Psychosomatic response to acute emotional stress in healthy students.

The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.

Direct infussion Electrospray Mass Spectrometry as a new non-invasive tool for serum metabolomics in induced-stress subjects

Background and Objectives: Nanotechnology is becoming a tool for the study of changes in the metabolome of patients in different states of disease. Analytical techniques such as Electrospray Mass Spectrometry, allow to find biomarkers by determination of metabolites. Nowadays, there is not an objective analytical approach for diagnosis of stress. Thus, the objectives of this pilot work are: Describing the development of a fast, direct and non-invasive analytical protocol, applied for the first time, to study the metabolomic profile of patient´s different states through a disease. Testing the protocol in a pilot sample with non-stressed and stress-induced subjects. Methods: High resolution direct infusion electrospray mass spectrometry has been used to analyse the metabolome of blood samples (0.3 ml) from six subjects. Results: Data prove a clear discrimination between non-stressed and stressed states in the metabolome. Data showed different predominant metabolites in both states. Results allow objective characterization of the state of the patient. Conclusions: Although this is a pilot study, the method was successful in discriminating different metabolites in non-stressed and stress-induced subjects (AU)

No disponible

Depression in the elderly community: I. Prevalence by different diagnostic criteria and clinical profile

Background and Objectives: Depression is one of the most intriguing disorders in the elderly. We conjecture that prevalence of depression in the community vary according to the diagnostic criteria used. Furthermore, we anticipate that important proportions of depression go untreated or inadequately treated in a Southern European city. Metodology: This report is part of the Zaragoza Study (or ZARADEMP 0), an epidemiological project to document psychiatric morbidity in a representative sample of the elderly. A two - phase design was completed in a sample of n= 1080 elderly (65+ years).Standardized instruments were used, and the Geratric Mental State (GMS) was the main instrument. Cases of depression were diagnosed with three different sets of diagnostic criteria: AGECAT syndrome, AGECAT diagnosis and DSM - IV criteria. Descriptive statistics were used. Results: In support of the working hypothesis, the prevalence of depression tended to be lower when stringent diagnostic criteria were used. It was 7.0 % with AGECAT syndrome,5.7% with AGECAT diagnosis among the cases, 4.8% with DSM - IV criteria. Anxiety, co - morbid syndromes were frequent among the cases (45.5%) and 18.2% of them had co - morbid AGECAT organic syndromes. Differential psychopathological profiles are observed between cases of major and minor depression. Undertreament or inadequate treatment was very frequent, and only 54.5% of major depression cases were onantidepressants. Conclusions: The prevalence of depression in the elderly varies according to diagnostic criteria used, and does not increase with age. Co-morbid anxiety and “organic” syndromes are common, and only half the major depressive cases were on antidepressants (AU)

No disponible

Depression in the elderly community: II. Outcome in a 4.5 years follow-up

No disponible

Background and Objectives: In this study, we test to what extent negative outcomes of depression reported in different countries may be confirmed in a Southern European population. Methods: This is a follow-up (mean 4.5 years) of the elderly sample interviewed in the baseline of the Zaragoza Study (or ZARADEMP 0). The general methodology is described in the previous paper. The same two-phase procedure completed at baseline was also implemented at follow-up and the same standardized instruments were used. Cases of depression at follow-up were diagnosed with AGECAT criteria. Operational criteria were also used for definition of both “incident case of depression” and “chronic case of depression”. Results: Six hundred and sixty three elderly (61.4%) were reassessed at follow-up, and216 died in the follow-up period. A negative outcome of both, major and minor depression was observed. Taken together, the pessimistic outcome (death, chronicity or conversion to other psychiatric diagnosis) was observed in 70.5% of cases of depression, but only in30.8% of “non-cases”, the differences being statistically significant (Z = 6.7; p < 0.001).Similarly, a high proportion of subcases of depression had a negative prognosis (48.5%),the differences with “non-cases” also being statistically significant (Z = 2.7; p < 0.005). Incidence rate of depression was 14.4 (95% C.I.: 11.0-18.6) the rate being significantly higher in women when compared to men. Conclusions: This is the first report of a negative outcome of depression in a representative sample of the elderly in a Southern European city. Subcases of depression also had a negative outcome. The clinical significance in AGECAT cases of depression is emphasized (AU)

Prevalence of “organic brain syndrome” in a Southern European population in two different time periods. The ZARADEMP Project

Background: Comparative studies of dementia in different time periods are quite limited in the international literature, but might be useful to test environmental hypotheses. The aim of this study is to compare the prevalence of “organic brain syndrome”, as a measure of dementia, in the elderly living in the same community in two different time periods and using the same methods. Methods: Representative samples of the elderly in the Zaragoza Study or ZARADEMP0 (n= 1,080), completed the past decade, and now in Wave I of the ZARADEMP Project or ZARADEMP I (n= 4,803) were interviewed. The Geriatric Mental State (GMS) was the main case-finding instrument and the results were analysed using the AGECAT diagnostic package to generate diagnoses. Results: Adjusted, total prevalence of “organic brain syndrome” in individuals aged 65years and older has not varied from the previous decade. It was 8.4% in ZARADEMP I ,and 7.4% in ZARADEMP 0 (prevalence ratio, PR = 0.83; CI 0.65-1.07). Adjusted prevalence among men was lower in ZARADEMP I (3.6%) when compared to ZARADEMP 0(5.5%), although the differences do not reach statistically significance (PR= 0.65; CI 0.41-1.05). However, in support of the working hypothesis, the differences were more marked, and we consider they reach statistically significant proportions in the age group 80-84years.Conclusions: The prevalence of “organic brain syndrome” has not increased from the previous decade. On the contrary, the prevalence tends to be lower in men, and the differences reach statistical significance in the age group 80-84 years. New analysis using diagnostic criteria of dementia in the same sample are required to confirm these findings (AU)

The ZARADEMP Project on the incidence, prevalence and risk factors of dementia (and depression) in the elderly community: I. The context and the objectives

Background and Objectives: The public health dimension of the problem ofdementia and depression in the elderly population is well documented, but epidemiologicaldata are generally considered to be insufficient and, at times, contradictory. This paperidentifies relevant research areas for the ZARADEMP Project, which follows the ZaragozaStudy (or ZARADEMP 0) and is part of both EURODEM and EURODEP Studies.Methods: Review of the literature. Hypotheses emerging in previous studies of thisresearch group.Results: The following relevant objectives to study in relation to dementia (and depression)have been identified: a) potential variations over time in the prevalence rate; b) provisionof reliable estimations of incidence rates, specific for age and gender; c) data aboutthe course and natural history of so called “mild cognitive deficit”; d) association betweenhypothesized risk factors and cases of dementia (and depression) and its most frequentsubtypes; and e) testing of hypotheses related to the overlap between dementia and depressionand, specifically, to what extent depression has an increased risk for DAT. Otherobjectives of the study are also reviewed, in particular the cross-cultural comparison offindings in Zaragoza and in other European cities incorporated in both EURODEM andEURODEP Studies. The importance of maintaining good, contemporary methodologicalstandards is emphasized.Conclusions: A number of relevant research areas in the epidemiology of both dementiaand depression in the elderly have been identified. Case-control studies based on incidentcases of dementia of the Alzheimer’s type (DAT) to adequately assess risk factorsseem particularly timely (AU)

The ZARADEMP Project on the incidence, prevalence and risk factors of dementia (and depression) in the elderly community: II. Methods and first results

Background: There is a pressing need to identify environmental risk factorsof dementia and depression in the elderly.Aims: To describe the methods and first results of the ZARADEMP Project, the firstpsychiatric study to document risk factors in incident cases of dementia (and depression)in a Southern European elderly population.Method: A three-wave (baseline and two follow-up waves) epidemiological study toidentify incident cases of dementia (and depression) was completed in a representativesample population. Valid Spanish versions of case-finding instruments, including theGeriatric Mental State (GMS) were administered by standardized researchers. The incidentcases, diagnosed by a panel of psychiatrists using DSM-IV criteria, will be includedin a case-control study.Results: Response rate was acceptable (63.6% in Wave I, 87’2% in Wave II and 85’8%in Wave III), and 4,803 individuals completed Wave I. Diagnostic agreement was achievedin 91.4% of probable cases presented to the panel, and a total of 146 incident cases ofdementia were identified.Conclusions: We feel confident that modern epidemiological requirements have beenfulfilled and the statistical power in the calculations of risk will be acceptable (AU)