Cannabis is one of the most commonly used substances among adolescents and young adults. Earlier age at cannabis initiation is linked to adverse life outcomes including multi-substance use and dependence. This study estimated the... more
Cannabis is one of the most commonly used substances among adolescents and young adults. Earlier age at cannabis initiation is linked to adverse life outcomes including multi-substance use and dependence. This study estimated the heritability of age at first cannabis use and identify associations with genetic variants. A twin-based heritability analysis using 8,055 twins from three cohorts was performed. We then carried-out a genome wide survival meta-analysis of age at first cannabis use in a discovery sample of 24,953 individuals from nine European, North American, and Australian cohorts, and a replication sample of 3,735 individuals. The twin-based heritability for age at first cannabis use was 38% (95% confidence interval [CI] 19-60%). Shared and unique environmental factors explained 39% (95% CI 20-56%) and 22% (95% CI 16-29%). The genome wide survival meta-analysis identified five SNPs on chromosome 16 within the Calcium-transporting ATPase gene (ATP2C2) at P < 5E-08. All f...
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Methylphenidate (MPH) is the most frequently used pharmacological treatment in children with attention-deficit/hyperactivity disorder (ADHD). However, a considerable interindividual variability exists in clinical outcome. Thus, we... more
Methylphenidate (MPH) is the most frequently used pharmacological treatment in children with attention-deficit/hyperactivity disorder (ADHD). However, a considerable interindividual variability exists in clinical outcome. Thus, we performed a genome-wide association study of MPH efficacy in 173 ADHD paediatric patients. Although no variant reached genome-wide significance, the set of genes containing single-nucleotide polymorphisms (SNPs) nominally associated with MPH response (P < 0.05) was significantly enriched for candidates previously studied in ADHD or treatment outcome. We prioritised the nominally significant SNPs by functional annotation and expression quantitative trait loci (eQTL) analysis in human brain, and we identified 33 SNPs tagging cis-eQTL in 32 different loci (referred to as eSNPs and eGenes, respectively). Pathway enrichment analyses revealed an over-representation of genes involved in nervous system development and function among the eGenes. Categories relat...
Research Interests: Genomics, Treatment Outcome, Adolescent, Medicine, Humans, and 14 moreChild, Female, Male, Single Nucleotide Polymorphism, Adulto, Methylphenidate, Metilfenidato, Child preschool, Attention deficit disorder with hyperactivity, Attention deficit hyperactivity disorder, Psychology and Cognitive Sciences, Central nervous system stimulants, Medical and Health Sciences, and Transtorno do Déficit de Atenção com Hiperatividade
Borderline Personality Disorder (BPD) is one of the Personality Disorder most frequently associated with Substance Use Disorder (SUD). According to different models, the Behavioral dysregulation-BPD subgroup has a higher prevalence of SUD... more
Borderline Personality Disorder (BPD) is one of the Personality Disorder most frequently associated with Substance Use Disorder (SUD). According to different models, the Behavioral dysregulation-BPD subgroup has a higher prevalence of SUD and certain impulsivity behaviors than the other two subgroups. Out of 156 BPD patients, 47 were in the Behavioral dysregulation-BPD subgroup, 55 in Affective dysregulation, and 54 in Disturbed relatedness. All patients completed the SCID-II for DSM-IV Axis II Disorders, SCID-I for DSM-IV Axis I Disorders, Barratt Impulsiveness Scale (BIS-11) and Revised Diagnostic Interview for Borderlines (DIB-R). In the comparison of the BPD subgroups, Behavioral dysregulation showed significantly more prevalence of SUD (alcohol and cocaine), and tendency for anxiolytics, higher impulsivity (DIB-R, but none in BIS-11), and higher number of suicide attempts and psychiatric admissions, although these was not significant in comparison with the other subgroups. This...
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The study focused on examining the prevalence of Personality Disorders (PD) in 51 male inmates diagnosed with Substance Use Disorders (SUDs) lifetime within a specialized unit at a prison. The instruments administered included the... more
The study focused on examining the prevalence of Personality Disorders (PD) in 51 male inmates diagnosed with Substance Use Disorders (SUDs) lifetime within a specialized unit at a prison. The instruments administered included the Structured Clinical Interview for DSM-IV Axis I and the Personality Diagnostic Questionnaire-4+. The type of crime most frequently committed by the incarcerated was the robbery (76.5%), including robbery with violence. 45.1% of the patients screened positive for Antisocial PD, followed by 35.3% for Paranoid and 23.5% for Obsessive Compulsive PD. The results reflect a male inmate sample exhibiting a clinical profile characterized by SUDs and PD, with almost half of the total sample presenting Antisocial PD. The presence of Antisocial and Paranoid PD with SUD suggests a more complex personality profile, with a tendency to carry out more aggressive crimes, including robbery with violence. A more comprehensive PD assessment should be carried out in prison sett...
Research Interests: Psychology, Clinical Psychology, Psychiatry, Personality, Personality Disorders, and 15 moreMedicine, Antisocial Personality Disorder, Humans, Prison, Male, Recidivism, Young Adult, Clinical Sciences, Prevalence, Middle Aged, Prisoners, Adult, Self report, Personality Tests, and Substance-Related Disorders
The comorbidity between substance-use disorders and borderline personality disorder (SUD-BPD) with other psychiatric disorders has been little studied. A total of 937 drug-dependent patients were evaluated using semistructured interviews... more
The comorbidity between substance-use disorders and borderline personality disorder (SUD-BPD) with other psychiatric disorders has been little studied. A total of 937 drug-dependent patients were evaluated using semistructured interviews and 13.7% were SUD-BPD patients. After multivariate analysis, gender, Affective Disorder (OR 2.59), Anxiety Disorder (OR 1.90), Eating Disorders (OR 4.29), Cocaine (OR 2.16), benzodiazepine dependence (OR 1.90), early age of onset of drug consumption (OR 0.94), and dependent (OR 4.04), paranoid (OR 3.70) and antisocial personality disorders (OR 3.46) were associated with SUD-BPD. Several psychiatric comorbidities are the norm in SUD-BPD patients; therefore these patients are a challenge for clinicians.
Research Interests: Psychology, Clinical Psychology, Psychiatry, Personality Disorders, Borderline Personality Disorder, and 15 moreMedicine, Comorbidity, Anxiety, Spain, Humans, Female, Male, Young Adult, Mental Disorders, Risk factors, Outpatients, Adult, Public health systems and services research, Risk Factors, and ANXIETY
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Disorders of the brain exhibit considerable epidemiological comorbidity and frequently share symptoms, provoking debate about the extent of their etiologic overlap. We quantified the genetic sharing of 25 brain disorders based on summary... more
Disorders of the brain exhibit considerable epidemiological comorbidity and frequently share symptoms, provoking debate about the extent of their etiologic overlap. We quantified the genetic sharing of 25 brain disorders based on summary statistics from genome-wide association studies of 215,683 patients and 657,164 controls, and their relationship to 17 phenotypes from 1,191,588 individuals. Psychiatric disorders show substantial sharing of common variant risk, while neurological disorders appear more distinct from one another. We observe limited evidence of sharing between neurological and psychiatric disorders, but do identify robust sharing between disorders and several cognitive measures, as well as disorders and personality types. We also performed extensive simulations to explore how power, diagnostic misclassification and phenotypic heterogeneity affect genetic correlations. These results highlight the importance of common genetic variation as a source of risk for brain diso...
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Affective psychoses include those disorders with psychotic and affective symptoms described in the DSM-IV-TR. In these pathologies, the prevalence of nicotine dependence is very high. The objective here is to carry out a review of the... more
Affective psychoses include those disorders with psychotic and affective symptoms described in the DSM-IV-TR. In these pathologies, the prevalence of nicotine dependence is very high. The objective here is to carry out a review of the relation between nicotine use and psychiatric disorders considered as affective psychoses at the epidemiological, clinical, prognostic and treatment levels. We review studies published in the PubMed database that include the keywords smoking, tobacco, nicotine and schizoaffective or bipolar disorder. Comorbidity of bipolar and schizoaffective disorder with nicotine consumption is 66-82.5 % and 67%, respectively. On the basis of this review it can be concluded that smoking results in poorer prognosis and greater clinical seriousness of bipolar and schizoaffective disorders. Use of other substances, psychiatric diagnosis, clinical seriousness and caffeine consumption are risk factors for nicotine use. The most effective treatment approach is pharmacologi...
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Cocaine consumption can induce transient psychotic symptoms expressed as paranoia or hallucinations. This work reviews that evidence and tries to obtain data regarding frequency of psychotic symptoms or cocaine induced psychosis (CIP),... more
Cocaine consumption can induce transient psychotic symptoms expressed as paranoia or hallucinations. This work reviews that evidence and tries to obtain data regarding frequency of psychotic symptoms or cocaine induced psychosis (CIP), risks or associated factors. Systematic review of studies found in PubMed database published until January 2011 where cocaine induced paranoia was present. Cocaine induced paranoia has a particular clinical presentation. It needs to be clearly identified due to its harmful consequences. The prevalence is between 12% in clinical studies and 100% in experimental studies. The following are considered potential risk factors: age of first use and length, amount of substance, route of administration, body mass index, genetic factors, personal vulnerability and comorbidity with AXIS I (psychosis, ADHD) and AXIS II disorders (antisocial personality disorder). It is needed to research with larger samples of cocaine users of different countries and contexts, in...
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Research Interests: Psychology, Treatment Outcome, Medicine, Humans, Placebo, and 15 moreFemale, Male, Placebos, Middle Aged, Adult, Educational Status, Osmosis, Methylphenidate, Psychiatric Status Rating Scales, Attention deficit disorder with hyperactivity, Sex Characteristics, Attention deficit hyperactivity disorder, Psychology and Cognitive Sciences, Central nervous system stimulants, and Medical and Health Sciences
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The Personality Diagnostic Questionnaire-4+ (PDQ-4+) is composed of a self-report and an interview, the Clinical Significance Scale, but no studies have reported joint findings. This study is the first to examine the diagnostic agreement... more
The Personality Diagnostic Questionnaire-4+ (PDQ-4+) is composed of a self-report and an interview, the Clinical Significance Scale, but no studies have reported joint findings. This study is the first to examine the diagnostic agreement between the Spanish version of the PDQ-4+ self-report and its corresponding interview. The sample comprised 235 psychiatric outpatients who were assessed with both instruments. The interview reduced to one half the number of diagnoses provided by self-report (83.4% to 38.3%; mean number of diagnoses 3.29 to .62). Diagnostic agreement was between fair and moderate (mean kappa .45 for PDQ-4+ total score). Findings suggest the utility of jointly administering the PDQ-4+ and its Clinical Significance Scale to screen for the presence or absence of personality disorders (PDs). Modifications in the diagnostic cut-offs for individual PDs and the PDQ-4+ total score may improve the efficacy of the instrument.
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Research Interests: Psychology, Clinical Psychology, Psychotherapy, Borderline Personality Disorder, Adolescent, and 15 moreGroup Psychotherapy, Medicine, Humans, Female, Cognitive Therapy, Male, Randomised Controlled Trial, Psychotherapist, Adult, Dialectical Behavior Therapy, Randomized Controlled Trial, Suicide Attempt, Emergency Department, Psychiatric Status Rating Scales, and Outcome measure
IntroductionCo-morbidity between Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUD) is considered to be about 25–50% in adults. Several studies show vulnerability factors to later SUD to be associated with... more
IntroductionCo-morbidity between Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUD) is considered to be about 25–50% in adults. Several studies show vulnerability factors to later SUD to be associated with childhood ADHD features, such as conduct problems, untreated ADHD and maltreatment.ObjectivesTo define childhood ADHD associated factors that predispose to SUD.Specifically, comorbidity with oppositional defiant disorder (ODD) and conduct disorder (CD), temperamental traits, academic failure, familial SUD history, childhood maltreatment and subtype, severity and age of treatment of ADHD symptoms.MethodsA comparative study was carried out in a sample of ADHD adults from the Department of Psychiatry H.U. Vall d’Hebron. Both groups, ADHD and ADHD+SUD subjects underwent the following assessment protocol: Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID-I & II), Wender Utath Rating Scale (WURS), SCID-I, SCID-II and K-SDAS.ResultsThe total sample...
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Adult attention deficit hyperactivity disorder (ADHD) has a prevalence up to 4% of the general adult population, however in Spain adult ADHD is underdiagnosed. Screening instruments can help clinicians to detect adult ADHD. The World... more
Adult attention deficit hyperactivity disorder (ADHD) has a prevalence up to 4% of the general adult population, however in Spain adult ADHD is underdiagnosed. Screening instruments can help clinicians to detect adult ADHD. The World Health Organization Adult ADHD Self-Report Scale-Version 1.1 (ASRS v1.1) is a 6-question scale designed to screen for adult ADHD. A validation of Spanish version of the ASRS v1.1 was performed. A case control study was carry out (adult ADHD vs non ADHD) in the Adult ADHD Program of the Hospital Universitari Vall d'Hebron (Barcelona). ADHD evaluation was performed using Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID-Part II) and the diagnosis was compared with the ASRS v1.1 responses. Logistic regression study was made to evaluate the sensitivity, specificity, positive and negative predictive values (PPV and NPV). Kappa coefficient of classification accuracy and area under curve (AUC) were calculated. Sample consisted of 90 adult ADHD and 90 controls. Average age was 31.6 (SD=10.09) and 57.8% of subjects were men (there were no significant differences between the two groups). Logistic regression analysis showed that the score model proposed by the authors of scale is significant (c2 =129.36, p=.0005): Sensitivity (82.2%), specificity (95.6%), PPV (94.8%), NPV (84.3%), Kappa coefficient 0.78 and AUC 0.89. The Spanish version of the ASRS v1.1 6-question shows adequate psychometric characteristics and it is a valid scale to screen ADHD for adults in a clinical setting.