Traducción al español y confiabilidad del Cuestionario de Tamizaje para Síntomas Prodrómicos (PRIME Screen) / Reliability study of the translation into Spanish of the PRIME Screen Questionnaire for Prodromic Symptoms

Introducción. Una de las condiciones fundamentales para la intervención temprana en la esquizofrenia es la detección certera de los estados prodrómicos, entendido como la constelación de signos y síntomas que predicen el inicio de una psicosis en personas sin antecedentes de cuadros psicóticos. Se han desarrollado diversas entrevistas diagnósticas para la detección de sujetos con síntomas prodrómicos. Objetivo. Traducir el Cuestionario de Tamizaje de Síntomas Prodrómicos (PRIME Screen) y obtener su confiabilidad en una muestra comunitaria de adolescentes de la Ciudad de México. Método. Se incluyeron un total de 532 adolescentes de un centro de educación tecnológica industrial de la Ciudad de México. A todos los sujetos se les aplicó el Cuestionario de Tamizaje de Síntomas Prodrómicos. Resultados. El 18,4% (n=98) fueron clasificados como sujetos con presencia de uno o más síntomas prodrómicos. El análisis factorial del instrumento arrojó tres factores que explican el 59,3 % de la varianza. La consistencia interna global del instrumento fue de 0,88. Discusión. Nuestros resultados sobre el análisis factorial exploratorio muestran la agrupación de los reactivos del instrumento en tres áreas principales denominadas como: a) alteración del entorno; b) alteraciones sensoperceptiva, y c) alteración de habilidades propias. El Cuestionario de Tamizaje de Síntomas Prodrómicos es un instrumento con un adecuado comportamiento clinimétrico que puede ser efectivo para la realización de tamizajes de síntomas prodrómicos en población adolescente

Introduction. A fundamental precondition for early intervention in schizophrenia is accurate detection of prodromal states, that is, sign and symptom constellations that predict the onset of psychosis in persons with no prior background. Several structured interviews have been designed for the detection of prodromal subjects. Objective. To translate and determine the reliability of the PRIME Screen in an adolescent community sample in México City. Method. A total of 532 adolescents of a technicalindustrial educational center of México City were included for the study. All the subjects were administered the PRIME Screen Questionnaire of Prodromal Symptoms. Results. A total of 98 subjects (18.4%) reported one or more prodromal symptoms. The results of the factorial analysis showed that the PRIME Screen questionnaire is conformed by three factors that explained 59.3% of the variance. Internal consistency of the instrument was of 0.88. Discussion. Our results on the exploratory factor analysis show that the items of the questionnaire are grouped into three main areas called: a) alteration of setting; b) sensorial-perceptual abnormalities, and c) alterations of self-skills. The Prodromal Symptoms Screen Questionnaire is an instrument with adequate clinimetric behavior that may be effective to conduct community- wide screening of adolescents for prodromal symptoms

Reliability study of the translation into Spanish of the PRIME Screen Questionnaire for Prodromic Symtoms.

INTRODUCTION: A fundamental precondition for early intervention in schizophrenia is accurate detection of prodromal states, that is, sign and symptom constellations that predict the onset of psychosis in persons with no prior background. Several structured interviews have been designed for the detection of prodromal subjects. OBJECTIVE: To translate and determine the reliability of the PRIME Screen in an adolescent community sample in México City. METHOD: A total of 532 adolescents of a technical-industrial educational center of México City were included for the study. All the subjects were administered the PRIME Screen Questionnaire of Prodromal Symptoms. RESULTS: A total of 98 subjects (18.4%) reported one or more prodromal symptoms. The results of the factorial analysis showed that the PRIME Screen questionnaire is conformed by three factors that explained 59.3% of the variance. Internal consistency of the instrument was of 0.88. DISCUSSION: Our results on the exploratory factor analysis show that the items of the questionnaire are grouped into three main areas called: a) alteration of setting; b) sensorial-perceptual abnormalities, and c) alterations of self-skills. The Prodromal Symptoms Screen Questionnaire is an instrument with adequate clinimetric behavior that may be effective to conduct community-wide screening of adolescents for prodromal symptoms.

Temperament and character in violent schizophrenic patients.

UNLABELLED: Preliminary evidence shows that personality traits are important in determining violent behavior in schizophrenia. As only some patients with schizophrenia show a greater risk for violence, this risk may therefore be considered as dynamic, varying as a function of the extent to which certain personality dimensions are present and the degree to which environmental events moderate or exacerbate their expression. OBJECTIVE: To compare temperament and character dimensions between violent and non-violent schizophrenic patients and to determine which temperament and character dimensions are predictors of violent behavior in schizophrenia. METHOD: We recruited 102 schizophrenic patients without concomitant substance abuse 4 months prior to the assessment. Diagnoses were based on the SCID-I. Personality dimensions were assessed with the Temperament and Character Inventory and violent behaviors with the Overt Aggression Scale. RESULTS: Higher levels of the temperament dimension novelty seeking and a lower cooperativeness, as a character dimension, were risk factors for violent behavior in schizophrenic patients. DISCUSSION: Our data indicate that schizophrenic patients will show a greater risk for violence according to certain personality configurations and the degree to which environmental events moderate or exacerbate their expression.

[Effect to the serotonin transporter gene (5-HTT) on personality dimensions in individuals without psychopathology]. / Efecto del gen transportador de la serotonina (5-HTT) sobre las dimensiones de la personalidad en individuos sin psicopatología.

INTRODUCTION: The aim of the present study was to assess the association between the serotonin transporter gene and the Temperament and Character Inventory (TCI) personality dimensions in subjects without psychopathology. METHOD: Fifty seven individuals without psychiatric symptoms were assessed with the SCL-90, and the TCI. In all subjects a peripheral blood sample was taken to determine their genotypes, after informed consent. Three groups were formed according to the 5-HTT genotype: SS, SL and LL, and the TCI results were compared. RESULTS: There was no association among the 5-HTT genotypes and any of the TCI subscales. There were also no statistical differences among any of the three groups divided by genotype only according to the TCI scores, as well as when compared with historical controls. CONCLUSIONS: These results are consistent with other studies that have not found associations among the different measurements of personality and 5-HTT genotypes. Likewise, our data suggest that our sample can be useful as a source of controls for later studies. This is the first study assessing TCI dimensions and the 5-HTT gene in the Mexican population.

Efecto del gen del transportador de la serotonina (5-HTT) sobre las dimensiones de la personalidad en individuos sin psicopatología / Effect to the serotonin transporter gene (5-HTT) on personality dimensions in individuals without psychopathology

Introducción. El presente estudio se realizó con el fin de estudiar el efecto de los genotipos moleculares del transportador de la serotonina (5-HTT) sobre las dimensiones de la personalidad basadas en el Inventario de Temperamento y Carácter (ITC) en personas sin presencia de psicopatología. Métodos. Participaron 57 individuos sin sintomatología psiquiátrica evaluados mediante el SCL-90 y que respondieron además el ITC. A todos se les tomó una muestra de sangre periférica para la determinación de sus genotipos previo consentimiento informado. Se formaron tres grupos según el genotipo del 5-HTT: SS, SL y LL, y se compararon los resultados del ITC entre cada grupo. Resultados. No se encontró relación entre los genotipos del 5-HTT y ninguna de las subescalas del ITC. Tampoco se pudieron demostrar diferencias entre ninguno de los tres grupos de acuerdo únicamente a las puntuaciones del ITC en comparación con ellos mismos, ni con un grupo de controles históricos publicados anteriormente. Conclusiones. Los resultados son consistentes con otros estudios en los que no se han encontrado asociaciones entre las diferentes medidas de la personalidad y los genotipos del 5-HTT. Asimismo, los datos sugieren que la muestra que participó en el presente estudio puede utilizarse como una fuente de controles para estudios posteriores. Éste es el primer estudio de asociación entre la personalidad y el gen del 5-HTT que se hace en la población mexicana

Introduction. The aim of the present study was to assess the association between the serotonin transporter gene and the Temperament and Character Inventory (TCI) personality dimensions in subjects without psychopathology. Method. Fifty seven individuals without psychiatric symptoms were assessed with the SCL-90, and the TCI. In all subjects a peripheral blood sample was taken to determine their genotypes, after informed consent. Three groups were formed according to the 5-HTT genotype: SS, SL and LL, and the TCI results were compared. Results. There was no association among the 5-HTT genotypes and any of the TCI subscales. There were also no statistical differences among any of the three groups divided by genotype only according to the TCI scores, as well as when compared with historical controls. Conclusions. These results are consistent with other studies that have not found associations among the different measurements of personality and 5-HTT genotypes. Likewise, our data suggest that our sample can be useful as a source of controls for later studies. This is the first study assessing TCI dimensions and the 5-HTT gene in the Mexican population

[Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL)]. / Estudio de fiabilidad interevaluador de la versión en español de la entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL).

INTRODUCTION: The K-SADS-PL diagnostic interview is useful for the cross-sectional and longitudinal evaluation of psychopathology in children and adolescents. The objective of this article was to describe the interrater reliability of the Spanish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL). METHOD: The interview was translated, back-translated and adapted to Spanish. Forty psychiatric outpatients (aged 6 to 17 years) were evaluated. The interviews were videotaped and scored by three independent raters. All of them included both the child's and parent's interview. Interrater reliability was obtained for affective, anxiety and conduct disorders using the Cohen's kappa coefficient. RESULTS: Kappa coefficients were between the good and excellent range for present and lifetime disorders (major depressive disorder kappa = 0.76, any anxiety disorder kappa = 0.84, attention deficit hyperactivity disorder kappa = 0.91 and conduct disorder, kappa = 1). CONCLUSION: The Spanish version of the K-SADS-PL is a reliable instrument for the assessment of psychopathology in children and adolescents.

Estudio de fiabilidad interevaluador de la versión en español de la entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) / Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL)

Introducción. La entrevista diagnóstica K-SADS-PL constituye un instrumento adecuado para evaluar la psicopatología de niños y de adolescentes transversal y longitudinalmente. El objetivo de este trabajo fue determinar la fiabilidad interevaluador de la versión en español de la entrevista K-SADS-PL. Método. Se realizó la traducción al español, retraducción al inglés y adaptación de la entrevista. Se evaluaron 40 pacientes de 6 a 17 años que acudieron a tres instituciones públicas de atención psiquiátrica. Las entrevistas a los pacientes y sus padres se videograbaron y calificaron por tres evaluadores independientes. Se obtuvieron los coeficientes kappa para la fiabilidad interevaluador. Resultados. Se obtuvieron coeficientes kappa de buenos a excelentes para trastorno depresivo mayor k = 0.76, cualquier trastorno ansioso k =0.84, trastorno por déficit de atención con hiperactividad k =0.9 y trastorno disocial k =1. Conclusiones. La versión en español de la entrevista K-SADS-PL es un instrumento fiable para diagnosticar la psicopatología de niños y adolescentes

Introduction. The K-SADS-PL diagnostic interview is useful for the cross-sectional and longitudinal evaluation of psychopathology in children and adolescents. The objective of this article was to describe the interrater reliability of the Spanish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime version (K-SADS-PL). Method. The interview was translated, back-translated and adapted to Spanish. Forty psychiatric outpatients (aged 6 to 17 years) were evaluated. The interviews were videotaped and scored by three independent raters. All of them included both the child’s and parent’s interview. Interrater reliability was obtained for affective, anxiety and conduct disorders using the Cohen’s kappa coefficient. Results. Kappa coefficients were between the good and excellent range for present and lifetime disorders (major depressive disorder k = 0.76, any anxiety disorder k = 0.84, attention deficit hyperactivity disorder k = 0.91 and conduct disorder, k = 1). Conclusion. The Spanish version of the K-SADS-PL is a reliable instrument for the assessment of psychopathology in children and adolescents

Reproducción de un modelo informático de las alucinaciones auditivas en la esquizofrenia / Replication of a computer model of auditory hallucinations in schizophrenia

Introducción. El podado sináptico anormal ha sido propuesto por algunos autores como una teoría para explicar a la esquizofrenia y ha sido estudiado de diversas maneras. Entre las aproximaciones al estudio de este fenómeno se ha utilizado la simulación informática. Métodos. Se utilizó un ordenador PC y los programas informáticos MATLAB versión 5.3 y Neural Networks Toolbox. Para la reproducción del modelo se utilizó la red de Elman para la unidad neuronal y la red publicada por McGlashan y Hoffman. Resultados. A medida que se eliminaron las sinapsis el porcentaje correcto de detección aumentó del 68 al 91 %, llegando a la cima cuando hubo una eliminación aproximada del 60 %. Cuando se continuó con la eliminación disminuyó la capacidad de detección y se presentaron palabras en la ausencia de una entrada, lo cual se consideró como una alucinación. Éstas se presentaron con mayor frecuencia cuando el podado alcanzó entre el 80 y 95 %. Conclusiones. El modelo de simulación por ordenador no sólo provee un modelo para la formación de síntomas, sino también un entendimiento de la utilidad adaptativa del podado. Cuando las unidades neuronales, en vez de las conexiones, fueron eliminadas sólo se obtuvo un empeoramiento progresivo de la percepción. Esto confirma la hipótesis propuesta de que la fisiopatología de la esquizofrenia subyace en la conexión entre las neuronas y no en las neuronas mismas

Introduction. Abnormal synaptic pruning has been proposed by some authors as a theory to explain schizophrenia. It has been studied in different ways, some of which are computerized models. Methods. A PC computer with MATLAB version 5.3 and Neural Networks Toolbox programs were used. To reproduce the model we used Elman’s network for neuronal unit and McGlashan and Hoffman’s network. Results. The corrected percentage of detection improved as synapses were prunned. It increased from 68% to 91 %, reaching the highest detection level when 60% of the synapses were eliminated. Detection capacity was reduced when synaptic elimination continued and the program started detecting words in the absence of input. This was considered as a hallucination. When pruning reached from 80% to 95%, hallucinations occurred more frequently. Conclusions. The computer simulation model provides a symptom formation model, and also a way of understanding pruning’s adaptative utility. When the neuronal units were eliminated (instead of connections), there was only progressive worsening in word perception. This confirms the hypothesis proposed that schizophrenia pathophysiology underlies neuronal connections, not the neurons

Características sociodemográficas asociadas a la conducta violenta en la esquizofrenia / Sociodemographic features related to violent behavior in schizophrenia

Introducción. Se ha propuesto que algunas variables sociodemográficas pueden predecir el comportamiento violento en pacientes con esquizofrenia. El objetivo del presente estudio es investigar la relación de las variables sociodemográficas y clínicas del padecimiento con la conducta violenta en pacientes con esquizofrenia. Método. Se incluyeron 106 pacientes con el diagnóstico de esquizofrenia. Se registraron las principales características demográficas y clínicas de cada uno de los pacientes en un formato diseñado previamente. Se utilizó la Escala de Agresión Explícita (EAE) para la evaluación de la conducta violenta. Resultados. El 49,1 % de los pacientes fueron clasificados como violentos. El estado civil, el abuso de alcohol, el número de hospitalizaciones psiquiátricas previas y la edad de la primera hospitalización fueron variables predictoras para la conducta violenta en esquizofrenia. Discusión. Las variables sociodemográficas predictoras de violencia en esquizofrenia son fáciles de evaluar en la primera entrevista con el paciente y pueden ser de utilidad para prevenir conductas violentas posteriores

Introduction. It has been proposed that some sociodemographic variables may predict violent behavior in schizophrenic patients. The aim of this study was to investigate the relationship of violent behavior with sociodemographic and clinical features in schizophrenic patients. Method. We included 106 schizophrenic patients. Sociodemographic and clinical characteristics of each patient were recorded in a previously designed record. Violent behaviors were assessed with the Overt Aggression Scale (OAS). Results. From the total sample, 49.1 % of the patients were classified as violent. Marital status, alcohol abuse, number of previous psychiatric hospitalizations and age of first hospitalization were predictive variables for violent behavior in schizophrenia. Discussion. Predictive sociodemographic variables for violence in schizophrenia are easy to measure during the first interview with the patient and can be useful for the prevention of future violence

[Sociodemographic features related to violent behavior in schizophrenia]. / Características sociodemográficas asociadas a la conducta violenta en la esquizofrenia.

INTRODUCTION: It has been proposed that some sociodemographic variables may predict violent behavior in schizophrenic patients. The aim of this study was to investigate the relationship of violent behavior with sociodemographic and clinical features in schizophrenic patients. METHOD: We included 106 schizophrenic patients. Sociodemographic and clinical characteristics of each patient were recorded in a previously designed record. Violent behaviors were assessed with the Overt Aggression Scale (OAS). RESULTS: From the total sample, 49.1 % of the patients were classified as violent. Marital status, alcohol abuse, number of previous psychiatric hospitalizations and age of first hospitalization were predictive variables for violent behavior in schizophrenia. DISCUSSION: Predictive sociodemographic variables for violence in schizophrenia are easy to measure during the first interview with the patient and can be useful for the prevention of future violence.

[Replication of a computer model of auditory hallucinations in schizophrenia]. / Reproducción de un modelo informático de las alucinaciones auditivas en la esquizofrenia.

INTRODUCTION: Abnormal synaptic pruning has been proposed by some authors as a theory to explain schizophrenia. It has been studied in different ways, some of which are computerized models. METHODS: A PC computer with MATLAB version 5.3 and Neural Networks Toolbox programs were used. To reproduce the model we used Elman's network for neuronal unit and McGlashan and Hoffman's network. RESULTS: The corrected percentage of detection improved as synapses were prunned. It increased from 68% to 91 %, reaching the highest detection level when 60% of the synapses were eliminated. Detection capacity was reduced when synaptic elimination continued and the program started detecting words in the absence of input. This was considered as a hallucination. When pruning reached from 80% to 95%, hallucinations occurred more frequently. CONCLUSIONS: The computer simulation model provides a symptom formation model, and also a way of understanding pruning's adaptative utility. When the neuronal units were eliminated (instead of connections), there was only progressive worsening in word perception. This confirms the hypothesis proposed that schizophrenia pathophysiology underlies neuronal connections, not the neurons.

Frontal and limbic metabolic differences in subjects selected according to genetic variation of the SLC6A4 gene polymorphism.

Allelic variants in the promoter region of the serotonin transporter (5-HTT) gene have been implicated in several psychiatric disorders and personality traits. In particular, two common alleles in a variable repeat sequence of the promoter region (SLC6A4) have been differentially associated with a display of abnormal levels of anxiety and affective illness in individuals carrying the "s" allele. The aim of this study was to compare the basal cerebral metabolic activity of non-psychiatric subjects in fronto-limbic structures to determine whether differences exist in basal metabolic activity within this functional polymorphism. PET scans with fluorine-18 fluorodeoxyglucose as radiotracer were performed in 71 non-psychiatric subjects previously screened for psychopathology and subsequently genotyped for SLC6A4; PET images were compared with SPM2 according to s/s (n = 27), s/l (n = 25), and l/l (n = 19) groups considering a significance threshold in a priori selected areas of P < 0.001 and an extent threshold > or =5 voxels. The analysis showed an effect of interest among the three genotype groups in right anterior cingulate gyrus (ACC), left middle frontal gyrus, and left posterior cingulate gyrus (PCC). Comparison between l/l vs. s/s showed increased metabolism for l/l in left middle frontal gyrus and an increase for s/s in right ACC and left PCC. Comparison between s/s vs. s/l showed an increase for s/s in left PCC and right ACC. Increased basal metabolism in fronto-limbic structures for the s/s group may be conceived as an "overactive metabolic state" of these structures, possibly related to an increased susceptibility for developing an anxiety-depression spectrum disorder.

A forced five-dimensional factor analysis and concurrent validity of the Positive and Negative Syndrome Scale in Mexican schizophrenic patients.

UNLABELLED: The heterogeneity of schizophrenic symptomatology is well documented. The positive-negative distinction is limited to cover the entire spectrum of schizophrenic psychopathology in order to describe the various clinical aspects of the disorder. METHOD: We recruited 150 schizophrenic patients between May 2002 and September 2003. Diagnoses were based on a structured clinical interview. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate general psychopathology and symptom severity. For the concurrent validity of the pentagonal model of the PANSS, the BPRS, the CDSS, the OAS and the MMSE were used. RESULTS: The forced five-factor principal-component analysis explained 53.4% of the total variance. There were significant correlations between the clinical rating scales and the five components of the PANSS. DISCUSSION: Our data support a pentagonal model underlying the multidimensional schizophrenic symptomatology as assessed by the PANSS. The five-factor structure of the PANSS in Mexican schizophrenic patients enables further elucidation of the various clinical aspects of schizophrenia.

Premorbid adjustment and violent behavior in schizophrenic patients.

UNLABELLED: We examined the influence of premorbid adjustment on violent behavior in schizophrenic patients. There is some evidence that poor premorbid adjustment predicts violent behavior, then we decided to examine this hypothesis further. METHOD: We recruited 72 schizophrenic patients without concomitant substance abuse 6 months prior to the assessment. Diagnoses were based on the SCID-I. Premorbid adjustment was evaluated with the Premorbid Adjustment Scale and violent behaviors with the Overt Aggression Scale. RESULTS: Violent schizophrenic patients showed an overall worse premorbid adjustment during childhood. In addition, the area of "peer relationships" was significantly diminished in several life period sections such as childhood, early and late adolescence in violent patients. DISCUSSION: Our data indicate that difficulties in social relationships during early stages of life may increase the risk of future violent behavior among schizophrenic patients.

[Sensitivity and specificity of the Overt Aggression Scale in schizophrenic patients]. / Sensibilidad y especificidad de la Escala de Agresión Explícita en pacientes con esquizofrenia.

INTRODUCTION: Research focused on the assessment of violent behavior in schizophrenic patients has been hindered by the lack of clinical instruments adapted to the Mexican psychiatric population. This study aimed to obtain sensitivity and specificity data as well as the most adequate cutoff point of the Overt Aggression Scale (OAS). METHOD: 137 schizophrenic patients were included. A clinical evaluation was performed with the PANSS subscale of excitability and the OAS. Diagnosis of violent behavior was obtained with the PANSS and clinical consensus of two psychiatrists. RESULTS: 66.4% of the sample was considered as nonviolent patients. A cutoff point of 7 points in the OAS showed sensitivity of 0.80 and specificity of 0.97, with adequate positive and negative predictive power. DISCUSSION: The objective assessment of violent behavior in schizophrenic patients can contribute to the development of new lines of research. Adaptation of the OAS for the assessment of violent behavior will encourage the development of better strategies for the detection and intervention of violent behavior in schizophrenia.

Sensibilidad y especificidad de la Escala de Agresión Explícita en pacientes con esquizofrenia / Sensitivay and specificity of the Overt Aggression Scale in schizophrenic patients

Introducción. La investigación enfocada a la evaluación de la conducta violenta en esquizofrenia se ha visto limitada por la carencia de instrumentos de medición adaptados a la población psiquiátrica mexicana. El objetivo del presente estudio fue la obtención de los datos de sensibilidad y especificidad y el establecimiento del punto de corte más adecuado de la Escala de Agresión Explícita (EAE). Método. Se incluyeron 137 pacientes con el diagnóstico de esquizofrenia. Se realizó una evaluación clínica con la PANSS y la EAE. El diagnóstico de conducta violenta se obtuvo por medio de la subescala de excitabilidad de la PANSS y el consenso clínico de dos psiquiatras. Resultados. El 66,4 por ciento de la muestra fue considerado como pacientes no violentos. Un punto de corte de 7 puntos en la EAE mostró una sensibilidad del 0,80 y una especificidad de 0,97, con un adecuado poder predictivo positivo y negativo. Discusión. La evaluación objetiva de la conducta violenta en pacientes con esquizofrenia puede contribuir al desarrollo de líneas de investigación. El contar con este instrumento específico y objetivo para la evaluación de la conducta violenta permitirá crear mejores estrategias para la detección e intervención de la conducta violenta en esquizofrenia (AU)

[Premorbid functioning by gender and its relationship with duration of untreated psychosis in first psychotic episode]. / Funcionamiento premórbido por género y su relación con la duración de la psicosis no tratada (DPNT) en el primer episodio psicótico.

INTRODUCTION: There are two phenotypes proposed for the psychotic disorders based on premorbid functioning and probably related with the duration of untreated psychosis (DUP). The aim of this study was to compare the clinical features, premorbid functioning and its relationship with DUP by gender in a group of first episode psychosis patients. METHODS: We included 77 patients in their first admission to a psychiatric facility. A clinical evaluation was performed with the PANSS, Calgary Depression Scale,Hamilton Depression Scale and Mania Rating Scale. Premorbid functioning was rated with the Premorbid Adjustment Scale. RESULTS: There were no clinical differences between men and women. Men had greater impairment in their premorbid functioning. Patients with short DUP (< 28 weeks) showed better premorbid functioning compared to those with long DUP (> 28 weeks). CONCLUSION: Duration of untreated psychosis is determined by premorbid functioning and it is possible that male patients, who show a higher frequency of poor premorbid functioning, have a longer delay in seeking treatment, that conditions a longer duration of untreated psychosis.

Funcionamiento premórbido por género y su relación con la duración de la psicosis no tratada (DPNT) en el primer episodio psicótico / Premorbid functioning by gender and its relationship with duration of untreated psychosis in first psychotic episode

Introducción. Existen dos fenotipos para los trastornos psicóticos sustentados en el funcionamiento premórbido y probablemente relacionados con la duración de la psicosis no tratada (DPNT). El objetivo del estudio fue establecer las diferencias de género en las características clínicas, el funcionamiento premórbido y su relación con la DPNT en pacientes con primer episodio psicótico. Métodos. Se incluyeron 77 pacientes en su primera admisión a un servicio de psiquiatría. Se realizó una evaluación clínica con la PANSS, Escala Calgary de Depresión, Escala de Hamilton de Depresión y Escala de Evaluación de Manía y la Escala de Ajuste Premórbido para evaluar el funcionamiento premórbido. Resultados. No hubo diferencias entre hombres y mujeres en la severidad clínica. Los hombres mostraron mayor deterioro en su funcionamiento premórbido. Los pacientes con DPNT corta (28 semanas), presentaron un mejor funcionamiento premórbido. Conclusión. La DPNT está determinada por el nivel de funcionamiento premórbido y es posible que los hombres, al presentar con mayor frecuencia un bajo funcionamiento premórbido, tarden más en buscar atención especializada para recibir un tratamiento específico prolongando la DPNT (AU)

Dopamine D4 receptor (DRD4) gene polymorphism in the first psychotic episode.

BACKGROUND: Dopamine D4 receptor (DRD4) has shown some interesting properties at genetic and possibly functional levels. It has been suggested that some molecular variants of the DRD4 gene (e.g., four and seven alleles) could be implicated in the pathogenesis of psychotic disorders. Additionally, the VNTR polymorphism could be implicated in part of the response to treatment with neuroleptics. This study tested the possible association between the 48-bp tandem repeats in exon 3 of the DRD4 gene and patients experiencing their first psychotic episode. METHODS: Patients with a first psychotic episode (FPE, n = 37) were diagnosed and compared with a matched control group (n = 37). The FPE group was subdivided into two categories: those with nonaffective and those with affective psychoses. The variable number of tandem repeats (VNTR) region of the DRD4 gene was amplified by PCR procedures. Chi-square statistics and appropriate corrections and adjustments were used for data analysis. CONCLUSIONS: A significantly lower frequency of the four repeat (4-R) carriers in the FPE group was observed. This association was sustained mainly by the affective psychotic group (chi2 = 9.99 df = 2, p = 0.0073). Although these results require testing with stringent methods, it is suggested that the DRD4-4R allele may confer some protection against psychosis, mainly of the affective subtype.

Lack of association of apolipoprotein E polymorphism in obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) could be considered a neurodevelopmental disorder, from several lines of evidence. One of the most widely studied genes in these disorders is the apolipoprotein E gene, particularly allele 4. We analyzed for association among patients with OCD versus normal controls and cognitively impaired patients. There were no significant differences between OCD probands compared with population controls. However, the cognitively impaired group showed a higher frequency of allele apolipoprotein E gene compared with normal controls and patients with OCD.