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Risperidone has been significant correlated with a direct effect of interleukin-6 (IL-6) levels in patients with schizophrenia. This fact allows the opportunity to link the probable immunomodulatory effect of antipsychotic medication. Specially, a proper functioning of IL-6 pathway plays a potential role in the treatment or development of schizophrenia. Our primary aim was to perform a systematic review and meta-analysis to determine the effect of risperidone on IL-6 levels in individuals with schizophrenia. Studies were identified through a systematic search using PubMed, Scopus, and Web of Science databases. The articles found were subjected to the inclusion and exclusion criteria; then, the mean and standardised differences were extracted to calculate the standardised mean differences using the CMA software. IL-6 levels in individuals with schizophrenia were compared before and after receiving risperidone as treatment. Increased levels of IL-6 levels were observed in individuals with schizophrenia who received risperidone (point estimate 0.249, lower limit 0.042, upper limit 0.455, p-value 0.018). In the Asian population sub-analysis, no statistically significant differences were observed (point estimate 0.103, lower limit −0.187, upper limit 0.215, p value 0.890). When we compared individuals with schizophrenia to the control groups, a significant increase of IL-6 levels was observed in the group with schizophrenia (point estimate 0.248, lower limit 0.024, upper limit 0.472, p-value 0.30). Risperidone appears to play an important role in IL-6 levels in schizophrenia. Potential implications of increased IL-6 levels in people with schizophrenia should be considered in future studies.KEY POINTSIncreased levels of IL-6 levels were observed in individuals with schizophrenia who received risperidone.Risperidone appears to play an important role in IL-6 levels in schizophrenia.This study could serve for future research focussed on IL-6. Increased levels of IL-6 levels were observed in individuals with schizophrenia who received risperidone. Risperidone appears to play an important role in IL-6 levels in schizophrenia. This study could serve for future research focussed on IL-6.

Background/objective It has been suggested that patients with rheumatoid arthritis (RA) often present depression and anxiety. The objective of this study was to estimate the prevalence of depression and anxiety symptoms in Mexican patients with RA and to determine associated factors of depression and anxiety in this population. Methods This was a cross-sectional study. We evaluated demographic characteristics, medical comorbidities, substance use, and disease characteristics in 103 patients with RA. Patients were enrolled from March 2016 to August 2017 The prevalence of depression and anxiety was estimated using the Hospital Anxiety and Depression Scale. We calculated the proportion of depression and anxiety symptoms and compared characteristics between groups. Finally, logistic regression model was used to determine the factors associated with depression and anxiety. Results Depression symptoms were present in 26.2% of patients, whereas anxiety symptoms were present in 16.5% of patients. Presence of hypertension was an associated factor with depression (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.06-9.23; p = 0.03). Low socioeconomic (OR, 3.78; 95% CI, 1.39-10.28; p = 0.009) and high scores of 28-joint Disease Activity Score were associated with anxiety (OR, 3.19; 95% CI, 1.20-8.45; p = 0.02). Conclusions Factor related to socioeconomic conditions, comorbid medical conditions, and disease activity were related to the presence of clinical depression and anxiety in Mexican patients with RA, which may have a negative impact in the course and outcome of the disease. We suggest an early identification of depression and anxiety in these patients through an early psychiatric evaluation.

Clinical evidence suggests that inflammation is a key factor to understand the causes of depressive symptoms. Fluoxetine is one of the main first-line medications used for depression, and it is hypothesized that it participates in the decrease of pro-inflammatory cytokines. Hence, our aim was to perform a meta-analysis and systematic review to understand the interaction of fluoxetine in the IL-1β, IL-6 and TNF-α inflammatory process. Studies identified in PubMed and Scopus databases were used to perform a meta-analysis via the Comprehensive software. Standardized mean difference (SMD) was used as a summary statistic. The analysis included a total of 292 individuals with major depressive disorder who received fluoxetine for a period longer than 6 weeks; additionally, IL-1β, IL-6 or TNF-α levels were measured at the end of the antidepressant treatment. The findings were significant revealed decreased levels of the cytokines studied. In conclusion, the pooled data suggest that fluoxetine treatment improved depressive symptomatology by the modulation of pro-inflammatory process such as IL-1β, IL-6 or TNF-α.

Isela Esther Juárez-Rojop,1 Carlos Mario Fortuny-Falconi,2 Thelma Beatriz González-Castro,3 Carlos Alfonso Tovilla-Zárate,2 Mario Villar-Soto,4 Ester Rodríguez Sanchez,4 Yazmín Hernández-Díaz,3 María Lilia López-Narvaez,5 Jorge L Ble-Castillo,1 Nonanzit Pérez-Hernández,6 José Manuel Rodríguez-Pérez6 1Multidisciplinary Academic Division of Health Sciences; Juarez Autonomous University of Tabasco, Villahermosa, Tabasco, Mexico; 2Multidisciplinary Academic Division of Comalcalco; Juarez Autonomous University of Tabasco, Comalcalco, Tabasco, Mexico; 3Multidisciplinary Academic Division of Jalpa de Méndez; Juarez Autonomous University of Tabasco, Jalpa de Méndez, Tabasco, Mexico; 4Psychiatric Care Services, Hospital of high specialty “Gustavo A. Rovirosa Pérez”, Ministry of Health, Villahermosa, Tabasco, Mexico; 5Pediatric Care Services, General Hospital of Yajalon “Dr. Manuel Velasco Suarez”, Yajalon, Chiapas, Mexico; 6Department of Molecular Biology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico Background: Diabetes mellitus is a chronic disease that requires attention and commitment on the part of patients; improving the quality of life of these patients reduces health costs, morbidity, and mortality. We focused on investigating the factors related with the quality of life and depression symptomatology in patients with type 2 diabetes.Participants and methods: A total of 173 Mexican patients with type 2 diabetes were recruited. An interview face-to-face, a sociodemographic characteristics questionnaire, the Short Form 36 (SF-36), and the Clinical Epidemiological Studies of Depression were applied. The biochemical parameters measured were blood glucose, cholesterol, triacylglycerol levels, and glycated hemoglobin.Results: In all SF-36 subscales, female patients had lower scores in comparison with male patients; individuals ≥65 years of age showed less physical function. We observed that married patients presented a better quality of life than people who were widowed or divorced (P

Background: It has been proposed that the risk of death by suicide is higher in patients with diabetes than in the general population. Therefore, it is necessary to investigate the risk factors of suicidal behavior in patients with type 2 diabetes. The aim of the present study was to analyze the prevalence of suicide attempt and determine the risk factors of suicide attempt, in patients with type 2 diabetes in a Mexican population. Methods: Clinic characteristics, anthropometric measurements, biochemical levels, depression, and suicidal behavior were evaluated in 185 Mexican patients with type 2 diabetes. A multivariate logistic regression analysis was performed to find predictive factors of suicide attempt. Results: 11.4% of patients reported previous suicide attempts n = 21). Younger patients (OR: 3.63, 95% CI: 1.29&ndash, 10.19), having depression (OR: 3.33, 95% CI: 1.13&ndash, 9.76) and normal BMI (OR: 3.14, 95% CI: 1.11&ndash, 8.83), were predictive factors of suicide attempt. No other variables in the study showed statistical significance. Conclusions: Our results showed a high prevalence of suicidal behavior in patients with type 2 diabetes. We found that younger age, depression and normal BMI could be risk factors of suicide attempt in these patients. Therefore, psychiatric interventions to prevent depression and suicidal behavior in this population are necessary. New studies using larger samples are necessary to replicate and confirm these results.

Objective Using the method of psychological autopsy, we identified differences by gender in socio-demographic aspects, signs and symptoms, and suicide characteristics in a population of the state of Tabasco. Mexico. Methods Between the years 2007–2014, 182 psychological autopsies were documented by the Secretary of Health of the State of Tabasco, Mexico. A structured questionnaire was used to obtain information on socio-demographic aspects and suicide characteristics. Results The sample was mainly formed by males (78%). 84% of the sample used hanging as suicide method. However, in comparison with the male group, females were older on the average (p = 0.002); they were mostly housewives (37.5%) and had more years of schooling (p = 0.004). Other significant differences predominantly present in the male group were: the use of alcohol at the time of suicide (52.1%), job retirement, and increases in apathy (50.7%) and aggressiveness (36.6%) (p Conclusion Our results suggest that there are differences by gender between subjects with completed suicide. Factors such as alcohol consumption, job retirement, aggressiveness and isolation/social apathy certainly render men more vulnerable to suicide in the Mexican population.

Background: Depression in patients with type 2 diabetes (T2D) is often undiagnosed and remains untreated, leading to poor therapy adherence and ill health-related outcomes. We evaluated the effect of vortioxetine versus sertraline in the treatment of depression, distress and metabolic control in subjects with T2D and depression. Methods: Participants were selected from the Clinic for Diabetes, diagnosed with depression when the score was ≥14 in the Hamilton Depression Rating Scale, and verified by a psychiatrist in agreement with the DSM-5 instrument (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). The criteria for recruitment also included glycosylated hemoglobin ≥7.5%, 18 to 60 years of age, and written informed consent. Pharmacological treatment for depression was assigned randomly: vortioxetine (10 mg/day) or sertraline (75 mg/day) for 8 weeks. Biochemical parameters, anthropometric measures and depression symptoms were evaluated after antidepressant treatment. This was a randomized singled-blind study. Results: Subjects that met the inclusion criteria were 50, of which only 21 patients with T2D and depression finished the treatment. Vortioxetine and sertraline showed partial remission of depression. Vortioxetine showed a major effect size in glycosylated hemoglobin and a moderate effect size on weight loss, fasting plasma glucose (FPG), cholesterol and triacylglycerol levels. On the other hand, patients treated with sertraline presented a slight increase in body weight, body mass index (BMI), and in all biochemical markers. Conclusions: Vortioxetine may ameliorate depressive symptoms and metabolic control in patients with T2D and depression. Trial registration number: NCT03978286.

Background: individuals with type 2 diabetes show emotional distress as they learn how to cope with the disease. The emotional distress increases the possibility of complications in these patients. The aims of the present study were to evaluate the impact of the emotional distress in the quality of life of individuals with diabetes, and to investigate the demographic and clinical characteristics associated with the emotional distress of living with diabetes in a Mexican population. Methods: a total of 422 Mexican individuals with type 2 diabetes were recruited from the outpatient Diabetes Clinic of the Hospital Regional de Alta Especialidad Dr. Gustavo A. Rovirosa of Villahermosa, Tabasco. Demographic and clinical characteristics along with quality of life (SF-36) were assessed in these individuals. The emotional distress of living with diabetes was measured using the 5-item Problem Areas in Diabetes. Patients were divided according to the presence of high or low distress. Results: we identified that 31.8% (n = 134) of patients presented high diabetes-related emotional distress. We observed that hepatic diseases as comorbidities (p = 0.008) and diagnosis of major depression (p = 0.04) are factors associated with the emotional distress of living with diabetes. These patients showed a reduced quality of life in all dimensions (p &lt, 0.001), the most affected dimensions were physical role (d = 0.37) and general health (d = 0.89) showing lower scores in comparison with patients with low emotional distress. Conclusions: our results suggest that Mexican individuals with type 2 diabetes mellitus show high emotional distress living with the disease and have a decreased quality of life. Therefore, it is necessary to decrease factors associated with the high emotional distress of living with diabetes in patients with type 2 diabetes.

We thank the comments of Fernandez-Nino [1] addressing our article [2] “Increase in Suicide Rates by Hanging in the Population of Tabasco, Mexico between 2003 and 2012”, which pointed out that the use of the epidemiological concept “prevalence” is not correctly applied in the present manuscript.

Schizophrenia is a severe mental illness that affects adults, especially between 15 to 35 years of age. Patients with schizophrenia have difficulty looking after themselves, completing their studies, holding a job, or being part of their community. In Mexico, there are mental health programs that provide help and assistance to people with mental health problems, but given the country’s current socioeconomic instability, a shortage of medication exists, as well as a deficit in trained personnel and mental health professionals, plus a lack of a public education program to prevent discrimination against people with mental disorders. Unfortunately, the exact number of people suffering from schizophrenia in developing countries (including Mexico) is unknown, since there are no recent censuses in mental health. Literature about schizophrenia mentions genetic predisposition and environmental factors. In this article, we showed 4 patients with schizophrenia who were treated at the Regional Hospital of High Specialty in Mental Health (Hospital Regional de Alta Especialidad en Salud Mental, HRAESM, in Spanish). Our main objective was the identification of symptoms in our patients and to compare the medication and side effects due to treatment in these patients. Substance abuse, dysfunctional family and family history of mental illness were characteristics associated with our patients, as well as side effects. However, the implementation of more studies is necessary to understand the risk factors associated with schizophrenia in our population.

Background Suicidal behavior is a leading cause of injury and death worldwide. Several studies have provided a possible relationship between genetic factors and suicidal behavior. Also, these studies have shown evidence for altered serotonergic neural transmission in the pathogenesis of suicidal behavior. In addition, genes pertaining to the serotonergic system have been proposed as candidates to establish biological correlates between suicidal behavior and the serotonergic system. The most studied genes are SCL6A4, HTR2A, HTR2C, HTR1A, HTR1B, TPH-1, and TPH-2. To get a comprehensive understanding of the association with suicidal behavior we will conduct genotype assays studies in a Mexican population. Methods/Design We will conduct a case–control study. The population sample will comprise adolescent and adult patients admitted for attempted of suicide and diagnosed by a psychiatrist. A peripheral blood sample will be taken from all the subjects (cases and controls). Genomic DNA from the leukocytes blood sample will be extracted. The genotypes of interest are distributed in the following genes: SCL6A4, HTR2A, HTR1A, HTR1B, HTR2C, TPH-2 and TPH-1. All the samples will be analyzed using a polymerase chain reaction (PCR) end-point method. We will evaluate the Hardy-Weinberg Equilibrium. The chi-squared test or Fisher’s exact test will be used to compare genotype and allele frequencies between control and case groups. The Quanto 1.2 software will measure the sample size of the association. For all the association analyses the level of significance will be set at p = 0.05 and the confidence interval at 95%. Discussion Suicidal behavior has been increase in Mexico, principally in young population. Our study will demonstrate the association between serotoninergic genes and suicide behavior in Mexican population.

Background: Worldwide, the suicide rate is decreasing. To examine changes in the rates of completed suicide in the Mexican population from 2003 to 2012, we analyzed these changes according to: (i) the method of suicide; (ii) age group and (iii) gender. Methods: The data analyzed were obtained from governmental organizations from the State of Tabasco, Mexico. The data provided 1836 cases of subjects born and residing in Tabasco, who completed suicide in this state. Results: Suicide by hanging was a common choice of suicide method for Mexicans. The rate of suicide by hanging increased from 5.80 to 6.49 per 100,000 persons between 2003 and 2012, a rate percentage increase of 11.89%. Conclusions: Hanging was found to be the most common choice of suicide in the Mexican population, probably because the materials required are easily available and the method does not require complicated techniques, especially in the 55–64 age group. Strategies for prevention and intervention should be developed for the Mexican population considering suicide rates by age group and gender.

Background The polymorphism COMTval158met has been associated with suicidal behavior in case-control and meta-analysis studies, but results and conclusions remain controversial. The objective of this study was to examine the association between COMT val158met with suicidal behavior in a case-control study and to assess the combined evidence -this case-control study and available data from other related studies- we carried out a meta-analysis. Methods We conducted a case-control study with 105 patients with suicide attempts and 236 controls. Subsequently, we performed a meta-analysis of published genetic association studies by searching through Medline, PubMed and Web of Science databases. Results No significant differences were found in the distribution of alleles (χ2 = 0.33, 1 df, p = 0.56) or genotypes (χ2 = 2.36, 2 df, p = 0.26). The meta-analysis comprising 12 association studies (including the present one) showed that the risk COMTmet allele of COMTval158/met is not associated with suicidal behavior (OR: 1.09, 95% CI: 0.97-1.23), even in the absence of heterogeneity (OR: 1.09, 95% CI: 0.97-1.23). Conclusion Our results showed no association between COMTval158/met and suicidal behavior. However, more studies are necessary to determine conclusively an association between COMT and suicidal behavior.

Introduction. Suicidal behaviour is a public health problem. It has been suggested that impulsive or premeditated personality interferes with aggressive acts such as suicide. Objective. In this study, we identified the socio-demographic differences when attempting suicide, as well as the concomitant depression among individuals characterized by impulsive or premeditated aggression. Methods. We performed a transversal study that included 200 residents of Villahermosa, Tabasco, Mexico, who regularly use the city’s General Health Services. The premeditated or impulsive aggression was evaluated using the Impulsive/Premeditated Aggression scale (IPAS). The sample was divided in two groups: impulsive and premeditator individuals. Suicidal attempt, presence of depression and socio-demographic characteristics were evaluated after wards and compared between groups. Results. The psychological evaluation revealed that impulsive aggression is present in 62.71% of the population. We observed that being unemployed and/or being a woman were characteristics associated with premeditated aggression. The premeditators group had the higher proportion of concomitant depression (χ 2 = 18.29, gl = 1, p = 0.001). The proportion of people that had attempted suicide at least once during their lives was similar in both groups (impulsive = 6.06%, premeditators = 6.30%). Discussion and conclusion. This study does not show any association between the personality (impulsive or premeditative) and the frequency of suicide attempts in the Tabascan General Health Services users. Nevertheless, the frame of mind (depression) could be associated with taking decisions when attempting suicide.