Publications by authors named "Maria Isabel Osuna"

3 Publications

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Smoking cessation opportunities in severe mental illness (tobacco intensive motivational and estimate risk - TIMER-): study protocol for a randomized controlled trial.

Trials 2019 Jan 14;20(1):47. Epub 2019 Jan 14.

Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.

Background: There is an increased risk of premature death in people with severe mental illness (SMI). Respiratory disorders and cardiovascular disease are leading causes of increased mortality rates in these patients, and tobacco consumption remains the most preventable risk factor involved. Developing new tools to motivate patients towards cessation of smoking is a high priority. Information on the motivational value of giving the lung age and prevention opportunities is unknown in this high-risk population.

Methods/design: This article describes in detail a protocol developed to evaluate an intensive motivational tool, based on the individual risks of pulmonary damage and prevention opportunities. It is designed as a randomized, 12-month, follow-up, multicenter study. A minimum of 204 smokers will be included, aged 40 years and older, all of whom are patients diagnosed with either schizophrenia or bipolar disorder (BD). Chronic obstructive pulmonary disease (COPD) will be evaluated using spirometry, and the diagnosis will then be validated by a pneumologist and the lung age estimated. Based on this value, a motivational message about prevention will be issued for the intervention group, which will be reinforced by individualized text messages over a period of 3 months. The efficacy of the method and the pulmonary damage variables will be evaluated: smoking cessation at the end of follow-up will be confirmed by cooximetry, and the COPD diagnosis and the severity of the staging for disease will be assessed.

Discussion: In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provide patients with SMI with a better chance of quitting smoking.

Trial Registration:, ID: NCT03583203 . Registered on 11 July 2018. Trial status: recruitment.
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January 2019

Setting the stage to quit smoking in Bipolar Disorder patients: brief advice in clinical practice.

Adicciones 2019 Apr 1;31(2):136-146. Epub 2019 Apr 1.

Reina Sofia University Hospital. CIBERSAM..

Tobacco consumption is the main preventable factor of mortality in smokers with bipolar disorder (BD), and any possible solutions are often blocked by prejudices over desire, and the possibilities and risks for these patients in giving up tobacco consumption. Adults with BD were recruited at 8 Mental Health Centres. Smokers were evaluated before and after a brief intervention based on the 3 A's and classified into a 'Stage of Change' (SOC) and their 'Readiness to Change' (RTC). A multiple linear regression was used to analyze the progression in their RTC and the independent effect of different variables (pharmacological treatment, history of psychotic symptoms, current anxiety symptoms, willingness, self-perceived capacity to quit smoking and subjective perception of cognitive functioning). Of 212 stable patients diagnosed with BD, current smokers (n=101; 47.6%) were included in the intervention phase, and 80.2% completed it. At baseline, 75.2% were considering the idea of giving up smoking and, after the brief intervention, 30.9% of the patients progressed in their SOC. A significant increase in the level of RTC was observed (53.3 vs 59.3, P=0.019). Perception of cognitive performance (β=-0.35;P=0.002), the degree of willing to quit (β=0.32;P=0.008), self-perceived capacity to quit tobacco smoking (β=-0.30;P=0.012), the patient's age (β=-0.72;P=0.004), the age of onset of smoking (β=0.48;P=0.022) and years as a smoker (β=0.48;P=0.025) were all factors that significantly influenced the chances of improving after the short intervention. Smokers with BD consider the idea of quitting and a brief intervention developed in the every day mental health care setting improves the level of readiness. The neurocognitive dysfunction associated with BD may limit patients' readiness to quit smoking.
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April 2019

Biochemical changes in the cingulum in patients with schizophrenia and chronic bipolar disorder.

Eur Arch Psychiatry Clin Neurosci 2008 Oct 24;258(7):394-401. Epub 2008 Apr 24.

Department of Psychiatry, Complejo Hospitalario, Carretera Bailén-Motril sn, Jaén, CP 23009, Spain.

Biochemical changes have been reported in vivo in the brain in schizophrenia patients using 1H-magnetic resonance spectroscopy (MRS). The aim of this study was to assess the specificity of biochemical changes occurring in schizophrenia patients, in a direct comparison with bipolar disorder patients. Fourteen patients with chronic paranoid schizophrenia, 17 euthymic type I bipolar patients with no previous history of psychotic symptoms and 15 healthy controls were included, most of them were female. They underwent a study with MRS: proton spectra were acquired using a Signa 1.5 T CVI scanner, with a localised single voxel PRESS sequence. N-acetyl aspartate (NAA), Creatine (Cr), and Choline (Cho) metabolite resonance intensities were all quantified in the cingulum, a region of interest in schizophrenia and bipolar disorder. Schizophrenia patients showed a significantly higher Cho/Cre as well as lower NAA/Cho ratios as compared with controls and bipolar patients. No significant differences were found among the three groups as regards NAA/Cre levels. These data are consistent with an increase in the concentration of choline in the cingulum in chronic schizophrenia, at least in this predominantly female group. Such an increase seems to be more intense than in psychosis-free bipolar disorder patients.
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October 2008