Ana Fresán

Instituto Nacional de Psiquiatría, Ciudad de México, The Federal District, Mexico

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Publications (66)98.42 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Personality traits are important candidate predictors of suicidal behavior. Several studies have reported an association between personality/temperament traits and suicidal behavior, suggesting personality traits as intermediary phenotypes related to suicidal behavior. Thus, it is possible that suicide attempts can be accounted for by increased familial rates of risk personality traits. The aim of this work was to evaluate personality traits in affective disorder patients with attempted suicide and to compare them with the personality trait scores of their parents. In addition, ITC scores in the two groups were compared with a healthy control sample. The patients evaluated met the DSM-IV criteria for major depression disorder or dysthymia and had a documented history of suicide attempts. Psychiatric diagnoses of patients and parents were done according to the SCID-I and the personality was assessed using the Temperament and Character Inventory. We analyzed 49 suicide attempt subjects and their parents (n = 95) and 89 control subjects. We observed that temperament and character dimensions were similar between patients and their parents (P > 0.05). In particular, we observed that high HA and low P, SD, and CO were shared among families. Our study is the first to report that the personality traits of affective disorder patients with a history of attempted suicide are shared between patients and their parents.
    Depression research and treatment 01/2014; 2014:291802.
  • Schizophrenia Research 10/2013; · 4.59 Impact Factor
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    ABSTRACT: The effects of pharmacological and psychosocial treatment on remission and the functional outcome in outpatients with schizophrenia were evaluated. Remission was assessed according to the criteria proposed by the Remission in Schizophrenia Working group and psychosocial functioning according to the Global Assessment of Functioning with a score > 60. Functional outcome was the result of these two variables. One hundred fifty two patients were randomized to receive either, antipsychotic treatment as usual (TAU) or social skills training and family psychoeducation in addition to TAU. A final sample of 119 patients: n = 68 in the social skills training group, and n = 51 in the TAU group completed the study protocol. Patients were assessed at baseline and at 6-month follow-up. At the end of the study, 80% of the patients fulfilled the criteria for symptomatic remission: 62 patients (91.2%) in the social skills training group in contrast to 34 patients (66.7%) in the TAU group. Functional improvement criteria were accomplished by 41 patients (34.5%) at the endpoint of the study. Forty of these patients (58.8%) belonged to social skills training and one patient to customary treatment (χ(2) = 41.7, df 1, p < 0.001) and when criteria for symptomatic remission and functional improvement were combined, 39 patients (97.5%) of the social skills training group and one patient (1.9%) of the customary treatment group achieved functional outcome. The results emphasize the need for psychosocial interventions as conjoint to pharmacological treatment to improve functional outcome in schizophrenia patients.
    Journal of psychiatric research 09/2013; · 3.72 Impact Factor
  • Ana Fresán, Carlos Berlanga
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    ABSTRACT: Introduction: The inability to experience pleasure, anhedonia, is recognized as al hallmark symptom of depression. A 14-item, self-report scale developed for the assessment of hedonic capacity: the Snaith-Hamilton Pleasure Scale (SHAPS) has proved to be a reliable and valid psychometric instrument. Objective: Because there are no versions of the scale in other languages, our objective in this study was to translate the instrument into spanish and to determine if the new version maintained the validity and reliability of its original english version. Methodology: The scale was translated into spanish and after reaching final consensus applied to a group of depressed patients participating in a pharmacological trial. The Hamilton Depression Rating Scale (HDRS) was also applied for comparative purposes. Results: Our results demonstrate that the SHAPS in its spanish version maintains the validity and reliability level of the original english version. A moderate internal consistency was determined by Cronbach alpha value of 0.77. Conclusion: our results demonstrate the the spanish version of the SHAPS has validity and reliability similar to its original version, and thus it represents a good alternative to evaluate anhedonia in spanish-speaking populations.
    Actas espanolas de psiquiatria 07/2013; 41(4):227-31. · 0.45 Impact Factor
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    ABSTRACT: Asociación de los trastornos externalizados y la edad de inicio en pacientes con trastorno bipolar tipo I y II ¿Son los síntomas de los trastornos externalizados predictores de una edad de inicio más temprano? SUMMARY Background Early onset mania (MIMT), compared with adolescent onset mania (MIA), has a different clinical presentation of classic mania adult onset (MIEA). Patients with MIA have a course more like the MIEA. External-izing disorders (ADHD, ODD, and TC) have been associated with an earlier age of onset of bipolar disorder and as a marker of poor prognosis. Our goal is to determine the frequency of symptoms related to disruptive behavior disorders in patients with bipolar disorder start very early, early and adult evaluated retrospectively. Methods The total sample (N=64) of adolescent and adult patients was obtained from the National Institute of Psychiatry (INPRF) clinics. The diagnosis was confirmed by the research team. Patients signed the informed asentment and consentment. We applied the K SADS PL Mexico, MINI and MINI KID. We used the EEPE-AA for externalizing disorders.
    Salud Mental 06/2013; · 0.42 Impact Factor
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    ABSTRACT: The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.
    Journal of Religion and Health 05/2013; · 1.02 Impact Factor
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    ABSTRACT: Schizophrenia is a chronic psychiatric disorder associated to high healthcare costs mainly driven by inpatient care. Lack of adherence to antipsychotic treatment is a common reason for relapse and rehospital-ization leading to poor prognosis and global functional impairment of patients. Risperidone long-acting injection (RLAI) has demonstrated its efficacy in treating symptoms of schizophrenia and offers the potential to improve adherence to treatment. Objective To determine clinical and functional efficacy of RLAI and use of health resources (eg., hospitalizations) in a 2-year follow up study among patients with schizophrenia from Latin America.
    Salud Mental 03/2013; 36(1):19-26. · 0.42 Impact Factor
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    Dataset: panss
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    ABSTRACT: The gene coding for catecol-o-methyltransferase (COMT), participant in the metabolism of catecholamines, has long been implicated as a candidate gene for schizophrenia. We determined the relation of the COMT Val108/158Met polymorphism with schizophrenia or its symptomatology (negative, disorganized and psychotic dimension). We conducted a case-control study comprising 186 patients with schizophrenia and 247 controls. The diagnosis of schizophrenia was established using the DSM-IV criteria for this illness. The clinical symptomatology was assessed through the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. No significant differences were found in the distribution of alleles (χ2 = 0.01, df = 1, p = 0.90) or genotypes (χ2 = 1.66, df = 2, p = 0.43) between schizophrenic patients and the control group. Multivariate analysis showed that the COMT Val108/158Met polymorphism has no influence in the clinical symptomatology of schizophrenia. Our results showed no association between COMT Val108/158Met and schizophrenia or evidence for an association between COMT and the clinical symptomatology of this illness. This suggests that the COMT gene may not contribute to the risk for schizophrenia among the Mexican population.
    Molecular Biology Reports 11/2012; · 2.51 Impact Factor
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    ABSTRACT: Backgound: In developing countries, little is known about public recognition and beliefs about treatment of severe mental disorders, both emergent key elements in reducing stigma and the gap of treatment of such patients. It has been proposed that they may be related to gender and perception of patient's aggressiveness and/or dangerousness. AIMS: To assess mental illness recognition and beliefs about treatment of schizophrenia, and to determine their relationship with perception of patient's aggressiveness/dangerousness and gender of the perceiver in a community sample of Mexico City. METHODS: A convenience sample of 1038 subjects responded to a questionnaire that assesses all variables after reading a vignette of a patient with paranoid schizophrenia. RESULTS: Women were 1.88 times more likely to recognize the presence of mental illness and considered psychiatric interventions as the most adequate treatment of symptoms. In contrast, non-psychiatric interventions were more often considered by men (64.7%). Responders who recognize mental illness were more likely to perceive the patient as dangerous, which was related to the suggestion of more restrictive interventions. CONCLUSIONS: It is necessary to direct special efforts to increase mental health literacy among men. The general public needs objective information about aggression and dangerousness in anti-stigma campaigns among developing countries similar to Mexico.
    International Journal of Social Psychiatry 10/2012; · 1.15 Impact Factor
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    ABSTRACT: Given that schizophrenia is a heterogeneous disorder, the analysis of clinical characteristics could help to identify homogeneous phenotypes that may be of relevance in genetic studies. Linkage and association studies have suggested that a locus predisposing to schizophrenia may reside within Xp11. We analyzed uVNTR and rs1137070, polymorphisms from MAOA and rs1799836 of MAOB genes to perform single SNP case-control association study in a sample of 344 schizophrenia patients and 124 control subjects. Single polymorphism analysis of uVNTR, rs1137070 and rs1799836 SNPs did not show statistical differences between cases and controls. Multivariate ANOVA analysis of clinical characteristics showed statistical differences between MAOB/rs1799836 and affective flattening scores (F = 4.852, P = 0.009), and significant association between MAOA/uVNTR and affective flattening in female schizophrenia patients (F = 4.236, P = 0.016) after Bonferroni's correction. Our preliminary findings could suggest that severity of affective flattening may be associated by modifier variants of MAOA and MAOB genes in female Mexican patients with schizophrenia. However, further large-scale studies using quantitative symptom-based phenotypes and several candidate variants should be analyzed to obtain a final conclusion.
    ISRN psychiatry. 01/2012; 2012:852949.
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    ABSTRACT: The objective was to determine the psychometric properties of the Dimensions of Psychosis Instrument (DIPI) in Mexican patients with schizophrenia spectrum disorders. One-hundred patients were recruited. Convergent and divergent validity were determined with the positive and negative scores of the Positive and Negative Syndrome Scale; a forced five-factor exploratory principal-components analysis with varimax rotation was developed. Total DIPI score shows an adequate convergent validity. The rotated principal component matrix accounted for 82.1% of the variance. Our study gives further support of the adequacy of the DIPI for the assessment of the five most common subjective experiences related to psychosis.
    Schizophrenia Research 08/2011; 132(2-3):153-6. · 4.59 Impact Factor
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    ABSTRACT: Benzodiazepine (BZD) dependence is a condition generally circumscribed to a therapeutic framework. Up to 44% of chronic users become dependent. The widespread use of BZD in psychiatry requires the evaluation of psychometric properties of self-reported instruments to characterize this phenomenon. To examine the reliability, construct and criterion validity of the Benzodiazepine Dependence Questionnaire (BDEPQ) in Mexican psychiatric patients. Patients were included if they met DSM-IV criteria for any Axis I disorder and were BZD users. A total of 150 patients were recruited. Diagnoses were made with the SCID-I and BZD dependence was determined with an adaptation of the substance dependence section of the SCID-I. All patients answered the BDEPQ. Almost half of the patients met criteria for BZD dependence. The BDEPQ showed adequate factor loadings with strong alpha values for the subscales and total score. A cut-off value of 23 reached the most stable sensitivity and specificity values. Psychometric properties of the BDEPQ in Mexican psychiatric patients support its utility as a tool for the clinical work and research as it shows to be a useful instrument for the early recognition of BZD dependence in clinical populations.
    Addictive behaviors 08/2011; 36(8):874-7. · 2.25 Impact Factor
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    ABSTRACT: Schizophrenia is a heritable, complex mental disorder. We analysed the DRD3 gene as a candidate to be related to schizophrenia and clinical features in affected sib-pairs. A positive association with the -250A/Ser9 haplotype and a trend toward an association with formal thought disorder were observed. A synergic effect of DRD3 polymorphisms on schizophrenia susceptibility is suggested.
    Psychiatry Research 07/2011; 190(2-3):367-8. · 2.46 Impact Factor
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    ABSTRACT: Objectives: The objectives of the study were to compare personality features according to age and sex cohorts in a community sample of Mexico City using the Temperament and Character Inventory–Revised (TCI-R) and to examine the TCI-R psychometric properties according to age and sex parameters. Method: A total of 2076 adults filled out the Spanish version of TCI-R. Results: Younger subjects exhibited higher novelty seeking. Self-directedness and cooperativeness scores increased with age. Harm avoidance and self-transcendence were lower in younger adults when compared with older subjects. Women scored higher than men in harm avoidance and reward dependence. Men between 26 and 45 years old reported higher novelty seeking. Women older than 25 years scored higher in self-transcendence, and those older than 45 years exhibited higher cooperativeness scores. The identified TCI-R structure corresponded to the original one. Internal consistency of the higher-order dimensions was good in all age cohorts, in men and women, and in the total sample (αs N.80). Conclusion: Our results give further support to personality specific dominant features in men and women. Differences in age cohorts may be explained by maturity and personal experiences acquired during life. The TCI-R psychometric properties and score distributions by age and sex cohorts may be useful for future studies with clinical samples and for cross-cultural comparison purposes.
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    ABSTRACT: The objectives of the study were to compare personality features according to age and sex cohorts in a community sample of Mexico City using the Temperament and Character Inventory-Revised (TCI-R) and to examine the TCI-R psychometric properties according to age and sex parameters. A total of 2076 adults filled out the Spanish version of TCI-R. Younger subjects exhibited higher novelty seeking. Self-directedness and cooperativeness scores increased with age. Harm avoidance and self-transcendence were lower in younger adults when compared with older subjects. Women scored higher than men in harm avoidance and reward dependence. Men between 26 and 45 years old reported higher novelty seeking. Women older than 25 years scored higher in self-transcendence, and those older than 45 years exhibited higher cooperativeness scores. The identified TCI-R structure corresponded to the original one. Internal consistency of the higher-order dimensions was good in all age cohorts, in men and women, and in the total sample (αs >.80). Our results give further support to personality specific dominant features in men and women. Differences in age cohorts may be explained by maturity and personal experiences acquired during life. The TCI-R psychometric properties and score distributions by age and sex cohorts may be useful for future studies with clinical samples and for cross-cultural comparison purposes.
    Comprehensive psychiatry 12/2010; 52(6):774-9. · 2.08 Impact Factor
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    ABSTRACT: Schizophrenia has been object of stigmatization throughout history. A critical component of stigma in schizophrenia is the perception that patients are extremely dangerous. The assessment of this concept in general population by the use of reliable and valid instruments will allow the development of programs aimed to reduce it. To develop an assessment instrument of the public conception of aggressiveness in schizophrenia and to determine its reliability and validity in a community sample of Mexico City. A total of 258 subjects completed the Public Conception of Aggressiveness Questionnaire (CAQ) which is made up of a brief clinical vignette and specific questions that assess subjective conceptions about aggressiveness and mental disorders in patients with schizophrenia. More than 40.0% of the sample considered that the patient with schizophrenia is aggressive and dangerous. The CAQ had an adequate internal consistency (alpha=0.74). The results of the factorial analysis showed that the two factors that explained 61.0% of the variance. The items of CAQ showed two major areas that evaluate: a) perception of presentation of aggressive behaviors and, b) mental illness recognition and social aspects of the stigma of dangerousness. The CAQ is an instrument with adequate psychometric properties that could be useful to evaluate the perception of aggressiveness in schizophrenia among general population.
    Actas espanolas de psiquiatria 01/2010; 38(6):340-4. · 0.45 Impact Factor
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    ABSTRACT: There is evidence that premorbid adjustment can differentiate schizophrenia from schizoaffective disorder. We recruited 41 patients with schizophrenia and 24 patients with schizoaffective disorder without substance abuse 6 months before the assessment. Diagnoses were based on the Structured Clinical Interview for DSM-IV. Psychotic symptoms were rated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale was used to assess depressive symptoms, and the Global Assessment of Functioning Scale was used to rate global psychosocial functioning. Premorbid adjustment was evaluated with the Premorbid Adjustment Scale. Patients with schizophrenia showed worse premorbid adjustment compared with the patients with schizoaffective disorder. The areas of "peer relationships" and "scholastic performance" showed deficits in schizophrenia. Significant associations were found between premorbid adjustment life periods and symptom severity in both groups. Differences found between groups may be related to an earlier illness onset in the schizophrenic group. Premorbid adjustment may be a useful clinical feature to differentiate schizoaffective disorder from schizophrenia.
    Psychiatry Research 02/2009; 165(3):234-40. · 2.46 Impact Factor
  • Omar Minaya, Ana Fresán
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    ABSTRACT: Major depression and anxiety disorders are frequently comorbid diagnoses. Previous studies proposed that personality traits are relevant in the distinction of both disorders. The psychobiological model of personality might be a useful tool to address these differences. To examine personality differences in first-episode depressed adult outpatients with and without comorbidity with anxiety disorders and control subjects. We recruited 80 patients with major depression and 89 non-psychiatrically ill subjects. Patients were on their first psychiatric admission due to major depressive disorder. The Montgomery&Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale were used to assess symptom severity and personality with the Temperament and Character Inventory. Depressed patients with and without anxiety disorders exhibited higher scores on the Harm avoidance, and lower scores on Persistence and Reward Dependence and in all character dimensions when compared to control subjects. Patients with anxiety disorders showed higher Persistence. Patients with depression exhibit an abnormal structure of personality. As Persistence has been related to the ability to generate and maintain internal motivation, it seems that depressed patients with a comorbid anxiety disorder are more likely to intensify their efforts in response to reward as a result of an increased arousal.
    Personality and Individual Differences. 01/2009;
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    ABSTRACT: To investigate the role of the apolipoprotein E (APOE) gene in schizophrenia, the authors analyzed 60 families with this mental disorder. An association in the presence of linkage test (APL) and haplotypes analysis were undertaken using the APL v1.1 software. A global allelic transmitted was significant for APOE-epsilon3 (chi(2)=6.24, p=0.01); this allele is mainly carried by female patients (chi(2)=8.33, p=0.003), whereas APOE-219G is preferentially transmitted in males (p=0.02). Furthermore, our results show that haplotypes APOE-epsilon3/APOE-219G are associated with schizophrenia (chi(2)=11.61, p=0.01). These results provide evidence that the APOE gene may play a significant role in the etiology of schizophrenia in the Mexican population.
    The Journal of neuropsychiatry and clinical neurosciences 01/2009; 21(4):440-4. · 2.34 Impact Factor

Publication Stats

259 Citations
2k Downloads
98.42 Total Impact Points

Institutions

  • 2004–2013
    • Instituto Nacional de Psiquiatría
      Ciudad de México, The Federal District, Mexico
  • 2012
    • Universidad Juárez Autónoma de Tabasco
      Villahermosa, Tabasco, Mexico
  • 2009–2012
    • Autonomous University of Mexico City
      Ciudad de México, The Federal District, Mexico
  • 2006
    • The National Institute of Neurology and Neurosurgery
      Tlalpam, The Federal District, Mexico