Browsing by Author "Verdolini, Norma"
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Item A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients(Elsevier Masson SAS, 2019-09) Murru, Andrea; Verdolini, Norma; Anmella, Gerard; Pacchiarotti, Isabella; Samalin, Ludovic; Aedo, Alberto; Undurraga, Juan; Goikolea, José; Benedikt, Amann; Carvalho, Andre; Vieta, EduardBackground: Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients. Methods: A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups. Results: Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean ± SD DTH were 312.16 ± 10.6 (SAD) vs. 337.62 ± 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005). Conclusions: SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological follow-up visits may delay hospitalizations by closely monitoring symptoms of self- and hetero-aggression.Publication Emotional intelligence: a comparison between patients after first episode mania and those suffering from chronic bipolar disorder type I(2023) Varo, Cristina; Amoretti, Silvia; Sparacino, Giulio; Jiménez, Esther; Solé, Brisa; Bonnin, Caterina Del Mar; Montejo, Laura; Serra, Maria; Torrent, Carla; Salagre, Estela; Benabarre, Antoni; Salgado-Pineda, Pilar; Montoro Salvatierra, Irene; Sáiz, Pilar A.; García-Portilla, María Paz; Sánchez-Gistau, Vanessa; Pomarol-Clotet, Edith; Ramos-Quiroga, Josep Antoni; Pacchiarotti, Isabella; García-Rizo, Clemente; Undurraga, Juan; Reinares, María; Martinez-Aran, Anabel; Vieta, Eduard; Verdolini, NormaBackground Deficits in emotional intelligence (EI) were detected in patients with bipolar disorder (BD), but little is known about whether these deficits are already present in patients after presenting a first episode mania (FEM). We sought (i) to compare EI in patients after a FEM, chronic BD and healthy controls (HC); (ii) to examine the effect exerted on EI by socio-demographic, clinical and neurocognitive variables in FEM patients. Methods The Emotional Intelligence Quotient (EIQ) was calculated with the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Performance on MSCEIT was compared among the three groups using generalized linear models. In patients after a FEM, the influence of socio-demographic, clinical and neurocognitive variables on the EIQ was examined using a linear regression model. Results In total, 184 subjects were included (FEM n = 48, euthymic chronic BD type I n = 75, HC n = 61). BD patients performed significantly worse than HC on the EIQ [mean difference (MD) = 10.09, standard error (S.E.) = 3.14, p = 0.004] and on the understanding emotions branch (MD = 7.46, S.E. = 2.53, p = 0.010). FEM patients did not differ from HC and BD on other measures of MSCEIT. In patients after a FEM, EIQ was positively associated with female sex (β = −0.293, p = 0.034) and verbal memory performance (β = 0.374, p = 0.008). FEM patients performed worse than HC but better than BD on few neurocognitive domains. Conclusions Patients after a FEM showed preserved EI, while patients in later stages of BD presented lower EIQ, suggesting that impairments in EI might result from the burden of disease and neurocognitive decline, associated with the chronicity of the illness.Item One-year course of illness and clinical management in a cohort of patients affected with schizoaffective and bipolar disorders.(2017) Murru, Andrea; Verdolini, Norma; Anmella, Gerard; Pacchiarotti, Isabella; Samalin, Ludovic; Undurraga, Juan; Guiso, Giovanni; Goikolea, Jose Manuel; Vieta, EduardSchizoaffective bipolar disorder (SAD) is a pleomorphic, severe, chronic condition which diagnostic definition lacks of solid and reliable diagnostic criteria in international diagnostic manuals [1]. Its clinical management often relies on indirect evidence derived from schizophrenia or bipolar disorder (BD)[2,3].Publication Prodromal phase: Differences in prodromal symptoms, risk factors and markers of vulnerability in first episode mania versus first episode psychosis with onset in late adolescence or adulthood(2022) Verdolini, Norma; Borràs, Roger; Sparacino, Giulio; Garriga, Marina; Sagué, Maria; Madero, Santiago; Palacios, Roberto; Serra, Maria; Florencia, Maria; Salagre, Estela; Aedo, Alberto; Salgado, Pilar; Montoro, Irene; Sánchez, Vanessa; Pomarol, Edith; Ramos, Josep; Carvalho, Andre; Garcia, Clemente; Undurraga, Juan; Reinares, María; Martinez, Anabel; Bernardo, Miguel; Vieta, Eduard; Pacchiarotti, Isabella; Amoretti, SilviaObjective: This study was aimed at identifying differences in the prodromal symptoms and their duration, risk factors and markers of vulnerability in patients presenting a first episode mania (FEM) or psychosis (FEP) with onset in late adolescence or adulthood in order to guide tailored treatment strategies. Methods: Patients with a FEM or FEP underwent a clinical assessment. Prodromes were evaluated with the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R). Chi-squared tests were conducted to assess specific prodromal symptoms, risk factors or markers of vulnerability between groups. Significant prodromal symptoms were entered in a stepwise forward logistic regression model. The probabilities of a gradual versus rapid onset pattern of the prodromes were computed with logistic regression models. Results: The total sample included 108 patients (FEM = 72, FEP = 36). Social isolation was associated with the prodromal stage of a FEP whilst Increased energy or goal-directed activity with the prodrome to a FEM. Physically slowed down presented the most gradual onset whilst Increased energy presented the most rapid. The presence of obstetric complications and difficulties in writing and reading during childhood were risk factors for FEP. As for markers of vulnerability, impairment in premorbid adjustment was characteristic of FEP patients. No specific risk factor or marker of vulnerability was identified for FEM. Conclusion: Early characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.Publication Shaped before birth: Obstetric complications identify a more severe clinical phenotype among patients presenting a first affective or non-affective episode of psychosis(2022) Sagué, Maria; Amoretti, Silvia; Garriga, Marina; Mezquida, Gisela; Williams, Evelyn; Serra, Maria; Forte, Maria; Varo, Cristina; Montejo, Laura; Palacios, Roberto; Madero, Santiago; Sparacino, Giulio; Anmella, Gerard; Fico, Giovanna; Giménez, Anna; Pons, Maria; Salgado, Pilar; Montoro, Irene; Sánchez, Vanessa; Pomarol, Edith; Ramos, Josep; Undurraga, Juan; Reinares, María; Martínez, Anabel; Pacchiarotti, Isabella; Valli, Isabel; Bernardo, Miguel; García, Clemente; Vieta, Eduard; Verdolini, NormaObstetric complications (OCs) may contribute to the heterogeneity that characterizes psychiatric illness, particularly the phenotypic presentation of first episode psychoses (FEP). Our aim was to examine the relationship between OCs and socio-demographic, clinical, functioning and neuropsychological characteristics in affective and non-affective FEP. We performed a cross-sectional,study where we recruited participants with FEP between 2011 and 2021, and retrospectively assessed OCs using the Lewis-Murray scale. OCs were used as a dichotomous variable and further stratified into three subtypes: complications of pregnancy, abnormal fetal growth and development, and difficulties in delivery. We performed a logistic stepwise forward regression analysis to examine variables associated with the presence of OCs. Of the 104 participants (67 affective FEP and 37 non-affective FEP), 31.7% (n = 33) had experienced OCs. Subjects with OCs showed a more gradual emergence of prodromal symptoms as well as higher negative and total Positive and Negative Syndrome Scale (PANSS) scores. In the multivariate analysis, the presence of OCs was independently associated with a younger age at first episode of any type (OR = 0.904, p = 0.003) and slower emergence of prodromal symptoms (OR = 0.274, p = 0.011). When considering specific types of OCs, those related with fetal growth were associated with worse neuropsychological performance, while OCs at delivery were related to earlier onset of illness and more severe symptoms. In conclusion, OCs signaled a specific FEP phenotype characterized by earlier and more protracted onset of illness as well as more burdensome symptoms, independently of FEP type (i.e., affective vs non-affective). These results indicate a potential target of early intervention in FEP.