Ana Fresán

University of Kansas, Lawrence, Kansas, United States

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Publications (74)103.71 Total impact

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    ABSTRACT: Objective: Schizophrenia is a complex psychiatric disorder, characterized by disturbed patterns of thought and affecting 0.3-2.0% of the world population. Previously, the multidrug resistance 1 (MDR1) gene has been associated with schizophrenia in treatment response studies in psychotic patients. The aim of this study was to determine the association between MDR1 gene polymorphisms and clinical characteristics in patients with schizophrenia. Methods: Positive and negative symptoms of schizophrenia were assessed with the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) in 158 Mexican patients with schizophrenia. Analyses of MDR1 gene polymorphisms were performed using TaqMan technology. A multivariate ANOVA was performed with MDR1 polymorphisms and gender as independent variables. Results: Males with the G/G genotype of MDR1 rs2032582 presented significantly higher levels of delusions (p = 0.02). When comparing female vs. male groups, the difference was statistically significant (p = 0.0003). Analyses of the MDR1 gene rs1045642 variant showed no significant differences. Conclusion: Our findings suggest that male carriers of the G allele of variant rs2032582 exhibit greater severity of delusions; however, these results should be taken as preliminary, and replication studies in other populations of different ethnic origins are required to confirm these findings.
    Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 06/2014;
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    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.
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    ABSTRACT: Se examinaron las opiniones de psicólogos y psiquiatras de habla inglesa y española acerca de los diagnósticos problemáticos, ausentes y estigmatizantes en la CIE-10 y DSM-IV, y de la necesidad de una clasificación nacional. Se llevó a cabo un análisis de contenido de las preguntas abiertas de las encuestas de WHO-WPA y WHO-IUPsyS. Se incluyeron a 3.222 participantes de 35 países. El grupo diagnóstico considerado más problemático fue trastornos específicos de la personalidad, especialmente entre psiquiatras, por la falta de validez y de especificidad. El trastorno por estrés postraumático complejo fue el diagnóstico que se sugirió incluir con mayor frecuencia, sobre todo por psicólogos, para dar cuenta de los procesos y consecuencias distintos del trauma complejo. La esquizofrenia fue el diagnóstico que se consideró más frecuentemente como estigmatizante, principalmente por psiquiatras, debido a la falta de conocimiento público. Del 14,4% que percibieron la necesidad de una clasificación nacional, dos tercios fueron de África o Latinoamérica. Las razones fueron que se debe considerar la diversidad socio-histórica en la expresión de psicopatología, las diferencias en la percepción de lo que es o no patológico, y la existencia de síndromes culturales. Se discuten las implicaciones para el desarrollo y difusión de la CIE-11.
    International Journal of Clinical and Health Psychology 01/2014; · 2.79 Impact Factor
  • 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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    Salud Mental 06/2013; 36(3):229-234. · 0.42 Impact Factor
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    Salud Mental 06/2013; 36(3):241-251. · 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: Facial expressions of emotion reveal complex mental states that have physiological correlates and signal internal states such as distress to others and are thus crucial in social interaction. In this preliminary study, we therefore sought to examine the link between current psychiatric symptoms and attachment styles in psychiatry residents and their ability to correctly identify facial expressions of emotions. Specifically, we hypothesized that greater current psychiatric symptoms and insecure attachment would be related to difficulties in deciphering facial expressions of negative emotions. A total of 56 psychiatry residents were included in the study, together with 50 university students pursuing careers unrelated to mental health. In order to evaluate the subjects' psychiatric symptoms, the Checklist (SCL-90) and Attachment Styles Questionnaire (ASQ) were used and in order to examine the ability to recognize facial expressions of emotion, we chose the Pictures of Facial Affect (POFA). All the respondents gave their informed consent in writing. The control group recognized fear significantly less as compared to psychiatry residents. Among psychiatry residents, there was a significantly positive correlation between hostility and fear recognition and anxiety and fear recognition. The same was observed between obsessive-compulsive symptoms and disgust recognition. In the control group, there was a significantly negative correlation between paranoid ideation and phobic anxiety with sadness recognition. In resident psychiatry, happiness recognition was positively related to an attachment-style based on confidence, while sadness recognition and surprise recognition correlated negatively with an attachment style based on considering relationships as being of secondary importance. This is one of the first studies to examine emotion recognition skills in medical professionals, and the association of this ability with psychiatric symptoms and attachment styles. We think it is important to observe longitudinally what the possible relevance of these findings might be for both diagnostic accuracy and therapeutic relationships.
    Salud Mental 04/2013; 36(2):95-100. · 0.42 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: El miedo es una emoción que se experimenta a lo largo de la vida y en ocasiones posibilita la adaptación. No obstante, el miedo puede tornarse desadaptativo y evolucionar hacia un trastorno fóbico que impacta negativamente en el individuo que lo padece. La infancia y la adolescencia son las etapas en las que típicamente inician las fobias, las cuales se han asociado al desarrollo de otros trastornos mentales en la vida adulta.
    Salud Mental 06/2012; 35(3):195-203. · 0.42 Impact Factor
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    Salud Mental 06/2012; 35(3):215-223. · 0.42 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

Publication Stats

315 Citations
103.71 Total Impact Points

Institutions

  • 2014
    • University of Kansas
      Lawrence, Kansas, United States
  • 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