Premorbid intelligence quotient and school failure as risk markers for bipolar disorder and major depressive disorder.

Mood disorders significantly impact global health, with MDD ranking as the second leading cause of disability in the United States and BD ranking 18th. Despite their prevalence and impact, the relationship between premorbid intelligence and the subsequent development of BD and MDD remains inconclusive. This study investigates the potential of premorbid Intelligence Quotient (IQ) and school failure frequency as risk factors for Bipolar Disorder (BD) and Major Depressive Disorder (MDD) in a birth cohort setting. We analyze data from the Pelotas population-based birth cohort study, comprising 3580 participants aged 22, who had no prior mood disorder diagnoses. Utilizing regression models and accounting for potential confounders, we assess the impact of IQ and school failure, measured at age 18, on the emergence of BD and MDD diagnoses at age 22, using individuals without mood disorders as comparators. Results reveal that lower IQ (below 70) at 18 is associated with an increased risk of BD (Adjusted Odds Ratio [AOR] 1.75, 95%CI: 1.00-3.09, p < 0.05), while higher IQ (above 120) is linked to MDD (AOR 2.16, 95%CI: 1.24-3.75, p < 0.001). Moreover, an elevated number of school failures is associated with increased BD risk (AOR 1.23, 95%CI: 1.11-1.41, p < 0.001), particularly for BD type 1 (AOR 1.36, 95% CI: 1.17-1.58, p < 0.001). These findings offer insights into the distinct premorbid intellectual characteristics of BD and MDD and contribute to a deeper understanding of their developmental trajectories, potentially informing the development of risk assessment tools for mood disorders.

Trajectories of Spirometric Patterns, Obstructive and PRISm, in a Population-Based Cohort in Latin America.

Background: Preserved ratio impaired spirometry (PRISm) has been associated with adverse outcomes and increased transition to other spirometric categories over time. We aimed to examine its prevalence, trajectories over time, and outcomes in a population-based sample from Latin America. Methods: Data were obtained from two population-based surveys of adults from three cities in Latin America (PLATINO study), conducted on the same individuals 5-9 years after their baseline examination. We estimated the frequency of PRISm defined by FEV1/FVC≥0.70 with FEV1 <80%, describing their clinical characteristics, longitudinal transition trajectories over time, factors associated with the transition. Results: At baseline, 2942 participants completed post-bronchodilator spirometry, and 2026 at both evaluations. The prevalence of normal spirometry was 78%, GOLD-stage 1 10.6%, GOLD 2-4 6.5%, and PRISm was: 5.0% (95% CI 4.2-5.8). PRISm was associated with less schooling, more reports of physician-diagnosis of COPD, wheezing, dyspnea, missing days at work, having ≥2 exacerbations in the previous year but without accelerated lung function decline. Mortality risk was significantly higher in PRISm (HR 1.97, 95% CI 1.2-3.3) and COPD GOLD 1-4 categories (HR 1.79, 95% CI 1.3-2.4) compared with normal spirometry. PRISm at baseline most frequently transitioned to another category at follow-up (46.5%); 26.7% to normal spirometry and 19.8% to COPD. The best predictors of transition to COPD were closeness of FEV1/FVC to 0.70, older age, current smoking, and a longer FET in the second assessment. Conclusion: PRISm, is a heterogeneous and unstable condition prone to adverse outcomes that require adequate follow-up.

Comorbilidades y estado de salud en individuos con y sin EPOC en 5 ciudades de América Latina: Estudio PLATINO / Comorbidities and Health Status in Individuals With and Without COPD in Five Latin American Cities: The PLATINO Study

INTRODUCCIÓN: La enfermedad pulmonar obstructiva crónica (EPOC) se asocia a comorbilidades que influyen en el estado de salud y en el pronóstico de los pacientes. El estudio PLATINO aporta datos sobre comorbilidades autorreportadas y percepción del estado general de salud (EGS) en la EPOC. MÉTODOS: PLATINO es un estudio poblacional, sobre prevalencia de EPOC en 5 ciudades de Latinoamérica. El diagnóstico de EPOC se realizó según el criterio de GOLD (FEV1/FVC < 0,70 post-broncodilatador). Se recogió información sobre las siguientes comorbilidades: cardíaca, hipertensión, diabetes, accidente cerebrovascular (ACV), úlcera y asma. El EGS se evaluó mediante el cuestionario SF-12, con la pregunta: «En general ¿diría usted que su salud es: excelente, muy buena, buena, regular o pobre?». Sumando las comorbilidades, se elaboró un índice de comorbilidad. RESULTADOS: Sobre una población total de 5.314 individuos se realizó diagnóstico de EPOC en 759. Las comorbilidades reportadas en orden decreciente fueron: cualquier tipo de enfermedad cardiovascular, hipertensión, úlcera péptica, enfermedad cardíaca, diabetes, ACV, asma y cáncer de pulmón. Los sujetos con EPOC tuvieron mayor índice de comorbilidad, prevalencia de cáncer de pulmón (p < 0,0001) y asma (p < 0,0001), así como mayor tendencia a hipertensión (p = 0,0652) y ACV (p = 0,0750). Los factores asociados a comorbilidad en EPOC fueron la edad, el índice de masa corporal (IMC) y el género femenino. Con el deterioro del EGS aumenta el número de comorbilidades. CONCLUSIONES: En población no seleccionada los individuos con EPOC presentan más comorbilidades. La edad, el sexo femenino y mayor IMC son los principales factores asociados a comorbilidad en estos pacientes. Independientemente de la condición de EPOC, un mayor número de comorbilidades se asocia a peor EGS (AU)

INTRODUCTION: Comorbidities are common in patients with chronic obstructive pulmonary disease (COPD), and have a significant impact on health status and prognosis. The PLATINO study provides data on self-reported comorbidities and perceived health status in COPD subjects. METHODS: PLATINO is a population-based study on COPD prevalence in five Latin American cities. COPD diagnosis was defined by GOLD criteria (FEV1/FVC<0.70 post-bronchodilator). Information was collected on the following comorbidities: heart disease, hypertension, diabetes, cerebrovascular disease, peptic ulcer and asthma. Health status was evaluated using the SF-12 questionnaire, derived from the question: "In general, would you say your health is excellent, very good, good, fair or poor?" A simple comorbidity score was calculated by adding the total number of comorbid conditions. RESULTS: Of a total population of 5314 individuals, 759 had COPD. Reported comorbidities by decreasing frequency were: any cardiovascular disease, hypertension, peptic ulcer, heart disease, diabetes, cerebrovascular disease, asthma and lung cancer. COPD patients had a higher comorbidity score and prevalence of lung cancer (P<0.0001) and asthma (P<0.0001), as well as a higher tendency to have hypertension (P=0.0652) and cerebrovascular disease (P=0.0750). Factors associated with comorbidities were age, body mass index (BMI) and female gender. The number of comorbidities increased as the health status deteriorated. CONCLUSIONS: In the PLATINO population-based study, COPD individuals had an increased number of comorbidities. Age, female gender and higher BMI were the factors associated with comorbidity in these patients. Comorbid conditions were associated with impaired health status, independently of the COPD status (AU)

[Spirometric reference values in 5 large Latin American cities for subjects aged 40 years or over]. / Valores de referencia espirométrica en 5 grandes ciudades de Latinoamérica para sujetos de 40 o más años de edad.

OBJECTIVE: In clinical practice, spirometry is a extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. The aim of this study was to report spirometric reference values for 5 cities in Latin America. PATIENTS AND METHODS: From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, São Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. The chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model. RESULTS: Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%. CONCLUSIONS: The proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.