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Bipolar Disorder: HELP
Articles by Guillermo Lahera
Based on 12 articles published since 2010
(Why 12 articles?)

Between 2010 and 2020, G. Lahera wrote the following 12 articles about Bipolar Disorder.
+ Citations + Abstracts
1 Guideline [Clinical practice guideline on bipolar disorder: drug and psychosocial therapy. Asociación Española de Neuropsiquiatría]. 2013

Bravo, Maria Fe / Lahera, Guillermo / Lalucat, Lluis / Fernández-Liria, Alberto / Anonymous1220765 / Anonymous1230765. ·Servicio de Psiquiatría, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma de Madrid, Madrid, España. ·Med Clin (Barc) · Pubmed #23891130.

ABSTRACT: Bipolar disorder is a chronic and recurrent mood disorder, which may severely impact on the patient's global functioning. It has been estimated that approximately 1.6% of the population is affected. A long delay in diagnosis and an excessive disparity in the treatment of these patients have been detected. Within the Quality Plan of the Spanish National Health System, one of the key strategies is to improve clinical practice through the development and use of clinical practice guidelines (CPGs). In this context, the CPG on bipolar disorder arises from an agreement between the Ministry of Health and the University of Alcalá, involving the Spanish Association of Neuropsychiatry as developer and project manager. Its main objective is to develop recommendations on the diagnostic, therapeutic and rehabilitative care for patients with bipolar disorder, primarily applicable in the public mental health services. In this paper we present the main recommendations on pharmacological and psychosocial interventions in bipolar disorder.

2 Review The influence of the working alliance on the treatment and outcomes of patients with bipolar disorder: A systematic review. 2020

Andrade-González, Nelson / Hernández-Gómez, Alba / Álvarez-Sesmero, Sonia / Gutiérrez-Rojas, Luis / Vieta, Eduard / Reinares, María / Lahera, Guillermo. ·Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. · Faculty of Psychology, Complutense University of Madrid, Madrid, Spain. · Department of Psychiatry, 12 de Octubre University Hospital, Madrid, Spain. · Faculty of Medicine, University of Granada, Granada, Spain. · Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain; IRyCIS, CIBERSAM, Madrid, Spain. Electronic address: guillermo.lahera@uah.es. ·J Affect Disord · Pubmed #31521862.

ABSTRACT: BACKGROUND: The working alliance plays an essential role in the treatment of patients with different diseases. However, this variable has received little attention in patients with bipolar disorder. Therefore, this systematic review aimed to examine the working alliance's influence on these patients' treatment outcomes, analyze its role in the adherence to pharmacotherapy, and identify the variables that are related to a good working alliance. METHODS: PubMed, PsycINFO, and Web of Science databases were searched until January 5, 2018 using a predetermined search strategy. Then, a formal process of study selection and data extraction was conducted. RESULTS: Seven articles fulfilled the inclusion criteria and they included a total of 3,985 patients with bipolar disorder type I and II. Although the working alliance's ability to predict the duration and presence of manic and depressive symptoms is unclear, a good working alliance facilitates the adherence to pharmacological treatment. In addition, good social support for patients is associated with a strong working alliance. LIMITATIONS: The selected studies used different definitions and measures of the working alliance and adherence, and most used self-reports to assess the working alliance. Furthermore, the relationships found among the variables were correlational. CONCLUSIONS: The working alliance can play an important role in adjunctive psychological therapies and in pharmacological and somatic treatments for patients with bipolar disorder. However, the number of studies on working alliance in bipolar disorder is rather limited and there is methodological heterogeneity between the studies.

3 Review Salience and dysregulation of the dopaminergic system. 2013

Lahera, Guillermo / Freund, Namdev / Sáiz-Ruiz, Jerónimo. ·Servicio de Psiquiatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain. guillermo.lahera@gmail.com ·Rev Psiquiatr Salud Ment · Pubmed #23084802.

ABSTRACT: Psychosis is a subjective and experiential phenomenon of the mind, influenced by cognitive and socio-cultural patterns of the individual. The neurobiological correlate of this phenomenon is the dysfunction of brain dopaminergic pathways. This article reviews the scientific evidence on the theoretical approaches of the dopaminergic hypothesis of psychosis and its relationship with the reward and salience systems. The aberrant salience occurs when the dysregulation of dopamine transmission produces a mistaken interpretation of neutral or irrelevant stimuli as a source of reward or punishment. Advances in neuroscience achieved in the last decade have led to the conceptualization of the constructs of visual, social and emotional salience, to test the hypothesis of aberrant salience in psychosis. Psychosis appears, therefore, as a trans-nosological pathological process, relatively nonspecific, which alters the attribution system of reality.

4 Article Social cognition in bipolar disorder: the role of sociodemographic, clinical, and neurocognitive variables in emotional intelligence. 2019

Varo, C / Jiménez, E / Solé, B / Bonnín, C M / Torrent, C / Lahera, G / Benabarre, A / Saiz, P A / de la Fuente, L / Martínez-Arán, A / Vieta, E / Reinares, M. ·Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain. · Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain. · Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain. ·Acta Psychiatr Scand · Pubmed #30786002.

ABSTRACT: OBJECTIVE: The main aims of this study were to examine the differences in the Emotional Intelligence (EI), the emotional domain of social cognition (SC), between euthymic patients with bipolar disorder (BD) and healthy controls (HC) and to evaluate the contribution of sociodemographic, clinical, and neuropsychological variables to EI. METHODS: We recruited 202 patients with BD and 50 HC. EI was evaluated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). The sociodemographic, clinical, and neurocognitive variables that showed a significant association with EI were entered into hierarchical multiple regression analysis. RESULTS: BD patients obtained significantly lower scores compared to HC in the Emotional Intelligence Quotient (EIQ) and in the Understanding Emotions branch score. The best fitting model for the variables associated with EI in the patients group was a linear combination of gender, estimated IQ, family history of affective diagnosis, and executive function. The model, including these previous variables, explained up to 27.6% of the observed variance (R CONCLUSIONS: The identification of variables associated with deficit in EI, such as male gender, lower estimated IQ, family history of affective diagnosis. and lower executive function performance, may help in selecting treatment targets to improve SC, and especially EI, in patients with BD.

5 Article Social cognition in bipolar disorder: Focus on emotional intelligence. 2017

Varo, C / Jimenez, E / Solé, B / Bonnín, C M / Torrent, C / Valls, E / Morilla, I / Lahera, G / Martínez-Arán, A / Vieta, E / Reinares, M. ·Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain. · Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Electronic address: evieta@clinic.ub.es. ·J Affect Disord · Pubmed #28427032.

ABSTRACT: BACKGROUND: The present study aims to characterize emotional intelligence (EI) variability in a sample of euthymic bipolar disorder (BD) patients through the Mayer- Salovey-Caruso Emotional Intelligence Test (MSCEIT). METHOD: A total of 134 euthymic BD outpatients were recruited and divided into three groups according to the total Emotional Intelligence Quotient (EIQ) score of the MSCEIT, following a statistical criterion of scores 1.5SDs above/below the normative group mean, as follows: a low performance (LP) group (EIQ <85), a normal performance (NP) group (85≤EIQ≤115), and a high performance (HP) group (EIQ >115). Afterwards, main sociodemographic, clinical, functional and neurocognitive variables were compared between the groups. RESULTS: Three groups were identified: 1) LP group (n=16, 12%), 2) NP group (n=93, 69%) and 3) HP group (n=25, 19%). There were significant differences between the groups in premorbid intelligence quotient (IQ) (p=0.010), axis II comorbidity (p=0.008), subthreshold depressive symptoms (p=0.027), general functioning (p=0.013) and in four specific functional domains: autonomy, occupation, interpersonal relations and leisure time. Significant differences in neurocognitive performance were found between groups with the LP group showing the lowest attainments. LIMITATIONS: The cross-sectional design of the study. CONCLUSION: Our results suggest that EI variability among BD patients, assessed through MSCEIT, is lower than expected. EI could be associated with premorbid IQ, subthreshold depressive symptoms, neurocognitive performance and general functioning. The identification of different profiles of SC may help guide specific interventions for distinct patient subgroups aimed at improving social cognition, neurocognitive performance and psychosocial functioning.

6 Article U-shaped curve of psychosis according to cannabis use: New evidence from a snowball sample. 2016

Brañas, Antía / Barrigón, María L / Garrido-Torres, Nathalia / Perona-Garcelán, Salvador / Rodriguez-Testal, Juan F / Lahera, Guillermo / Ruiz-Veguilla, Miguel. ·Department of Psychiatry, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Madrid, Spain. · Department of Psychiatry, Hospital Fundación Jiménez Díaz, Madrid, Huelva, Spain. · UGC de Salud Mental, Complejo Hospitalario Universitario de Huelva, Huelva, Spain. · UGC de Salud Mental Hospital Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain. · Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Sevilla, Sevilla, Spain. · Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá de Henares, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. · Grupo Neurodesarrollo y Psicosis, Instituto de Biomedicina de Sevilla (IBIS), Consejo Superior de Investigaciones Cientificas/Universidad de Sevilla/Unidad de Gestión Clínica (UGC) de Salud Mental Hospital Virgen del Rocío, Sevilla, Spain miguel.ruiz.veguilla.sspa@juntadeandalucia.es. ·J Psychopharmacol · Pubmed #27539930.

ABSTRACT: BACKGROUND: The aim of this study was to investigate the relationship between psychotic-like experiences (PLEs) assessed using the Community Assessment of Psychic Experience (CAPE) questionnaire and the pattern of cannabis use in a non-clinical sample collected by snowball sampling. METHODS: Our sample was composed of 204 subjects, distributed into three groups by their cannabis use pattern: 68 were non-cannabis users, 40 were moderate cannabis users and 96 were daily cannabis users. We assessed the psychotic experiences in each group with the CAPE questionnaire; and then controlled for the effect of possible confounding factors like sex, age, social exclusion, age of onset of cannabis use, alcohol use and other drug use. RESULTS: We found a significant quadratic association between the frequency of cannabis use and positive (β = -1.8; p = 0.004) and negative dimension scores (β = -1.2; p = 0.04). The first-rank and mania factors showed a significant quadratic association (p < 0.05), while the voices factor showed a trend (p = 0.07). Scores for the different groups tended to maintain a U-shape in their values for the different factors. When we adjusted for gender, age, social exclusion, age of onset of cannabis use, and use of alcohol and other drugs, only the first-rank experiences remained significant. CONCLUSIONS: We found there was a U-shaped curve in the association between cannabis use and the positive and negative dimensions of the CAPE score. We also found this association in mania and first-rank experiences.

7 Article Relationship between olfactory function and social cognition in euthymic bipolar patients. 2016

Lahera, Guillermo / Ruiz-Murugarren, Salvador / Fernández-Liria, Alberto / Saiz-Ruiz, Jerónimo / Buck, Benjamin E / Penn, David L. ·1Department of Medicine and Medical Specialties (Psychiatry),University of Alcala,Madrid,Spain. · 2Department of Psychiatry,Príncipe de Asturias University Hospital,Alcala,Madrid,Spain. · 4Department of Psychology,University of North Carolina-Chapel Hill,NC,USA. ·CNS Spectr · Pubmed #23759120.

ABSTRACT: OBJECTIVE/INTRODUCTION: There is a close functional and neuroanatomical relationship between olfactory ability and emotional processing. The present study seeks to explore the association between olfactory ability and social cognition, especially facial emotion perception, in euthymic bipolar patients. METHODS: Thirty-nine euthymic outpatients meeting DSM-IV-TR criteria for bipolar disorder and 40 healthy volunteers matched on socio-demographic criteria were recruited. Both groups were assessed at one time point with the University of Pennsylvania Smell Identification Test (UPSIT), the Emotion Recognition Test, and The Faux Pas Recognition Test, as well as measures of general cognition and functioning. RESULTS: The bipolar patients showed a significant impairment in olfactory identification (UPSIT) and social cognition measures compared to healthy controls. Analyses revealed significant relationships between olfactory identification and facial emotion recognition, theory of mind, general cognition, and a trend-level relationship with functioning. Controlling for age and cigarettes smoked, relationships remained significant between olfactory function and facial emotion recognition. CONCLUSION: There is a deficit of olfactory identification in euthymic patients with bipolar disorder that is correlated with a deficit in both verbal and non-verbal measures of social cognition.

8 Article Hostile attributions in bipolar disorder and schizophrenia contribute to poor social functioning. 2015

Lahera, G / Herrera, S / Reinares, M / Benito, A / Rullas, M / González-Cases, J / Vieta, E. ·Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain. · Usera Mental Health Center, Doce de Octubre University Hospital, Madrid, Spain. · Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain. · Provincial Hospital of Toledo, Toledo, Spain. · San Fernando Psychosocial Rehabilitation Center, EXTER., Madrid, Spain. · Alcalá de Henares Psychosocial Rehabilitation Center, EXTER., Madrid, Spain. ·Acta Psychiatr Scand · Pubmed #25645449.

ABSTRACT: OBJECTIVE: To compare the profile of attributional style of a group of out-patients with bipolar disorder (BD) and schizophrenia (SZ), and a group of healthy controls - along with other social cognition domains - such as emotion recognition and theory of mind (ToM). METHOD: A total of 46 out-patients diagnosed with BD, 49 with SZ, and 50 healthy controls were assessed in attributional style (Ambiguous Intentions Hostility Questionnaire), facial emotion recognition (FEIT, FEDT, ER-40), and ToM (Hinting Task). Symptomatology, clinical variables and global functioning were also collected. RESULTS: Both groups with SZ and BD showed hostile social cognitive biases, compared with the control group. Patients with BD also showed a capacity for emotional recognition similar to those with SZ and worse than control subjects. In contrast, patients with SZ showed poorer ToM. Subthreshold depressive symptoms and an attributional style toward hostility appeared as the factors with a strongest association to global functioning in BD. In SZ, PANSS score and a tendency to aggressiveness were the most relevant factors. CONCLUSION: Attributional style (along with other domains of social cognition) is altered in out-patients with BD and SZ. The presence of residual symptoms and a hostile social cognitive bias may contribute to the functional impairment of both groups.

9 Article Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients with sub-threshold depressive symptoms: a randomized controlled trial. 2014

Lahera, Guillermo / Bayón, Carmen / Fe Bravo-Ortiz, Maria / Rodríguez-Vega, Beatriz / Barbeito, Sara / Sáenz, Margarita / Avedillo, Caridad / Villanueva, Rosa / Ugarte, Amaia / González-Pinto, Ana / de Dios, Consuelo. ·University Hospital La Paz, IDIPAZ, Madrid, Spain. consuelo.dios@salud.madrid.org. ·BMC Psychiatry · Pubmed #25124510.

ABSTRACT: BACKGROUND: The presence of depressive subsyndromal symptoms (SS) in bipolar disorder (BD) increases the risk of affective relapse and worsens social, cognitive functioning, and quality of life. Nonetheless, there are limited data on how to optimize the treatment of subthreshold depressive symptoms in BD. Mindfulness-Based Cognitive Therapy (MBCT) is a psychotherapeutic intervention that has been shown effective in unipolar depression. The assessment of its clinical effectiveness and its impact on biomarkers in bipolar disorder patients with subsyndromal depressive symptoms and psychopharmacological treatment is needed. METHODS/DESIGN: A randomized, multicenter, prospective, versus active comparator, evaluator-blinded clinical trial is proposed. Patients with BD and subclinical or mild depressive symptoms will be randomly allocated to: 1) MBCT added to psychopharmacological treatment; 2) a brief structured group psychoeducational intervention added to psychopharmacological treatment; 3) standard clinical management, including psychopharmacological treatment. Assessments will be conducted at screening, baseline, post-intervention (8 weeks) and 4 month follow-up post-intervention. The aim is to compare MBCT intervention versus a brief structured group psychoeducation. Our hypothesis is that MBCT will be more effective in reducing the subsyndromal depressive symptoms and will improve cognitive performance to a higher degree than the psychoeducational treatment. It is also hypothesized that a significant increase of BDNF levels will be found after the MBCT intervention. DISCUSSION: This is the first randomized controlled trial to evaluate the effects of MBCT compared to an active control group on depressive subthreshold depressive symptoms in patients with bipolar disorder. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.

10 Article Deficits in recognition, identification, and discrimination of facial emotions in patients with bipolar disorder. 2013

Benito, Adolfo / Lahera, Guillermo / Herrera, Sara / Muncharaz, Ramón / Benito, Guillermo / Fernández-Liria, Alberto / Montes, José Manuel. ·Psychiatry Department, Hospital Provincial de Toledo, Toledo, Spain. · Psychiatry Department, Universidad de Alcalá, Madrid, Spain. · Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Madrid, Spain. · Spanish Association of Neuropsychiatry, Spanish Association of NeuropsychiatrySpain, Spain. · Hospital del Sureste, ArgandaMadrid, Spain. ·Braz J Psychiatry · Pubmed #24402219.

ABSTRACT: OBJECTIVE: To analyze the recognition, identification, and discrimination of facial emotions in a sample of outpatients with bipolar disorder (BD). METHODS: Forty-four outpatients with diagnosis of BD and 48 matched control subjects were selected. Both groups were assessed with tests for recognition (Emotion Recognition-40 - ER40), identification (Facial Emotion Identification Test - FEIT), and discrimination (Facial Emotion Discrimination Test - FEDT) of facial emotions, as well as a theory of mind (ToM) verbal test (Hinting Task). Differences between groups were analyzed, controlling the influence of mild depressive and manic symptoms. RESULTS: Patients with BD scored significantly lower than controls on recognition (ER40), identification (FEIT), and discrimination (FEDT) of emotions. Regarding the verbal measure of ToM, a lower score was also observed in patients compared to controls. Patients with mild syndromal depressive symptoms obtained outcomes similar to patients in euthymia. A significant correlation between FEDT scores and global functioning (measured by the Functioning Assessment Short Test, FAST) was found. CONCLUSIONS: These results suggest that, even in euthymia, patients with BD experience deficits in recognition, identification, and discrimination of facial emotions, with potential functional implications.

11 Article Social cognition and interaction training (SCIT) for outpatients with bipolar disorder. 2013

Lahera, G / Benito, A / Montes, J M / Fernández-Liria, A / Olbert, C M / Penn, D L. ·Príncipe de Asturias University Hospital, Department of Psychiatry, University of Alcala, Madrid, Spain. guillermo.lahera@uah.es ·J Affect Disord · Pubmed #22840617.

ABSTRACT: INTRODUCTION: Patients with bipolar disorder show social cognition deficits during both symptomatic and euthymic phases of the illness, partially independent of other cognitive dysfunctions and current mood. Previous studies in schizophrenia have revealed that social cognition is a modifiable domain. Social cognition and interaction training (SCIT) is an 18-week, manual-based, group treatment designed to improve social functioning by way of social cognition. METHOD: 37 outpatients with DSM-IV-TR bipolar and schizoaffective disorders were randomly assigned to treatment as usual (TAU)+SCIT (n=21) or TAU (n=16). Independent, blind evaluators assessed subjects before and after the intervention on Face Emotion Identification Task (FEIT), Face Emotion Discrimination (FEDT), Emotion Recognition (ER40), Theory of Mind (Hinting Task) and Hostility Bias (AIHQ). RESULTS: Analysis of covariance revealed significant group effects for emotion perception, theory of mind, and depressive symptoms. The SCIT group showed a small within-group decrease on the AIHQ Blame subscale, a moderate decrease in AIHQ Hostility Bias, a small increase in scores on the Hinting Task, a moderate increase on the ER40, and large increases on the FEDT and FEIT. There was no evidence of effects on aggressive attributional biases or on global functioning. LIMITATION: No follow up assessment was conducted, so it is unknown whether the effects of SCIT persist over time. CONCLUSION: This trial provides preliminary evidence that SCIT is feasible and may improve social cognition for bipolar and schizoaffective outpatients.

12 Article Social cognition and global functioning in bipolar disorder. 2012

Lahera, Guillermo / Ruiz-Murugarren, Salvador / Iglesias, Paloma / Ruiz-Bennasar, Claudia / Herrería, Elvira / Montes, José Manuel / Fernández-Liria, Alberto. ·Principe de Asturias University Hospital, University of Alcala, Madrid, Spain. guillermo.lahera@uah.es ·J Nerv Ment Dis · Pubmed #22297310.

ABSTRACT: The purpose of this study was to assess the role of social cognition, together with other relevant clinical variables and measures of general cognition, in the global functioning of euthymic bipolar patients. Thirty-nine euthymic outpatients fulfilling DSM-IV-TR criteria for bipolar disorder type I or II were recruited and were divided in two groups: high (n = 19) and low (n = 20) global functioning. Both groups' performance was compared in verbal and nonverbal social cognition (Faux pas test and Facial Emotion Recognition test), sustained attention and executive function. The low-functioning group showed a significant impairment in both verbal and nonverbal measurements of social cognition compared with the high-functioning group. Globally, both bipolar groups showed a significant impairment in facial emotion recognition compared with a similar sample of healthy volunteers. Social cognition may play a significant role in the clinical-functional gap of bipolar patients.