IntroductionWorse sleep quality and increased inflammatory markers in women with schizophrenia (Sch) have been reported (Lee et al. 2019). However, the physiological mechanisms underlying the interplay between sleep and the inflammatory pathways are not yet well understood (Fang et al. 2016).ObjectivesAnalyze the relationship between Neutrophil/Lymphocyte (NLR), Monocyte/Lymphocyte (MLR) and Platelet/Lymphocyte (PLR) ratios, and insomnia in Sch stratified by sex.MethodsFinal sample included 176 Sch patients (ICD-10 criteria) [mean age: 38.9±13.39; males: 111(63.1%)]. Assessment: PANSS, Calgary Depression Scale (CDSS), and Oviedo Sleep Questionnaire (OSQ) to identify a comorbid diagnosis of insomnia based on ICD-10. Fasting counting blood cell were performed to calculate ratios. Statistics: U Mann-Whitney, logistic regression.ResultsInsomnia as comorbid diagnosis was present in 22 Sch (12.5%) with no differences between sex [14 males (12.6%), 8 females (12.3%)], neither in their age. Female patients with insomnia showed increased NLR [2.44±0.69 vs. 1.88±0.80, U=122.00 (p=0.034)]. However, no differences in PLR and MLR were found, neither in any ratio in males. Regression models using insomnia as dependent variable and covariates (age, PANSS-positive, PANSS-negative, CDSS) were estimated. Females: presence of insomnia was associated with NLR [OR=3.564 (p=0.032)], PANSS-positive [OR=1.263 (p=0.013)] and CDSS [OR=1.198 (p=0.092)]. Males: only PANSS-positive [OR=1.123 (p=0.027)] and CDSS scores [OR=1.220 (p=0.005)] were associated with insomnia.ConclusionsNLR represent an inflammatory marker of insomnia in Sch but only in female patients. Improving sleep quality in these patients could help to decrease their inflammatory response.DisclosureNo significant relationships.
IntroductionOrexins are involved in the regulation of circadian rhythms which play an important role in mood regulation(1,2), and are hypothesised to be associated with major depressive disorder(3). However, scarce studies analyse their relationship with bipolar disorder (BD).ObjectivesTo evaluate the relationship of orexin-A and the clinical course of BDMethods95 BD patients were tested for serum orexin-A. The clinical course was analysed through number of depressive, manic/mixed episodes. HDRS and YMRS were used to assess severity of current episode. Statistics: Spearman correlations, U Mann-Whitney, linear regression analysis.ResultsMean age was 50.03 (SD=12.87) and 64.2% were women. 63.2% had BD-type I. Mean number of manic, depressive and mixed episodes was 2.32 (SD=3.07), 7.28 (SD=12.37), and 3.01 (SD=9.06), respectively. Mean age of onset was 26.09 (SD=10.50). Mean concentration of orexin-A was 21.78 pg/ml (SD=15.41), with no differences in sex, body mass index, age at onset or presence of insomnia(ICD-10). A correlation with age was observed; r=0.24 (p=0.019). No association was identified between orexin-A and severity of current episode. In relation to clinical course, no correlation was found with manic or mixed episodes. However, a negative correlation was identified between orexin-A levels and number of depressive episodes; r=-0.36 (p=0.001). When linear regression (orexin-A as dependent variable) was used to control for age, only this covariate (B=0.304) entered in the model (R2=0.067, F=6.045, p=0.015).ConclusionsNo relationship between orexin-A and number of manic/mixed episodes were detected. The association of orexin-A with number of depressive episodes dissappeared when age was controlled.DisclosureNo significant relationships.
IntroductionCOVID-19 pandemic and lockdown have provoked a considerable psychological impact in Spain. Some studies have reported greater psychological impact in the younger population. To date, no previous study has focused on depressive disorder (DD) patients based on their age.ObjectivesTo describe the psychological impact on DD according to age.MethodsCross-sectional study of an online survey available from 19 to 26 March 2020. Out of a total of 21207 respondents, 608 (2.9%) reported suffering from DD (mean age ±SD = 41.2 years±14.07 [18-82], 80.6% women). The subsample (608) was divided according to age, “youngsters” <45 (57.4%)/ “elders” ≥45. DASS-21 and IES scales were employed. Statistical analyses: Chi-square, t-Student test.ResultsBoth groups did not differ (p>0.05) in sex, having COVID-19 symptoms, having family/friends infected, or income changes. While youngsters were single more frequently (68.8% vs 14.3%, χ² = 179.7, p<0.001), elders had somatic illness more frequently (64.8% vs 39.7% χ² =30.401, p<0.001). Youngsters obtained higher scores in depression (4.69 vs 4.1, T=5.413, p<0.001), anxiety (2.86 vs 1.97, T=5.249, p<0.001) and stress (4.48 vs 3.17, T=6.355, p<0.001) DASS-21 subscales, as in intrusive (3.42 vs 3.05, T=1.984, p=0.048) and avoidant (4.64 vs 4.11, T=3.056, p=0.002) IES scores.ConclusionsDespite the group of elders with depression being more vulnerable to severe COVID-19 disease and presenting more frequently somatic comorbidities, younger depressive patients suffered more from depressive, anxiety, stress and avoidant symptoms and intrusive thoughts, in line with previous reports in the general population.DisclosureNo significant relationships.
IntroductionSchizophrenia is one of the most disabling diseases affecting the patient’s ability to live independently, to be socially active and to work or study1,2. Therefore, identifying predictors of functioning in the first stages of the disease is important to prevent a negative progression of functional outcome in these patients3.ObjectivesTo identify the factors associated with real-world functioning in patients with recent onset of the disease.MethodsSecondary analysis of a cross-sectional, naturalistic study. 84 patients with Schizophrenia (F20), aged 18-71 in their first five years of the disorder under maintenance treatment. Assessments: PANSS, CDS, CGI-S, CAINS; functioning: PSP, cognition: MATRICS. Statistical analysis: student-t test, ANOVA, Pearson correlation and lineal regression.ResultsMean age (SD): 31.30 (10.08); men: 62.8%. Statistical significant differences (p<0.05) were found in work status, benzodiazepines and antidepressants use. Furthermore, significant correlations (p<0.05) were found with depressive, positive and negative symptoms (avolition, anhedonia, alogia and affective flattening) and cognition. A significant predictive model was obtained that explains the 72.1% of the variance [F(5,74)= 20.952; p< 0.001]. This model included depressive symptoms (B= -0.940; p= 0.001), negative symptoms (B= -1.696; p< 0.001), avolition and anhedonia (B= -0.643; p= 0.001), affective flattening and alogia (B= 1.197; p= 0.003), and visual learning (B= 0.202 p= 0.039).ConclusionsNegative and depressive symptoms are the main determinants of real-world functioning in patients with recent onset of schizophrenia. Visual learning also contributes to this outcome. On the other hand, the positive relationship between expressive domain and functioning needs furthermore investigation.DisclosureNo significant relationships.
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