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Metabolic Disturbances Are Associated With Psychiatric Readmission: Results From a Swiss Psychiatric Cohort
Abstract
Introduction
High BMI has been associated with psychiatric rehospitalisation.
Objectives
We aimed to replicate this finding in a large Swiss psychiatric cohort and to examine whether other metabolic disturbances are independently associated with psychiatric readmission.
Methods
Data on 16’727 hospitalizations of 7’786 patients admitted between January 1st, 2007 and December 31st, 2019 at the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to International Diabetes Federation definition. Generalized Linear Mixed Models were used to investigate the associations between psychiatric readmission and metabolic syndrome and/or its five components.
Results
The readmitted population (N=2’935; 37.7% patients) had higher BMI, and were more likely to have central obesity, hypertriglyceridemia, and hypertension. Multivariate analyses confirmed that having a BMI ≥ 25 kg.m-2 was associated with psychiatric readmission (25 kg.m-2≤ BMI< 30 kg.m-2: OR = 1.88; 95%CI [1.55-2.29]; BMI≥30 kg.m-2: OR = 3.5; 95%CI [2.85-4.30]) when compared to patients with 18.5≤BMI<25 kg.m-2. Interestingly, novel factors associated with readmission were identified including metabolic syndrome (OR = 1.57, 95%CI [1.05-2.33]), central obesity (OR = 1.81, 95%CI [1.33-2.46]), hypertriglyceridemia (OR = 1.59; 95%CI [1.38-1.83]), HDL hypocholesterolemia (OR = 1.22; 95%CI [1.06-1.40]) and hyperglycemia (OR = 1.58; 95%CI [1.35-1.85]).
Conclusions
Metabolic syndrome, central obesity, hypertriglyceridemia, HDL hypocholesterolemia, hyperglycemia and obesity were associated with psychiatric readmission. Possible causes will be presented and discussed (e.g. reduced adherence to treatment in patients with metabolic disorders, multiple psychotropic treatments in non-responders increasing the risk of metabolic worsening).
Pharmacogenetic Markers to Predict Safety of Antipsychotics in Adolescents Experiencing Acute Psychotic Episodes
Abstract
Introduction
There are relatively fewer pharmacogenetic studies of antipsychotics in adolescents than in adult patients. The development of personalized pharmacotherapy is promising.
Objectives
Identify the most significant pharmacogenetic predictors of antipsychotic safety in adolescents experiencing acute psychotic episodes
Methods
The study included 101 adolescents diagnosed with acute polymorphic psychotic disorder at the time of admission (F23.0-9 according to ICD-10). All patients were taking an antipsychotic as their main treatment for 14 days. Children's Global Assessment Scale (CGAS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I), UKU Side Effects Rating Scale (UKU SERS), Sympson-Angus Scale (SAS), Barnes Akathisia rating scale (BARS) were used. All study participants underwent pharmacogenetic testing of pharmacokinetic and pharmacodynamic factors.
Results
CYP2D6 "intermediate" metabolism increased the risk of developing an adverse reaction by a trend of significance (OR=2.616 (95% CI 0.950-7.203); p=0.063). Carriage of HTR2A rs6313 was associated with a lower score on the UKU SERS “Other Symptoms” subscale (Beta=(-0.289); p=0.003) and an objective score on the BARS akathisia severity scale (Beta=(-0.217); p=0.029). DRD3 rs324026 carriers had a lower BARS akathisia scale score (Beta=(-0.349); p=0.004); DRD3 rs6280 carriers had a lower SAS extrapyramidal symptom severity scale score (Beta=(-0.351); p=0.003). Carriers of ANKS1B rs7968606 were associated with a higher SAS scale score (Beta=0.237; p=0.017).
Conclusions
We proposed that genotyping of CYP2D6*4, *10, DRD3 rs324026 (C allele), DRD3 rs6280 (C allele), HTR2A rs6313 (TT genotype) and ANKS1B rs7968606 (T allele) will predict the high risk of intolerance to antipsychotics in adolescents with acute psychotic episodes.
Suicide Behaviour and Problematic Internet Use
Abstract
Introduction
The use of internet among children and adolescent has risen in the last decade. In addition, suicide is the second cause of death among adolescents. Previous research have indicated the relation between Problematic Internet Use (PIU) and different mental health problems. Nonetheless there is a lack of studies analyzing the relation between suicide behaviour and PIU
Objectives
The main objective of the present work was to analyze the relation between Problematic Internet Use and suicide behaviour and depression in adolescents
Methods
A total of 1036 adolescents (450 males) were randomly selected. Mean age was 15,21 (SD = 1,23). The Adolescent Behavioural Suicide Scale SENTIA, The Reynolds Adolescent Depression Scale Short Form (RADS-SF), and The Compulsive Internet Use Scale (CIUS) were used. A Manova was performed with two groups (risk and non-risk to PIU) as independent variables and suicide and depression scores as dependent variables
Results
The results revealed a statiscally signifficant association between PIU and both depression and suicide behaviour (λ = 0.245, F(2,81,000) = 15.549, P ≤ 0.001, η² = 0.116). In particular, adolescents at a higher risk for PIU obtained higher scores on suicide behaviours and depression.
Conclusions
Results found in the present study reveal that adolescents have moderate prevalence rates for PIU. Also adolescents at risk for PIU with a total of more than 3 hour sof internet use everyday were at a higher risk for suicide. Prevention strategies should be devote to intervene in internet use as it maybe a variable affecting suicide behaviour.
Empathy and Aggressive Behavior From Teenagers in Educative Institutions in Monteria, Colombia
Abstract
Introduction
According to the World Health Organization (2016), adolescence is one of the most important transitional steps in the life of a human being, recognized by an accelerated rate of growth and changes in behavior. Adolescents from Colombia have reached this step, immersed in a context with a history of social, interpersonal and economic violence. In this sense, study of constructs such as empathy and aggressive behaviors are crucial to appease a healthy school coexistence and thus, contribute to a peace cultur
Objectives
Analyze the relationship between empathy and aggressive levels from adolescents.
Methods
This study was done through a cross-sectional study of correlational scope in 240 (N= 240) students. The Prosocial Behavior Questionnaire developed by Martorell and Gonzalez (1922) and the Aggressive questionnaire, developed by Buss and Perry (1992) were applied. The first one was used to measure empathy and the latter to appraise aggressiveness.
Results
There was evidenced of adequate levels of empathy and a great percentage of medium levels of verbal and physical aggressiveness. (Graph 1). In addition, there was a significant statistical correlation of negative magnitude between these variables (Table 1).
Conclusions
It was concluded that the higher the optimal levels of empathy, the lower the aggressive behavior presented by teenagers.
Cannabis Use in Early ADHD: A 3-Years Follow-up Study in Relations to Clinical Characteristics
Abstract
Introduction
ADHD is known to increase the risk of substance use, and is associated with lower degrees of education, criminal behavior and neuropsychic difficulties. Previous research is limited by small samples, variable findings, and short follow-up time. Earlier research tends to be limited to substance use above the threshold for abuse or dependency.
Objectives
This study aims at looking at the effects of cannabis use both over and under threshold for abuse or dependency in relations to clinical characteristics over a 3-year follow-up period.
Methods
At follow up a total of 203 patients were diagnosed with ADHD either as primary of as secondary diagnosis, of those 57 (28,1%) had lifetime use of cannabis (LUC), mean age at inclusion was 15 and half years old and 40% were of female sex. SPSS (v.29) were used to perform independent sample t-tests to test for effects and Hierarchical block-wise regressions were done to check for confounding variables.
Results
Lifetime cannabis use was associated with lower global functioning (p=0.000), increased risk of suicidal ideation (p=0.007), more suicide attempts (p=0.049), more self-reported symptoms (p=0.001), more school drop-out (p=0.000) and with psychotic features (p=0.024). Even after testing for know confounders such as female sex and age LUC explained significant variance.
Conclusions
LUC is associated with increased functional and clinical characteristics. The findings are discussed in relationship with clinical practice and limitations of the study.