IntroductionIrritability is the most frequently reported symptom in child and adolescent depression. The association of both has been linked with high rates of chronicity, comorbility and impairment.ObjectivesTo study the association between irritability and depressive symptoms in children and adolescents.MethodsWe have studied 857 participants recruited from the only child and adolescent mental health clinic in a catchment area of 122,968 people under 18 (2004–2010). A sample of 857 participants (112 controls and 745 patients) was included to carry out a cross-sectional study. Irritability was measured by a Visual Analog Scale (VAS irritability)–scored from 0 to 10–, and depressive symptoms by the Children's Depression Inventory (CDI). The participants were categorized into controls and patients, and according to their irritability (≤ 4 [I], 5 [II] and ≥ 6 [III]). The mean of CDI score was calculated for each of the groups, adjusted by sex and age, and analyzed by ANCOVA.ResultsThe following means were obtained from the controls: 13,71 (group I), 9,82 (group II) and 17,45 (group III). Regarding to the patients: 13,92 (group I), 11,54 (group II) and 15,64 (group III). A quadratic association (P < 0.0015) was found between VAS irritability score and CDI score.ConclusionsThere is not a linear association between irritability and depressive symptoms in children and adolescent. High rates of depressive symptoms were associated both with high and low rates of irritability. Several questions remain unexplained about the status of irritability in psychiatry, as Stringaris group has been pointed out.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction:Along last years psychiatric literature has shown an increased interest about Borderline Personality Disorder (BPD) diagnosis. Nevertheless, few studies in large samples has been developed in our country. This study is a part of a main research: Personality Disorders in Andalusian Community. Diagnostic evolution and its link with use of health services.Objectives:•To study BPD diagnosis in Andalusian inpatients throughout the last 10 years.•To establish a predictive model analyzing the BPD diagnostic evolution.Method:The information has been obtained from the Basic Information Minimum Set: A record of admissions (with clinical and demographic variables) registered in the Andalusian population. We made an observational naturalistic study about the number of inpatients with BPD diagnosis, and an analytical study (Linear Regression) to determine the trend marked in the last years about evolution in the diagnosis of inpatients with Personality Disorders (PD).Results:The number of total psychiatric admissions was 99444 (64968 inpatients): 10755 records had a Personality Disorder (PD) diagnosis.The number of patients with BPD diagnosis has increased from 75 in 1995 to 340 in 2004 (11,8% to 26,13% over percentage of PD). the linear regression had a thread of 0,95, with a determination coefficient of 91,6% (standard error 0,34), with statistical significance (p = 0,00), establishing a prediction linear model about the increase of inpatients with BPD diagnosis.Conclusions:1.The number of inpatients with BPD diagnosis in Andalusia is increasing over last years.2.The model predicts a growing of BPD diagnosis along next years.
The development, evaluation and use of biological markers with a diagnostic purpose in psychiatry is extremely important. However, with certain exceptions, truly sensitive and specific markers have not yet emerged. In order to investigate the relationship between the immune apparatus and the hypothalamic-pituitary activity on the one hand, and the psychopathological state of the patients on the other, we used a longitudinal design and assessed monocyte parameters (HLA-DR, CD 35, vimentin filaments, and phagocytosis index) and neuroendocrine tests (dexamethasone suppression test [DST] and thyrotropin-releasing hormone [TRH] stimulation test) at intake and at follow-up in 49 depressed patients. Immunological parameters were compared with neuroendocrine tests in both phases of the study. The combined use of both immunological and neuroendocrine tests did not add sensitivity to the immunological identification of depressed patients. The findings lead us to consider the role of the monocyte parameters as sensitive depressive state markers, while the combined use of both neuroendocrine and immunological tests in current clinical practice would be debatable.
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