Anomalías físicas menores y características clínicas en pacientes con trastornos del espectro de la esquizofrenia / Minor physical abnormalities and clinical features in patients with schizophrenia spectrum disorders

Introducción. Las anomalías físicas menores son variantes morfológicas inespecíficas producidas durante la gestación.Son marcadores de eventos (heredados o adquiridos) relacionados con la neuroprogresión’ de los trastornos del espectro de la esquizofrenia y podrían estar implicadas de forma diferencial con sus perfiles sintomáticos. El objetivo del estudiofue explorar la relación de las anomalías físicas menores con el síndrome positivo, el síndrome negativo y la psicopatologíageneral en pacientes con esquizofrenia u otras psicosis funcionales. Pacientes y métodos. Estudio de corte transversal de pacientes con esquizofrenia u otras psicosis funcionales hospitalizadosde forma consecutiva por un episodio psicótico agudo. Las anomalías físicas menores se evaluaron mediante la escalaWaldrop, y las características clínicas de la psicosis, mediante la Positive and Negative Syndrome Scale (PANSS). Resultados. Se evaluaron 41 pacientes con psicosis funcionales: 32 (78%) con esquizofrenia y 9 (21,9%) con trastorno psicótico no especificado. No hubo relación entre la puntuación en la escala Waldrop y la puntuación en la PANSS, su escalanegativa y su escala de psicopatología general. La escala positiva de la PANSS y la escala Waldrop se correlacionaron entoda la muestra (rho de Spearman = 0,356; p = 0,022). En el grupo de pacientes con esquizofrenia la correlación fue aún mayor (rho de Spearman = 0,420; p = 0,017).Conclusiones. La trayectoria desde estadios aparentemente premórbidos hasta presentaciones clínicas específicas en pacientescon trastornos del espectro de la esquizofrenia está determinada por el neurodesarrollo, que es un proceso dinámico influido por la herencia genética y por lesiones ambientales (AU)

Introduction. Minor physical anomalies are nonspecific morphologic variants generated during gestation. They are markersof events (inherited and/or acquired) related with the ‘neuroprogression’ of the schizophrenia spectrum disorders and may be differentially involved with their symptom profiles. The aim of the study was to explore the relationship of minorphysical anomalies with positive syndrome, negative syndrome and general psychopathology in patients with schizophrenia or other functional psychoses. Patients and methods. Cross-sectional study of patients with schizophrenia or other functional psychoses consecutivelyhospitalized with an acute psychotic episode. Minor physical anomalies were evaluated with the Waldrop scale and clinical characteristics of psychosis were measured with the Positive and Negative Syndrome Scale (PANSS). Results. 41 patients with functional psychoses were evaluated: 32 (78%) with schizophrenia, 9 (21.9%) with psychotic disorder not otherwise specified. There was no relationship between the Waldrop scale score and score on the PANSS,its negative scale and its general psychopathology scale. The positive scale of the PANSS and the Waldrop scale were correlated in the whole sample (Spearman rho = 0.356; p = 0.022). In the group of patients with schizophrenia, the correlation was even greater (Spearman rho = 0.420; p = 0.017). Conclusions. The path from apparently premorbid stages to specific clinical pictures in patients with schizophrenia spectrum disorders is determined by the neurodevelopment, a dynamic process influenced by genetic inheritance and environmental injuries (AU)

Schizotypy and pathological personality profile in siblings of patients with psychosis / Esquizotipia y perfil de personalidad patológica en hermanos de pacientes psicóticos

Schizotypy has been proposed to be the expression of the genetic vulnerability to schizophrenia. Schizotypal features have been associated with personality dimensions found in patients with psychosis. In this study, we compared the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) scores of patients with psychosis, siblings scoring higher on schizotypy (SSHS), and siblings scoring lower (SSLS). The SSHSs displayed a DAPP-BQ profile characterized by high scores in the dimensions of affective lability, anxiousness, submissiveness, social avoidance, identity problems, oppositionality, narcissism, and restricted expression, distinguishing them from the SSLS. Due to these dimensions, SSHSs are more similar to the patients’ DAPP-BQ profile. The results suggest that this pathological personality profile might contribute to increase the risk of developing psychosis in siblings who have more schizotypal features (AU)

Esquizotipia y perfil de personalidad patológica en hermanos de pacientes psicóticos. La esquizotipia ha sido propuesta como la expresión de la vulnerabilidad genética para la esquizofrenia. Las características esquizotípicas han sido asociadas con las dimensiones de personalidad encontradas en pacientes con psicosis. En este estudio comparamos las puntuaciones del Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) de pacientes con psicosis, hermanos con puntuaciones altas en esquizotipia (SSHS) y hermanos con puntuaciones bajas (SSLS). Los SSHS mostraron un perfil del DAPP-BQ caracterizado por puntuaciones elevadas en las dimensiones de labilidad afectiva, ansiedad, sumisión, evitación social, problemas de identidad, oposición, narcisismo y expresión restringida, distinguiéndolos de los SSLS. Estas dimensiones hacen a los SSHS más parecidos al perfil del DAPP-BQ de los pacientes. Los resultados sugieren que este perfil de personalidad patológica podría contribuir a incrementar riesgo de desarrollar psicosis en los hermanos que tienen más características esquizotípicas (AU)

Schizotypy and pathological personality profile in siblings of patients with psychosis.

Schizotypy has been proposed to be the expression of the genetic vulnerability to schizophrenia. Schizotypal features have been associated with personality dimensions found in patients with psychosis. In this study, we compared the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) scores of patients with psychosis, siblings scoring higher on schizotypy (SSHS), and siblings scoring lower (SSLS). The SSHSs displayed a DAPP-BQ profile characterized by high scores in the dimensions of affective lability, anxiousness, submissiveness, social avoidance, identity problems, oppositionality, narcissism, and restricted expression, distinguishing them from the SSLS. Due to these dimensions, SSHSs are more similar to the patients' DAPP-BQ profile. The results suggest that this pathological personality profile might contribute to increase the risk of developing psychosis in siblings who have more schizotypal features.

[Psychological and behavioural symptoms as factors of progression to Alzheimer-type dementia in mild cognitive impairment]. / Síntomas psicológicos y conductuales como factores de progresión a demencia tipo Alzheimer en el deterioro cognitivo leve.

INTRODUCTION: Mild cognitive impairment (MCI) is a cognitive disturbance in which intensity is not enough to be classified as dementia and does not affect significantly the functioning or activities of daily living. The MCI has a progression rate to Alzheimer-type dementia (ATD) related to different factors. AIM: To evaluate the association between the presence of psychological and behavioural symptoms (PBS) with progression to ATD en MCI subjects. PATIENTS AND METHODS: We evaluated 318 patients with MCI assessed in a Dementia Unit of Catalonia between 1998 to 2002 who were followed five years after the MCI diagnosis. We determined the PBS presence, those classified as affective, behavioural and psychotic symptoms. We also assessed sociodemographic aspects and the ApoE genotype. RESULTS: The mean age was 74 +/- 7.87 years-old, 56.7% presented PBS, with affective (53%), behavioural (32.2%) and psychotic symptoms (14.8%). In the study, 32.1% progressed to ATD. We found association between the presence of PBS and the progression to ATD (OR = 2.77; 95% CI = 1.66-4.63), specifically with behavioural and psychotic symptoms. The ApoE epsilon4 allele showed association with the progression to ATD (OR = 1.81; 95% CI = 1.11-2.94). The logistic regression model showed a significant association between the PBS and the epsilon4 allele with the progression to ATD. CONCLUSIONS: The PBS presence in MCI patients is associated with ATD progression with or without ApoE epsilon4 allele.

Síntomas psicológicos y conductuales como factores de progresión a demencia tipo Alzheimer en el deterioro cognitivo leve / Psychological and behavioural symptoms as factors of progression to Alzheimer-type dementia in mild cognitive impairment

Introducción. El deterioro cognitivo leve (DCL) es una alteración cognitiva cuya intensidad no es suficiente para ser catalogada como demencia, ya que no interfiere significativamente en la autonomía funcional en las actividades de la vida diaria. El DCL presenta una tasa de progresión a demencia tipo Alzheimer (DTA) relacionada con diferentes factores. Objetivo. Evaluar la asociación entre la presencia de síntomas psicológicos y conductuales (SPC) con la progresión a DTA en sujetos con DCL. Pacientes y métodos. Evaluamos 318 pacientes con DCL valorados por una unidad de demencias de Cataluña de 1998 a 2002, con seguimiento los cinco años siguientes al diagnóstico de DCL. Se determinó la presencia de SPC clasificados en síntomas afectivos, psicóticos y conductuales. También se evaluaron otras variables sociodemográficas y el genotipo ApoE. Resultados. La edad promedio fue de 74 ± 7,87 años, y el 56,7% presentó SPC con síntomas afectivos (53%), conductuales (32,2%) y psicóticos (14,8%). El 32,1% progresó a DTA. Se encontró asociación estadística entre la presencia de SPC con la progresión a DTA (OR = 2,77; IC 95% = 1,66-4,63), concretamente con alteraciones conductuales y síntomas psicóticos. El alelo épsilon 4 del gen ApoE mostró asociación con la progresión a DTA (OR = 1,81; IC 95% = 1,11-2,94). El modelo de regresión logística mostró asociación significativa entre los SPC y el alelo épsilon 4 con la progresión a DTA. Conclusiones. La presencia de SPC en el DCL se asocia con la progresión a DTA, tanto en presencia como en ausencia del alelo épsilon 4 del gen ApoE (AU)

Introduction. Mild cognitive impairment (MCI) is a cognitive disturbance in which intensity is not enough to be classified as dementia and does not affect significantly the functioning or activities of daily living. The MCI has a progression rate to Alzheimer-type dementia (ATD) related to different factors. Aim. To evaluate the association between the presence of psychological and behavioural symptoms (PBS) with progression to ATD en MCI subjects. Patients and methods. We evaluated 318 patients with MCI assessed in a Dementia Unit of Catalonia between 1998 to 2002 who were followed five years after the MCI diagnosis. We determined the PBS presence, those classified as affective, behavioural and psychotic symptoms. We also assessed sociodemographic aspects and the ApoE genotype. Results. The mean age was 74 ± 7.87 years-old, 56.7% presented PBS, with affective (53%), behavioural (32.2%) and psychotic symptoms (14.8%). In the study, 32.1% progressed to ATD. We found association between the presence of PBS and the progression to ATD (OR = 2.77; 95% CI = 1.66-4.63), specifically with behavioural and psychotic symptoms. The ApoE epsilon4 allele showed association with the progression to ATD (OR = 1.81; 95% CI = 1.11-2.94). The logistic regression model showed a significant association between the PBS and the epsilon4 allele with the progression to ATD. Conclusions. The PBS presence in MCI patients is associated with ATD progression with or without ApoE epsilon4 allele (AU)

[Delusions and their relation with temperament and character in psychotic patients]. / Delirios y su relación con el temperamento y carácter en pacientes con trastorno psicótico.

Delusions and their relation with temperament and character in psychotic patients. Recent studies have investigated the relationship between personality traits and symptomatology in schizophrenia. The aim of this study is to investigate whether Cloninger's dimensional personality traits are related to psychotic delusional symptomatology. In the study, we include a sample of 105 patients with DSM-IV diagnosis of schizophrenia or another psychotic disorder. Delusions were evaluated by the SCAN interview. Our results suggest that some personality traits may contribute to heterogeneity in the presentation of psychotic positive delusional disorder congruent with affective symptoms. Thus, Harm Avoidance would be related to delusions that course with a depressive state and Novelty Seeking to those concurrent with an expansive affectivity.

Delirios y su relación con el temperamento y carácter en pacientes con trastorno psicótico / Delusions and their relation with temperament and character in psychotic patients

En numerosos estudios y desde diferentes modelos se ha especulado sobre la relación entre personalidad y psicosis. El objetivo de este trabajo es estudiar si las dimensiones o rasgos de personalidad, evaluados con el Modelo de Cloninger y presentes en pacientes psicóticos, están relacionados con niveles de sintomatología delirante. Participaron en el estudio una muestra de 105 pacientes diagnosticados dentro del grupo de esquizofrenias u otros trastornos psicóticos no orgánicos según criterios DSM-IV. La evaluación de los delirios se realiza con la entrevista SCAN. Tras estudiar posibles relaciones y vínculos, nuestros resultados nos podrían llevar a pensar que exista relación entre síntomas delirantes y personalidad de acuerdo con una congruencia afectiva semejante. Así, Evitación del daño presentaría relación con síntomas que cursan con un estado de ánimo depresivo, y Búsqueda de novedades con síntomas que implican un ánimo expansivo (AU)

Recent studies have investigated the relationship between personality traits and symptomatology in schizophrenia. The aim of this study is to investigate whether Cloninger’s dimensional personality traits are related to psychotic delusional symptomatology. In the study, we include a sample of 105 patients with DSM-IV diagnosis of schizophrenia or another psychotic disorder. Delusions were evaluated by the SCAN interview. Our results suggest that some personality traits may contribute to heterogeneity in the presentation of psychotic positive delusional disorder congruent with affective symptoms. Thus, Harm Avoidance would be related to delusions that course with a depressive state and Novelty Seeking to those concurrent with an expansive affectivity (AU)