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Título Longitudinal studies of functional magnetic resonance imaging in first-episode psychosis: A systematic review Autores Carlos González-Vivas, Pau Soldevila-Matías, Olga Sparano, Gracián García-Martí, Luís Martí-Bonmatí, Benedicto Crespo-Facorro, André Aleman, Julio Sanjuan. Año publicación 2019 Revista European Psychiatry. The Journal of the European Psychiatric Association. Abstract Background Little is known about changes in brain functioning after first-episode psychosis (FEP). Such knowledge is important for predicting the course of disease and adapting interventions. Functional magnetic resonance imaging has become a promising tool for exploring brain function at the time of symptom onset and at follow-up. Method A systematic review of longitudinal fMRI studies with FEP patients according to PRISMA guidelines. Resting-state and task-activated studies were considered together. Results Eleven studies were included. These reported on a total of 236 FEP patients were evaluated by two fMRI scans and clinical assessments. Five studies found hypoactivation at baseline in prefrontal cortex areas, two studies found hypoactivation in the amygdala and hippocampus, and three others found hypoactivation in the basal ganglia. Other hypoactivated areas were the anterior cingulate cortex, thalamus and posterior cingulate cortex. Ten out of eleven studies reported (partial) normalization by increased activation after antipsychotic treatment. A minority of studies observed hyperactivation at baseline. Conclusions This review of longitudinal FEP samples studies reveals a pattern of predominantly hypoactivation in several brain areas at baseline that may normalize to a certain extent after treatment. The results should be interpreted with caution given the small number of studies and their methodological and clinical heterogeneity. Cita González-Vivas C, Soldevila-Matías P, Separan O, et al. Longitudinal studies of functional magnetic resonance imaging in firstepisode psychosis: A systematic review. Eur Psychiatry. 2019 Jun;59:60-69. http://doi.org/10.1016/j.eurpsy.2019.04.009

Título First-Episode Psychotic Patients Showed Longitudinal Brain Changes Using fMRI With an Emotional Auditory Paradigm Autores Carlos González-Vivas, Gracián García-Martí, Pau Soldevila-Matías, Roberto Sanz-Requena, Eduardo J. Aguilar, María José Castro-Bleda, Luis Martí-Bonmatí, Julio Sanjuan Año publicación 2020 Revista Frontiers in Psychiatry. Abstract Most previous longitudinal studies of functional magnetic resonance imaging (fMRI) in first-episode psychosis (FEP) using cognitive paradigm task found an increased activation after antipsychotic medications. We designed an emotional auditory paradigm to explore brain activation during emotional and nonemotional word processing. This study aimed to analyze if longitudinal changes in brain fMRI BOLD activation is present in patients vs. healthy controls. A group of FEP patients (n = 34) received clinical assessment and had a fMRI scan at baseline and follow-up (average, 25-month interval). During the fMRI scan, both emotional and nonemotional words were presented as a block design. Results were compared with a pair of healthy control group (n = 13). Patients showed a decreased activation at follow-up fMRI in amygdala (F = 4.69; p = 0.04) and hippocampus (F = 5.03; p = 0.03) compared with controls. Middle frontal gyrus was the only area that showed a substantial increased activation in patients (F = 4.53; p = 0.04). A great heterogeneity in individual activation patterns was also found. These results support the relevance of the type of paradigm in neuroimaging for psychosis. This is, as far as we know, the first longitudinal study with an emotional auditory paradigm in FEP. Our results suggested that the amygdala and hippocampus play a key role in psychotic disease. More studies are needed to understand the heterogeneity of response at individual level. Cita González-Vivas C, García-Martí G, Soldevila-Matías P, et. al. First-Episode Psychotic Patients Showed Longitudinal Brain Changes Using fMRI With an Emotional Auditory Paradigm. Front Psychiatry. 2020 Dec 11;11:593042 http://doi.org/10.3389/fpsyt.2020.593042

Título Clozapine-related drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a systematic review Autores Renato de Filippis,Pau Soldevila-Matías, Pasquale De Fazio, Daniel Guinart, Inmaculada Fuentes-Durá, Jose M. Rubio, John M. Kane, Georgios Schorets Año publicación 2020 Revista Expert Review of Clinical Pharmacology Abstract Introduction The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe, multiorganic, and potentially life-threatening drug-induced hypersensitivity reaction, linked to several common drugs, including antiepileptics, antibiotics, and several psychotropic drugs, including clozapine. Due to the importance of clozapine in the management of treatment-resistant schizophrenia, a systematic review and characterization of clozapine-related DRESS syndrome is long overdue. Areas covered This systematic review was conducted following PRISMA guidelines. PubMed, Embase, PsychINFO, and the Cochrane Library databases were independently reviewed up to 1 November 2019 for articles reporting clozapine-related DRESS syndrome cases. The RegiSCAR score system was applied to systematically characterize the clinical presentations of selected studies. Expert opinion Clozapine-related DRESS syndrome was reported in six patients from four articles. Five patients received polypharmacy. Skin rash and liver involvement with elevated liver enzymes were very common. No fatal cases were found. Treatment mainly included clozapine discontinuation and immunosuppression. The mismatch between incidences of DRESS with other responsible drugs, the common misdiagnosis of this syndrome, and the fact that an extensive literature search only identified six cases suggests that clozapine-related DRESS may be overlooked. It is, therefore, necessary to optimize diagnostic strategies to identify immune-related side effects of clozapine. Cita De Filippis R, Soldevila-Matías P, De Fazio P, et al. Clozapine-related drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a systematic review. Expert Rev Clin Pharmacol. 2020 Aug;13(8):875-883. http://doi.org/10.1080/17512433.2020.1787831

Título Unravelling cases of clozapine-related Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) in patients reported otherwise: A systematic review Autores Renato de Filippis, Pau Soldevila-Matías, Daniel Guinart, Pasquale De Fazio, Jose M Rubio, John M Kane, Georgios Schoretsanitis Año publicación 2021 Revista Journal of Psychopharmacology Abstract Background he drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity reaction. Aims Aim was to review reports of clozapine-related reactions fulfilling the registry of severe cutaneous adverse reaction (RegiSCAR) criteria for DRESS syndrome reported as such or otherwise, to provide a descriptive overview of demographic patterns, clinical manifestations, and DRESS course and investigate associations between demographic, DRESS parameters, and clinical outcomes. Methods This review was conducted following preferred reporting items for systematic reviews and meta-analyses guidelines and registered with PROSPERO (registration number CRD42020156385). We searched PubMed/Embase/PsychInfo/Cochrane for reports of clozapine-related reactions meeting RegiSCAR criteria. Associations between RegiSCAR scores and time-to-recovery with demographic/clinical variables were assessed. Demographic/clinical characteristics of patients with versus without reported DRESS were compared using non-parametrical tests. Results We identified 26 reports of 27 patients meeting RegiSCAR criteria. Males (n = 19, 70.4%) and patients with schizophrenia (n = 18, 66.7%) were mainly affected. Twelve patients (44.4%) received clozapine-monotherapy. DRESS symptoms manifested within a month after clozapine initiation (n = 24, 88.9%). Lungs and liver were the most common organs involved (n = 12, 44.4%; n = 11, 40.7%), with a mean time to recovery of 33.75 days. Clozapine rechallenge led to DRESS recurrence in four patients. Death rate was 7.4%. No associations were detected between RegiSCAR criteria or days to recovery with any demographic/clinical variables. No differences between patients with versus without reported DRESS were detected. Conclusions Clozapine-related DRESS may be rare, but also underreported. Clinicians need to be aware of it even in patients under clozapine-monotherapy or without skin rash. Cita De Filippis R, Soldevila-Matías P, Guinart D, et al. Unravelling cases of clozapine-related Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) in patients reported otherwise: A systematic review J Psychopharmacol. 2021 May 27 http://doi.org/10.1177/02698811211021587

En el número de junio de 2019 de la revista The Journal of Nervous and Mental Disease (con un índice de impacto de 1.859) se ha publicado un artículo científico en el que ha colaborado el Centro de Referencia Estatal de Atención Psicosocial a personas con Trastorno Mental Grave (Creap) del Imserso en Valencia para su desarrollo junto con investigadores de la Universidad de Valencia. Los objetivos de este estudio fueron: Obtener el perfil cognitivo de pacientes españoles con esquizofrenia en el WAIS-IV. Comparar su perfil con el perfil de un grupo de control sano. Comparar el perfil cognitivo de los pacientes con esquizofrenia con el rendimiento observado en dos estudios previos preparados en Canadá y China. Se midió una muestra de 99 pacientes ambulatorios y 99 participantes de control sanos, emparejados por edad, sexo y nivel educativo, utilizando el WAIS IV, que incluye 10 subpruebas centrales, 4 índices y 2 puntuaciones de inteligencia general, para obtener su perfil cognitivo. Los resultados mostraron que solo el rendimiento en el Índice de Comprensión Verbal y sus subpruebas fueron similares en los grupos de pacientes y de control; este patrón de deterioro cognitivo fue similar al patrón de los estudios canadiense y chino. Invitamos a la consulta directa de este artículo en la citada revista a través del siguiente enlace, o acceder a un resumen del mismo en castellano (241 Kb.). Para más información de todas las novedades realizadas en el Centro no dude en consultar nuestra página web y nuestro blog

Con frecuencia, las personas con problemas de salud mental sufren un elevado riesgo metabólico derivado de una mala alimentación y pautas dietéticas erróneas que derivan en riesgo cardiovascular por sobrepeso, obesidad e índices sanguíneos de triglicéridos, colesterol y azúcar de alto riesgo. El equipo de Enfermería del Creap trabaja desde el área de salud para desarrollar una mejora en estos aspectos con los usuarios, dando prioridad a unos hábitos de alimentación basados en productos naturales y sin procesar, no precocinados, sin colorantes ni conservantes y sin grasas perjudiciales y nocivas para la salud. Enmarcada en el Taller de Nutrición, ayer se llevó a cabo una nueva Excursión Saludable dentro del entorno comunitario próximo al centro, en el barrio de Campanar, con la visita al Horno Manuela, un horno artesano con una gran tradición familiar. Así, los usuarios/as pudieron conocer el proceso de elaboración de distintos tipos de pan de una forma totalmente natural y artesanal a partir de masa madre, así como el funcionamiento de un horno de leña. La visita concluyó con una estupenda degustación de productos del día, una oportunidad para resolver dudas y agradecer la amabilidad con la que nos han acogido. ¡Muchas gracias de nuevo por la experiencia!