RESUMO
Sleep disturbance is a common complaint in depression. However, objective data in relation to the architecture of sleep associated with depression in childhood have been inconsistent. The objective measurement of sleepiness and executive functions is little known in depressive children. The objective of this study was to determine the differences in the sleep architecture, daytime sleepiness and executive functions in children with and without depression. Method The participants were 20 children with an average of 10.5 (SD=1.5) years old; nine were girls. Ten met the diagnostic criteria for major depression and ten were control. There were no differences by sex and age between groups with and without depression (p>.05). The instruments were: Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), the Children Depression Inventory, and the Battery of Executive Frontal Functions. Also, there were two consecutive nights of polysomnographic recording and Multiple Sleep Latency Test (MSLT). Results No differences were found in the architecture of sleep, sleep efficiency was greater than 90% in both groups and the indexes of initiation and sleep maintenance did not show statistically significant differences. There were no differences in daytime sleepiness, sleep onset latency in the MSLT was 22.8 (SD=6.4) minutes for the group with depression and 23.7 (SD=4.1) for the control. The executive functions showed differences in tasks involving: visual-motor and impulse control, working memory and identification of the risk-benefit ratio. Conclusions The results suggest that prefrontal structures are more vulnerable to depression than the structures that regulate the circadian and homeostatic sleep.
La alteración del sueño es una queja común en la depresión. Sin embargo, los datos objetivos sobre las alteraciones en la estructura del sueño asociadas a la depresión infantil han sido inconsistentes. Por otro lado, el estudio objetivo de la somnolencia y las funciones ejecutivas en niños con depresión es poco conocida. El objetivo fue conocer si existen diferencias en la estructura del sueño, la somnolencia diurna y las funciones ejecutivas en niños con y sin depresión. Método Participaron 20 niños con promedio de 10.5 (DE=1.5) años de edad, de los cuales 45% fueron niñas. Diez cumplieron los criterios diagnósticos de depresión mayor y 10 fueron controles. No hubo diferencias por sexo y edad entre los grupos (p>.05). Los instrumentos fueron: La entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), el Inventario de Depresión Infantil, y la Batería de Funciones Frontales y Ejecutivas. Asimismo, se realizaron dos noches consecutivas de registro polisomnográfico y la Prueba de Latencias Múltiples a Sueño (PLMS). Resultados No se encontraron diferencias en la estructura del sueño, la eficiencia del sueño fue mayor al 90% en ambos grupos y no hubo diferencias en los índices de inicio y continuidad del sueño, así como en las diferentes etapas de sueño. Tampoco se obtuvieron diferencias en la somnolencia diurna, la latencia al inicio de sueño en la PLMS fue de 22.8 (DE=6.4) minutos para el grupo con depresión y 23.7 (DE=4.1) para el control. Las funciones ejecutivas mostraron diferencias en tareas que implican: control visomotor y de impulsos, memoria de trabajo e identificación de la relación riesgo-beneficio. Conclusiones Los resultados sugieren que las estructuras prefrontales son más vulnerables a la depresión que las estructuras que regulan el ritmo circadiano y homeostático del sueño.
RESUMO
Chronic kidney disease (CKD) is a common and debilitating illness that impacts neurocognitive function. However, the majority of previous studies varied in methodologic design and rigor, thus minimizing definitive conclusions. The present study was designed to determine the impact of CKD on neurocognitive function through specific examination of CKD factors and therapeutic interventions. We evaluated 120 CKD outpatients and 41 healthy donors (controls) in terms of neurocognitive function, anxiety, and depressive symptomatology, and somnolence. Information regarding medical and treatment history was recorded. Twenty-three percent of CKD patients presented with cognitive impairment. Stage 5 patients had lower scores (p < .05) compared with controls and patients in stage 3 and 4 on measures of global cognitive function. No differences in global cognitive function were found between stage 3 and 4 patients and controls. A greater proportion of patients undergoing hemodialysis relative to those treated with peritoneal dialysis showed impairment on measures of memory functions. Results suggest that stage 5 CKD patients may present with impaired cognitive functions. Anemia appeared to be a key variable that may explain the memory impairment in this sample. Future longitudinal investigations of CKD are warranted to determine the trajectory of cognitive impairment.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Falência Renal Crônica/complicações , Adulto , Ansiedade/etiologia , Atenção/fisiologia , Estudos Transversais , Depressão/etiologia , Distúrbios do Sono por Sonolência Excessiva/etiologia , Feminino , Humanos , Falência Renal Crônica/terapia , Modelos Lineares , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos ProspectivosRESUMO
OBJECTIVE: To assess the presence of emotional distress in patients with chronic kidney disease (CKD), and the effect of kidney transplant on these symptoms. MATERIAL AND METHODS: This was a two-part study. Part one was cross-sectional, observational, and descriptive, where 75 patients with CKD were evaluated for emotional distress with the Hospital Anxiety and Depression Scale (HAD) and the Symptom Checklist 90 (SCL-90). In part two, we longitudinally followed 19% of the study cohort to examine symptomatological changes after their kidney transplantation. RESULTS: The results of the HAD indicated that 30.7% of the study cohort with End-Stage Renal Disease (ESRD) showed anxious symptoms, and 25.3% showed depressive symptoms. The change in the HAD total score before and after kidney transplant was not significant. However, a significant decrease in total score on the SCL-90 was observed before and after transplantation. CONCLUSION: Improvement on emotional distress was found after kidney transplantation.
Assuntos
Falência Renal Crônica/psicologia , Transplante de Rim/psicologia , Estresse Psicológico/diagnóstico , Adulto , Anemia/complicações , Anemia/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Lista de Checagem , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/psicologia , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Masculino , México , Pessoa de Meia-Idade , Diálise Peritoneal/psicologia , Estudos Prospectivos , Diálise Renal/psicologia , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Avaliação de Sintomas , Adulto JovemRESUMO
Objetivo. Valorar el impacto del Trasplante Renal exitoso sobre el funcionamiento cognoscitivo de los pacientes con Insuficiencia Renal Crónica (IRC). Método. Se aplicó el Neuropsi Atención y Memoria, el Hospital Anxiety and Depression Scale, la Escala de Somnolencia de Epworth y la Escala Isquémica de Hachinski a 42 pacientes con IRC y 41 donadores vivos sanos (grupo control). De los 42 pacientes que fueron sometidos a trasplante renal, se evaluó con los mismos instrumentos a 28 de ellos en un tiempo de 6 meses posterior a su trasplante. Se valoró en los mismos tiempos a sus donadores renales (grupo control). Resultados. El funcionamiento cognoscitivo global del grupo IRC mejoró después del trasplante renal aún controlando los efectos de aprendizaje. Las áreas en las que el grupo postrasplantado mejoraron fueron el Stroop y la evocación verbal a largo plazo haciendo uso de claves. Conclusiones. El trasplante renal se aprecia como una solución ideal que elimina factores (medibles o no medibles) que están impactando en el funcionamiento cognoscitivo.
Aim. To assess the impact of kidney transplantation on neuropsychological functioning of Chronic Kidney Disease(CKD) patients. Methods.: 42 kidney transplant (KT) recipients and 41 healthy living donors control group- were tested by a comprehensive neuropsychological battery: Neuropsi Attention and Memory, the Hospital Anxiety and Depression Scale, The Epworth Sleepiness Scale and the Hachinski Ischemic Scale. 28 patients were followed up 6 months after KT. Their kidney donors were evaluated pre as well as post donation (at same time of study group) for comparison. Results. An improvement in global cognitive functioning after KT was found (when learning effects were controlled). Patients improved in Stroop test and auditory/verbal delayed recall using cues. Conclusions. Renal transplant is suggested as an ideal solution as it eliminates factors (measurable or not) that have an impact over cognitive functioning.
Assuntos
Humanos , Masculino , Feminino , Cognição/fisiologia , Insuficiência Renal Crônica/psicologia , Testes Neuropsicológicos , Transplante de Rim/psicologia , Estudos de Casos e Controles , Estudos LongitudinaisRESUMO
El objetivo de esta investigación fue evaluar psicológica y neuropsicológicamente a un grupo de internos violentos de una Penitenciaría Federal en México y caracterizarlos de acuerdo con la clasificación de impulsividad y premeditación de Barratt (Barratt, Stanford, Lynn, Liebman y Kent, 1999) y utilizando la clasificación de Hare (1991) de psicopatía, para analizar las diferencias entre los grupos de acuerdo a diferentes clasificaciones. La muestra fue integrada por 75 participantes, 50 internos y 25 controles para el estudio 1 (impulsivos vs premeditados) y 54 sujetos para el estudio 2 (no psicópatas vs psicópatas). Se administraron la Escala de Impulsividad de Plutchik, el Inventario de Hostilidad de Buss-Durkee, la batería neuropsicológica NEUROPSI ATENCIÓN y MEMORIA (Ostrosky-Solís, Gómez, Ardila, Rosselli, Pineda y Matute; 2003) y la batería de Funciones Frontales y Ejecutivas (Flores, Ostrosky y Lozano, 2008). Los resultados indican que las poblaciones violentas independientemente de su clasificación pueden ser diferenciadas de la población no violenta. Sin embargo, no se encontraron diferencias significativas en las evaluaciones neuropsicológicas entre los grupos impulsivo y premeditado, mientras que los resultados entre los no psicópatas y psicópatas muestran diferencias significativas en distintos dominios cognoscitivos. Los resultados se discuten en términos de la base anatómica que subyace a dichos procesos.
The objective of this research was to assess psychological and neuropsychological a violent internal group of a Federal Prison in Mexico and characterized according to the Barratts classification of impulsivity and premeditation scale (Barratt, Stanford, Lynn, Liebman and Kent, 1999) and using the classification of Hare (1991) of psychopathy, to analyze differences between groups according to different classifications. The sample was composed of 75 participants, 50 inmates and 25 controls for study 1 (impulsive vs. premeditated) and 54 subjects for study 2 (nonpsychopaths vs psychopaths. Were administered the Scale of the Plutchik Impulsivity, Hostility Inventory Buss-Durkee, neuropsychological battery neuropsychiatric attention and memory (Ostrosky-Solís, Gomez, Ardila, Rosselli,Pineda and Matute, 2003) and the battery of frontal function and Executive (Flores, Ostrosky and Lozano, 2008). Results indicate that violent populations regardless of classification can be differentiated psychological and neuropsychological nonviolent population. However, there were no significant differences in neuropsychological evaluations among impulsive and premeditated groups, while, results between psychopaths and psychopaths do not show significant differences in various cognitive domains. The results are discussed in terms of the anatomical basis underlying these processes.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prisioneiros/psicologia , Transtorno da Personalidade Antissocial/psicologia , Estudos de Casos e Controles , Comportamento Impulsivo/psicologia , Escolaridade , México , Violência/psicologiaRESUMO
OBJECTIVES: Irritable bowel syndrome (IBS), constipation, and bloating are more prevalent in women than men, but gender differences associated with dyspepsia are inconsistent.The aim of this study was to determine gender differences in the prevalence of symptoms diagnostic for functional gastrointestinal disorders (FGIDs) in subjects with IBS and dyspepsia, as well as in controls in Mexico. METHODS: A database of 1,021 subjects (61% women) who completed the Rome II Modular Questionnaire (RIIMQ) in Spanish Mexico was analyzed. Gender differences in the frequency of all symptoms included in the RIIMQ between those fulfilling criteria for IBS (28.9%), dyspepsia (4.0%) and controls without any FGIDs (38.2%) were studied. Subjects fulfilling criteria only for other FGIDs were excluded. RESULTS: There were higher proportions of women with IBS (67.8%) and dyspepsia (85.4%) compared with the control group (55.9%) (P<0.001). In IBS, women more frequently reported changes in the number of bowel movements (BMs) associated with the onset of abdominal discomfort/pain, fewer than three BMs/week and abdominal fullness/bloating/swelling than men. Men with IBS more frequently reported swallowing air to belch and abdominal pain that improved after a BM than women. In controls, burping and hard or lumpy stools were both more frequent in men. CONCLUSIONS: In Mexico, gender differences in FGIDs exist, with both IBS and dyspepsia being more common in women than men. In IBS, symptoms related to constipation and bloating were more common in women, but the dyspepsia group was too small to draw any conclusions. Finally, this is the first study to report that belching is more common in men than women controls not fulfilling criteria for any FGID.
Assuntos
Dispepsia/fisiopatologia , Síndrome do Intestino Irritável/fisiopatologia , Adulto , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Feminino , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/epidemiologia , Masculino , México/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Las funciones cognitivas, entre ellas las ejecutivas (FE), después de un traumatismo craneoencefálico (TCE) presentan alteraciones, que afecta la vida cotidiana de los pacientes. El propósito del estudio fue evaluar las funciones ejecutivas de pacientes adultos con TCE moderado y severo, para conocer las características neuropsicológicas distintivas de la intensidad de la lesión. Participaron 26 pacientes, 10 con TCE Moderado (edad=34.80+/-14.45; escolaridad=15.20+/-2.525 años); y 16 con TCE Severo (edad=32.17+/-9.42; escolaridad= 12.11+/-4.15 años), pareados por edad y escolaridad con un grupo control sano. Evaluados individualmente con la Batería de Funciones Ejecutivas y Frontales(Flores, Ostrosky-Solís y Lozano, 2008). Los resultados indican que los pacientes con TCE presentan principalmente problemas en el WCST, torre de Hanoi, la Iowa Gambling Task, memoria de trabajo, y habilidades semánticas. Además muestran compromiso en la velocidad del procesamiento de información, comete errores perseverativos, y dificultades en la flexibilidad mental. Los resultados sugieren mayor afección en tareas de la corteza prefrontal dorso lateral. Estos datos permitirán diseñar e implementar programas dedicados a la intervención cognitiva enfocados la mejoría de las FE.
Cognitive functions including executive functions (FE) are affected following a traumatic brain injury (TBI), diminished patients daily life. The purpose of the present study was measuring EF of adult moderate and severe TBI patients, and knows the neuropsychological profile related with lesion intensity. Participated 26 patients, divided in 10 with Moderate TBI (age=34.80+/-14.45; education= 15.20+/-2.525 years); and 16 with Severe TBI (age=32.17+/-9.42; education= 12.11+/-4.15 years), matched by age and level of education with a healthy control group. Participants were individually assessing with the Executive Function and Frontal Lobes Neuropsychological Battery (Flores, Ostrosky-Solís y Lozano, 2008). Results show that TBI patients mainly had problems in resolve the WCST, Hanoi Tower, Iowa Gambling Task, working memory and in process semantic information. At the same time shows decreased time in processing information, perseverations,intrusions, and less mental flexibility. Data suggest a major affection on dorso lateral prefrontal cortex tasks. This data would help to design rehabilitation programs to cognitive intervention focused on EF.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Função Executiva/fisiologia , Traumatismos Craniocerebrais/fisiopatologia , Traumatismos Craniocerebrais/psicologia , Distribuição por Idade e Sexo , Análise de Variância , Ansiedade/etiologia , Depressão/etiologia , Escolaridade , Testes Neuropsicológicos , Índice de Gravidade de Doença , Fatores de Tempo , Traumatismos Craniocerebrais/patologiaRESUMO
INTRODUCCION: Son diversos los factores que intervienen en el desarrollo de la psicopatía. Se ha observado una predisposición genética que al interactuar con la vivencia de eventos traumáticos en edades tempranas, potencia el desarrollo de este trastorno conductual, fuente de actos agresivos y violentos en contra de la sociedad. OBJETIVO: Conocer la incidencia de eventos traumáticos (p.ej. eventos estresantes, abuso físico, abuso emocional y abuso sexual) y su influencia en el nivel de psicopatía de adultos convictos masculinos. PARTICIPANTES Y MATERIAL: Se realizó una revisión del historial criminal y una entrevista semiestructurada para clasificar a los internos de acuerdo a su nivel de psicopatía. Se les aplicó el Inventario de Eventos Traumáticos para conocer la frecuencia y diversidad de eventos sufridos antes de los 18 años. RESULTADOS: Los internos con alta psicopatía presentaron una alta incidencia de eventos traumáticos, específicamente de eventos estresantes, de abuso emocional y de abuso sexual y un total de eventos significativamente mayor que el grupo con psicopatía baja. Los eventos traumáticos y el abuso emocional fueron variables que contribuyeron significativamente al nivel de psicopatía de los internos. CONCLUSIONES: Los eventos traumáticos vividos durante la infancia y la adolescencia favorecen la manifestación de conductas violentas a través de la afectación de los mecanismos neurobiológicos que subyacen a la psicopatía, en donde se puede observar una asociación entre la frecuencia de eventos vividos y el grado de psicopatía presentes en la vida adulta.
INTRODUCTION: The factors that interact to drive the development of psychopathy are diverse. A genetic predisposition has been observed that, when coupled with the experience of traumatic events at a young age, potentiates the development of this behavioral and affective disorder that leads to aggressive and violent acts against society. OBJECTIVES: To understand the incidence of traumatic events (e.g., stressful events, physical abuse, emotional abuse, and sexual abuse) and their influence in the psychopathy of adult male convicts. PARTICIPANTS AND MATERIALS: Background criminal career reviews and semi-structured interviews were conducted to classify the inmates according to their psychopathy level utilizing the Revised Hare Psychopathic Scale. In addition, the Early Trauma Inventory was applied to assess the frequency and diversity of events experienced before the participants were 18 years of age. RESULTS: Inmates with high psychopathy also presented with a high incidence of traumatic events, as well as stressful events, emotional and sexual abuse in a higher frequency than the group with low psychopathy. The incidence of traumatic events and emotional abuse were found to predict the degree of psychopathy among the inmates. CONCLUSIONS: Traumatic events experienced during infancy and adolescence seem to favor the manifestation of violent conduct by interacting with neurobiological factors that underlie psychopathy, such that an association may be observed between the frequency of childhood traumatic events and the level of psychopathy present in adult life.
Assuntos
Humanos , Masculino , Adulto , Maus-Tratos Infantis/psicologia , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Fatores Etários , Abuso Sexual na Infância/psicologia , Escolaridade , Incidência , Entrevistas como Assunto , México/epidemiologia , Prisioneiros/psicologia , Interpretação Estatística de Dados , Transtorno da Personalidade Antissocial/etiologia , Violência/psicologiaRESUMO
La psicopatía es un trastorno de la personalidad que caracterizado por rasgos interpersonales, afectivos, conductuales y de estilo de vida. Está asociada con conducta violenta, existen pocos estudios que evalúen la tendencia hacia la violencia en psicópatas mediante técnicas de asociaciones implícitas como el Test de Asociaciones Implícitas (IAT). Se desarrolló el IAT-violencia, para evaluar las distorsiones cognitivas acerca de la violencia en 195 reos de acuerdo al nivel de psicopatía y al tipo de delito, se exploró el desempeño en la prueba de acuerdo a los niveles de los factores 1 y 2 de psicopatía. Los resultados indican que los sujetos violentos con alta psicopatía presentan distorsiones cognitivas acerca de la violencia. Aquellos con alto factor 2 de psicopatía presentan distorsiones cognitivas acerca de la violencia. Se discute la relación entre los factores 1 y 2 con la conducta violenta y la importancia de contar con instrumentos breves, confiables y objetivos. Las entrevistas semi-estructuradas requieren 1.5-3.5 horas, un entrenamiento especializado para evaluar el grado de psicopatía. Se discute el potencial para detectar sujetos que estén en riesgo de cometer alguna ofensa violenta mediante el IAT-violencia que toma 15 minutos y cuya calificación es automatizada.
Psychopathy is a personality disorder characterized by interpersonal, affective, behavioral and life-style traits. There is a relationship between psychopathy and violent behavior but few studies assess the tendency toward violence in psychopaths by implicit association methods like the Implicit Association Test (IAT). The violent-IAT was developed to assess the cognitive distortions about violence of 195 male inmates according to their psychopathy level and the offense committed, in addition, the performance in the test according to the factor level 1 and 2 of psychopathy was assessed. The results showed that psychopath-violent inmates had cognitive distortions about violence; and those with high factor 2 of psychopathy level inmates had a tendency toward violence. The discussion focused in the relationship between both psychopathy factors and violent behavior; and the importance to have reliable, objective and brief instruments like violent-IAT to measure the tendency toward violent behavior. The semi-structured interviews need a long time and a specialized training to assess the psychopathy level. The potential to detect subjects in high risk of committing extreme violent offenses by violent-IAT, that only need 15 minutes and gives an automatic-scored, is also discussed.
Assuntos
Humanos , Associação , Cognição , Testes de Personalidade , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Atitude , Estudos de Casos e Controles , Julgamento , Psicometria , Prisioneiros/psicologia , Violência/psicologiaRESUMO
The case of a 48-year-old woman accused of killing at least 12 elderly women and attempting to kill another one during the last 3 years is presented. Extensive neuropsychological, electrophysiological, and neuropsychiatric testing showed no evidence of a DSM-IV-TR Axis I diagnosis, but a decrease in executive functions and abnormalities in the processing of affective stimuli were found. Behavioral and psychophysiological studies revealed dissociation between knowing how to behave and actually behaving in socially acceptable ways. According to the woman, killing was just her response to "humiliating situations." Two potentially significant conditions in her past history are found: (i) childhood abuse; and (ii) multiple head injuries. It is conjectured that the nature of her crimes, paranoid and personality traits, a probable frontal brain dysfunction, as well as a specific demographic and social context represent unusual factors accounting for her violent behavior.