viernes, 26 de junio de 2020

Persecutory Subtype Of Delusional Disorder. Descriptive Study Of 129 Cases.


Subtipo Persecutorio Del Trastorno Delirante: Estudio De Series De 129 Casos.
Persecutory Subtype Of Delusional Disorder. Descriptive Study Of 129 Cases.

Francisco Mármol Bernal (1), Rogelio Luque Luqueb (2), Mohamed Farouk Allam (3), Rafael Fernández-Crehuet Navajas (4)

(1) Delegación Territorial de Salud, Córdoba, España.
(2) Hospital Universitario Reina Sofía. Universidad de Córdoba, España.
(3) Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Córdoba, España.

Rev Chil Neuro-Psiquiat 2020; 58 (2): 116-126

Summary
Objective. The objective of this study is to investigate the demographic, environmental, psychosocial and clinical characteristics of the persecutory subtype in a group of patients with delusional disorder (DD). Methodology. Retrospective descriptive study of DD cases registered at Psychiatry and Mental Hygiene Clinic of Cordoba according to DSM-IV-TR criteria was conducted. We obtained a sample of 261 DD patients who met the inclusion criteria; of them 129 cases has persecutory subtype. Data and variables collected were divided into 4 groups: I. Socio-demographic and general data. II. DD risk factors (personal and family). III. DD clinical picture and diagnosis (presentation, symptoms, disability, use of health care resources, treatment, and evolution). Results. The proportion of males versus females of the persecutory subtype was of 1.04. Only 5.4% of patients had primary level of education. At the first visit of the psychiatry clinic, 65.9% of the patients were married and about half of them shared home. About 14.7% of patients had a past history of alcohol consumption, and only 0.8% consumed other drugs. Ideas of reference and of persecution were found in 98.4% and 99.2% respectively. Conclusions. It is necessary to conduct future prospective studies to investigate the risk factors associated with the persecutory subtype of DD.

Key words: delusional disorder, paranoia, persecutory subtype, retrospective study, case series.


Resumen
Objetivo. El objetivo de este estudio es conocer las características demográficas, factores ambientales, factores de riego psicosociales, y clínicas del subtipo persecutorio en un grupo de pacientes con trastorno delirante (TD). Metodología. Estudio epidemiológico retrospectivo sobre un Registro de Casos en el Dispensario de Psiquiatría e Higiene Mental de Córdoba sobre pacientes con TD según criterios DSM-IV-TR. Aquellos pacientes que cumplieron con los criterios de inclusión definidos constituyeron nuestra muestra final de 261 casos, de ellos 129 casos presentaban el subtipo persecutorio. Las variables sobre las que se recogió información en base a protocolos, fueron agrupadas con el orden siguiente: I. Variables de los datos sociodemográficos y generales. II. Variables de los Factores de riesgo del TD (familiares y personales). III. Variables del Cuadro Clínico y el Diagnostico del TD (Presentación, sintomatología delirante, funcionalidad y discapacidad, utilización de los recursos sanitarios, tratamiento, problemas psicosociales, evolución y curso). Resultados. La proporción hombres versus mujeres en el subtipo persecutorio fue de 1,04. Solo el 5,4% de estos pacientes tenía estudios primarios. Un 65,9%, al realizar la primera consulta psiquiátrica, se encontraba casado y el 50,4% convivían en el hogar. Un 14,7% consumió previamente alcohol y un 0,8% otras sustancias. Las ideas de referencia y de persecución se presentaron el 98,4% y en el 99,2% de los casos respectivamente. Conclusiones. Son necesarios futuros estudios prospectivos para investigar los factores de riesgo del subtipo persecutorio del TD.

Palabras clave: Trastorno delirante, paranoia, subtipo persecutorio, estudio retrospectivo, series de casos.

Rev Chil Neuro-Psiquiat 2020; 58 (2): 116-126

miércoles, 10 de junio de 2020

Is there a benefit of vitamin D supplementation in deficient children and adolescents suffering from obesity? A meta-analysis

Is there a benefit of vitamin D supplementation in deficient children and adolescents suffering from obesity? A meta-analysis

M F Nassar, E K Emam, M F Allam

QJM: An International Journal of Medicine, Volume 113, Issue Supplement_1, March 2020, hcaa063.001, https://doi.org/10.1093/qjmed/hcaa063.001

Published: 05 May 2020

Background and objectives. Both childhood obesity and vitamin D deficiency are common in the Middle East. This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity.
Methods. Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation.
Results. Ten studies were retrieved, but only six were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the two studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the six retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers.
Conclusion. Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation. Our results suggest that only with simultaneous weight adjustment strategies, vitamin D sufficiency would be achieved more effectively.

Vitamin D supplementation in deficient children suffering from obesity.

Keywords: Adolescents, children, clinical trials, obesity, supplementation, vitamin D

Topic: obesity, adolescent, child, vitamin d, childhood obesity

Issue Section: Pediatrics

https://academic.oup.com/qjmed/article-abstract/113/Supplement_1/hcaa063.001/5829038