observed that fear of COVID-19 was greater in 55 to 59 years old people, with an abrupt drop above 70; that depressed mood and the increased of alcohol consumption were more frequent in youngest subjects, and that depressed mood was also frequent among subjects who lost their jobs during quarantine. Finally, we observed an elevated degree of agreement with the quarantine measure, even in some people who suffered a decrease in their income greater than 80% during quarantine. These results are useful for obtaining information about risk groups, enabling specific preventive and therapeutic strategies could be designed.

Introducción: Luego de que la Organización Mundial de la Salud (OMS) declarara la pandemia por el nuevo coronavirus (COVID-19), se implementaron medidas a nivel mundial con el objetivo de contener su progresión. El 20 de marzo de 2020 se inició el confinamiento preventivo obligatorio en Argentina. Estudios realizados en el marco de esta pandemia en China, han evidenciado consecuencias psicológicas como resultado del temor al contagio y de las medidas de aislamiento. Método: El objetivo del presente estudio es explorar a través de una encuesta autoadministrada por vía electrónica, actitudes y temores frente al COVID-19, la presencia de sintomatología depresiva y el patrón de consumo de alcohol de la población argentina durante el confinamiento (n = 759). Resultados: Como resultado, observamos que el temor al COVID-19 fue mayor en las personas de entre 55 y 59 años, con un descenso abrupto en los mayores de 70; que el ánimo depresivo y el incremento en el consumo de alcohol fueron más frecuentes en los más jóvenes y que el estado de ánimo depresivo mostró una frecuencia mayor en quienes perdieron el empleo durante el confinamiento. Finalmente, observamos que el grado de acuerdo de los participantes con la medida de confinamiento fue superior al 90% incluso en aquellas personas que sufrieron una disminución de sus ingresos mayor al 80% durante la cuarentena. Los resultados de este estudio brindan información sobre grupos de riesgo para el desarrollo de síntomas psicopatológicos. Estos resultados constituyen una base necesaria para el diseño de estrategias preventivas y terapéuticas focalizadas.

Prevalence and clinical impact of childhood adversities in women with schizophrenia.

Patients with schizophrenia have higher rates of adverse childhood experiences (ACEs) than the general population, and those who suffered multiple traumatic experiences have a higher prevalence of positive symptoms, poorer social functioning and more suicidal ideations and behavior. The current study aims to determine the prevalence of ACEs in a female patient sample with schizophrenia. An observational descriptive cross-sectional study was conducted. Participants included 50 female patients older than 18 years, with schizophrenia. Semi-structured interviews and the Adverse Childhood Experiences Questionnaire were conducted. We observed that 90% experienced at least one ACE. Most (52%) suffered 4 or more ACEs. A high prevalence of emotional abuse and neglect was found and a significant relationship between patients who suffered multiple ACEs and the presence of suicidal behavior and persistent auditory hallucinations.

Adverse Childhood Experiences among Men with Schizophrenia.

Individuals who suffered traumatic events or adverse experiences during their childhood have an increased risk of developing during adulthood physical problems, aggressive behavior, and psychiatric disorders, such as schizophrenia. Patients diagnosed with schizophrenia have higher rates of traumatic experiences during childhood than the general population, and those who suffered multiple traumatic events have an increased risk of disease relapse. The current study aims to determine the prevalence of different types of adverse experiences during childhood among a male patient sample with schizophrenia. An Observational descriptive cross-sectional study was conducted at Jose T. Borda Hospital, in Buenos Aires, Argentina. Participants included 51 male patients between the ages of 18 and 63 years with a diagnosis of schizophrenia. Semi-structured interviews were conducted, applying a socio-demographic questionnaire, SCID I and II scales to assess psychiatric diagnosis, and the Adverse Childhood Experiences (ACE) Questionnaire to evaluate the presence of adverse childhood experiences. Statistical analyses were conducted using SPSS 22 software. We observed that 94% of participants had experienced at least one adverse childhood experience. Most (63%) suffered from 4 or more disruptive child events. A high prevalence of family history of mental illness was found, also emotional abuse and neglect. Most traumatic events occurred within the family group. It was found a moderately significant relationship between patients who suffered adverse events and the presence of auditory hallucinations.

Clozapine Rechallenge After Neutropenia or Leucopenia.

To rechallenge with clozapine for a patient who previously has experienced neutropenia or leucopenia or during clozapine treatment is a difficult clinical decision. Herein, we analyzed the results of such a rechallenge in 19 patients. We analyzed all the reports, from the database of the pharmacovigilance department of the Argentine National Administration of Drugs, Foods, and Medical Devices, of patients who were rechallenged with clozapine after a leucopenia or a neutropenia. Nineteen cases of rechallenge after leucopenia or neutropenia were reported between 1996 and 2014. One third of the patients re-exposed to clozapine developed a new hematologic adverse reaction. The second blood dyscrasia was less severe in 83% of the cases and had a shorter median latency as compared with the first (8 weeks vs 182 weeks, P = 0.0045). There were no significant differences for demographic and clinical characteristics of patients who developed a second dyscrasia as compared with those who did not. The present study shows that almost 70% of the patients rechallenged with clozapine after a leucopenia or a neutropenia did not develop a new hematological adverse effect, whereas the remaining 30% had a faster but less serious neutropenia.

Clozapine-associated neutropenia and agranulocytosis in Argentina (2007-2012).

The risks of severe leukopenia and agranulocytosis have varied over time and among geographical regions and cultures, with little information available on South American populations. Accordingly, we reviewed and analyzed data from a 6-year experience monitored by an Argentine national registry to which reporting of adverse events reports is required. We analyzed data for 2007-2012 from the pharmacovigilance program of the Argentine drug-regulatory agency (ANMAT) using standard bivariate and multivariate statistical methods and survival analysis. We identified 378 cases of adverse hematological events over 6 years among an average of 12 305 individuals/year treated with clozapine (308±133 mg/day) to estimate the mean annualized rates of leukopenia [0.19 (95% confidence interval [CI] 0.11-0.27)], neutropenia [0.38 (95% CI 0.34-0.43)], and agranulocytosis [0.05 (95% CI 0.02-0.08)] % per year [median latency 2 (95% CI 1.3-2.1) months]; fatalities related to agranulocytosis averaged 4.2 (95% CI 0.0-9.2) per 100 000 treated individuals/year. Factors associated significantly and independently with agranulocytosis were female sex, older age, and use of other drugs in addition to clozapine. With monitoring by international standards, recent risks of clozapine-associated agranulocytosis in Argentina were lower, but fatality rates were higher than that in other regions of the world. Risk factors include the use of multiple psychotropic drugs, female sex, and older age.