Diego J Palao

Diego J Palao
Autonomous University of Barcelona | UAB · Department of Psychiatry and Legal Medicine

MD, PhD

About

208
Publications
28,256
Reads
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1,875
Citations
Additional affiliations
September 2010 - present
Autonomous University of Barcelona
Position
  • Professor (Associate)
January 2010 - April 2016
Autonomous University of Barcelona
Position
  • Professor (Associate)
September 2006 - present
Corporació Sanitària Parc Taulí
Position
  • Executive Director of Mental Health

Publications

Publications (208)
Article
Full-text available
The aim of our study was to examine whether there are sex-based differences in the relationship between personality traits and hypothalamic–pituitary–adrenal (HPA) axis measures. A total of 106 healthy volunteers (56.6% women; age: 48.0 ± 15.8 years) were studied. The revised temperament and character inventory (TCI-R) and the Childhood Trauma Ques...
Presentation
Full-text available
Background: Suicide is among the leading causes of preventable death worldwide. The impact of suicide affects personal, social, and economic level. Therefore, its prevention is a priority for public health systems. Previous studies seem to support the efficacy of providing active contact to persons who have made a suicide attempt. The current syste...
Article
Full-text available
Background Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care progra...
Article
Full-text available
Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to comp...
Preprint
Full-text available
Background: Suicide is among the leading causes of preventable death worldwide. The impact of suicide affects personal, social, and economic level. Therefore, its prevention is a priority for public health systems. Previous studies seem to support the efficacy of providing active contact to persons who have made a suicide attempt. The current syste...
Poster
Introduction: Since Kraepelin's time, the nosology of delusional disorder (DD) has been a subject of debate. The condition has been considered by some to be a form of affective illness. More recently, various studies report the prevalence of affective comorbidity in DD to range between 21-55.8%. This explains why many patients are treated with a co...
Preprint
Full-text available
Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care progr...
Article
Objective Research suggests abnormalities in reward-based processes in anorexia nervosa (AN). However, few studies have explored if such alterations might be associated with different temporal activation patterns. This study aims to characterize alterations in time-dependent processes in the ventral striatum (VS) during social feedback in AN using...
Article
Full-text available
Background: Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and...
Article
A neurobiological framework of chronic stress proposes that the stress-response system can be functionally altered by the repeated presentation of highly stressful situations over time. These functional alterations mainly affect brain processing and include the dysregulation of the hypothalamic-pituitary-adrenal axis and associated processes. In th...
Article
Introduction: Suicide attempts represent a public health concern. The objective of this study is to describe the clinical characteristics of patients visiting an emergency room for a suicide attempt and included in a suicide prevention program, the Catalonia Suicide Risk Code (CSRC), particularly focusing on the follow-up evaluations. Materials and...
Article
Background The COVID-19 pandemic might increase suicide behaviors. However, results are still limited and inconclusive, especially in adolescents. Methods To provide a preliminary evidence of the effects of the COVID-19 pandemic on suicide attempts (SA), we compared data from the Catalonia Suicide Risk Code (CRSC), during the first 12 months of Sp...
Conference Paper
Full-text available
Introduction Over the last decades, antipsychotic plasma levels have been used to evaluate therapeutic response, adherence and safety of antipsychotics in schizophrenia. Their clinical utility in delusional disorder (DD) has been poorly studied. Aims To investigate the relationship between plasma concentrations of risperidone (R), 9-OH-risperidone...
Poster
Full-text available
Introduction A delusion of parasitosis is defined as the fixed, false belief of infestation by invisible organisms or fibrous material of unknown origin. The differential diagnosis is true infection, substance use disorder, dementia or other neuropsychiatric disease. Aims Our goal was to characterize delusions of parasitosis, classically named Ekb...
Poster
Full-text available
Introduction In order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up. Aims This poster describes a sample of DD patients referred to a specialized unit for DD...
Poster
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Introduction Prevalence rates of panic attacks have been reported to be around 24-63% in psychotic patients. Common underlying biological substrates for panic and paranoia have been proposed, suggesting that delusional disorder (DD) may be preceded by the development of anxiety disorders. Aims The main objective of this study was to investigate a...
Poster
Full-text available
Introduction Day care programs have been extensively used to treat people with acute psychiatric disorders. Day hospitals (DH) can act as an alternative to admission in patients with acute symptoms, shorten the duration of admission, be useful for rehabilitation and maintenance care or enhance treatment in patients with poor adherence to outpatient...
Poster
Full-text available
Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a biological basis overlapped with obsessive compulsive disorders and body dysmorphic disorder (BDD). The combination of pharmacological treatment and psychological interventions have been considered the gold-standard. Aims Our main objective was to present the case...
Poster
Introduction Paranoia querulans is a type of persistent delusional disorder of the persecutory subtype, recognized under ICD-10 and DSM-IV. Being a classically described entity, evidence is lacking from its conceptualization as a nosological entity to diagnosis and treatment. Furthermore, controversy still exists regarding its interplay between the...
Conference Paper
Full-text available
Introduction: Treatment response in schizophrenia can be influenced by cultural and ethno-biological factors. However, in delusional disorder (DD), these potential influences have been poorly investigated. Aims: This review aims to synthesize what is known about the influence that cultural and biological factors may have on treatment response in DD...
Poster
Introduction Mycobacterium kansasii is a nontuberculous mycobacterium that causes infection associated with past or current tuberculosis disease. Clinical syndromes and radiological findings are mostly indistinguishable from that of Mycobacterium tuberculosis, thus requiring microbiological confirmation. Objectives We report a case of a 44-year-ol...
Poster
Full-text available
Introduction Antipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression. Objectives Our aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We als...
Preprint
A neurobiological framework of chronic stress proposes that the stress-response system can be functionally altered by the repeated presentation of highly stressful situations over time. These functional alterations mainly affect brain processing and include the dysregulation of the hypothalamic-pituitary-adrenal axis and associated processes. In th...
Article
Cognitive impairment has been associated with both childhood adversity and abnormalities of hypothalamic-pituitary-adrenal (HPA) axis function. An interaction exists between the functional polymorphism rs1360780 in the FKBP5 gene and childhood maltreatment, influencing a variety of clinical outcomes. Our goal was to study the relationship between d...
Poster
Full-text available
Introduction: Several neuroimaging studies on psychosis spectrum have been published in the last decades, most of them based on schizophrenia. Secondary to neuroanatomical dysfunctions, important clinical and prognosis implications have been reported. Nevertheless, only a few studies have investigated features in delusional disorder. Objectives: To...
Article
Full-text available
RESUMEN A pesar de ser un diagnóstico fiable y válido, en las últimas décadas ha habido una confusión en la terminología utilizada para describir al trastorno delirante y una controversia acerca de la utilidad de clasificar el trastorno en subtipos según el contenido. El principal objetivo de esta revisión es resumir la evidencia en datos epidemiol...
Article
Objectives: The objectives of our study were to explore gender differences in Cognition and Social Cognition in patients affected by Psychosis in process of psychosocial rehabilitation and to establish a model of the relationship between Psychopathology, Cognition and Social Cognition in function of the gender, and attending to relevant clinical, s...
Poster
Objectives The main goal of our study is to describe the “matchbox sign” in patients with delusions of infestation attending our emergency department. In a second step, we aimed to compare clinical features between patients who presented the “matchbox sign” and those who did not and whether they differed in attendance rates to other medical service...
Poster
Objectives Our goal is to describe sociodemographic, clinical features and treatment outcomes of inpatients with COVID-19 related delusional symptoms during the state of emergency. As a second objective, we aimed to compare the content and severity of delusions between COVID+ and COVID- patients. Methods We conducted a retrospective case series of...
Conference Paper
Objectives Our main aim was to investigate whether patients with schizophrenia (SZ), schizoaffective disorder (SZA), first episode of psychosis (FEP) and delusional disorder (DD) differ in the frequency and prevalence of suicidal attempts. Methods A systematic review was performed using Scopus and PubMed databases (1980- September 2020) according...
Article
Objective We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology. Methods Three groups were studied: schizophrenia (N = 63), ROP (N = 43) and healthy adolescents (N = 45). Cognitive biases were...
Article
Full-text available
Virtual Reality (VR) is considered an effective way to boost empathy by adopting the perspective of others, thus having clear potential for improving anti-bullying programs. However, this potential benefit of VR is limited by both the lack of adequate content and the lack of empirical evidence of its effectiveness. In this article, we present the p...
Article
Full-text available
Introduction: Cognitive biases are key factors in the development and persistence of delusions in psychosis. The Cognitive Biases Questionnaire for Psychosis (CBQp) is a new self-reported questionnaire of 30 relevant situations to evaluate five types of cognitive biases in psychosis. In the context of the validation of the Spanish version of the CB...
Article
Full-text available
Delusional disorder is a difficult-to-treat clinical condition with health needs that are often undertreated. Although individuals with delusional disorder may be high functioning in daily life, they suffer from serious health complaints that may be sex-specific. The main aim of this narrative review is to address these sex-specific health needs an...
Conference Paper
Introduction Recent research suggests that gender has an influence on the clinical presentation and prognosis of patients with schizophrenia. Women are over-represented in delusional disorder (DD). However, its impact on DD has been poorly studied. Aims Our goal was to estimate the prevalence and incidence of DD and to explore gender differences i...
Poster
Introduction Delusional disorder (DD) has been traditionally considered a difficult to treat and rare disorder. Overrepresentation of women, delayed onset of symptoms, poor insight and lack of compliance have been described as main clinical features. Early detection and optimal therapeutic alliance has been found to be crucial. Aims Our main goal...
Poster
Background The estrogen protection hypothesis in schizophrenia supports the notion that women are protected by estrogens from menarche until menopause. The loss of neuroprotection beginning in the run up to menopause may increase the risk of acute exacerbations. Case report A 47-year-old woman was referred to our day hospital because of delusions...
Poster
Background Although gender differences in psychopathological symptoms and clinical features of schizophrenia have been well-documented, they have been poorly investigated in delusional disorder (DD). Aims Our goal was to explore gender differences in sociodemographic and clinical variables in DD. Methods This narrative, non-systematic, critical r...
Article
Background Electroconvulsive therapy (ECT) is considered the most effective treatment for major depressive disorder (MDD). In recent years, the pursuit of the neurobiological mechanisms of ECT action has generated a significant amount of functional magnetic resonance imaging (fMRI) research. Objective In this systematic review, we integrated all f...
Article
Full-text available
Background ICU patients undergoing invasive mechanical ventilation experience cognitive decline associated with their critical illness and its management. The early detection of different cognitive phenotypes might reveal the involvement of diverse pathophysiological mechanisms and help to clarify the role of the precipitating and predisposing fact...
Article
Introduction: Intimate partner violence (IPV) is the most common and alarming form of violence against women, affecting around 30% of all women around the world. Using an integrative methodology, we approach IPV as a form of chronic exposure to severe stress that alters the stress-response system of exposed women. The aim of this study is to test...
Article
Full-text available
Antipsychotic plasma levels have been extensively used in the assessment of poor treatment response, lack of adherence and adverse events in delusional disorder. They have not been used as indicators of metabolizer status, to determine whether a delusional disorder patient is a poor, intermediate, or ultra-rapid metabolizer of antipsychotics. Pharm...
Article
Objective: We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology. Methods: Three groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45). Cognitive biases were a...
Article
Full-text available
Women with schizophrenia show sex-specific health needs that differ according to stage of life. The aim of this narrative review is to resolve important questions concerning the treatment of women with schizophrenia at different periods of their life—paying special attention to reproductive and post-reproductive stages. Review results suggest that...
Poster
Full-text available
Introduction Recent research has revealed that neurocognitive and social cognitive deficits are core features in patients with schizophrenia. The link between both branches of cognition remains still far from definitive in delusional disorder. Thus, the main goal of this systematic review was to explore non-social and social cognitive deficits in p...
Poster
Full-text available
Introduction Delusional disorder has been considered an uncommon mental illness with an estimated prevalence of 24 to 30 cases and an annual incidence of 0.7 to 3 cases per 100.000 population. Objectives Our aim was to empirically estimate prevalence and incidence of delusional disorder in an emergency department and to describe main sociodemograp...
Poster
Full-text available
Introduction Functional imaging studies have generated evidence implicating dopaminergic dysfunction in the pathophysiology of schizophrenia. Although blockade of the dopamine D2 receptor is the main mechanism of antipsychotic action, treatment response variability calls for an examination of other biological systems in psychotic syndromes. Object...
Poster
Full-text available
Introduction Antipsychotic plasma levels have been extensively used for the assessment of poor treatment response, lack of adherence and adverse events in schizophrenia. However, evidence for delusional disorder is sparse. Aims Our main goal was to investigate the relationship between risperidone (R) and 9-hydroxyrisperidone (9-OH-R) plasma concen...
Poster
Full-text available
Introduction Suicide is one of the leading causes of death among people with psychotic illness. Aims Our goal was to investigate the frequency of suicidal ideation, suicide attempts and completed suicide in four groups of psychotic disorders. Methods A systematic review was performed using Scopus and Pubmed databases (1990-2018) according to the...
Poster
Full-text available
Introduction Culture-bound syndromes (CBS) have been described as recurrent locality-specific patterns of aberrant behaviour and troubling experience. CBS occur throughout the world but, in Western countries, they are described most often in immigrants from low-to-middle income countries. Objectives Our goal was to describe the CBS found among atte...
Poster
Introduction Current literature reports the occurrence of manic states in hypothyroid subjects after hormone supplementation. However, after drug overdose of levothyroxine, little research has described the induction of delayed mixed states. Aims Our aim is to present a case of overdose of levothyroxine with suicidal intention in a women diagnosed...
Article
Full-text available
IntroductionCognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP).Methods Twenty-eight stable ROP out...
Article
Full-text available
Introduction Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk...
Article
Seasonal changes in mood and diurnal preference are two well‐characterized chronobiological phenotypes in major depressive disorder (MDD) and bipolar disorder (BD). The biological mechanisms regulating physiological changes related to seasonality and chronotype involve several genes known as “clock” or circadian genes. Our goal was to study the rel...
Article
Full-text available
Introducción: En el marco de una estrategia para implementar un nuevo programa clínico para la depresión en atención primaria, desarrollamos un curso onlinecon clases videograbadas dirigido a los médicos y enfermeras que van a introducir el programa en su práctica clínica. Sujetos y métodos: La evaluación del curso se realizó mediante un cuestiona...
Article
Full-text available
Background Heterogeneity in cognitive functioning among major depressive disorder (MDD) patients could have been the reason for the small-to-moderate differences reported so far when it is compared to other psychiatric conditions or to healthy controls. Additionally, most of these studies did not take into account clinical and sociodemographic char...
Article
Different therapeutic strategies are used for lowering prolactin concentrations in patients with psychotic disorders with antipsychotic-induced hyperprolactinaemia. We aimed to examine the evidence from open-label studies and randomized clinical trials (RCTs) that studied four prolactin-lowering therapeutic strategies in people with psychotic disor...
Article
Full-text available
The data presented in this paper describe supplementary material to the article entitled “Pharmacological treatment strategies for lowering prolactin in people with a psychotic disorder and hyperprolactinaemia: a systematic review and meta-analysis” [1]. Although raw data was published on the original article, additional raw data has been included...
Article
Full-text available
Background Previous studies assessing the neurotoxicity of haloperidol, risperidone and paliperidone in cell culture suggest that paliperidone shows the strongest neuroprotective effect and a reduced apoptosis level. Other studies including patients with schizophrenia suggest that switching from risperidone long-acting injection (RLAI) to paliperid...
Article
Full-text available
Background Substance use (tobacco, cannabis and alcohol consumption) is associated with the risk of developing a psychotic disorder as well as the risk of presenting psychotic experiences. We aimed to study the associations between substance use and psychotic-like experiences in a sample of healthy adolescents aged between 14 and 15 years. We also...
Article
Full-text available
Background Cognitive deficits are a common cause of functional disability in people with psychotic disorders. Cognitive remediation produces moderate improvements in cognitive performance in people with schizophrenia, although there is variability in the responses between patients. As previous longitudinal studies suggest that free thyroxin (FT4) l...
Article
Full-text available
En las últimas décadas, los movimientos migratorios han hecho que cada vez acudan más pacientes de otras culturas en nuestras consultas. Muchas veces, síntomas definidos como psicóticos o delirantes se explican, en parte, por un componente cultural. No hay duda de que la cultura influye en cómo las personas experimentan sus emociones, en cómo y en...
Article
Background : Suicide prevention is an emerging priority for public health systems. Here, we present the Catalonia Suicide Risk Code (CSRC), a secondary suicide prevention program that provides a systematic approach to follow-up care for patients at risk. We describe the care pathway of the CSRC and characteristics of the patients enrolled in the pr...
Article
Hypothalamic-pituitary-adrenal (HPA) axis dysregulation and cognitive deficits are two well-characterized endophenotypes present in different serious mental illnesses (SMIs), including major depressive disorder, bipolar disorder and schizophrenia. Our aim was to study the influence of genetic and epigenetic variations in HPA axis-related genes on c...
Article
Full-text available
Introducción: En el marco de una estrategia para implementar un nuevo programa clínico para la depresión en atención primaria, desarrollamos un curso online con clases videograbadas dirigido a los médicos y enfermeras que van a introducir el programa en su práctica clínica. Sujetos y métodos: La evaluación del curso se realizó mediante un cuestion...
Article
Full-text available
Background: Previous studies have shown associations between obsessive-compulsive disorder (OCD) and hypothalamic-pituitary-adrenal axis activity (HPA). We aimed to investigate the association between obsessive-compulsive (OC) symptoms and HPA axis functionality in a non-clinical sample and to explore whether there are sex differences in this rela...