ABSTRACT
PURPOSE/BACKGROUND: Since the emergence of the coronavirus disease 2019 (COVID-19), many efforts have been made to prevent and to treat the disease. In this line, the anti-inflammatory effect of selective serotonin reuptake inhibitors (SSRI) as alternatives for treating chronic inflammatory diseases has been studied. There is previous evidence of the usefulness of these drugs for reducing COVID-19 impact. METHODS/PROCEDURES: We conducted a retrospective single-center cohort study of adult patients with a positive reverse transcriptase-polymerase chain reaction for COVID-19, evaluating the association between SSRI use and in-hospital mortality. FINDINGS/RESULTS: Of 1689 included patients, 182 (10.8%) were exposed to SSRI. A total of 291 patients died during the hospitalization, representing an in-hospital mortality of 17.2% (95% confidence interval [CI], 15.4%-19.0%): 44 (24.2%) of the exposed to SSRIs versus 247 (16.4%) of those not exposed to SSRIs (crude odds ratio [OR], 1.62; 95% CI, 1.12-2.34; P = 0.009). No independent effect of SSRIs on in-hospital mortality was found when applying either the inverse probability of treatment weighting (OR, 1.15; 95% CI, 0.71-1.89; P = 0.56) or with conventional multivariable analysis 0.81 (95 % CI: 0.28-2.31, P = 0.69). IMPLICATIONS/CONCLUSIONS: In the present retrospective study of patients hospitalized for COVID-19, prior use of SSRIs did not reduce mortality.
Subject(s)
COVID-19 , Selective Serotonin Reuptake Inhibitors , Adult , Humans , Selective Serotonin Reuptake Inhibitors/adverse effects , Retrospective Studies , Cohort StudiesABSTRACT
La anorexia nerviosa (AN) es una enfermedad muy grave. Tiene un curso crónico y una morbi-mortalidad entre las más altas de las patologías psiquiátricas. Se caracteriza por una firme negativa a aumentar o recuperar peso, un miedo intenso a engordar y distorsiones de la imagen corporal. Estas ideas extrañas, exageradas en muchas ocasiones sorprenden por la firmeza con que son defendidas por las pacientes. "En algunos casos la desnutrición autoprovodada está asociada con creencias sobre la alimentación y la forma del cuerpo que son tan extremas que los psiquiatras las describen como delirantes o cuasi delirantes". De hecho, las características de la enfermedad la hacen comparable con algunos tipos de psicosis. De acuerdo con Bruch existe como un rasgo propio de la enfermedad la "negación delirante de la delgadez". A lo largo del trabajo se revisa una posible fisiopatología de estas ideas delirantes. Y se las compara con las ideas delirantes presentes en otras patologías. Para ello en la primera parte del trabajo se ha decripto la AN, su clínica y su fisopatología. En esta segunda parte se detalla la fisiopatología del síntoma delirio. Se concluye con una descripción de los delirios del tipo que se presentan en la anorexia nerviosa.
Nervous Anorexia (NA) is a very serious disease. It is a chronic condition and its morbidity is among the highest of psychiatric pathologies. It is characterized by a strong unwillingness to put on or regain weight, a deep fear to grow fat, and by distortions of the body image. These strange ideas, which in many circumstance are exaggerated, are striking in the sense that they are strongly held by the patients. At times, self-induced malnutrition is associated with beliefs about diet and silhouette, which are so extreme that Psychiatrists describe them as delirious or quasi-delirious. In fact, the characteristics of the disease make it possible to compare it with some types of psychosis. According to Bruch, there is a feature which is characteristic of the disease, namely, "the delirious denial of thinness". In this article, the author does a review of a possible physiopathology of these delirious ideas and compares them with the delirious ideas existing in other pathologies. In this second part the auhtor specifies the physiopathology of the delirium symptom and concludes with a description of the types of deliriums that manifest in nervous anorexia.
Subject(s)
Humans , Anorexia Nervosa/physiopathology , Delirium , Denial, Psychological , Body Image/psychology , Psychotic Disorders , Capgras Syndrome/physiopathology , Paranoid Disorders/physiopathologyABSTRACT
La anorexia nerviosa (AN) es una enfermedad muy grave. Tiene un curso crónico y una morbi-mortalidad entre las más altas de las patologías psiquiátricas. Se caracteriza por una firme negativa a aumentar o recuperar peso, un miedo intenso a engordar y distorsiones de la imagen corporal. Estas ideas extrañas, exageradas en muchas ocasiones sorprenden por la firmeza con que son defendidas por las pacientes. En algunos casos la desnutrición autoprovocada está asociada con creencias sobre la alimentación y la forma del cuerpo que son tan extremas que los psiquiatras las describen como delirantes o cuasi delirantes. De hecho las características de la enfermedad la hacen comparable con algunos tipos de psicosis. De acuerdo con Bruch existe como un rasgo propio de la enfermedad la negación delirante de la delgadez. A lo largo del trabajo se revisa una posible fisiopatología de estas ideas delirantes. Y se las compara con las ideas delirantes presentes en otras patologías. Para ello, en la primera parte del trabajo se describe la AN, su clínica y su fisiopatología. Para luego en la segunda detallar la fisiopatología del síntoma delirio. Y concluir por la descripción de los delirios del tipo que se presentan en la anorexia nerviosa.
Nervous Anorexia (NA) is a very serious disease. It is a chronic condition and ists morbidity is among the highest of psychiatric pathologies. It is characterized by a strong unwilllingness to put on or regain weight, a deep fear to grow fat, and by distortions of the body image. These strange ideas, which in many circumstances are exaggerated, are striking in the sense that they are strongly held by the patients. At times, self-induced malnutrition is associated with beliefs about diet and silhouette, which are so extreme that Psychiatrists describe them as delirious or quasi-delirious. In fact, the characteristics of the disease make it possible to compare it with some types of psychosis. According to Bruch, there is a feature which is characteristic of the disease, namely, "the delirious denial of thinness". In this article, the author does a review of a possible physiopathology of these delirious ideas and compares them with the delirious ideas existing in other pathologies. In order to do so, NA is firstly described, as well as its clinical characteristics and its physiopathology. Then, the physiopathology of the symptoms of delirium is specified. And finally, a description is made of the kinds of deliriums that manifest in this disease.
Subject(s)
Humans , Anorexia Nervosa/diagnosis , Anorexia Nervosa/physiopathology , Feeding and Eating Disorders/mortality , Feeding and Eating Disorders/pathology , Body Image/psychology , Neurobiology , Neuropeptides , Psychotic Disorders/pathology , Neurocognitive Disorders/diagnosisABSTRACT
La anorexia nerviosa (AN) es una enfermedad muy grave. Tiene un curso crónico y una morbi-mortalidad entre las más altas de las patologías psiquiátricas. Se caracteriza por una firme negativa a aumentar o recuperar peso, un miedo intenso a engordar y distorsiones de la imagen corporal. Estas ideas extrañas, exageradas en muchas ocasiones sorprenden por la firmeza con que son defendidas por las pacientes. ôEn algunos casos la desnutrición autoprovocada está asociada con creencias sobre la alimentación y la forma del cuerpo que son tan extremas que los psiquiatras las describen como delirantes o cuasi delirantesö. De hecho las características de la enfermedad la hacen comparable con algunos tipos de psicosis. De acuerdo con Bruch existe como un rasgo propio de la enfermedad la ônegación delirante de la delgadezö. A lo largo del trabajo se revisa una posible fisiopatología de estas ideas delirantes. Y se las compara con las ideas delirantes presentes en otras patologías. Para ello, en la primera parte del trabajo se describe la AN, su clínica y su fisiopatología. Para luego en la segunda detallar la fisiopatología del síntoma delirio. Y concluir por la descripción de los delirios del tipo que se presentan en la anorexia nerviosa. (AU)
Nervous Anorexia (NA) is a very serious disease. It is a chronic condition and ists morbidity is among the highest of psychiatric pathologies. It is characterized by a strong unwilllingness to put on or regain weight, a deep fear to grow fat, and by distortions of the body image. These strange ideas, which in many circumstances are exaggerated, are striking in the sense that they are strongly held by the patients. At times, self-induced malnutrition is associated with beliefs about diet and silhouette, which are so extreme that Psychiatrists describe them as delirious or quasi-delirious. In fact, the characteristics of the disease make it possible to compare it with some types of psychosis. According to Bruch, there is a feature which is characteristic of the disease, namely, "the delirious denial of thinness". In this article, the author does a review of a possible physiopathology of these delirious ideas and compares them with the delirious ideas existing in other pathologies. In order to do so, NA is firstly described, as well as its clinical characteristics and its physiopathology. Then, the physiopathology of the symptoms of delirium is specified. And finally, a description is made of the kinds of deliriums that manifest in this disease. (AU)
