IIS BioGipuzkoa - Asociación Instituto de Investigación Sanitaria BioGipuzkoa (País Vasco)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/16974

El núcleo del Instituto es la OSI Donostialdea (Organización Sanitaria Integrada), y su ámbito de referencia lo constituyen las OSIs del territorio de Gipuzkoa. Al igual que en la mayoría de Institutos de Investigación Sanitaria, también está integrada la Universidad, en nuestro caso la Universidad del País Vasco-Euskal Herriko Unibertsitatea (UPV-EHU). A este nivel se encuentran asimismo incorporadas la Diputación Foral de Gipuzkoa, la Fundación Euskampus y la Fundación Ikerbasque, gracias a la cual se ha logrado aumentar la masa crítica investigadora incorporando personal de gran renombre internacional. Su singularidad radica en el resto de los miembros integrantes. En el Parque Científico y Tecnológico de Gipuzkoa se hallan enclavados un elevado número de centros de base tecnológica, entre los que se encuentran los centros que forman parte del Instituto: Vicomtech, Cidetec, Osatek, Matía Instituto Gerontológico y Onkologikoa, y otros centros convenidos con el Instituto que no están dentro de sus Órganos de Gobierno: BCBL, CIC nanoGUNE, CIC biomaGUNE, CITA Alzheimer, Fundación Dr. Carlos Elosegui de Policlínica Gipuzkoa y Tecnalia. Acreditado por el Instituto de Salud Carlos III como Instituto de Investigación Sanitaria en 2011, y renovando esta acreditación cada 5 años, forma parte así del total de 34 Institutos de Investigación Sanitaria acreditados existentes en la actualidad.

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Executive Summary of the Spanish Guidelines for the Diagnosis and Management of Imported Febrile Illnesses from the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Imported Pathology Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEPI-SEIMC), the Spanish Society of Family and Community Medicine (SEMFYC), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Emergency Medicine (SEMES)
(Elsevier, 2024) Camprubí-Ferrer, Daniel; Díaz Menendez, Marta; Crespillo-Andújar, Clara; Galparsoro, Harkaitz Azkune; Belhassen-García, Moncef; Cuadros González, Juan; Rubio Muñoz, Jose Miguel; Llenas-García, Jara; Oteo, José A; Gayoso Martín, Sara; Santos Larrégola, Laura; Salvador, Fernando; Rojo-Marcos, Gerardo; Balerdi-Sarasola, Leire; Kortajarena Urkola, Xabier; Soriano Pérez, Manuel Jesús; Onieva-García, María Ángeles; Alegría Coll, Iñaki; Arranz, Javier; Membrillo de Novales, Javier; Sociedad Española de Medicina Tropical y Salud Internacional
The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool. The present executive summary shows a selection of some of the most relevant questions and recommendations included in the guidelines.
Epidemiological and Clinical Insights into the Enterovirus D68 Upsurge in Europe 2021-2022 and Emergence of Novel B3-Derived Lineages, ENPEN Multicentre Study
(Oxford University Press, 2024-10-16) Pires Simoes, Margarida; Hodcroft, Emma B; Simmonds, Peter; Albert, Jan; Alidjinou, Enagnon K; Ambert-Balay, Katia; Andrés, Cristina; Antón, Andrés; Auvray, Christelle; Bailly, Jean-Luc; Baldanti, Fausto; Bastings, Capser; Beard, Stuart; Berengua, Carla; Berginc, Natasa; Bloemen, Mandy; Blomqvist, Soile; Bosma, Froukje; Böttcher, Sindy; Bubba, Laura; Buderus, Stafan; Cabrerizo, Maria; Calvo, Cristina; Celma, Cristina; Ceriotti, Ferruccio; Clark, Gemma; Costa, Inës; Coste-Burel, Marianne; Couderé, Karen; Cremer, Jeroen; Del Cuerpo Casas, Margarita; Daehne, Theo; de Beer, Jessica; de Ceano-Vivas, Maria; De Gascun, Cillian; de Rougemont, Alexis; Dean, Jonathan; Dembinski, Jennifer L; Diedrich, Sabine; Diez-Domingo, Javier; Dillner, Lena; Dorenberg, Dagny H; Ducancelle, Alexandra; Dudman, Susanne; Dyrdak, Robert; Eis-Huebinger, Anna-Maria; Falces-Romero, Iker; Farkas, Agnes; Feeney, Susan; Fernandez-Garcia, Maria Dolores; Flipse, Jacky; Franck, Kristina T; Galli, Cristina; Garrigue, Isabelle; Geeraedts, Felix; Georgieva, Irina; Giardina, Federica; Guiomar, Raquel; Hauzenberger, Elenor; Heikens, Esther; Henquell, Cécille; Hober, Didier; Hönemann, Mario; Howson-Wells, Hannah; Hruškar, Željka; Ikonen, Niina; Imbert, Berthemarie; Jansz, Arjan R; Jeannoël, Marion; Jiřincová, Helena; Josset, Laurence; Keeren, Kathrin; Kramer-Lindhout, Naomie; Krokstad, Sidsel; Lazrek, Mouna; Le Guillou-Guillemette, Hélène; Lefeuvre, Caroline; Lind, Andreas; Lunar, Maja M; Maier, Melanie; Marque-Juillet, Stéphanie; McClure, C Patrick; McKenna, James; Meijer, Adam; Menasalvas Ruiz, Ana; Mengual-Chuliá, Beatriz; Midgley, Sofie; Mirand, Audrey; Molenkamp, Richard; Montes, Milagrosa; Moreno-Docón, Antonio; Morley, Ursula; Murk, Jean-Luc; Navascués-Ortega, Ana; Nijhuis, Roel; Nikolaeva-Glomb, Lubomira; Nordbø, Svein A; Numanovic, Sanela; Oggioni, Massimo; Oñate Vergara, Eider; Pacaud, Jordi; Pacreau, Marie L; Panning, Marcus; Pariani, Elena; Pekova, Lili; Pellegrinelli, Laura; Petrovec, Miroslav; Pietsch, Corinna; Pilorge, Léa; Piñeiro, Luis; Piralla, Antonio; Poljak, Mario; Prochazka, Birgit; Rabella, Nuria; Rahamat-Langendoen, Janette C; Rainetova, Petra; Reynders, Marijke; Riezebos-Brilman, Annelies; Roorda, Lieuwe; Savolainen-Kopra, Carita; Schuffenecker, Isabelle; Smeets, Leo C; Stoyanova, Asya; Stefic, Karl; Swanink, Caroline; Tabain, Irena; Tjhie, Jeroen; Thouault, Luc; Tumiotto, Camille; Uceda Renteria, Sara; Uršič, Tina; Vallet, Sophie; Van Ranst, Marc; Van Wunnik, Peter; Verweij, Jaco J; Vila, Jorgina; Wintermans, Bas; Wollants, Elke; Wolthers, Katja C; Xavier López-Labrador, F; Fischer, Thea Kølsen; Harvala, Heli; Benschop, Kimberley SM; Austrian Federal Ministry of Health (Austria); Ministry of Health (República Checa); Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERESP (Epidemiología y Salud Pública); Santé Publique France; Unión Europea. Comisión Europea. NextGenerationEU; Ministry of Health Welfare and Sport (Países Bajos); National Institutes of Health (Estados Unidos); Slovenian Research Agency; Swiss National Science Foundation
Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 infections and its clinical impact during the fall-winter season of 2021-2022. From 19 European countries, 58 institutes reported 10 481 (6.8%) EV-positive samples of which 1004 (9.6%) were identified as EV-D68 (including 852 respiratory samples). Clinical data were reported for 969 cases; 78.9% of infections were reported in children (0-5 years); and 37.9% of cases were hospitalized. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases including 6 diagnosed with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of 2 novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale European EV-D68 upsurge with severe clinical impact and the emergence of B3-derived lineages.
Evolution of invasive pneumococcal disease by serotype 3 in adults: a Spanish three-decade retrospective study
(Elsevier, 2024-06) Calvo-Silveria, Sara; González-Díaz, Aida; Grau, Inmaculada; Marimón, José María; Cercenado, Emilia; Quesada, M Dolores; Casabella, Antonio; Larrosa, Nieves; Yuste, Jose Enrique; Berbel, Dàmaris; Alonso, Marta; Tubau, Fe; Belman, Sophie; Cadenas-Jiménez, Irene; Martin-Galiano, Antonio Javier; Domínguez, María Ángeles; Martí, Sara; Liñares, Josefina; Pallarés, Román; Càmara, Jordi; Ardanuy, Carmen; Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERES (Enfermedades Respiratorias); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas)
Background: Invasive pneumococcal disease due to serotype 3 (S3-IPD) is associated with high mortality rates and long-term adverse effects. The introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into the Spanish paediatric immunisation programme has not led to a decrease in the adult S3-IPD. We aimed to analyse the incidence, clinical characteristics and genomics of S3-IPD in adults in Spain. Methods: Adult IPD episodes hospitalized in a Southern Barcelona hospital were prospectively collected (1994-2020). For genomic comparison, S3-IPD isolates from six Spanish hospitals (2008-2020) and historical isolates (1989-1993) were analysed by WGS (Illumina and/or MinION). Findings: From 1994 to 2020, 270 S3-IPD episodes were detected. When comparing pre-PCV (1994-2001) and late-PCV13 (2016-2020) periods, only modest changes in S3-IPD were observed (from 1.58 to 1.28 episodes per 100,000 inhabitants year). In this period, the incidence of the two main lineages shifted from 0.38 to 0.67 (CC180-GPSC12) and from 1.18 to 0.55 (CC260-GPSC83). The overall 30-day mortality remained high (24.1%), though a decrease was observed between the pre-PCV (32.4%; 95.0% CI, 22.0-45.0) and the late-PCV13 period (16.7%; 95.0% CI, 7.5-32.0) (p = 0.06). At the same time, comorbidities increased from 77.3% (95.0% CI, 65.0-86.0) to 85.7% (95.0% CI, 71.0-94.0) (p = 0.69). There were no differences in clinical characteristics or 30-day mortality between the two S3 lineages. Although both lineages were genetically homogeneous, the CC180-GPSC12 lineage presented a higher SNP density, a more open pan-genome, and a major presence of prophages and mobile genetic elements carrying resistance genes. Interpretation: Adult S3-IPD remained stable in our area over the study period despite PCV13 introduction in children. However, a clonal shift was observed. The decrease in mortality rates and the increase in comorbidities suggest a change in clinical management and overall population characteristics. The low genetic variability and absence of clinical differences between lineages highlight the role of the S3 capsule in the disease severity.
Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-09-25) Marcos-Delgado, Alba; Martín-Sánchez, Vicente; Molina-Barceló, Ana; Alonso-Molero, Jéssica; Perez-Gomez, Beatriz; Pollán, Marina; Aragones, Nuria; Ederra-Sanz, María; Fernández-Tardón, Guillermo; Binefa, Gemma; Moreno, Victor; Barrios-Rodríguez, Rocío; Amiano, Pilar; Huerta, José María; Teso, Enrique Pastor; Alguacil, Juan; Castaño-Vinyals, Gemma; Kogevinas, Manolis; Molina de la Torre, Antonio José; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Junta de Castilla y León (España); Regional Government of Andalusia (España)
The aim of our study is to evaluate the relationship between sociodemographic and clinical characteristics of individuals with Colorectal Cancer (CRC), tumour-intrinsic characteristics and treatment received with health-related quality of life (HRQoL). Methods: Cross-sectional analysis of data from 805 survivors from the MCC study was conducted. HRQoL was assessed through a general and specific questionnaire, SF-12 and FCSI (Colorectal Symptom Index). Statistical analyses were performed with linear regression with adjustment for sociodemographic variables, stage at diagnosis and histological grade. Results: Participants had survived a median of 7.9 years from diagnosis (IQR 7.1-8.5 years). Age at diagnosis, sex and area showed a clear association with HRQoL in both physical and mental dimensions of the SF-12 questionnaire. A direct association between CRC recurrence was also found in the PCS-12 and MCS-12 dimensions and radical surgery in the PCS-12. Regarding the scores in FCSI questionnaire, statistically significant differences were observed by sex, age and area, with older women being the most impaired (p < 0.001). Conclusions: Age, sex and area was associated with lower scores of HRQoL among CRC survivors. Knowing the determinants related to HRQoL would allow us to lay the groundwork to develop strategies that help reduce morbidity and mortality, relapses and increase HRQoL.
Burden of postmenopausal breast cancer attributable to excess body weight: comparative study of body mass index and CUN-BAE in MCC-Spain study
(BMJ Publishing Group, 2024-12-10) Cubelos-Fernández, Naiara; Dávila-Batista, Verónica; Fernández-Villa, Tania; Castaño-Vinyals, Gemma; Perez-Gomez, Beatriz; Amiano, Pilar; Ardanaz, Eva; Delgado Sillero, Irene; Llorca, Javier; Tardón, Guillermo Fernández; Alguacil, Juan; Vanaclocha-Espi, Mercedes; Marcos-Gragera, Rafael; Moreno, Victor; Aragones, Nuria; Dorronsoro, Ane; Guevara, Marcela; Reguero Celada, Sofía; Pollan-Santamaria, Marina; Kogevinas, Manolis; Martín, Vicente; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Ministerio de Ciencia e Innovación (España); Fundación Marqués de Valdecilla; International Cancer Genome Consortium; Ministerio de Economía y Competitividad (España); Red Temática de Investigación Cooperativa en Cáncer (RTICC) (España); Junta de Castilla y León (España); Regional Government of Andalusia (España); Generalitat Valenciana (España); Fundación La Caixa; Basque Government (España); Gobierno de la Región de Murcia (España); Unión Europea. Comisión Europea; Asociación Española Contra el Cáncer; Agència de Gestió d´Ajuts Universitaris i de Recerca (AGAUR); Government of Catalonia (España); Fundación Caja de Ahorros de Asturias; University of Oviedo (España); Unión Europea. Fondo Social Europeo (ESF/FSE)
Background: 10% of postmenopausal breast cancer cases are attributed to a high body mass index (BMI). BMI underestimates body fat, particularly in older women, and therefore the cancer burden attributable to obesity may be even higher. However, this is not clear. CUN-BAE (Clínica Universidad de Navarra-Body Adiposity Estimator) is an accurate validated estimator of body fat, taking into account sex and age. The objective of this study was to compare the burden of postmenopausal breast cancer attributable to excess body fat calculated using BMI and CUN-BAE. Methods: This case-control study included 1033 cases of breast cancer and 1143 postmenopausal population controls from the multicase-control MCC-Spain study. Logistic regression models were used to calculate odds ratios (ORs). The population attributable fraction (PAF) of excess weight related to breast cancer was estimated with both anthropometric measures. Stratified analyses were carried out for hormone receptor type. Results: Excess body weight attributable to the risk of breast cancer was 23.0% when assessed using a BMI value ≥30 kg/m2 and 38.0% when assessed using a CUN-BAE value of ≥40% body fat. Hormone receptor stratification showed that these differences in PAFs were only observed in hormone receptor positive cases, with an estimated burden of 19.9% for BMI and 41.9% for CUN-BAE. Conclusion: These findings suggest that the significance of excess body fat in postmenopausal hormone receptor positive breast cancer could be underestimated when assessed using only BMI. Accurate estimation of the cancer burden attributable to obesity is crucial for planning effective prevention initiatives.
Targeted Next-Generation Sequencing in a Large Cohort of Genetically Undiagnosed Patients with Neuromuscular Disorders in Spain.
(2020-05-11) Gonzalez-Quereda, Lidia; Rodriguez, Maria Jose; Diaz-Manera, Jordi; Alonso-Perez, Jorge; Gallardo, Eduard; Nascimento, Andres; Ortez, Carlos; Natera-de Benito, Daniel; Olive, Montse; Gonzalez-Mera, Laura; Munain, Adolfo Lopez de; Zulaica, Miren; Poza, Juan Jose; Jerico, Ivonne; Torne, Laura; Riera, Pau; Milisenda, Jose; Sanchez, Aurora; Garrabou, Gloria; Llano, Isabel; Madruga-Garrido, Marcos; Gallano, Pia
The term neuromuscular disorder (NMD) includes many genetic and acquired diseases and differential diagnosis can be challenging. Next-generation sequencing (NGS) is especially useful in this setting given the large number of possible candidate genes, the clinical, pathological, and genetic heterogeneity, the absence of an established genotype-phenotype correlation, and the exceptionally large size of some causative genes such as TTN, NEB and RYR1. We evaluated the diagnostic value of a custom targeted next-generation sequencing gene panel to study the mutational spectrum of a subset of NMD patients in Spain. In an NMD cohort of 207 patients with congenital myopathies, distal myopathies, congenital and adult-onset muscular dystrophies, and congenital myasthenic syndromes, we detected causative mutations in 102 patients (49.3%), involving 42 NMD-related genes. The most common causative genes, TTN and RYR1, accounted for almost 30% of cases. Thirty-two of the 207 patients (15.4%) carried variants of uncertain significance or had an unidentified second mutation to explain the genetic cause of the disease. In the remaining 73 patients (35.3%), no candidate variant was identified. In combination with patients' clinical and myopathological data, the custom gene panel designed in our lab proved to be a powerful tool to diagnose patients with myopathies, muscular dystrophies and congenital myasthenic syndromes. Targeted NGS approaches enable a rapid and cost-effective analysis of NMD- related genes, offering reliable results in a short time and relegating invasive techniques to a second tier.
COPPADIS-2015 (COhort of Patients with PArkinson's DIsease in Spain, 2015), a global-clinical evaluations, serum biomarkers, genetic studies and neuroimaging--prospective, multicenter, non-interventional, long-term study on Parkinson's disease progression
(2016-02-25) Santos-García, Diego; Mir, Pablo; Cubo, Esther; Vela, Lydia; Rodríguez-Oroz, Mari Cruz; Martí, Maria José; Arbelo, José Matías; Infante, Jon; Kulisevsky, Jaime; Martínez-Martín, Pablo; COPPADIS Study Group; Santos-García, Diego; Mir, Pablo; Cubo, Esther; Vela, Lydia; Rodríguez-Oroz, Mari Cruz; Martí, Maria José; Arbelo, José Matías; Infante, Jon; Kulisevsky, Jaime; Martínez-Martín, Pablo; COPPADIS Study Group
Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder causing motor and non-motor symptoms that can affect independence, social adjustment and the quality of life (QoL) of both patients and caregivers. Studies designed to find diagnostic and/or progression biomarkers of PD are needed. We describe here the study protocol of COPPADIS-2015 (COhort of Patients with PArkinson's DIsease in Spain, 2015), an integral PD project based on four aspects/concepts: 1) PD as a global disease (motor and non-motor symptoms); 2) QoL and caregiver issues; 3) Biomarkers; 4) Disease progression. Methods/design: Observational, descriptive, non-interventional, 5-year follow-up, national (Spain), multicenter (45 centers from 15 autonomous communities), evaluation study. Specific goals: (1) detailed study (clinical evaluations, serum biomarkers, genetic studies and neuroimaging) of a population of PD patients from different areas of Spain, (2) comparison with a control group and (3) follow-up for 5 years. COPPADIS-2015 has been specifically designed to assess 17 proposed objectives. Study population: approximately 800 non-dementia PD patients, 600 principal caregivers and 400 control subjects. Study evaluations: (1) baseline includes motor assessment (e.g., Unified Parkinson's Disease Rating Scale part III), non-motor symptoms (e.g., Non-Motor Symptoms Scale), cognition (e.g., Parkinson's Disease Cognitive Rating Scale), mood and neuropsychiatric symptoms (e.g., Neuropsychiatric Inventory), disability, QoL (e.g., 39-item Parkinson's disease Quality of Life Questionnaire Summary-Index) and caregiver status (e.g., Zarit Caregiver Burden Inventory); (2) follow-up includes annual (patients) or biannual (caregivers and controls) evaluations. Serum biomarkers (S-100b protein, TNF-α, IL-1, IL-2, IL-6, vitamin B12, methylmalonic acid, homocysteine, uric acid, C-reactive protein, ferritin, iron) and brain MRI (volumetry, tractography and MTAi [Medial Temporal Atrophy Index]), at baseline and at the end of follow-up, and genetic studies (DNA and RNA) at baseline will be performed in a subgroup of subjects (300 PD patients and 100 control subjects). Study periods: (1) recruitment period, from November, 2015 to February, 2017 (basal assessment); (2) follow-up period, 5 years; (3) closing date of clinical follow-up, May, 2022.
Diagnosis and treatment of disorders of intracranial pressure: consensus statement of the Spanish Society of Neurology's Headache Study Group
(Elsevier, 2024-02-29) García-Ull, J; González-García, N; Torres-Ferrus, Marta; García-Azorín, D; Molina-Martinez, Francisco José; Beltrán-Blasco, I; Santos-Lasaosa, Sonia; Latorre, G; Gago-Veiga, A B; Láinez, J M; Porta-Etessam, J; Nieves-Castellanos, C; Mínguez-Olaondo, A; López-Bravo, A; Quintas, S; Morollón, N; Díaz-Insa, S; Belvís, R; Irimia, P
[EN] Primary intracranial pressure disorders include idiopathic intracranial hypertension and spontaneous intracranial hypotension. These two entities have presented a remarkable advance in diagnostic and therapeutic techniques in recent years. Therefore, the Spanish Society of Neurology's Headache Study Group (GECSEN) considered it necessary to prepare this consensus document with the inclusion of diagnostic and therapeutic algorithms to facilitate and improve their management in clinical practice. This document was created by a committee of experts of the GECSEN based on a systematic review of the literature, incorporating the experience of the participants, and establishing practical recommendations with levels of evidence and grades of recommendation. [ES] Los trastornos primarios de la presión intracraneal incluyen la hipertensión intracraneal idiopática y la hipotensión intracraneal espontánea. El diagnóstico y tratamiento de ambas entidades ha presentado un avance destacable en los últimos años; por lo que desde el Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología (GECSEN) consideramos necesaria la elaboración de este documento de consenso con la inclusión de algoritmos diagnósticos y terapéuticos para mejorar su manejo en la práctica diaria. Este documento ha sido redactado por un comité de expertos del GECSEN tras realizar una revisión sistemática de la bibliografía, incorporando la experiencia de los participantes y estableciendo unas recomendaciones prácticas con niveles de evidencia y grados de recomendación.
Omega-3 Fatty Acid Intake during Pregnancy and Child Neuropsychological Development: A Multi-Centre Population-Based Birth Cohort Study in Spain
(Multidisciplinary Digital Publishing Institute (MDPI), 2022-02) Tahaei, Hana; Gignac, Florence; Pinar, Ariadna; Fernandez-Barres, Silvia; Romaguera, Dora; Vioque, Jesus; Santa-Marina, Loreto; Subiza-Perez, Mikel; Llop, Sabrina; Soler-Blasco, Raquel; Arija, Victoria; Salas-Salvado, Jordi; Tardon, Adonina; Riano-Galan, Isolina; Sunyer, Jordi; Guxens, Monica; Julvez, Jordi
Background: There are few studies that look at the intake of all types of omega-3 polyunsaturated fatty acids (n-3 PUFAs) during the different stages of pregnancy along with a long-term neuropsychological follow-up of the child. This study aims to explore the association between maternal n-3 PUFA intake during two periods of pregnancy and the child's neuropsychological scores at different ages. Methods: Prospective data were obtained for 2644 pregnant women recruited between 2004 and 2008 in population-based birth cohorts in Spain. Maternal n-3 PUFA intake during the first and third trimester of pregnancy was estimated using validated food frequency questionnaires. Child neuropsychological functions were assessed using Bayley Scales of Infant Development version one (BSID) at 1 year old, the McCarthy Scale of Children's Abilities (MSCA) at 4 years old, and the Attention Network Test (ANT) at 7 years old. Data were analysed using multivariate linear regression models and adjusted for potential covariates, such as maternal social class, education, cohort location, alcohol consumption, smoking, breastfeeding duration, and energy intake. Results: Compared to participants in the lowest quartile (<1.262 g/day) of n-3 PUFA consumption during the first trimester, those in the highest quartile (>1.657 g/day) had a 2.26 points (95% confidence interval (CI): 0.41, 4.11) higher MSCA general cognitive score, a 2.48 points (95% CI: 0.53, 4.43) higher MSCA verbal score, and a 2.06 points (95% CI: 0.166, 3.95) higher MSCA executive function score, and a 11.52 milliseconds (95% CI: -22.95, -0.09) lower ANT hit reaction time standard error. In the third pregnancy trimester, the associations were weaker. Conclusions: Positive associations between n-3 PUFA intake during early pregnancy and child neuropsychological functions at 4 and 7 years of age were found, and further clinical research is needed to confirm these findings.
Documento de consenso para el manejo de la esquistosomiasis en atención primaria
(Elsevier, 2022-08) Salas-Coronas, Joaquin; Pérez Pérez, Alejandra; Roure, Silvia; Sánchez Peinador, Carmen; Santos Larrégola, Laura; Arranz Izquierdo, Javier; Bocanegra, Cristina; García López Hortelano, Milagros; Garcia Vazquez, Elisa; Moza Moriñigo, Helena; Azkune Galparsoro, Harkaitz
Human schistosomiasis is the parasitic disease with the highest morbidity and mortality worldwide after malaria. It is endemic in more than 78 tropical and subtropical countries, especially in sub-Saharan Africa, and it is estimated that 236 million people are infected. It can cause serious health complications at the genitourinary and hepatosplenic level, leading to the death of 300,000 people each year. The number of imported cases in Western countries has increased in recent years due to the arrival of a significant number of migrants from endemic regions and a growing number of travelers who have visited them. On the other hand, outbreaks of autochthonous transmission have recently been reported in Corsica (France) and Almería (Spain). For all these reasons, the European health authorities have recommended serological screening for the disease in all migrants from endemic areas who have been living in Europe for less than 5 years. Since Primary Care is usually the first point of contact for these people with the Health System, doctors must know the main aspects of the disease, and be provided with the necessary means for its diagnosis and treatment. This document has been prepared by professionals belonging to five scientific societies of Primary Care (SEMFyC, SEMG, SEMERGEN), Pediatrics (SEIP) and Tropical Medicine and International Health (SEMTSI), in order to establish clear recommendations for the diagnosis and management of schistosomiasis in Primary Care.
A Descriptive Analysis of ATTR Amyloidosis in Spain from the Transthyretin Amyloidosis Outcomes Survey
(Springer, 2021-12) González-Moreno, Juan; Losada-López, Inés; Cisneros-Barroso, Eugenia; Garcia-Pavia, Pablo; Gonzalez-Costello, Jose; Munoz-Beamud, Francisco; Campistol, Josep Maria; Fernandez-Torron, Roberto; Chapman, Doug; Amass, Leslie
Introduction: Transthyretin amyloidosis (ATTR amyloidosis) is a clinically heterogeneous disease caused by mutations in the transthyretin (TTR) gene or aggregation of wild-type transthyretin (ATTRwt). In Spain, there are two large endemic foci of ATTR amyloidosis caused by the Val30Met variant, with additional cases across the country; however, these data may be incomplete, as there is no centralized patient registry. The Transthyretin Amyloidosis Outcomes Survey (THAOS) is an ongoing, global, longitudinal, observational survey of patients with ATTR amyloidosis, including both inherited and wild-type disease, and asymptomatic patients with TTR mutations. This analysis aimed to gain a deeper understanding of the clinical profile of patients with ATTR amyloidosis in Spain. Methods: This was a descriptive analysis of the demographic and clinical characteristics of symptomatic patients enrolled at six sites geographically dispersed throughout Spain (data cutoff: January 6, 2020). Patient data at enrollment, including genotype, demographics, and clinical presentation for symptomatic patients, were recorded. Patients were grouped by predominant phenotype based on clinical measures at enrollment: predominantly cardiac, predominantly neurologic, or mixed (cardiac and neurologic). Results: There were 379 patients (58.0% male; 63.3% symptomatic) enrolled in the six THAOS sites in Spain. Predominant genotypes were the Val30Met mutation (69.1%) or ATTRwt (15.6%). Predominant phenotype distribution was neurologic (50.4%), mixed (35.8%), and cardiac (13.8%) for all symptomatic patients (n = 240); neurologic (67.8%), mixed (21.2%), and cardiac (11.0%) for symptomatic Val30Met (n = 146); and mixed (64.9%), cardiac (22.8%), and neurologic (12.3%) for symptomatic ATTRwt (n = 57). Symptomatic patients reported a range of ATTR amyloidosis signs and symptoms at enrollment, with autonomic neuropathy and sensory neuropathy common in all phenotypes. Conclusions: These results from THAOS highlight the phenotypic heterogeneity associated with ATTR amyloidosis in Spain and the importance of comprehensive neurologic and cardiac evaluations in all patients with ATTR amyloidosis.
Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students
(Multidisciplinary Digital Publishing Institute (MDPI), 2021-05) Ballester, Laura; Alayo, Itxaso; Vilagut, Gemma; Almenara, Jose; Cebria, Ana Isabel; Echeburua, Enrique; Gabilondo, Andrea; Gili, Margalida; Lagares, Carolina; Piqueras, Jose A; Roca, Miquel; Soto-Sanz, Victoria; Blasco, Maria Jesus; Castellvi, Pere; Forero, Carlos G; Mortier, Philippe; Alonso, Jordi; UNIVERSAL Study Group
Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18-24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT's Cronbach's alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.
Epidemiology and costs of depressive disorder in Spain: the EPICO study
(Elsevier, 2021-09) Vieta, Eduard; Alonso, Jordi; Perez-Sola, Victor; Roca, Miquel; Hernando, Teresa; Sicras-Mainar, Antoni; Sicras-Navarro, Aram; Herrera, Berta; Gabilondo, Andrea
Depressive Disorders are the most common psychiatric diagnoses in the general population. To estimate the frequency, costs associated with Depressive Disorders in usual clinical practice, and in the whole Spanish population, a longitudinal, retrospective, observational study was carried out using data from the BIG-PAC database (R). Study population: all patients aged >= 18 years with a diagnosis of a Depressive Disorder in 2015-2017. Prevalence was computed as the proportion of Depressive Disorder cases in the adult general population, and the incidence rate, as the number of new Depressive Disorder cases diagnosed per 1,000 person-years in the population using health services, during 2015-2017. We collected demographic variables, comorbidity, direct health costs, and indirect costs (temporary and permanent disability). Health costs related to Depressive Disorders were estimated according to the annual resource use rate (resource/patient/year). Indirect costs were calculated according to the human capital method. Using the study data and information from the Spanish National Institute of Statistics, we estimated the cost of Depressive Disorders corresponding to the Spanish adult population, including premature mortality. 69,217 Depressive Disorder patients aged >= 18 years who met the inclusion/exclusion criteria were studied (mean age: 56.8 years; female: 71.4%). Prevalence of Depressive Disorders in the general population was 4.73% (95% CI: 4.70- 4.76%). Annual incidence rates (2015-2017) were 7.12, 7.35 and 8.02 per 1,000 person-years, respectively. Total costs observed in our Depressive Disorder patients were euro 223.9 million (corresponding to a mean of euro 3,235.3; mean/patient/year), of which, 18.4% were direct health care costs and 81.6%, non-health indirect costs (18% temporary occupational disability, 63.6% permanent disability). Considering also the cost of premature death , the mean cost per patient/year was euro 3,402 and the estimated societal costs of Depressive Disorders in Spain were euro 6,145 million. The prevalence and incidence of Depressive Disorders are consistent with other series reviewed. Resource use and total costs (especially non-health costs) were high. (c) 2021 The Author(s). Published by Elsevier B.V. This is an open access research article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )
Economic impact of treatment-resistant depression: A retrospective observational study
(Elsevier, 2021-12-01) Perez-Sola, Victor; Roca, Miquel; Alonso, Jordi; Gabilondo, Andrea; Hernando, Teresa; Sicras-Mainar, Antoni; Sicras-Navarro, Aram; Herrera, Berta; Vieta, Eduard
Background: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. Methods: A retrospective, observational-study was carried out using data from the BIG-PAC database (R). Patients aged ≥ 18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with ≥ 2 antidepressants including the prescription of ≥ 3 antidepressants (N06A) or ≥ 2 antidepressant and ≥ 1 antipsychotic (N05A; including lithium) b) antidepressants administered for ≥ 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was ≤ 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. Outcomes: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). Results: 21,630 patients with MDD aged ≥ 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 personyears, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were €4,147.9, being higher for TRD than for non-TRD patients (€6,096 vs. €3,846; p<0.001): a) direct costs (€1,341 vs. €624; p<0.001), b) lost productivity (€1,274 vs. €821; p<0.001) and c) permanent disability (€3,481 vs. €2,401; p<0.001, adjusted). Sensitivity analyses showed no differences with the reported results. Conclusions: The population based TRD incidence in Spain was similar to recent data from other European countries. TRD is associated with greater resource use and higher costs compared with non-TRD patients.
Genome-wide Association Study of Bladder Cancer Reveals New Biological and Translational Insights
(Elsevier, 2023-07) Koutros, Stella; Kiemeney, Lambertus A; Pal Choudhury, Parichoy; Milne, Roger L; Lopez de Maturana, Evangelina; Ye, Yuanqing; Joseph, Vijai; Florez-Vargas, Oscar; Dyrskjøt, Lars; Figueroa, Jonine; Dutta, Diptavo; Giles, Graham G; Hildebrandt, Michelle A T; Offit, Kenneth; Kogevinas, Manolis; Weiderpass, Elisabete; McCullough, Marjorie L; Freedman, Neal D; Albanes, Demetrius; Kooperberg, Charles; Cortessis, Victoria K; Karagas, Margaret R; Johnson, Alison; Schwenn, Molly R; Baris, Dalsu; Furberg, Helena; Bajorin, Dean F; Cussenot, Olivier; Cancel-Tassin, Geraldine; Benhamou, Simone; Kraft, Peter; Porru, Stefano; Carta, Angela; Bishop, Timothy; Southey, Melissa C; Matullo, Giuseppe; Fletcher, Tony; Kumar, Rajiv; Taylor, Jack A; Lamy, Philippe; Prip, Frederik; Kalisz, Mark; Weinstein, Stephanie J; Hengstler, Jan G; Selinski, Silvia; Harland, Mark; Teo, Mark; Kiltie, Anne E; Tardón, Adonina; Serra, Consol; Carrato, Alfredo; García-Closas, Reina; Lloreta, Josep; Schned, Alan; Lenz, Petra; Riboli, Elio; Brennan, Paul; Tjønneland, Anne; Otto, Thomas; Ovsiannikov, Daniel; Volkert, Frank; Vermeulen, Sita H; Aben, Katja K; Galesloot, Tessel E; Turman, Constance; De Vivo, Immaculata; Giovannucci, Edward; Hunter, David J; Hohensee, Chancellor; Hunt, Rebecca; Patel, Alpa V; Huang, Wen-Yi; Thorleifsson, Gudmar; Gago-Dominguez, Manuela; Amiano, Pilar; Golka, Klaus; Stern, Mariana C; Yan, Wusheng; Liu, Jia; Li, Shengchao Alfred; Katta, Shilpa; Hutchinson, Amy; Hicks, Belynda; Wheeler, William A; Purdue, Mark P; McGlynn, Katherine A; Kitahara, Cari M; Haiman, Christopher A; Greene, Mark H; Rafnar, Thorunn; Chatterjee, Nilanjan; Chanock, Stephen J; Wu, Xifeng; Real, Francisco X; Silverman, Debra T; Garcia-Closas, Montserrat; Stefansson, Kari; Prokunina-Olsson, Ludmila; Malats, Nuria; Rothman, Nathaniel; NIH - National Cancer Institute (NCI) (Estados Unidos); Radboud University Medical Center; Asociación Española Contra el Cáncer; Instituto de Salud Carlos III; Canadian Institutes of Health Research (CIHR) Cancer Council Victoria; National Health and Medical Research Council (Australia)
Background: Genomic regions identified by genome-wide association studies (GWAS) for bladder cancer risk provide new insights into etiology. Objective: To identify new susceptibility variants for bladder cancer in a meta-analysis of new and existing genome-wide genotype data. Design, setting, and participants: Data from 32 studies that includes 13,790 bladder cancer cases and 343,502 controls of European ancestry were used for meta-analysis. Outcome measurements and statistical analyses: Log-additive associations of genetic variants were assessed using logistic regression models. A fixed-effects model was used for meta-analysis of the results. Stratified analyses were conducted to evaluate effect modification by sex and smoking status. A polygenic risk score (PRS) was generated on the basis of known and novel susceptibility variants and tested for interaction with smoking. Results and limitations: Multiple novel bladder cancer susceptibility loci (6p.22.3, 7q36.3, 8q21.13, 9p21.3, 10q22.1, 19q13.33) as well as improved signals in three known regions (4p16.3, 5p15.33, 11p15.5) were identified, bringing the number of independent markers at genome-wide significance (p < 5 × 10-8) to 24. The 4p16.3 (FGFR3/TACC3) locus was associated with a stronger risk for women than for men (p-interaction = 0.002). Bladder cancer risk was increased by interactions between smoking status and genetic variants at 8p22 (NAT2; multiplicative p value for interaction [pM-I] = 0.004), 8q21.13 (PAG1; pM-I = 0.01), and 9p21.3 (LOC107987026/MTAP/CDKN2A; pM-I = 0.02). The PRS based on the 24 independent GWAS markers (odds ratio per standard deviation increase 1.49, 95% confidence interval 1.44-1.53), which also showed comparable results in two prospective cohorts (UK Biobank, PLCO trial), revealed an approximately fourfold difference in the lifetime risk of bladder cancer according to the PRS (e.g., 1st vs 10th decile) for both smokers and nonsmokers. Conclusions: We report novel loci associated with risk of bladder cancer that provide clues to its biological underpinnings. Using 24 independent markers, we constructed a PRS to stratify lifetime risk. The PRS combined with smoking history, and other established risk factors, has the potential to inform future screening efforts for bladder cancer. Patient summary: We identified new genetic markers that provide biological insights into the genetic causes of bladder cancer. These genetic risk factors combined with lifestyle risk factors, such as smoking, may inform future preventive and screening strategies for bladder cancer.
High adherence to a mediterranean diet at age 4 reduces overweight, obesity and abdominal obesity incidence in children at the age of 8
(Nature Publishing Group, 2020-09) Notario-Barandiaran, Leyre; Valera-Gran, Desiree; Gonzalez-Palacios, Sandra; Garcia-de-la-Hera, Manuela; Fernandez-Barres, Silvia; Pereda-Pereda, Eva; Fernández-Somoano, Ana; Guxens, Mònica; Iñiguez, Carmen; Romaguera, Dora; Vrijheid, Martine; Tardón, Adonina; Santa-Marina, Loreto; Vioque, Jesus; Navarrete-Muñoz, Eva María; INMA Project
Background/objectives: A higher adherence to a Mediterranean diet has been shown to be protective against obesity in adults, but the evidence is still inconclusive in children at early ages. Our objective was to explore the association between adherence to Mediterranean Diet at the age of 4 and the prevalence of overweight, obesity, and abdominal obesity at 4 years of age, and incidence at the age of 8. Subjects/methods: We analyzed data from children of the INMA cohort study who attended follow-up visits at age 4 and 8 years (n = 1801 and n = 1527, respectively). Diet was assessed at the age of 4 using a validated food frequency questionnaire. The adherence to MD was evaluated by the relative Mediterranean diet (rMED) score, and categorized as low (0-6), medium (7-10), and high (11-16). Overweight and obesity were defined according to the age-sex specific BMI cutoffs proposed by the International Obesity Task Force, and abdominal obesity as waist circumference >90th percentile. We used Poisson regression models to estimate prevalence ratios at 4 years of age, and Cox regression analysis to estimate hazard ratios (HR) from 4-8 years of age. Results: In cross-sectional analyses at the age of 4 no association was observed between adherence to MD and overweight, obesity, or abdominal obesity. In longitudinal analyses, a high adherence to MD at age 4 was associated with lower incidence of overweight (HR = 0.38; 95% CI: 0.21-0.67; p = 0.001), obesity (HR = 0.16; 95% CI: 0.05-0.53; p = 0.002), and abdominal obesity (HR = 0.30; 95% CI: 0.12-0.73; p = 0.008) at the age of 8. Conclusion: This study shows that a high adherence to MD at the age of 4 is associated with a lower risk of developing overweight, obesity, and abdominal obesity at age 8. If these results are confirmed by other studies, MD may be recommended to reduce the incidence of obesity at early ages.
Association of Lifestyle Factors and Neuropsychological Development of 4-Year-Old Children
(Multidisciplinary Digital Publishing Institute (MDPI), 2020-08) O'Connor, Giselle; Julvez, Jordi; Fernandez-Barres, Silvia; Navarrete-Muñoz, Eva María; Murcia, Mario; Tardon, Adonina; Riaño Galan, Isolina; Amiano, Pilar; Ibarluzea, Jesus; Garcia-Esteban, Raquel; Vrijheid, Martine; Sunyer, Jordi; Romaguera, Dora
Background: We aimed to assess how lifestyle factors such as diet, sleep, screen viewing, and physical activity, individually, as well as in a combined score, were associated with neuropsychological development in pre-school age children. Methods: We conducted a cross-sectional study in 1650 children of 4 years of age, from the Environment and Childhood Project (INMA) population-based birth cohorts in four regions of Spain. Children were classified per a childhood healthy lifestyle score (CHLS) with a range of 0 to 4 that included eating in concordance with the Mediterranean diet (1 point); reaching recommended sleep time (1 point); watching a maximum recommended screen time (1 point); and being physically active (1 point). The McCarthy Scales of Children's Abilities (MSCA) were used to test neuropsychological development. Multi-adjusted linear regression models were created to assess the association with the lifestyle factors individually and as a combined score. Results: CHLS was not associated with MSCA general cognitive score (1-point increment = -0.5, 95% CI: -1.2, 0.2). Analyzed by separate lifestyle factors, physical activity had a significant negative association with MSCA score and less TV/screen time had a negative association with MSCA score. Conclusion: In this cross-sectional study, a combined score of lifestyle factors is not related to neuropsychological development at pre-school age.
Maternal nut intake in pregnancy and child neuropsychological development up to 8years old: a population-based cohort study in Spain
(Springer, 2019-07) Gignac, Florence; Romaguera, Dora; Fernandez-Barres, Silvia; Phillipat, Claire; Garcia Esteban, Raquel; Lopez-Vicente, Monica; Vioque, Jesus; Fernández-Somoano, Ana; Tardon, Adonina; Iniguez, Carmen; Lopez-Espinosa, Maria-Jose; Garcia de la Hera, Manoli; Amiano, Pilar; Ibarluzea, Jesus; Guxens, Monica; Sunyer, Jordi; Julvez, Jordi
There is scientific evidence on the protective effects of nut intake against cognitive decline in the elderly; however, this effect has been less explored in child neurodevelopment and no studies have explored the potential longitudinal association with nut intake during pregnancy. We aimed to analyze the association of maternal nut intake during pregnancy with child neuropsychological outcomes. We included 2208 mother-child pairs from a population-based birth cohort in four regions of Spain. The follow up settings were during pregnancy (first and third trimesters), birth, 1.5, 5 and 8years. Neuropsychological examinations were based on Bayley Scales of Infant Development (1.5years), McCarthy scales of Children's Abilities (5year), Attention Network Test (ANT, 8year) and N-Back test (8year). Nut intake in pregnancy was reported through a validated food frequency questionnaire during the first and the third trimester. Multivariable regressions analyzed associations after controlling for priori selected confounders notably maternal education, social class, body mass index, energy intake, fish intake, omega-3 supplements, alcohol consumption and smoking habits during pregnancy. Children within the highest tertile of maternal nut consumption during first pregnancy trimester (>32g/week) had a decrease of 13.82ms [95% confidence interval (CI) -23.40, -4.23] in the ANThit reaction time standard error, compared to the first tertile (median 0g/w). A similar protective association pattern was observed with the other cognitive scores at the different child ages. After correcting for multiple testing using Bonferroni familywise error rate (FWER), Hochberg FWER and Simes false discovery rate, ANThit reaction time standard error remained significant. Final model estimates by inverse probability weighting did not change results. Third pregnancy trimester nut intake showed weaker associations. These data indicate that nut intake during early pregnancy is associated with long-term child neuropsychological development. Future cohort studies and randomized clinical trials are needed to confirm this association pattern in order to further extend nutrition guidelines among pregnant women.
Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies
(Springer, 2019-03) Miranda-Mendizabal, Andrea; Castellvi, Pere; Pares-Badell, Oleguer; Alayo, Itxaso; Almenara, Jose; Alonso, Iciar; Blasco, Maria Jesus; Cebria, Annabel; Gabilondo, Andrea; Gili, Margalida; Lagares, Carolina; Piqueras, Jose Antonio; Rodriguez-Jimenez, Tiscar; Rodriguez-Marin, Jesus; Roca, Miquel; Soto-Sanz, Victoria; Vilagut, Gemma; Alonso, Jordi
Objectives: To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults. Methods: Systematic review (5 databases until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12-26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed. Results: Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54-2.50), and males for suicide death (HR 2.50, 95% CI 1.8-3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend's suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied. Conclusions: More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.
Accuracy of online survey assessment of mental disorders and suicidal thoughts and behaviors in Spanish university students. Results of the WHO World Mental Health-International College Student initiative
(Public Library of Science (PLOS), 2019-09-05) Ballester, Laura; Alayo, Itxaso; Vilagut, Gemma; Almenara, Jose; Cebria, Ana Isabel; Echeburua, Enrique; Gabilondo, Andrea; Gili, Margalida; Lagares, Carolina; Piqueras, Jose Antonio; Roca, Miquel; Soto-Sanz, Victoria; Blasco, Maria Jesus; Castellvi, Pere; Forero, Carlos G; Bruffaerts, Ronny; Mortier, Philippe; Auerbach, Randy P; Nock, Matthew K; Sampson, Nancy; Kessler, Ronald C; Alonso, Jordi; UNIVERSAL study group
Objective: To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive Episode[MDE], Mania/Hypomania[M/H], Panic Disorder[PD], Generalized Anxiety Disorder[GAD]) and suicidal thoughts and behaviors[STB] used in the UNIVERSAL project. Methods: Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18-24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales [CIDI-SC], the Self-Injurious Thoughts and Behaviors Interview [SITBI] and the Columbia-Suicide Severity Rating Scale [C-SSRS]. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview [MINI]. Measures of diagnostic accuracy and McNemar chi(2) test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity. Results: A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1-55.1% and negative predictive values 90.2-99.0%; likelihood ratios positive were in the range of 2.1-14.6 and likelihood ratios negative 0.1-0.6. All outcomes showed adequate areas under the curve [AUCs] (AUC> 0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs> 0.8). Conclusion: The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes.

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