Association of FAAH p.Pro129Thr and COMT p.Ala72Ser with schizophrenia and comorbid substance use through next-generation sequencing: an exploratory analysis

Objective: Individuals with schizophrenia and substance use disorders have a poor prognosis and increased psychiatric symptoms. The present study aimed to explore the association of 106 genes in individuals with schizophrenia and comorbid substance use through a next-generation sequencing (NGS) analysis and different in silico algorithms. Methods: We included 105 individuals diagnosed with schizophrenia and a family history of schizophrenia, of whom 49 (46.67%) presented comorbid substance use. Using NGS, we sequenced 106 genes previously associated with schizophrenia. Logistic regression models were used to assess differences in allele frequencies, and a generalized gene-set analysis was performed at the gene level. Functional annotations were performed using different algorithms and databases. Results: We identified a total of 3,109 variants, of which 25 were associated with schizophrenia and comorbid substance use and were located in regulatory and coding regions. We found low-frequency variants in COMT p.Ala72Ser, independently of p.Val158Met, that were associated with substance use. The endocannabinoid functional variant FAAH p.Pro129Thr was also associated with substance use. Conclusions: Genetic variants of genes related to dopaminergic and cannabinoid neurotransmitter systems were associated with comorbid substance use in schizophrenia. Nevertheless, more studies with larger sample sizes are needed to confirm our findings.

Las percepciones de crianza materna podrían influenciar las conductas autolesivas en adolescentes con diagnóstico de trastornos de la conducta alimentaria / Memories of maternal upbringing could influence self-injurious behaviors in adolescents with diagnosis of eating disorders

RESUMEN Objetivo : Explorar las percepciones de crianza parental en adolescentes diagnosticados con algún trastorno de la conducta alimentaria, e identificar posibles diferencias con alteraciones de la conducta alimentaria y conductas autolesivas. Material y métodos : Un total de 45 adolescentes con algún tipo de trastorno de la conducta alimentaria (TCA) (11 diagnosticados con anorexia nervosa, 23 con bulimia nervosa y 11 con trastorno "por atracón"), pacientes en áreas de consulta externa y hospitalización del Hospital Psiquiátrico Infantil Juan N. Navarro fueron sistemáticamente estudiados. Resultados : Se encontró que cuánto mayores las percepciones de favoritismo (r = 0,41, valor p = 0,005) o rechazo (r = 0,36, valor p = 0,016) del padre, mayores fueron también los puntajes en la Escala de Actitudes Alimentarias. Se encontraron asimismo diferencias en la dimensión de calidez de la madre, entre los adolescentes que presentaron autolesiones (media = 39,6, d.e = 11,3) comparados con aquéllos que no las presentaron (media = 47,4, d.e = 8.8) (t = -2,6, valor p = 0,015). Conclusiones : Los adolescentes con diagnóstico de TCA presentaron diferencias en la percepción de crianza parental, factor que puede influenciar decisivamente la manifestación de otras conductas psicopatológicas.

SUMMARY Objective : To explore the perceived parental rearing behavior in adolescents diagnosed with an eating disorder, and to identify eventual differences with altered eating and self-injurious behaviors. Material and methods : A total of 45 adolescents diagnosed with some eating disorder (11 diagnosed with anorexia nervosa, 23 with bulimia nervosa and 11 with binge eating disorder), recruited from the outpatient and hospitalization areas of the Juan N Navarro Children's Psychiatric Hospital, were included. Results : It was found that the greater the memories of favoritism (r = 0.41, p-value = 0.005) or rejection (r = 0.36, p-value = 0.016) by the father, the higher the scores ​​on the Eating Attitude Scale. Differences were also found in the mother's warmth dimension, between the adolescents who presented self-injuries (mean = 39.6, de = 11.3) and those who did not present them (mean = 47.4, de = 8.8) (t = -2.6, value p = 0.015). Conclusions : Adolescents with a diagnosis of eating disorders presented differences in their perception of parental rearing, a factor that may decisively influence the manifestation of other psychopathological behaviors.

Riesgo de sindemia de COVID-19 y fiebre del dengue en el sur de México / Risk of a syndemic between COVID-19 and dengue fever in southern Mexico

Resumen Una sindemia es la convergencia de dos o más enfermedades en un mismo espacio y tiempo. En México, la epidemia de dengue está activa y predomina en zonas del Pacífico y Golfo de México; por su parte, la epidemia de COVID-19 afecta severamente las mismas zonas que el dengue. Dado que estas enfermedades comparten numerosas manifestaciones clínicas, en zonas endémicas de enfermedades tropicales es importante la evaluación minuciosa del paciente que consulta por fiebre, para establecer oportunamente un diagnóstico correcto. Las pruebas de laboratorio son necesarias para llevar a cabo las medidas pertinentes en cada paciente. En México, el riesgo de sindemia de COVID-19 y dengue es alto, por lo que puede colapsar los sistemas de salud. Los estados del sureste y los colindantes con el Pacífico requieren especial atención ya que presentan condiciones geográficas, ambientales y climáticas que favorecen la rápida propagación del dengue y COVID-19. La infección simultánea empeorará la situación epidemiológica, complicará el diagnóstico, control y tratamiento de ambas enfermedades.

Abstract A syndemic is the convergence of two or more diseases in the same space and time. In Mexico, the dengue epidemic is active and predominates in areas of the Pacific and the Gulf of Mexico; in turn, the COVID-19 epidemic severely affects the same areas as dengue fever. Given that both these diseases share many clinical manifestations, in areas where tropical diseases are endemic, it is important to make careful evaluations of the patient who consults for fever in order to establish a timely diagnosis. Laboratory diagnostic tests are necessary to take the pertinent measures for each patient. In Mexico, the risk of a syndemic between COVID-19 and dengue fever is high, and thus it that can collapse health systems. The states of southeastern Mexico and the Pacific region require special attention, since they have geographic, environmental and climatic conditions that favor the rapid spread of dengue and COVID-19. Simultaneous infection will worsen the epidemiological situation, and complicate the diagnosis, control and treatment of both diseases.

Self-perceived health in psychiatrists and psychiatry trainees. The role of perfectionism and distress / Autopercepción de la salud en psiquiatras y residentes de psiquiatría. El rol del perfeccionismo y el distrés

Abstract Introduction Self-perceived health (SPH) is related to disease and well-being. Psychiatrists report burnout and mental disorders more frequently than other physicians, while personality traits related to perfectionism may influence the perception of well-being and health in these professionals. Objective To compare and determine the association between demographic variables, health conditions, perceived distress, perfectionism, and SPH. Method A cross-sectional, retrospective, comparative study was performed through an online survey. Psychiatrists and psychiatry trainees who were willing and able to participate were included. Demographic variables and self-reports of mental and physical conditions were examined. SPH was rated on a 10-point visual analogue scale and perfectionism through the Multidimensional Perfectionism Scale. Comparative analyses and multiple linear regression models were performed. Results Three hundred and thirty psychiatry trainees and 355 psychiatrists were recruited. Psychiatrists reported more physical conditions (32.4% vs. 15%, p < .001), distress (p < .001), and perfectionism (p < .001). Major depression and anxiety were present over 50% of all participants. A higher SPH was associated with being partnered and having higher distress levels in psychiatry trainees and with the absence of a physical health condition, less concern over errors, and higher personal standards in psychiatrists. Discussion and conclusion Self-oriented perfectionism may have a significant motivational component, accentuated by competitiveness and individualism. Being married and having higher levels of distress in psychiatry trainees appears to create a sense of satisfaction with achievements. The implementation of strategies to prioritize and meet goals is necessary to have an adequate work-life balance without affecting personal satisfaction or the sense of achievement.

Resumen Introducción La autopercepción de la salud (APS) se relaciona con enfermedad y bienestar. Los psiquiatras reportan desgaste emocional y trastornos mentales con mayor frecuencia que otros médicos. El perfeccionismo puede influir en la percepción de la salud en estos profesionistas. Objetivo Comparar y determinar la asociación de variables demográficas, condiciones de salud, distrés y perfeccionismo con la APS. Método Se realizó un estudio transversal, retrospectivo y comparativo mediante una encuesta en línea. Se incluyeron psiquiatras y residentes de psiquiatría que participaron voluntariamente. Se registraron variables demográficas, enfermedades médicas y psiquiátricas (autorreporte). La APS se evaluó con una escala análogo-visual de 10 puntos y el perfeccionismo con la Escala Multidimensional de Perfeccionismo. Se realizaron análisis comparativos y modelos de regresión lineal múltiple. Resultados Se reclutaron 330 residentes y 355 psiquiatras. Los psiquiatras reportaron más enfermedades físicas (32.4% vs. 15%, p < .001), distrés (p < .001) y perfeccionismo (p < .001). Más del 50% de los participantes reportaron ansiedad y depresión. Una mayor APS se asoció con tener pareja y mayor distrés en los residentes, y con la ausencia de una enfermedad física, menor preocupación por errores y mayores estándares personales en los psiquiatras. Discusión y conclusión El perfeccionismo orientado hacía sí mismo puede tener un componente motivacional acentuado por la competitividad y el individualismo. Tener una pareja y presentar mayor distrés en los residentes pudiera crear una sensación de satisfacción por logros. La creación de estrategias para priorizar y alcanzar objetivos es necesaria para tener un equilibrio de vida sin afectar la satisfacción personal y la sensación de logro.

Development of the Mexican Version of the Empathy Quotient / Desarrollo de la versión mexicana del Cuestionario de Empatía

Abstract Introduction Empathy is defined as the ability or process to identify and understand other person's situation, feelings, and motives. These responses are essential for relationships and social behavior. Baron-Cohen et al. created the Empathy Quotient (EQ), a scale explicitly designed to have a clinical application. The instrument evaluates three constructs of empathy and several studies around worldwide, but not in Mexico. Objective To examine the psychometric properties and the factor congruence of the EQ in a community sample from Mexico City. Method Cronbach´s alpha coefficient and a correspondence factorial analysis was performed to test the relation between response options and factors from the Exploratory Factor Analysis 200 adults without Axis I disorders through the MINI, filled out the Spanish version of the short version (28-items) of the EQ. An exploratory factor analysis was performed while reliability was tested with Cronbach's alpha. In addition, correspondence factorial analysis and the factor congruence coefficient were determined. Results Five items were eliminated from the original 28-item EQ. From the 23 remaining items, only 16 were grouped in the three original proposed dimensions (cognitive empathy: 8 items, emotional reactivity: 4 items and social skills: 3 items), while one item showed communality with a different domain from the one originally proposed. Reliability was adequate (.82) as well as the congruence coefficients (.76 to .99). Discussion and conclusion The EQ Mexican 16-item version is a good tool to assess empathy in a Mexican population.

Resumen Introducción La empatía es definida como la capacidad para identificar y comprender las situaciones, sentimientos y motivaciones de otra persona. Estas respuestas son esenciales para relaciones y comportamientos sociales. Baron-Cohen et al. crearon el cociente de empatía (EQ), una escala diseñada para tener aplicación clínica. El instrumento evalúa tres constructos de empatía y ha probado sus propiedades psicométricas con resultados adecuados en varios estudios mundiales, pero no en México. Objetivo El propósito de este estudio fue examinar las propiedades psicométricas y la congruencia factorial del EQ en una muestra mexicana. Método El alpha de Cronbach y el análisis factorial fueron aplicados para probar la relación entre las opciones de respuesta y los factores en 200 adultos sin diagnóstico, a través de la entrevista MINI. Se utilizó la versión corta en español del EQ y se realizó un análisis factorial exploratorio dónde se probó la confiabilidad con el alfa de Cronbach y se determinó adecuada correspondencia y congruencia factorial. Resultados Se eliminaron cinco reactivos de la escala original de 28 reactivos. De los 23 reactivos restantes, solo 16 se agruparon en las tres dimensiones originales (empatía cognitiva: 8 reactivos, reactividad emocional: 4 reactivos y habilidades sociales: 3 reactivos) mientras que un reactivo mostró una comunalidad con un dominio diferente del original. La confiabilidad fue (.82), así como los coeficientes de congruencia (.76 a .99). Discusión y conclusión La versión del EQ es una buena herramienta para evaluar la empatía en población mexicana.

Exploratory analysis of polygenic risk scores for psychiatric disorders: Applied to dual diagnosis

Background Concurrence of substance use disorders (SUDs) is high in individuals with psychiatric illnesses; more importantly, individuals with both disorders (dual diagnosis) have more severe symptoms. Psychiatric disorders have been proposed to share a genetic susceptibility with SUDs. To explore this shared genetic susceptibility, we analyzed whether any of the polygenic risk scores (PRSs) for psychiatric disorders could be associated to dual diagnosis in patients with schizophrenia (SCZ) or bipolar disorder (BD). Methods We included 192 individuals of Mexican ancestry: 72 with SCZ, 53 with BD, and 67 unrelated controls without psychiatric disorders. We derived calculations of PRS for autism spectrum disorders, attention-deficit/hyperactive disorder, BD, major depression, and SCZ using summary genome-wide association statistics previously published. Results We found that dual diagnosis had a shared genetic susceptibility with major depressive disorder (MDD) and SCZ; furthermore, in individuals with BD, dual diagnosis could be predicted by PRS for MDD. Conclusions Our results reinforce the notion that individuals with dual diagnosis have a higher genetic susceptibility to develop both disorders. However, analyses of larger sample sizes are required to further clarify how to predict risks through PRS within different populations.

Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials

Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

Stigma and perceived aggression towards schizophrenia in female students of medicine and psychology / Estigma y percepción de agresión hacia la esquizofrenia en mujeres estudiantes de medicina y psicología

Abstract Introduction The main attitudes towards people with schizophrenia are fear and rejection, which derive from the idea that patients have no control over their behavior and that they are aggressive, violent, and/or dangerous. Several studies have shown that mental health professionals show negative attitudes towards patients with schizophrenia from the start of their professional training. Objective To compare the stigmatizing attitudes and perception of aggression of female undergraduate students of medicine and psychology towards people with schizophrenia. Method Fifty-seven (49.6%) undergraduate medical students and 58 (50.4%) psychology students in the early semesters of their professional training were included. Both groups answered the Opinion Scale on Mental Illness and the Public Concept of Aggressiveness Questionnaire (PCA). Results Over 60% of the students from both degree courses considered that the individual with schizophrenia described in the vignette could be aggressive, with a higher percentage corresponding to female students enrolled in the medical degree program. In this group, more negative attitudes towards the disease were observed in terms of separatism, restriction, and stigmatization. Discussion and conclusion It is essential to promote clear, objective information with a biopsychosocial approach to the disease in the syllabus in order to reduce or eliminate stigmatizing beliefs and attitudes regarding schizophrenia acquired prior to professional training.

Resumen Introducción Las principales actitudes hacia las personas con esquizofrenia son de temor y rechazo, las cuales surgen de la idea de que los pacientes no tienen control sobre su comportamiento y que son agresivos, violentos y/o peligrosos. Diversos estudios han señalado que los profesionales de la salud mental muestran actitudes negativas hacia los pacientes con esquizofrenia desde el inicio de su formación profesional. Objetivo Comparar las actitudes estigmatizadoras y la percepción de agresión de mujeres estudiantes de pregrado de medicina y de psicología hacia las personas con esquizofrenia. Método Se incluyeron 57 (49.6%) estudiantes de pregrado de medicina y 58 (50.4%) de psicología que cursaban los primeros semestres de su formación profesional. Ambos grupos contestaron la Escala de Opiniones sobre la Enfermedad Mental y el Cuestionario de Concepto Público de Agresividad (CPA). Resultados Más del 60% de las estudiantes de ambas carreras consideraron que el sujeto con esquizofrenia descrito en la viñeta podría ser agresivo. De éstas, el mayor porcentaje de alumnas pertenecía a la carrera de medicina. De forma similar, en este grupo se observaron mayores actitudes negativas hacia la enfermedad en términos de separatismo, restricción y estigmatización. Discusión y conclusión Es necesario promover dentro del currículo académico información clara y objetiva con un enfoque biopsicosocial de la enfermedad con la finalidad de reducir o eliminar las creencias y actitudes estigmatizadoras sobre la esquizofrenia adquiridas antes de la formación profesional.

Mental health literacy about bipolar disorder and schizophrenia among medical students: a comparative study of illness recognition, treatment, and attitudes according to perception of aggressiveness-dangerousness / Alfabetización en salud mental sobre el trastorno bipolar y la esquizofrenia en estudiantes de medicina: estudio comparativo del reconocimiento de la enfermedad, tratamiento y actitudes de acuerdo a la percepción de agresión-peligrosidad

Abstract Introduction Lack of information may result in health professionals' negative attitudes toward individuals with mental illness. Objective We sought to determine the association between the perception of aggressiveness-dangerousness and illness recognition, suggested treatment, and attitudes regarding schizophrenia and bipolar disorder in a group of medical students. Method This field study used a non-experimental, cross-sectional comparative design in a purposive sample of medical students. Mental illness recognition, beliefs about adequate treatment, perception of patient's aggressiveness-dangerousness, and attitudes toward severe mentally ill persons were assessed with previously validated instruments. Results Of the 104 participants, 54.8% identified a mental health condition in the schizophrenia vignette compared with only 3.8% in the case of bipolar disorder. Most students believed that both diagnoses could lead to aggressive behaviors. Dangerousness was more frequently perceived in the schizophrenia vignette. Discussion and conclusion It is necessary to sensitize and educate medical students so they have accurate information about symptoms and available treatments for individuals with mental illnesses.

Resumen Introducción La falta de información puede dar como resultado actitudes negativas de los profesionales de la salud hacia los individuos con trastornos mentales. Objetivo Determinar la asociación entre la percepción de agresión-peligrosidad y el reconocimiento de la enfermedad, tratamiento sugerido y actitudes sobre la esquizofrenia y el trastorno bipolar en un grupo de estudiantes de pregrado de medicina. Método El presente es un estudio no experimental, transversal comparativo en una muestra propositiva de estudiantes de medicina. El reconocimiento de la enfermedad, creencias acerca del tratamiento más adecuado, percepción de la agresión-peligrosidad del paciente y las actitudes hacia los trastornos mentales graves fueron evaluados con instrumentos previamente validados. Resultados El 54.8% de un total de 104 participantes identificaron un estado de salud mental en la viñeta de esquizofrenia en contraste con tan sólo el 3.8% para el caso de trastorno bipolar. La mayoría de los estudiantes consideraron que ambos diagnósticos se relacionaban con conductas agresivas. La peligrosidad fue percibida más frecuentemente en la viñeta del caso con esquizofrenia. Discusión y conclusión Es necesario sensibilizar y educar a los estudiantes de medicina para que tengan información clara y precisa sobre los síntomas y tratamientos disponibles para los individuos con trastornos mentales.

Uso de tecnologías de la información en el rendimiento académico basados en una población mexicana de estudiantes de Medicina / Use of information technologies in the academic performance based on a Mexican population of medical students

Introducción: en la actualidad, las tecnologías de la información han modificado la relación entre los diferentes factores que inciden en el rendimiento académico. Dentro de las herramientas virtuales disponibles, los Grupos de Google fueron seleccionados para su aplicación, bajo la hipótesis que su uso permite mejorar el aprovechamiento de los estudiantes durante el curso y a su vez mejorar sus calificaciones. Objetivo: comparar las calificaciones obtenidas en dos grupos de estudiantes de Medicina que cursaron la asignatura de genética. Métodos: un grupo que utilizó las herramientas virtuales de los Grupos de Google y el otro grupo en el cual no se utilizó estas herramientas. Resultados: al comparar las calificaciones en ambos grupos, el resultado confirmó nuestra hipótesis, pues se observó mayor rendimiento académico en los estudiantes que utilizaron las herramientas virtuales de los Grupos de Google. Conclusiones: el uso de las tecnologías conlleva a un cambio en la dimensión gnoseológica de la actividad educativa, cambio que aún adolece de una base metodológica acabada. Los resultados obtenidos en este estudio sugieren que el uso de Tecnologías de la Información y Comunicación en la enseñanza de las Ciencias Médicas, como las herramientas virtuales de los Grupos de Google, aumenta el rendimiento académico en estos estudiantes(AU)

Introduction: Today, information technologies have changed the relationship between the different factors that influence academic performance. Within the available virtual tools, the Google Groups were chosen for their application, under the hypothesis that their use allows to improve the students' use during the course and, in turn, improve their marks. Objective: To compare the marks obtained in two groups of medical students who studied the subject of genetics. Methods: A group that used the virtual tools of Google Groups and the other group, in which these tools were not used. Results: When comparing the marks obtained by both groups, the result confirmed our hypothesis, as it was observed greater academic performance in the students who used the virtual tools of the Google Groups. Conclusions: The use of technologies leads to a change in the gnoseological dimension of educational activity, a change that still suffers from a finished methodological basis. The results obtained in this study suggest that the use of information and communication technologies in the teaching of medical sciences, as the virtual tools of the Google Groups, increases the academic performance in these students(AU)

Evaluación psicológica de la agresividad impulsiva/predeterminada y factores asociados: Un estudio transversal en usuarios de los servicios de salud en Tabasco, México / Psychological evaluation of impulsive/premeditated aggression and associated factors: a cross-sectional study in users of health services in Tabasco, Mexico

Resumen: INTRODUCCIÓN: La conducta suicida es un problema de salud pública. Se sugiere que la personalidad impulsiva o predeterminada participa en los actos de agresividad como el suicidio. OBJETIVO: En este estudio se identificaron diferencias sociodemográficas, de intento de suicidio y la presencia de depresión entre individuos con característica de agresividad impulsiva o predeterminada. MÉTODOS: Se realizó un estudio de tipo transversal que incluyó a 200 residentes de Villahermosa, Tab., México, usuarios de los servicios de salud en ese Estado. La agresividad predeterminada o impulsiva se caracterizó usando la Escala de Agresión Impulsiva/Predeterminada (IPAS). Las características sociodemográficas, de intento de suicidio y de depresión fueron divididas de acuerdo al tipo de agresividad. Subsecuentemente fueron comparadas las características entre los dos grupos. RESULTADOS: Los resultados psicológicos revelaron que la agresividad impulsiva está presente en 62.71 % de la población. Estar desempleado y ser mujer fueron asociadas con la agresividad predeterminada. De igual forma, la mayor proporción de personas con depresión se observó en el grupo de personas predeterminadas (x2 = 18.29, gl = 1, p = 0.001). La proporción de personas con por lo menos un intento de suicidio a lo largo de la vida es similar en las impulsivas y las predeterminadas (6.06% y 6.30%, respectivamente). DISCUSIÓN Y CONCLUSIÓN: El presente estudio no muestra relación entre la personalidad y la proporción del intento de suicidio en los usuarios de los servicios de salud en Tabasco. Sin embargo, el estado de ánimo podría estar asociado con la toma de decisiones.

Abstract: INTRODUCTION: Suicidal behaviour is a public health problem. It has been suggested that impulsive or premeditated personality interferes with aggressive acts such as suicide. OBJECTIVE: In this study, we identified the socio-demographic differences when attempting suicide, as well as the concomitant depression among individuals characterized by impulsive or premeditated aggression. METHODS: We performed a transversal study that included 200 residents of Villahermosa, Tabasco, Mexico, who regularly use the city's General Health Services. The premeditated or impulsive aggression was evaluated using the Impulsive/Premeditated Aggression scale (IPAS). The sample was divided in two groups: impulsive and premeditator individuals. Suicidal attempt, presence of depression and socio-demographic characteristics were evaluated after wards and compared between groups. RESULTS: The psychological evaluation revealed that impulsive aggression is present in 62.71% of the population. We observed that being unemployed and/or being a woman were characteristics associated with premeditated aggression. The premeditators group had the higher proportion of concomitant depression (x2 = 18.29, gl = 1, p = 0.001). The proportion of people that had attempted suicide at least once during their lives was similar in both groups (impulsive = 6.06%, premeditators = 6.30%). DISCUSSION AND CONCLUSION: This study does not show any association between the personality (impulsive or premeditative) and the frequency of suicide attempts in the Tabascan General Health Services users. Nevertheless, the frame of mind (depression) could be associated with taking decisions when attempting suicide.

Association study between the MDR1 gene and clinical characteristics in schizophrenia

Objective: Schizophrenia is a complex psychiatric disorder, characterized by disturbed patterns of thought and affecting 0.3-2.0% of the world population. Previously, the multidrug resistance 1 (MDR1) gene has been associated with schizophrenia in treatment response studies in psychotic patients. The aim of this study was to determine the association between MDR1 gene polymorphisms and clinical characteristics in patients with schizophrenia. Methods: Positive and negative symptoms of schizophrenia were assessed with the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) in 158 Mexican patients with schizophrenia. Analyses of MDR1 gene polymorphisms were performed using TaqMan technology. A multivariate ANOVA was performed with MDR1 polymorphisms and gender as independent variables. Results: Males with the G/G genotype of MDR1 rs2032582 presented significantly higher levels of delusions (p = 0.02). When comparing female vs. male groups, the difference was statistically significant (p = 0.0003). Analyses of the MDR1 gene rs1045642 variant showed no significant differences. Conclusion: Our findings suggest that male carriers of the G allele of variant rs2032582 exhibit greater severity of delusions; however, these results should be taken as preliminary, and replication studies in other populations of different ethnic origins are required to confirm these findings. .

Phytochemical screening and hypoglycemic activity of Carica papaya leaf in streptozotocin-induced diabetic rats

The extraction of plant constituents is essential to isolate biologically active compounds, aimed to understand their role on the treatment of diabetes. This study was designed to explore the preliminary phytochemical and physicochemical analysis of Carica papaya L., Caricaceae, leaf, and further evaluation of its hypoglycemic effect on diabetic rats. C. papaya leaves were extracted using chloroform, n-hexane or ethanol. For each extract a phytochemical screening was performed. The tests were conducted in triplicate and the qualitative and quantitative determination of the various metabolites was done using analytical standards proposed by Mexican Herbal Pharmacopoeia. The chloroform extract, containing steroids and quinones as major components, was chosen to study C. papaya biological effects. The chloroform extract was evaporated to dryness, and doses 0, 31, 62, 125 mg/kg were orally administered in 300 µl polyethylene glycol to diabetic rats; and 0 and 62 mg/kg to non-diabetic rats. After a 20-day treatment with the chloroform extract, the animals were sacrificed and blood was obtained for biochemical studies. The main effect observed was a decrease in serum glucose, triglycerides and transaminases in diabetic rats after the administration of C. papaya chloroform extract. These results confirm the potential beneficial action of C. papaya to treat the symptoms of diabetic patients.

Clinical and Epidemiological Characteristics of Suicides Committed in Medellin, Colombia / Características clínicas y epidemiológicas del suicidio consumado en Medellín, Colombia

Background: The purpose of this study was to identify the characteristics of individuals who committed suicide in Medellín between 2008 and 2010, and to identify variables related to the type of events. Methods: A retrospective and descriptive analysis was conducted on data provided by the National Institute of Legal Medicine and Forensic Sciences. In addition, a univariate and bivariate analysis was used to identify the sociodemographic and medical-legal characteristics of the deceased. Multiple correspondence analysis was also used in order to establish typologies. The information was analyzed using STATA 11.0. Results: Of the 389 cases occurring between 2008 and 2010, 84.6% (n = 329) were men. The male to female ratio was 5:1; 64% of the cases occurred in people aged 18-45 years; 6.7% occurred in children under 18, with hanging being the method most chosen by the victims (48.3%). Exploratory analysis was used to identify a possible association between the use of violent methods and events occurring in the housing and social strata 1, 2 and 3. Conclusions: Some factors could be associated with suicide, providing data that could consolidate health intervention strategies in our population.

Antecedentes: El propósito del estudio es identificar las características de los individuos que cometieron suicidio en la ciudad de Medellín entre 2008 y 2010, además de identificar variables relacionadas con la tipología de los eventos. Métodos: Análisis descriptivo retrospectivo de los datos suministrados por el Instituto Nacional de Medicina Legal y Ciencias Forenses. Además, análisis univariable y bivariable para identificar las características sociodemográficas y médico-legales de los fallecidos. Para establecer posibles tipologías, se utilizó el análisis de correspondencias múltiples. La información se analizó utilizando el programa STATA 11.0. Resultados: De los 389 casos ocurridos entre 2008 y 2010, el 84,6% (n = 329) correspondió a varones. La razón varones:mujeres es 5:1. El 64% de los casos ocurrió en personas de 18-45 anños y el 6,7%, en menores de 18 años. El ahorcamiento fue el método más elegido por las víctimas (48,3%). El análisis exploratorio permitió identificar una posible asociación entre el uso de métodos violentos con los eventos que ocurren en la vivienda y los estratos sociales 1, 2 y 3. Conclusiones: Se pudo delinear algunos factores asociados al suicidio consumado, aportando elementos que pueden consolidar estrategias de intervención en la salud de nuestra población.

Avances en genómica de los trastornos de la conducta alimentaria / Genomic Advances in Eating Behavior Disorders

Resumen Los trastornos de la conducta alimentaria son un problema de salud pública. La etiología de la enfermedad es desconocida, pero se sugiere que tiene una base psiquiátrica, química y biológica. El objetivo de esta revisión es presentar evidencias de cómo la investigación genómica ha contribuido en el estudio de los trastornos de la conducta alimentaria y muestra la intensa investigación dirigida a conocer los genes que pudieran estar participando en la etiológica de los trastornos de la conducta alimentaria.

Abstract Eating behavior disorders are a public health issue. The etiology of these types of disorders is unknown, and they may have psychiatric, chemical and biological origins. The aim of this review is to present evidence that shows the contribution of genomic research in the study of eating behavior disorders. It also shows the considerable research that has been undertaken to identify the genes that may participate in the etiology of eating behavior disorders.

No association between the HTR1A gene and suicidal behavior: a meta-analysis / A não associação entre o gene HTR1A e comportamento suicida: uma metanálise

OBJECTIVE: Dysfunction of serotonin 1A receptors (HTR1A) may play a role in the genesis of suicidal behavior. We studied the association between a functional polymorphism in the HTR1A gene and suicidal behavior. METHOD: We performed a meta-analysis of published genetic association studies by searching through Medline, PubMed, and Web of Science databases to analyze a possible correlation between the rs6295 polymorphism and suicidal behavior in different populations. RESULTS: Four studies comprising a total of nine hundred and fifty seven patients with suicidal behavior and nine hundred and fifty seven controls were the eligible. The G allele of the rs6295 polymorphism may not be associated with suicidal behavior (Random-effects model: OR = 1.08; 95 percent CI: 0.80-1.45; p(Z) = 0.80) in presence of heterogeneity (Q = 17.84, df = 4, p = 0.0013). In a second analysis that presented no heterogeneity, a negative association was also observed (OR = 0.94; 95 percentCI: 0.79-1.13; p(Z) = 0.99). CONCLUSION: To our knowledge, the present study is the first meta-analysis searching for a correlation between rs6295 of HTR1A and suicidal behavior. Our results showed no association between HTR1A and suicidal behavior. However, more studies assessing different populations, as well as larger samples, are needed.

OBJETIVO: É possível que uma disfunção nos receptores 1A de serotonina (HTR1A) desempenhe um papel na origem do comportamento suicida. Estudamos a associação entre um polimorfismo funcional no gene HTR1A e comportamento suicida. MÉTODO: Realizamos uma metanálise de estudos de associação genética já publicados através de uma busca nos banco de dados do Medline, PubMed e Web of Science para identificar uma possível correlação entre o polimorfismo rs6295 e comportamento suicida em diferentes populações. RESULTADOS: Foram selecionados quatro estudos com um total de 957 pacientes com comportamento suicida e 957 controles. O alelo G do polimorfismo rs6295 não pôde ser associado a comportamento suicida (modelo de efeitos aleatórios: OR = 1,08; 95 por centoCI: 0,80-1,45; p(Z) = 0,80) na presença de heterogeneidade (Q = 17,84, df = 4, p = 0,0013). Em uma segunda análise, sem heterogeneidade, também foi observada uma associação negativa (OR = 0,94; 95 por centoCI: 0,79-1,13; p(Z) = 0,99). CONCLUSÃO: Pelo que nos consta, trata-se da primeira metanálise cujo objetivo é identificar uma correlação entre o polimorfismo rs6295 do HTR1A e comportamento suicida. Os nossos resultados não demonstraram existir uma correlação entre o HTR1A e comportamento suicida. No entanto, são necessários estudos adicionais que incluam outras populações, assim como amostras maiores.

Estudio de asociación y metaanálisis del gen de la apolipoproteína E y esquizofrenia / Association study and meta-analysis of the apolipoprotein gene and schizophrenia

Antecedentes: La esquizofrenia es una enfermedad mental cuyas causas etiológicas son desconocidas. Los estudios de epidemiología genética, de asociación y de ligamiento, han sugerido la presencia de factores genéticos involucrados en el desarrollo de la esquizofrenia. Existen numerosos estudios dirigidos a comprender la participación del gen de la apolipoproteína E (ApoE) en la esquizofrenia, sin embargo, los resultados son controversiales por la falta de replicación de los hallazgos. Objetivo: Para conocer el efecto del alelo ε4 de ApoE en esquizofrenia, se analizó la frecuencia de genotipos y alelos de ApoE en pacientes de origen mexicano. Resultados y conclusiones: No observamos diferencias estadísticamente significativas en los pacientes con esquizofrenia comparados con el grupo control en las frecuencias por alelos (χ2=0.94, gl=2, p=0.62) ni por genotipos (χ2=1.02, gl=2, p=0.59). Finalmente, el metaanálisis de 19 estudios de asociación, incluyendo el presente estudio, mostró que el alelo de riesgo ε4 de ApoE no está asociado con el desarrollo de la esquizofrenia (OR=1.04, IC 95%=0.90-1.21, p=0.184), sin la presencia de heterogeneidad (χ2=18.8, gl=18, p=0.4).

BACKGROUND: Schizophrenia is a mental disorder of unknown etiology. Epidemiological, association and linkage studies suggest the presence of genetic factors in the development of this disorder. Numerous studies have been undertaken to gain insight on the role of the ApoE gene in schizophrenia. However, findings remain controversial. OBJECTIVE: The current study analyzed the ApoE gene among schizophrenic patients of Mexican origin. RESULTS AND CONCLUSIONS: No significant differences were found in the distribution of alleles (chi2=0.94, df=2, p=0.62), or genotypes (chi2=1.02, df=2, p=0.59). The meta-analysis comprising 19 association studies (including the present one) showed that the risk allele epsilon4 of ApoE is not associated with the development of schizophrenia (OR 1.04, CI 95%=0.90-1.21, p=0.184) in the absence of heterogeneity (chi2=18.8, df=18, p=0.4).