bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of in Vivo Treatment with Delta9-THC on Mice Adrenal Gland
Authors: Moura E. , Esteves-Pinto C. , Serrão M.P. , Azevedo I. , Vieira-Coelho M.
Published: March 2009

Introduction:

The efficacy of antidepressants has been linked in part to their ability to reduce activity of the hypothalamic-pituitary-adrenal (HPA) axis; however, the mechanism by which antidepressants regulate the HPA axis is largely unknown. Recent research has demonstrated that endocannabinoids can regulate the HPA axis and exhibit antidepressant potential.

Aim:

The purpose of this study was therefore to evaluate the effect of chronic administration of delta-9-tetrahydrocannabinol (delta9-THC) on the adrenal gland of mice.

Methods:

Delta9-THC (10 mg/kg, 1 THC:1 chremophor:18 saline) or vehicle (CT, 1 chremophor:18 saline) was administered i.p. for 10 days to C57Bl6 mice aged 15 weeks. At the end of the study rats were placed in metabolic cages. Noradrenaline (NA) and adrenaline (AD) levels in samples and tissues were evaluated by HPLC-ED. Statistical analysis was done by ANOVA followed by Student's t test. Results are presented as mean±SEM.

Results:

Treatment with delta9-THC did not produce changes in mice weight (CT: 25±1; delta9-THC: 24±1 g, n=5-6) but produced a significant reduction in adrenal gland weight (CT: 1.4±0.2; delta9-THC: 0.6±0.1* mg, n=5-6, *P˂0.01). However, treatment with delta9-THC did not produce significant changes in NA and AD adrenal content (NA: 7.5±2.1, 5.3±0.6; AD: 14.1±1.1, 11.1±2.1 nmol, CT and delta9-THC respectively, n=5-6) or in NA and AD urine levels (NA: 0.88±0.06, 1.18±0.17; AD: 0.64±0.07, 0.81±0.09 nmol/24h, CT and delta9-THC respectively, n=5-6).

Conclusion:

Chronic treatment with delta9-THC reduces adrenal gland weight in mice. These results suggest that endocannabinoids may act directly at the adrenal gland to regulate the HPA axis.
Disrupting Reconsolidation of Alcohol Memories Reduces Cue-induced Alcohol Seeking Behavior in Rats
Authors: von der Goltz C. , Vengeliene V. , Kiefer F. , Spanagel R.
Published: March 2009

In humans alcohol seeking behavior is frequently evoked by the retrieval of memories associated with an alcohol experience. Consolidated memories can become labile if reactivated by reexposure. The aim of our study was to examine whether the behavioral impact of previously conditioned alcohol associated cues is significantly reduced by blocking the reconsolidation of the previously learned alcohol associations that are retrieved by reexposition. For this purpose we applied an animal model for cue-induced relapse to alcohol-seeking behavior. We show that post-retrieval i.p.-administration of 0.1 mg/kg of the NMDA antagonist MK-801 (n=8-10 per group) significantly reduced alcohol seeking behavior during the following test day as compared to vehicle treated animals. Similarly, memory reconsolidation was disrupted by ICV administration of 400 μg of the protein synthesis inhibitor anisomycin (n=9-11 per group). Pharmacological disruption of reconsolidation of alcohol-associated memories may thus provide a potential therapeutic strategy for the prevention of relapse in alcohol addiction.
Association Between Orexin Plasma Concentration and Psychopathology in Alcohol Dependent Patients During Acute Detoxification
Authors: von der Goltz C. , Grosshans M. , Koopmann A. , Fink T. , Wiedemann K. , Kiefer F.
Published: March 2009

Aims:

The orexins (hypocretins) are neuropeptides recently identified as neurotransmitters in lateral hypothalamus neurons. Although the majority of studies associated the function of orexin neurons with arousal and sleep, these neurons also project to reward-associated brain regions, including the nucleus accumbens and ventral tegmental area. This indicates a possible role for orexins in reward function and motivation and thus in addictive diseases. Additionally, there is growing evidence from preclinical studies for an involvement of orexins in the regulation of stress, affectivity and drug seeking behavior.

Method:

We investigated orexin plasma concentrations and psychological symptoms in a sample of 34 alcohol dependent subjects on day 1 and day 14 of detoxification. For this purpose we used the Brief Symptom Inventory (BSI) as well as the Obsessive-Compulsive Drinking Scale to identify self-reported clinically relevant psychological symptoms including alcohol craving.

Results:

As a main result a significant positive correlation between orexin plasma concentration and depression as well as global distress indicies of the BSI was detected during early withdrawal (day 1), which is not shown after detoxification on day 14. No association with subjective craving for alcohol was found.

Conclusion:

Our data indicate that orexins may be directly involved in affective dysregulation in alcohol dependent patients; moreover the effects of orexins on reinstatement of drug seeking behaviors might be mediated by impaired brain stress systems.
Cannabis and MDMA abuse Continues to Incline Among Adoelescents
Authors: Vucetic-Arsic S. , Alcaz S. , Stankovic M. , Daragan-Saveljic J.
Published: March 2009

Objective:

The substance cannabis and 3,4-methylendioxiymethamphetamine MDMA (Ecstasy) is a popular recreational stimulant commonly referred to as “club drugs”. They produce maladaptive behavioral or psychological changes. Last evidence from World Health Organization indicates increasing route for MDMA abuse in new generation.

The aim of this study is to evaluate the specific groups of patients and to make the distinction between generations and model of substance abuse.

Methods:

The retrospective study includes patients treated in Special Hospital on Addictions in Belgrade diagnosed by any set of criteria during the period of last 15 years. Authors investigated early onset and frequency of MDMA and cannabis abuse patients regard to different age.

Results:

Total of 400 patients was separated to four different groups- main ages 40, 30, 20 and 18 years old.

Significant positive correlation was found between youngest patients and there first contact (14, 5 year old) with club drugs. Frequency and duration period of addiction were 1,6 year. In a contrarily, in older group (40 and 30) we found later consummation of cannabis 19,2 and 23,5 year old for MDMA. Also we notice irregular pattern of club drugs abuse and short period of intensive consumption 2,7 month.

Conclusion:

Our data suggests that distribution of cannabis and ecstasy abuse between adolescents spreads. These results indicate that chronic and frequent drug use may lead to distinct patterns of cognitive impairment in youngest patients and may be getaway drugs for latter heroin abuse.
Evolution of Drug use After Enforcing a Protocol in a Medium Stay Unit. Results Four Years Later
Authors: Torreblanca M. , Zallo E. , Pinilla E. , Euba O. , Merino R. , Barreiro A. , Arroita A. , Sánchez N.
Published: March 2009

Aims:

Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychistric illness, so it’s important to guarantee drug abstinence at least during hospitalization. This is even more significant in a medium stay unit because patients are more serious and resistant to treatment.

In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.

We evaluate if with the protocol, drug use decreases during hospitalization in a medium stay unit in a psychiatric hospital.

Methods:

We first compared drug use (positive results in urine samples) from 2000 to 2002 (before protocol: urine samples collected when there’s drug misuse suspicion) with the period after the protocol was enforced (from 2003 to 2006). Afterwards, we analyzed if drug use during hospitalization continues decreasing in 2007.

In the protocol urine samples are collected when there’s a past misuse history, consumption suspicion, randomly and every time they leave for home.

Results:

It is proved that drug use decreases during hospitalization since the new protocol came into force. Drug use continues reducing since the enforcement of the drug screening protocol.

Conclusion:

The introduction and exhaustive completion of a protocol designed to decrease drug misuse in a psychiatric hospitalization unit, provokes a high reduction of drug use, and each year, the reduction of drug misuse is higher. So we think it’s convenient to generalize this kind of measures.
Does Serotonin Augmentation Have Any Effect on Cognition and Activities of Daily Living in Alzheimer’s Dementia?: A Double-blind Clinical Trial
Authors: Mowla A.
Published: March 2009

Objective:

Recent studies suggest that cholinergic dysfunction does not provide a complete account of age-related cognitive deficits and other neuronal systems like monoaminergic hypofunction are involved. In several studies selective serotonin reuptake inhibitors demonstrated promotion in neurogenesis in the hippocampus and enhanced memory and cognition. The aim of this study is to survey the effect of serotonin augmentation on cognition and activities of daily living in patients with Alzheimer's disease.

Method:

The trial was designed as a 12-week randomized, placebo-controlled, double-blind study. One hundred and twenty two patients aged 55-85 years, suffering from mild to moderate alzheimer's dementia were randomly allocated in one of the three treatment group: fluoxetine plus rivastigmine, rivastigmine alone or placebo group. Efficacy measures comprised assessments of cognition, activities of daily living and global functioning. Hamilton Depression Scale also was used to assess changes in mood throughout study.

Result:

Fluoxetine plus rivastigmine and rivastigmine groups demonstrated improvement on measures of cognitive and memory without any significant difference; however, the former group did better in their activities of daily living and global functioning. Patients taking placebo had significant deterioration in all the efficacy measures. Patients taking rivastigmine or rivastigmine plus fluoxetine had improvements in Hamilton Depression Scale without significant differences.

Conclusion:

Concomitant use of selective serotonin enhancing agents and acetyl cholinesterase inhibitors can provide greater benefit in activities of daily living and global functioning in patients with cognitive impairment. Although our study is preliminary and larger double blind studies are needed to confirm the results.
Are Noradrenergic Antidepressants a Valuable Choice in the Treatment of Panic Disorder? A Review and Meta Analysis
Authors: Chiesa A. , Serretti A. , Calati R. , Perna G. , Bellodi L. , De Ronchi D.
Published: March 2009

Objective:

The aim of the present review and meta analysis is to evaluate the efficacy of new noradrenergic antidepressants (NAD) in the treatment of panic disorder (PD).

Methods:

A literature search was conducted using MEDLINE, ISI web of knowledge and references of selected articles. Data from fourteen papers focusing on venlafaxine, mirtazapine and reboxetine were entered in RevMan 4.2.10 Our primary outcome measures were the rate of response, remission and side effects of NAD compared to placebo. Further analysis included the end-point mean number of panic attacks, the Panic and Anticipatory Anxiety Scale and the Hamilton Scale for Anxiety’ values.

Results:

We found a significant higher rate of response (OR = 3.2, 95% CI=2.61 to 3.92), remission (OR = 2.14, 95% CI=1.72 to 2.66) and side effects (OR = 1.41, 95% CI=1.11 to 1.78) for NAD compared to placebo, even though the studies were very heterogeneous. Analysis performed on the three drugs individually showed higher rate of response for patients treated with venlafaxine and mirtazapine whereas no statistical difference was found between reboxetine and placebo. The number of panic attacks and the values of all scales measuring the intensity of panic disorder at the end of trial were significantly lower for patients treated with a NAD.

Conclusion:

Although the small sample size of some studies and limiting statistical assumptions could reduce the significativity of our findings, both venlafaxine and mirtazapine showed a significant efficacy for the treatment of PD which was comparable to selective serotonine reuptake inhibitors. Further studies on reboxetine are needed.
The use of Sertraline in Psychiatric Practice
Authors: Zivlak - Radulovic N. , Miskovic M. , Zoric D. , Maglov T. , Ilic D.
Published: March 2009

Sertraline is an antidepressant of the third generation of the selective serotonin reuptake inhibitor (SSRI) class. It is simple to use and has a wide application in treating various psychiatric disorders, but with much less pronounced side effects.

The aim of this study is to establish the frequency and adverse effects in users of sertraline during clinical treatment.

The method of work was a prospective study which comprised 30 participants who came for a medical examination for the first time and who had a valid indication for drug suitability. The patients were observed during the following two control check-ups. The findings thus gathered were statistically analysed and shown on the graphs.

Conclusion:

The examination has shown that the possible side effects of sertraline are rare and mainly of temporary nature, and confirm the effectiveness and safety of sertraline in routine clinical practice.
Mirtazapine Induced Tardive Akathisia: A Case Report
Authors: Ozyildirim I. , Kosecioglu S.
Published: March 2009

Aims:

Akathisia is a side effect generally associated with antipsychotic drugs. However, akathisia is also reported as a side effect of antidepressants, especially of the selective serotonin reuptake inhibitor group. Mirtazapine is an antidepressant that has a special role in relation with akathisia. There have been randomized controlled studies reporting that mirtazapine is effective in treatment of antipsychotic-induced akathisia. However, there have also been few cases in which acute akathisia are induced by mirtazapine. We would like to report a case of mirtazapine induced tardive akathisia.

Case report:

Mrs. A is a 43-year old woman who applied to psychiatrist four years ago for complaints such as depressive mood, anhedonia, reduced sleep and poor appetite. She was diagnosed as having a major depressive disorder and prescribed 15 mg mirtazapine at night. Mrs. A benefited from the treatment within 1-2 months, complied with medication but did not attend follow-up examinations. About a year later, she started to have severe restlessness, shaking and need to move about one hour after mirtazapine intake. Therefore, patient started use mirtazapine once every three days for the following three years. Akathisia starting after mirtazapine intake disappeared about 8-10 hours later and patient did not have akathisia during two days that she did not have mirtazapine intake.

Conclusion:

Mirtazapine might be effective both in treatment and precipitation of akathisia. These effects might be determined by multiple interactions among factors such as duration of mirtazapine treatment, presence of concomitant treatment, neurological basis of the disorder.
Treatment of Depressive Patients with Duloxetine in a Hospital Consulting Department
Authors: Calvin J.L. Rodriguez
Published: March 2009

Objective:

Depressive symptoms present quite frequently in in-patients in general hospitals with a variety of organic conditions. The main aim of treatment is to manage the symptoms and prevent them from recurring.

The primary endpoint for this study was to assess the effectiveness of treatment with duloxetine in a group of in-patients with depressive symptoms in the general hospital.

Methods:

This was an observational study with duloxetine, in which a total of 40 patients were included who presented depressive symptoms while in-patients in a general hospital and who had the established inclusion criteria.

The clinical effectiveness of the treatment was assessed with the Hamilton scale and the Clinical Global Impression scales for severity and change.

Results:

A total of 40 patients were treated with duloxetine, 6 of whom (15%) dropped out of the study. The average maintenance dose administered at the baseline visit was 60 mg/day and at discharge was 75 mg/day. At the end of follow-up, there was a reduction with respect to the baseline values of 13.6 points on the Hamilton scale and 2.4 points on the CGI of severity scale. 63.4% of the patients felt “much better” at the final visit, according to the CGI of change scale.

Conclusions:

According to the results, it seems that DULOXETINE may be a good treatment option for patients admitted to general hospital for different conditions of organic origin who present depressive symptoms while in hospital, both for its therapeutic effectiveness and for its good tolerability profile.
The Effectiveness of Drama Therapy on Decreasing of the Symptoms of Social Anxiety Disorder in Children
Authors: Anari A. , Ddadsetan P. , Sedghpour B. Saleh
Published: March 2009

The effectiveness of Drama therapy on decreasing of the symptoms of Social Anxiety Disorder (Performance Anxiety, Performance Avoidance, Social Anxiety & Social Performance Subtests) in 10-11 years old children was investigated in this study. 2 schools were randomly selected from elementary schools of Tehran city. First, Validation the Liebowitz Social Anxiety Scale for Children and Adolescents (Liebowitz, Klein & Masia-Warner, 2003) is done in one of that school; Then, in two schools, from 300 children ages 10-11, 32 children whose had received the highest scores on the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) were selected. Subjects were divided into control and experimental groups. Experimental group received Drama therapy intervention for 6 weeks, twice a week sessions lasting two hours. The results were analyzed using covariance and indicated the children in experimental group reported a significant decrease in symptoms of Social Anxiety Disorder (Performance Anxiety, Performance Avoidance, Social Anxiety & Social Performance Subtests) as compared to the control group. In addition, in 3 month follow up, results had stabilized in experimental group as compared to the control group. The emerged findings can have clinical application in prevention and treatment of social anxiety disorder in children.
Impact of Anxiety on the Pain Intensity in Patients with Temporomandibular Joint Disorder During Splint Treatment
Authors: Badel T. , Keros J. , Lovko S. Kocijan , Kern J. , Marotti M.
Published: March 2009

Objectives:

Level of anxiety and pain intensity before and after splint treatment of patients with temporomandibular joint disorder (TMJD) was compared.

Methods:

TMJD in 60 patients (mean age 37.9 years, 80% women) was diagnosed using patient's history and clinical examination, and was confirmed by magnetic resonance imaging of the TMJs. Pain intensity was rated on a visual-analogue scale. The anxiety was confirmed by Spielberger's State-Trait Anxiety Inventory (STAI).

Results:

A higher level of anxiety was determined due to the fact that the mean score in STAI 1 was 39.80 and STAI 2 was 41.10. Before visiting a dentist, the patients suffered pain for 8.7 months on average. There is a statistically significant difference between patients depending on how long they previously suffered pain and anxiety values for all patients in STAI 1 and 2 (p< 0.0001). Including only patients with determined anxiety depending on age and gender there was no statistical difference in previous pain duration (p>0.05). There is a correlation between anxiety values on STAI 1 scale and post-treatment pain intensity (p< 0.026), and on STAI 2 scale pain intensity proved to be statistically significant before (p< 0.002) and after (p< 0.049) treatment. There was a statistically significant difference in scores of STAI 2 tests of patients with bruxism behaviour (p< 0.042).

Conclusions:

There is a possibility of negative interaction of psychological and psychosocial factors within all forms of musculoskeletal disorders’ treatment, including TMDs. This study confirmed the connection between anxiety and various categories of pain intensity in patients during splint treatment.
Depression, Anxiety, Self Contempt, Correlated with Demographic Factors in Semnan Cardiovascular Clinic Referrals
Authors: Beheshti A. , Irajian G. , Darabian M. , Moghadas A. Jazayeri , Irajian N.
Published: March 2009

Introduction:

Depression, anxiety and self contempt increase in recent years. A number of these patients, who have chest pain, come or refer to cardiovascular clinic without any cardiovascular or other organic disease. Such patients will be deviated from correct therapeutic way. It seems that demographic factors can affect on psychological disorder of these patients and the cause of their refer to cardiovascular clinic.

The aim of this study was to determine the correlation of depression, anxiety and self contempt with demographic factors in cardiovascular clinic referrals in Semnan, IRAN.

Materials and methods:

In this analytical-descriptive study, data were collected in questionnaire from 400 patients who referred to cardiovascular clinic with chest pain and do not have any cardiovascular or other organic disease and analyzed by t-test, chi-square and men-vitni tests.

Results:

Of the 400 patients, 55.8% of women, 57.1% of divorced and 60% persons with less than one million RLS income showed light depression. Also, 73% of persons with less than one million RLS income, showed light anxiety, 36.1% of women showed light self contempt and 30.8% of divorced showed moderate self contempt.

Discussion:

In this study, depression was correlated with sex, divorce and low income, anxiety was correlated only with low income, self contempt was correlated with sex and divorce. Results of this study showed similarity with some studies and differ from other studies. It seems that this difference arises from patient's cultural diversity.
Psychophatology Differences Between Pregnant Women who Conceived Naturally and Through Assisted Reproduction
Authors: Ramos-Fuentes M.I. , Cardoso-Moreno M.J. , Vaz-Leal F.J. , Fernandez-Sanchez N. , Rodriguez-Santos L. , Bejar A. , Berjano N. , Dominguez J.A. , González E.
Published: March 2009

Objective:

In the past few decades, new and more efficient techniques to help solve fertility problems have become widely available throughout the developed world. The aim of this study was to determine whether there were differences on psychopathology factors between women who had conceived after in vitro fertilization (IVF) and women who had conceived naturally.

Methods:

The sample was composed of 41 pregnant women of whom 28 women had conceived through assisted reproductive technology (IVF) and 13 had conceived naturally. Women were evaluated by week 20 of pregnancy at the Infanta Cristina University Hospital Obstetrics and Gynecology Service, in Badajoz. Women consented to complete the Symptom Checklist-90-Revised (SCL-90-R).

Results:

IVF women were characterized by higher scores on Anxiety Scale (t = 3.90; p = 0.045) and lower scores on Hostility Scale (t = 4.35; p = 0.041) than women who had conceived naturally. There were no differences in the others scales.

Conclusions:

IVF women appear to present a temperamental profile characterized by a tendency to anxiety. Further research is needed to firstly, confirm these preliminary findings, and secondly, to longitudinally explore its impact on pregnancy outcome and mother-infant attachment.
Treatment of Chronic Pain with Buprenorphine in a Veteran with Traumatic Brain Injury
Authors: Alao A. , Chung C. , Sachdeva S.
Published: March 2009

Case presentation:

We report a case of a 27-year-old Iraq War veteran with no previous psychiatric history who sustained severe traumatic brain injury (TBI) following a blast injury from an improvised explosive device. The patient subsequently suffered severe anxiety symptoms controlled only with combined therapy with benzodiazepines and venlafaxine. Even more disabling, the patient also experienced intractable headache and shoulder pain unresponsive to non-steroidal anti-inflammatory agents, tramadol, gabapentin, or NMDA-receptor antagonists. Given the risk of respiratory depression with his current medications, opioid analgesics were not favored for the management of his pain. The patient was started on sublingual buprenorphine at a dose of 8mg three times daily with significant improvement. This dose was maintained and the patient was able to function relatively pain-free.

Conclusion:

Chronic pain is a significant complication in patients with TBI and is reported by a majority of patients with TBI, regardless of the severity of the injury. The treatment of chronic pain among individuals can be challenging. Patients with TBI may be on other medications for impulse control, such as anticonvulsants and benzodiazepines. Further treatment with narcotic analgesics may therefore increase the risk of respiratory depression. Buprenorphine is a partial mu agonist whose effects plateau at higher doses, at which time it begins to act like an antagonist. It is this property at higher doses that limits its dose-dependent respiratory depression. Buprenorphine thus has the advantage of effective analgesia with minimal sedation and may be useful to treat chronic pain among TBI patients already taking benzodiazepines.
Clinical Implications of Anxiety in Diabetes: A Critical Review of the Evidence Base
Authors: Mitsonis C. , Dimopoulos N. , Psarra V.
Published: March 2009

Introduction:

Substantial literature supports clinically important associations between anxiety and chronic medical conditions. Diabetes is among the most psychologically and behaviorally demanding chronic medical illnesses. Anxiety has been associated with poor glycemic control, regimen adherence, and with accelerated rates of coronary heart disease in diabetic patients.

Aim:

The aim of this study is to provide an overview of the role of clinically significant anxiety in patients with diabetes mellitus.

Methods:

MEDLINE, EMBASE and PSYCINFO databases were searched using the combined search terms diabetes, diabetes mellitus, anxiety symptoms and anxiety disorders. Published reference lists were also examined. In total 25 studies were identified that fulfilled the inclusion criteria.

Results:

Anxiety was present in 41.7% of diabetic patients. There was no significant difference between those with Types 1 and types 2 diabetes. The rate of elevated symptoms was significantly higher in diabetic women than in diabetic men. General anxiety disorder was the most prevalent of the clinical disorders and was found in 13.2% of the diabetic patients. The rates of the other anxiety disorders were within the range of those reported in community studies. Treatment of anxiety was associated with improved glycemic control, particularly in the subgroup of patients with severe anxiety.

Conclusions:

Emerging data offer a strong argument for the role of anxiety in diabetes. Psychological interventions and/ or pharmacological treatments in patients with diabetes are needed, in order to increase treatment adherence and control of the disease and improve patients’ functioning and quality of life.
Functional and Quality of Life Impairment in Generalized Anxiety Disorder: Effect of Short-term Treatment with Pregabalin and Venlafaxine-XR
Authors: Mychaskiw M.A. , Alvir J.M. , Hoffman D.L. , Herman B.K. , Joshi A.
Published: March 2009

Aims:

To determine the incidence and clinical correlates of functional and quality of life (QoL) impairment in patients with generalized anxiety disorder (GAD), and to evaluate the efficacy of pregabalin and venlafaxine-XR in improving functional outcomes.

Methods:

A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20, randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR(75-225 mg/d, N=125), or placebo (N=128). Anxiety-related impairment in QoL was evaluated using the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q) and impairment in functioning using the Sheehan Disability Scale (SDS).

Results:

At baseline, a similar proportion of patients in the 3 treatment groups met criteria for impairment on the Q-LES-Q (70.1%-77.6%) and SDS (74.1%-82.7%). For all groups combined, baseline impairment was more highly correlated with psychic than somatic anxiety on both the Q-LES-Q and SDS (Spearman r-values, -0.32 vs. -0.28 and 0.27 vs. 0.14,respectively). On the SDS but not on the Q-LES-Q, significantly more subjects in the pregabalin (67.2%) and venlafaxine-XR (59.5%) groups had improvement into the normative range compared with placebo (42.9%; p< 0.05) at endpoint. The mean HAM-A change score (all subjects) was significantly greater among patients whose Q-LES-Q returned to normal (“remitters” vs. non-remitters: -19.3 vs. -11.9; p< 0.05).

Conclusion:

At baseline, approximately 75% of GAD patients reported moderate-to-severe impairment in QoL and functioning which was modestly correlated with severity of GAD symptomatology. Pregabalin produced improvement in QoL and functioning that was correlated with reduction in anxiety symptom severity.
Sexual Dysfunctions in Anxious Depressive Disorders
Authors: Tiugan A.
Published: March 2009

Background:

The ethiopathogenic mechanisms of depression and anxiety overlap at a certain moment on most part of those of the sexual dysfunction. Hypercorticolezemia from the anxious depressive disorders, with direct impact on the hypocampus (reducing the volume), through the two mechanisms (biological and organic) may generate and especially accentuate the dysfunctions in the sexual activity.

Objectives:

In more than few cases, the anxious depressive disorders are accompanied by sexual dysfunctions, wh

During antidepressant therapy, especially with inhibitors specific for recapturing serotonine, different types of sexual dysfunctions may appear.

Methods:

In a retrospective examination, out of 420 patients fulfilling the DSM IV R criteria for the anxious and depressive with anxious and depressive disorder, the presence of sexual dysfunction was highlighted in 340 patients (80,9%). In 260 patients (76,47%) the sexual dysfunction was present in the clinical board of anxiety and depression; in 78 patients (30%) the sexual dysfunction accentuated during antidepressant therapy (predominantly with specific inhibitors for recapturing serotonin). In 80 patients (23,53%), the anxious depressive symptomatology was preceded by sexual dysfunctions in various clinical forms. ich accentuate the anxiety and the depression.

Conclusions:

The presence of sexual dysfunction in an anxious depressive board represents a negative predictive factor in the evolution of the affective disorder, delaying remission. The use of the mood stabilizer, by increasing GABA in the mezocortical circuit and equilibrating the GABA/DOPAMINE, can be beneficial for the improvement of the sexual dysfunction in the anxious depressive disorders.
Estimation of placebo Effect in Therapy of Generalized Anxiety Disorder
Authors: Grigorova O.
Published: March 2009

Studying of placebo response in patients with Generalized Anxiety Disorder (GAD) was the aim of research. 90 patients (68 female, 22 male, mean age of 33 years) were studied. All patients accepted inactive placebo (P) within 7 days and then - Alprazolam (A) in a dose of 1-3 mg per day within 4 weeks. Efficacy of treatment was estimated weekly by the HAM-A scale. After week of placebo reception, patients with HAM-A score < 9 made group of remission (R), with ≥50% HAM-A reduction - placebo responders group (PR), with HAM-A reduction 25-49% - partial placebo responders group (PPR), ≤ 25% HAM-A reduction - placebo nonresponders group (PNR).

After week of reception placebo 16.6% of patients HAM-A made group R, 26.7% - PR; 30% - PPR, 26.7% - PNR. After active therapy (A) Therapeutic Remission group (RT - HAM-A score < 9) consisted of 100% of group R, 75% of PR, 81.5% of PPR and 8,33% of PNR. 25% of PR, 18% of PPR and 8.33% of PNR became Therapeutic Responders (TR - HAM-A reduction >50%). Partial Therapeutic Responders (PTR - HAM-A reduction 25-49%) and Therapeutic Nonresponders (TNR ≤ 25% HAM-A reduction) consisted only of PNR (62.5% and 20.83%).

Absent response on (P) frequently correlated with low efficacy of therapy of (A). High positive placebo effect (PE) was defined in patients in whom improvement after transferring on active therapy became even more expressed. The received data allow to consider presumably PE like predictor of efficacy of benzodiazepines therapy for GAD.
Autoantibodies in Bipolar and Cluster B Personality Disorders
Authors: Almeida J. Traça , Barahona-Correa B. , Santos A. , da Silva J. Alves , Filipe P. , Talina M. , Xavier M.
Published: March 2009

Prevalence of depression and other common psychiatric disorders in autoimmune diseases has been extensively documented. The association between subclinical autoimmunity and behavioural or psychiatric syndromes remains less studied. The best known example is raised titres of autoantibodies with high affinity for the basal ganglia in some obsessive compulsive spectrum syndromes (e.g. Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). The possible role of autoimmunity in impulse control disorders remains understudied.

We proposed to study the relation between autoimmunity, affective bipolarity and impulsive psicopathology.

Methods:

14 bipolar, 10 cluster B personality disorder inpatients. Titres for rheumatoid factor (RA), antithyroglobulin (ATG), antiperoxidase (APO) antinuclear (ANA), anti-neutrophil cytoplasmic (ANCA) and antistreptolysin (ASO) antibodies were measured in all subjects. Psychiatric assessment: non-structured psychiatric interview, MINI International Neuropsychiatric Interview and Millon Clinical Multiaxial Inventory-II.

Results:

21,4% of bipolar patients had positive ATG titre vs 11,1% in the cluster B personality group. 28,6% of bipolar patients had positive APO titre vs 22,2% in the cluster B personality group. 16,7% of bipolar patients had positive ASO titre vs 30,0% in the cluster B personality group. None of this differences reached significance.

ASO titre correlated significantly with antisocial (rho=0,435, p=0,043) and autodestructive (rho=0,461, p=0,031) ratings and almost significantly with borderline (rho=0,420, p=0,052) ratings.

Conclusions:

The results obtained partly agree with the existing studies. As far as we know a possible correlation between ASOs and impulsive behaviour has not been previously described. The results obtained call for further investigation in the subject.
Effects of Parent Training on Salivery Cortisol in Children and Adolescents with Disruptive Behavior Disorder
Authors: Attari A. , Motamedi M. , Siavash M. , Hassanzadeh A. , Soltani M.
Published: March 2009

Aims:

Since adulthood antisocial, aggressive and delinquent behaviors often have their onset early in life, investigating the association between biological factors and disruptive behaviors in children and adolescents are important and are emphasized on in the recent years. Baseline cortisol level seems to be a valuable biological marker of individuals with Disruptive Behavior Disorder (DBD). This study examined the effect of parent training on salivary cortisol levels of children with DBD.

Methods:

Saliva samples were assayed to determine cortisol levels in nineteen clinic-referred children with DBD (aged 8 through 13 years) before and after an eight-session parent training program. Children's disruptive behaviors were assessed by Child Behavior Check List before and after the intervention.

Results:

Children's salivary cortisol increased significantly after parent training sessions. Children with DBD who had lower basal cortisol levels had more severe disruptive behaviors and a better response to intervention by parent training as assessed by changes in cortisol levels and disruptive behaviour scores. However, post-interventional reduction of disruptive behaviors and increase in cortisol level was significant for all levels of baseline cortisol.

Conclusions:

Parent training is an effective method for behavioral modification in DBD. Salivary cortisol may be considered a predictive factor for severity of the child or adolescent's disruptive behaviors and also for response of those behaviors to parent training.
Influence of Subanesthetic Dose of Ketamine on Theta Cordance in Healthy Volunteers: Implications for Antidepressant Effect
Authors: Brunovsky M. , Horacek J. , Bares M. , Novak T. , Tislerova B. , Sos P. , Krajca V. , Höschl C.
Published: March 2009

Aims:

A series of clinical studies demonstrated that QEEG prefrontal theta cordance value decreases after one week of treatment in responders to antidepressants and precedes clinical improvement. Ketamine, a non-competitive antagonist of NMDA receptors, has a unique rapid antidepressant effect but its influence on theta cordance is still unknown.

Methods:

In a double-blind, cross-over, placebo-controlled experiment we studied the influence of ketamine (0.54 mg/kg) on theta cordance in a group of 20 right-handed healthy volunteers. Participants were evaluated with the Brief Psychiatric Rating Scale before infusion and after 10 and 30 min. Three EEG segments obtained at baseline and prior to BPRS examinations at 10 and 30 min after dosing were entered into spectral analyses and QEEG cordance values in theta frequency band were calculated for four regions (prefrontal, central, left and right temporal).

Results:

Ketamine infusion induced a decrease in prefrontal theta cordance at 10 (p=0.04) and 30 min (p=0.02) and a significant increase of theta cordance in central region at both time points (p=0.01). We observed no significant effect on cordance values in the left and right temporal regions.

Conclusions:

Our data indicate that ketamine infusion immediately induces similar changes as monoaminergic-based antidepressants do gradually after a series of downstream signaling steps. The reduction in theta prefrontal cordance could serve as a marker of fast antidepressant effect of ketamine, a hypothesis that should be tested in antidepressants-refractory patients.

This study was supported by a grant of IGA MHCR NR/9330-3 and by a project of MEYS CR VZ0021620816.
ERKs - a New Marker in Psychiatry?
Authors: Mateus M. , da Silva Borges G.P. , Silva C. , Lourenço F.
Published: March 2009

Recent studies involved the pathways of kinases regulated by extracellular signal (ERK - extracellular signal regulated kinases), a broad range of key cellular processes, in the mechanisms of depression and consequently in the action of antidepressants. It is also known that the use of specific inhibitors of phosphorylation of ERKs1 / 2 showed to have antidepressant effect in animal models. Fluoxetina (SSRI) was recently discovered to be a potente inhibitor of phosphorylation of ERKs. The ERKs1 / 2 and recently the 3, are present in neurons and glia, these also engaged in biological mechanisms of depression.

The authors propose to do, based on the current literature, the characterization of the type (s) of cell (s) where changes in activation of ERKs1 / 2, occur during depression, and during the administration of antidepressants, in order to understand, to what extent these kinases may be considered as biological markers of depression. Possibly also to examine the feasibility of using these markers in clinical use.
Anxiety, Depression, Quality of Life Related to Induction of Heat Shock Protein 70 (HSP70i) in Biopsies of Inflammatory Bowel Disease Patients
Authors: Vlachos I. , Coccossis M. , Barbati C. , Goumas C. , Nomikou L. , Triantaphyllidis J.K. , Malgarinos G. , Papadimitriou G.N. , Patsouris E. , Nicolopoulou P.
Published: March 2009

Anxiety and Depression have often been associated in literaure, with the course of the Inflammatory Bowel Diseases(IBD):Crohn's Disease (CD) and Ulcerative Colitis (UC). The chronic character of the disease influences Quality of Life (QoL) of affected patients.

Aim:

To measure Anxiety, Depression and Qol in IBD patients through psychometric tools and correlate these results with the presence or absence of the inducible form of Heat Shock Protein 70 (HSP70i) in the histologic examination of the same patients. The HSPs are cellular proteins with ubiquitus presence in humans, known to exert cytoprotecive functions when induced under conditions of cellular stress ( heat, hypoxia, etc as well as psychophysiological stress).

Мethod:

The study was conducted between 2005 and 2008 in two general state hospitals in the broader area of Athens, Greece.

Sample:

59 IBD patients hospitalized for the endoscopic investigation of a possible relapse of their disease participated in the study(37 UC, 21 CD, 1 Intermediate Colitis).

Procedure:

A cross-sectional study was conducted through administration of the inventories and the comparison of their values with the presence of HSP70i in the histologic examination of each patient.

Instruments used:

a.

WHOQOL-BREF;

b.

Zung Depression Scale;

c.

STAI (State Trait Anxiety Inventory);

d.

Нospital Anxiety Depression Scale;

e.

SPA-810 Antigen for HSP70i (Stressgen, Canada).

Results:

The X2 distribution for nominal data showed that the presence of the inducible form of HSP70 in the lymphoid tissue, the neutrophiles and the monocytes of IBD patients’ histologic examination is not the same (not homogeneous) regarding depression, anxiety and quality of life, suggesting its possible psychosomatic character (X2>6.635,d.f.=1,p< 0.01).
Sings of Apoptosis of Immunocompetent Cells in Patients with Depression
Authors: Vyalova N. , Ivanova S.
Published: March 2009

Data have been obtained showing that programmed cell death - apoptosis - plays an important role in mediating the mechanisms of adaptation of the body to external influences. Studies were performed using 26 patients with depression (20 women and 6 men) with a mean age of 48,0±12,6 years. The control group consisted of 20 healthy subjects, identical in gender and age to patients in the experimental group. Measures of apoptosis of peripheral blood lymphocytes and serum cortisol concentrations were determined. A significant increase in lymphocyte apoptosis was found in patients with depression, resulting in an increase in the proportion of lymphocytes expressing the FAS receptor; cells with morphological signs characteristic of apoptosis (nuclear condensation, vacuolization) were also seen. The proportion of neutrophils with sings of spontaneous apoptosis in patients with depression prior to treatment was greater then that in healthy subjects, with values of 0,63±0,26% and 0,25±0,12 respectively (p< 0,05). The proportion of lymphocytes with fragmented nuclei was also greater, at 2,03±0,72% compared with 0,97±0,35 in healthy controls (p< 0,05). An increase in serum cortisol to 440,64±22,04 nM was found in patients with depression, while the mean in healthy subjects was 323,03±21,45 nM. A positive correlation between cortisol and CD95 cells was found, demonstrating the important role of corticosteroids in controlling expressing the apoptosis marker in immunocompetent cells. A high level of CD95+ lymphocytes and a high level of spontaneous apoptosis may result from the destructive influences of stress on the body of depressed patients.
Increased Serum Neurotrophin-4/5 Levels in Bipolar Disorder
Authors: Walz J. , Magalhães P.V.d.S. , Giglio L.M. , Cunha A.B. , Stertz L. , Fries G. , Andreazza A. , Kapczinski F.
Published: March 2009

Neurotrophins are central to several aspects of central nervous system function, and emerging evidence links these growth factors to mood disorders. The purpose of this study was to investigate serum neurotrophin-4/5 (NT-4/5) levels in patients with bipolar disorder, both within mood episodes and in euthymia. Patients with bipolar I disorder (n=154) and controls (n=30) had their NT-4/5 serum levels assayed using an ELISA. Levels of NT-4/5 levels were significantly higher in bipolar disorder patients than in controls; NT-4/5 levels were increased in mania, depression and euthymia, but not significantly different between BD mood states. As far as are aware, this is the first study showing NT-4/5 immunocontent alterations in bipolar disorder. A tentative explanation would be that NT-4/5 increases is compensating for ongoing oxidative damage in dopaminergic neurons.
Development and use of a Biological Rhythm Interview
Authors: Giglio L.M. , Magalhães P.V.d.S. , Andreazza A. , Walz J. , Jakobsen L. , Rucci P. , Rosa A.R. , Vieta E. , Kapczinski F.
Published: March 2009

Introduction:

As several lines of evidence point to irregular biological rhythms in bipolar disorder, and its disruption may lead to new illness episodes, having an instrument that measures biological rhythms is critical. This report describes the validation of a new instrument, the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), designed to assess biological rhythms in the clinical setting.

Methods:

Eighty-one outpatients with a diagnosis of bipolar disorder and 79 control subjects matched for type of health service used, sex, age and educational level were consecutively recruited. After a pilot study, 18 items evaluating sleep, activities, social rhythm and eating pattern were probed for discriminant, content and construct validity, concurrent validity with the Pittsburgh Sleep Quality Index (PSQI), internal consistency and test-retest reliability.

Results:

A three-factor solution, termed sleep/ social rhythm factor, activity factor and feeding factor, provided the best theoretical and most parsimonious account of the data; items essentially loaded in factors as theoretically intended, with the exception of the sleep and social scales, which formed a single factor. Test-retest reliability and internal consistency were excellent. Highly significant differences between the two groups were found for the whole scale and for each BRIAN factor. Total BRIAN scores were highly correlated with the global PSQI score.

Discussion:

The BRIAN scale presents a consistent profile of validity and reliability. Its use may help clinicians to better assess their patients and researchers to improve the evaluation of the impact of novel therapies targeting biological rhythm pathways.
Waist Circumference as a Simple and Meaningful Means to Assess Insulin Resistance Among Outpatients with Bipolar Disorder
Authors: Gomes F.A. , Magalhães P.V.d.S. , Kunz M. , Andreazza A. , Silveira L. , Weyne F. , Ceresér K. , Furlanetto T. , Kapczinski F.
Published: March 2009

Aims:

To evaluate insulin resistance (IR) among outpatients with bipolar disorder (BD) in order to determine clinical correlates of IR in this patient population.

Method:

We performed a cross-sectional study in sixty-five DSM-IV-TR BD patients consecutively assessed from January to August 2007 at the Bipolar Disorder Program, Hospital de Clínicas de Porto Alegre, Brazil. IR was diagnosed using the homeostatic model assessment - insulin resistance (HOMA-IR). Metabolic syndrome (MS) diagnosis and metabolic variables were assessed using three definitions: National Cholesterol Educational Program - Adult Treatment Panel III (NCEP-ATP III); NCEP-ATP III modified criteria and International Diabetes Federation (IDF).

Results:

IR was present in 43.1% of the sample (women 40%, men 44.4%). The prevalence of MS defined by the NCEP-ATP III criteria was 32.3%, NCEP-ATP III modified was 40% and IDF was 41.5%. NCEP-ATP III modified criteria showed the best trade-off between sensitivity (78.6%) and specificity (89.2%) to detect insulin resistance. Waist circumference was the best clinical parameter associated with IR in the linear regression model (B=0.014, SE 0.002, t=6.18, p< 0.001). Areas under ROC curves were similar for waist circumference and different MS definitions (chi2=2.98, df=3, p=0.39).

Conclusion:

Currently MS criteria may provide reasonable sensitivity and specificity for the detection of insulin resistance in patients with bipolar disorder. Waist circumference may be a simple and inexpensive means to predict insulin resistance in this population.