La esquizofrenia es una enfermedad que afecta aproximadamente al 1% de la población mundial. Es u... more La esquizofrenia es una enfermedad que afecta aproximadamente al 1% de la población mundial. Es una de las enfermedades psiquiátricas más debilitantes con un alto costo económico, social, familiar y personal. En Costa Rica, la esquizofrenia constituye la primera causa de internamiento entre los desórdenes psiquiátricos en el Hospital Nacional Psiquiátrico. El presente estudio analiza el diagnóstico preliminar de los primeros 120 pacientes incluidos en el proyecto sobre la Genética de la Esquizofrenia. Al comparar el diagnóstico del entrevistador, el diagnóstico final por consenso y el diagnóstico del último egreso hospitalario se encontraron diferencias en alrededor del 40% de los sujetos en el estudio. Se encontró un relativo sub-registro de la sintomatología afectiva en los diagnósticos de egreso con el consecuente sobre-diagnostico de los trastornos esquizofrénicos en los hospitales nacionales. El trastorno esquizoafectivo fue uno de los diagnósticos con menor concordancia. Las d...
Justificación y objetivo: la esquizofrenia es una enfermedad crónica con importantes repercusione... more Justificación y objetivo: la esquizofrenia es una enfermedad crónica con importantes repercusiones sociales que afecta al 1% de la población mundial. Se describe las características de la esquizofrenia en una muestra de pacientes del Valle Central de Costa Rica.Métodos: estudio descriptivo, transversal en esquizofrénicos diagnosticados a través del proceso de mejor estimado diagnostico según la cuarta edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSMIV).Resultados: de 260 esquizofrénicos, 186 (71.5%) son varones y 74 (28.5%) mujeres, la edad promedio de entrevista es 38.95 años (Desviación Standard (DS): 11.37), menor en los varones(37.54 años, DS: 10.46) que en las mujeres (42.49 (DS: 12.81, p0.05).Discusión: Nuestros pacientes presentaron características clínicas y demográficas similares a lo observado en otras poblaciones. Más de la mitad de los individuos tenían antecedente de síntomas afectivos siendo los depresivos los más frecuentes. Los varones sol...
Brain-derived neurotrophic factor val66met polymorphism has been implicated in the pathophysiolog... more Brain-derived neurotrophic factor val66met polymorphism has been implicated in the pathophysiology of bipolar disorder. We investigated the neurochemistry of the left dorsolateral prefrontal cortex of bipolar disorder and healthy participants in relation to the brain-derived neurotrophic factor val66met polymorphism using H-magnetic resonance spectroscopy. Absolute N-acetyl-aspartate, phosphocreatine+creatine (PCr+Cr), choline-containing compounds, myo-inositol, and glutamate levels were measured. Bipolar disorder met-carriers had lower PCr+Cr levels than bipolar disorder val/val patients, and bipolar disorder val/val patients had higher PCr+Cr levels than val/val healthy controls. These results indicate that bipolar disorder met-carriers have abnormal energy metabolism in the left dorsolateral prefrontal cortex.
Across ethnicity/race, prevalence rates of bipolar disorder are similar. However, African America... more Across ethnicity/race, prevalence rates of bipolar disorder are similar. However, African Americans and Latinos may receive less specialty mental health treatment and different medications, and may be less adherent to treatment regimens than European American patients. This study compared illness characteristics, treatment history, and overall functioning in a sample of European American, African American, and Latino patients with bipolar disorder. The samples were drawn from the first 2,000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. There were 1,686 European Americans, 65 African Americans, and 77 Latinos. The data were collected upon study entry, with structured interviews, clinicianrated forms, and self report. African Americans had a greater likelihood of psychosis and fewer psychiatric medication prescriptions than did European Americans. Latinos had greater alcohol comorbidity, fewer psychiatric medication prescriptions and specialt...
Interest in understanding the comorbidity of schizophrenia and substance use disorder has been in... more Interest in understanding the comorbidity of schizophrenia and substance use disorder has been increasing due to the increase of this diagnosis, to the negative effects observed in the subject and to the health service costs. This dual disorder can have dramatic effects on the clinical course of the psychiatric disorder, this being, for example increased relapses, re-hospitalizations, more severe symptoms, noncompliance with antipsychotic medication, marked mood changes, increased rates of hostility and suicidal ideation as well as in other areas of functioning, including interpersonal violence and victimization, homelessness, and legal problems. Literature from the United States and Europe in particular suggests that the prevalence rates for this dual diagnosis may range from 10 to 70%. In this study, we have reviewed the prevalence of the dual diagnosis of schizophrenia and substance use disorder as well as the sociodemographic characteristics in the literature on Latin-American p...
We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-relate... more We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-related medical conditions in elderly Mexican American (MA) and non-Hispanic white (NHW) residents of El Paso County, Texas. We analyzed the extent to which depressive symptoms in this population are associated with these conditions. Elderly MA residents possessed a higher prevalence of current depression, a relatively unique health-related condition profile, and were more likely to experience a set of conditions that impede participation in daily life—conditions that we found to be strongly associated with high depressive symptomatology in the elderly. After adjusting for educational attainment, using multiple regression analyses, depression was not associated with ethnicity and only six of the health related conditions showed significant differences between MA and NHW subjects. We believe these results provide an important insight into the mechanism of health-related conditions and depressiv...
Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is a... more Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is also likely informed by as yet only partially described epigenetic contributions. Using a sequencing-based method for genome-wide analysis, we quantitatively compared the blood DNA methylation landscapes in SZ and BP subjects to control, both in an understudied population, Hispanics along the US-Mexico border. Remarkably, we identified thousands of differentially methylated regions for SZ and BP preferentially located in promoters 3′-UTRs and 5′-UTRs of genes. Distinct patterns of aberrant methylation of promoter sequences were located surrounding transcription start sites. In these instances, aberrant methylation occurred in CpG islands (CGIs) as well as in flanking regions as well as in CGI sparse promoters. Pathway analysis of genes displaying these distinct aberrant promoter methylation patterns showed enhancement of epigenetic changes in numerous genes previously related to psychiatr...
La esquizofrenia es una enfermedad que afecta aproximadamente al 1% de la población mundial. Es u... more La esquizofrenia es una enfermedad que afecta aproximadamente al 1% de la población mundial. Es una de las enfermedades psiquiátricas más debilitantes con un alto costo económico, social, familiar y personal. En Costa Rica, la esquizofrenia constituye la primera causa de internamiento entre los desórdenes psiquiátricos en el Hospital Nacional Psiquiátrico. El presente estudio analiza el diagnóstico preliminar de los primeros 120 pacientes incluidos en el proyecto sobre la Genética de la Esquizofrenia. Al comparar el diagnóstico del entrevistador, el diagnóstico final por consenso y el diagnóstico del último egreso hospitalario se encontraron diferencias en alrededor del 40% de los sujetos en el estudio. Se encontró un relativo sub-registro de la sintomatología afectiva en los diagnósticos de egreso con el consecuente sobre-diagnostico de los trastornos esquizofrénicos en los hospitales nacionales. El trastorno esquizoafectivo fue uno de los diagnósticos con menor concordancia. Las d...
Justificación y objetivo: la esquizofrenia es una enfermedad crónica con importantes repercusione... more Justificación y objetivo: la esquizofrenia es una enfermedad crónica con importantes repercusiones sociales que afecta al 1% de la población mundial. Se describe las características de la esquizofrenia en una muestra de pacientes del Valle Central de Costa Rica.Métodos: estudio descriptivo, transversal en esquizofrénicos diagnosticados a través del proceso de mejor estimado diagnostico según la cuarta edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSMIV).Resultados: de 260 esquizofrénicos, 186 (71.5%) son varones y 74 (28.5%) mujeres, la edad promedio de entrevista es 38.95 años (Desviación Standard (DS): 11.37), menor en los varones(37.54 años, DS: 10.46) que en las mujeres (42.49 (DS: 12.81, p0.05).Discusión: Nuestros pacientes presentaron características clínicas y demográficas similares a lo observado en otras poblaciones. Más de la mitad de los individuos tenían antecedente de síntomas afectivos siendo los depresivos los más frecuentes. Los varones sol...
Brain-derived neurotrophic factor val66met polymorphism has been implicated in the pathophysiolog... more Brain-derived neurotrophic factor val66met polymorphism has been implicated in the pathophysiology of bipolar disorder. We investigated the neurochemistry of the left dorsolateral prefrontal cortex of bipolar disorder and healthy participants in relation to the brain-derived neurotrophic factor val66met polymorphism using H-magnetic resonance spectroscopy. Absolute N-acetyl-aspartate, phosphocreatine+creatine (PCr+Cr), choline-containing compounds, myo-inositol, and glutamate levels were measured. Bipolar disorder met-carriers had lower PCr+Cr levels than bipolar disorder val/val patients, and bipolar disorder val/val patients had higher PCr+Cr levels than val/val healthy controls. These results indicate that bipolar disorder met-carriers have abnormal energy metabolism in the left dorsolateral prefrontal cortex.
Across ethnicity/race, prevalence rates of bipolar disorder are similar. However, African America... more Across ethnicity/race, prevalence rates of bipolar disorder are similar. However, African Americans and Latinos may receive less specialty mental health treatment and different medications, and may be less adherent to treatment regimens than European American patients. This study compared illness characteristics, treatment history, and overall functioning in a sample of European American, African American, and Latino patients with bipolar disorder. The samples were drawn from the first 2,000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. There were 1,686 European Americans, 65 African Americans, and 77 Latinos. The data were collected upon study entry, with structured interviews, clinicianrated forms, and self report. African Americans had a greater likelihood of psychosis and fewer psychiatric medication prescriptions than did European Americans. Latinos had greater alcohol comorbidity, fewer psychiatric medication prescriptions and specialt...
Interest in understanding the comorbidity of schizophrenia and substance use disorder has been in... more Interest in understanding the comorbidity of schizophrenia and substance use disorder has been increasing due to the increase of this diagnosis, to the negative effects observed in the subject and to the health service costs. This dual disorder can have dramatic effects on the clinical course of the psychiatric disorder, this being, for example increased relapses, re-hospitalizations, more severe symptoms, noncompliance with antipsychotic medication, marked mood changes, increased rates of hostility and suicidal ideation as well as in other areas of functioning, including interpersonal violence and victimization, homelessness, and legal problems. Literature from the United States and Europe in particular suggests that the prevalence rates for this dual diagnosis may range from 10 to 70%. In this study, we have reviewed the prevalence of the dual diagnosis of schizophrenia and substance use disorder as well as the sociodemographic characteristics in the literature on Latin-American p...
We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-relate... more We investigated the prevalence of “high” levels of depressive symptomatology and 13 health-related medical conditions in elderly Mexican American (MA) and non-Hispanic white (NHW) residents of El Paso County, Texas. We analyzed the extent to which depressive symptoms in this population are associated with these conditions. Elderly MA residents possessed a higher prevalence of current depression, a relatively unique health-related condition profile, and were more likely to experience a set of conditions that impede participation in daily life—conditions that we found to be strongly associated with high depressive symptomatology in the elderly. After adjusting for educational attainment, using multiple regression analyses, depression was not associated with ethnicity and only six of the health related conditions showed significant differences between MA and NHW subjects. We believe these results provide an important insight into the mechanism of health-related conditions and depressiv...
Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is a... more Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is also likely informed by as yet only partially described epigenetic contributions. Using a sequencing-based method for genome-wide analysis, we quantitatively compared the blood DNA methylation landscapes in SZ and BP subjects to control, both in an understudied population, Hispanics along the US-Mexico border. Remarkably, we identified thousands of differentially methylated regions for SZ and BP preferentially located in promoters 3′-UTRs and 5′-UTRs of genes. Distinct patterns of aberrant methylation of promoter sequences were located surrounding transcription start sites. In these instances, aberrant methylation occurred in CpG islands (CGIs) as well as in flanking regions as well as in CGI sparse promoters. Pathway analysis of genes displaying these distinct aberrant promoter methylation patterns showed enhancement of epigenetic changes in numerous genes previously related to psychiatr...
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