bluuebunny/crossref_metadata_2025 huggingface dataset:
Extreme Alleles at the Human Caveolin 1 Gene Novel Purine Complex and Risk of Alzheimer’s Disease
Authors: Ohadi M. , Heshmati Y. , Mirabzadeh A.
Published: March 2009

Caveolin-1 (CAV1) is the principal structural protein of caveolae membranes that are found in most cell types. Aberrant expression and mutation of this gene are associated with a wide range of disorders including neurodegenerative disorders and various cancers. We report a novel purine complex of three polymorphic motifs located at the enhancer region of the gene and risk of late-onset Alzheimer's disease. Extreme haplotypes with accumulated homozygosity for those haplotypes were observed in the Alzheimer's cases comparing with the controls (p< 0.000). Based on our findings, there is a window of haplotypes and haplotype lengths in the controls. Shorter and longer haplotypes were associated with Alzheimer's disease in our cases.

This purine complex contains GGAA and GAAA motifs, the consensus binding sites for the Ets and IRF family transcription factors, respectively, and is highly conserved in distantly-related non-human primates in respect with location and motif sequence. The effect of the extreme haplotypes in the expression of the gene and the pathophysiology of Alzheimer's disease remain to be clarified.
A Novel Polymorphic Purine Complex at the Upstream Region of the Human Caveolin-1 Gene and Risk of Alzheimer’s Disease
Authors: Ohadi M. , Heshmati Y. , Mirabzadeh A. , Khorshid H.R. Khorram , Kamali K.
Published: March 2009

Crucial interaction of caveolin-1 (CAV1) with beta- and gamma-secretases, and aberrant expression of the gene encoding this protein in Alzheimer's disease (AD) support a role for CAV1 in the pathophysiology of this disease.

We report a novel polymorphic purine complex stretching ~150 bp of genomic DNA at the 1.5 kb upstream region of the human CAV1 gene, alleles and genotypes of which are associated with sporadic late-onset AD. Extra-short alleles were observed in the case group that were absent in the control subjects. Increased homozygosity for haplotypes was also observed at this region in the Alzheimer's cases, for those alleles and allele lengths shared by the case and control groups [(c2=30.75, df=1, p< .000, OR=4.54, CI 95% (2.56-8.3)]. This region contains GGAA and GAAA motifs, the consensus binding sites for the Ets and IRF family transcription factors, respectively, and is highly conserved in distantly-related non-human primates in respect with location and motif sequence. The effect of this complex sequence on the expression of CAV1, and the related mechanisms in the pathophysiology of AD remain to be clarified.
A Challenging Case of Dementia
Authors: Pereira C. , Cordeiro S.
Published: March 2009

Background:

Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common causes of presenile dementia. Diagnosis relies on clinical evaluation based on neurologic and neuropsychological performance. Neuroimaging, including single-photon emission computed tomography (SPECT) is often obtained for confirmation. The overlap of symptoms in initial presentation such as changes in mood, personality, and behaviour may difficult the differential diagnosis. The present report aims to describe the case of a 68 year old male, with no prior psychiatric history until the age of 66, when he was first admitted for hospitalization with the diagnosis of severe depressive episode without psychotic symptoms (ICD10 F32.2). Two years later he was hospitalized for the second time, Investigation led to the diagnosis of dementia. Diagnostic categorization was difficult in the absence of imaging results consistent with clinical presentation and therapeutic response to cholinesterase inhibitors.

Aims:

To describe an atypical presentation of dementia and discuss the diagnosis and therapeutic response.

Methods:

We performed a Clinical file review and a comprehensive MEDLINE database search.
Prevalence of Behavioural and Psychological Symptoms of Dementia in Nursing Homes in Berlin
Authors: Majic T. , Pluta J.-P. , Mell T. , Decker A. , Heinz A. , Rapp M.A.
Published: March 2009

Background:

Behavioral and Psychological Symptoms of Dementia (BPSD) include agitation, apathy, hallucinations, and depression. These symptoms are a challenge to professional nursing care, resulting in frequent psychiatric hospitalization, which incur high costs to the national healthcare systems.

Objective:

To estimate the prevalence of BPSD in nursing home residents in 16 representative nursing homes in Berlin, Germany.

Methods:

In a cross-sectional clustered cohort study, BPSD were assessed using the Dementia Mood Assessment Scale (DMAS), the Neuropsychiatric Inventary (NPI) and the Cohen-Mansfield Agitation Inventory (CMAI). Dementia stage severity was measured by Functional Assessment Staging (FAST) and the Mini-Mnetals State Examination (MMSE). Furthermore, the patients" history recording psychotropics and number of psychiatric hospitalizations were registered. The prevalence and incidence rates of BPSD as well the duration of hospitalization and the quantity of drug prescription were estimated.

Results:

BPSD are common above all in nursing home residents with dementia, exhibiting prevalence rates of above 60% of all nursing home residents suffering from dementia. The severity of BPSD was related to number of psychiatric hospitalizations, the amount of psychotropics prescribed, and caregiver burden (p < .05).

Conclusion:

The high prevalence rate of BPSD reflects a significant problem in nursing home care, and is related to negative health outcomes and caregiver burden. Thus, nursing home care could be improved by minimizing the severity of BPSD, as well as the amount of drugs prescribed and the frequency of demented patients" hospitalization.
Neuropsychological Performance in Both Alzheimer’s Disease and Vascular Dementia is Related to Cardiovascular Comorbidity [P01-103]
Authors: Hofrichter N. , Dick S. , Tritschler E. , Knobel A. , Heinz A. , Rapp M.A.
Published: March 2009

Aims:

Vascular pathology has been implicated in the pathogenesis of both Alzheimer's disease and vascular dementia. While performance decrements in vascular dementia are by definition thought to be related to vascular load, performance decrements in Alzheimer's disease have not yet been studied in relationship to cardiovascular comorbidity. The aim of this study was to describe neuropsychological performance in patients with mild Alzheimer's disease and vascular dementia in relationship to cardiovascular comorbidity.

Method:

39 patients suffering form vascular dementia and 34 patients suffering form Alzheimer's disease underwent neuropsychological testing using an extended neuropsychological battery, including tests of episodic memory, working memory, naming, verbal fluency, executive functions, and language. Cardiovascular comorbidity was assessed form medical history and chart review using the Charlson comorbidity index.

Results:

Patients suffering form Alzheimer's disease and vascular dementia did not differ in terms of age, education, gender distribution, or dementia severity. Cardiovascular comorbidty was more pronounced in vascular dementia patients. In both Alzheimer's disease and vascular dementia, neuropsychological performance in tests of working memory and executive functioning was related to cardiovascular comorbidity, but the relationship was stronger in vascular dementia.

Conclusion:

Vascular load affects neuropsychological performance in both Alzheimer's disease and vascular dementia, suggesting that cardiovascular comorbidity affects cognition across both forms of dementia.
A Case of Early Dementia in a Schizoaffective Disorder Patient
Authors: Ribeiro A. , e Silva F. Ramalho , Matos M.
Published: March 2009

Establishing a differential diagnosis in psychiatry may be very laboring. The authors aim to illustrate diagnostic complexity and its therapeutic implications, through the presentation and discussion of a presumable dementia clinical picture. We present the case of a fifty six-year old woman, attending our outpatient clinics since her twenties with the diagnosis of schizoaffective disorder. On April of 2007 the patient was admitted to a fifteen-day hospitalization due to psychotic symptoms, which remitted with therapeutic doses of risperidone and ansiolytics. One week after being discharged the patient was readmitted to the hospital due to an abrupt onset of a clinical picture characterized by behavioral changes, motor agitation and repetitive behaviors, refusal to eat, depressive mood, mystical delusions, hallucinatory activity, loss of insight, and severe impairment in occupational and social functioning. Although several clinical trials of antipsychotics, antidepressants and mood stabilizers were tried, along with electroconvulsive therapy, her general clinical state has remained unchanged for the fifteen months of hospitalization. Blood and urine examinations, tumoral markers, infectious and immunological study, lumbar puncture, neuroimaging, EEG and brain biopsy were performed, without conclusive results. We consider that the presumptive diagnosis is a Frontotemporal Dementia (FTD). Due to this entity's distinct neuropsychiatric manifestations, its diagnosis can be challenging. This presentation also emphasizes the importance of a holistic analyzes of clinical situations and of a multidisciplinary approach.
Saccadic Eye Movements in Dementia, Major Depression and Healthy Controls - Relationship with Cognitive Functions [P01-105]
Authors: Schewe H.-J. , Vohs K. , Uebelhack R.
Published: March 2009

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.

Results:

Saccadic latency and number of saccadic intrusions were significantly (p< 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p< 0.01) or number of saccadic intrusions (r = -0.80, p< 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p< 0.01) and intrusions (r = 0.74, p< 0.01).

There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).

Conclusions:

It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.
New Diagnostic Approaches: To Enable Care Home Staff Understand and work Effectively with Behaviours that Challenge in Dementia
Authors: Scott A.
Published: March 2009

Background:

Behaviours that challenge in dementia exceed the capability of care home staff. Evidence shows medication, traditionally the first line treatment has limited benefit, may hasten cognitive decline and is associated with vascular and cardiac problems in older people. Alternatively, admission to hospital occurs despite 90% of behaviours occurring as a response to care practices or environmental factors. Instead, the reasons should be addressed focusing on when, where, why and with whom these behaviours manifest themselves.

AIMS In 2006, a five-month pilot study within the Northern Health and Social Services Board (NHSSB) (Antrim and Ballymena, Northern Ireland), using the Newcastle Model, a bio-psycho-social intervention received 20 referrals involving 11 care homes.

Method:

This new diagnostic approach formulatesbehaviours in terms of peoples’ needs, which are assumed to drive behaviours. The model is a hybrid of well-established ideas from various psychological models,but its distinguishing feature lies in the unique integration of teaching, supervision and intense support provided to care home staff. The NeuroPsychiatric Inventory Caregiver Distress (NPI-D) measures frequency and severity of behaviours and level of distress this causes staff. This was administered pre and post intervention.

Results:

Four hospital admissions were averted which, based on the average length of stay, would have cost an estimated £81,500. NPI-D scores decreased following interventions.

Conclusion:

The potential of this pilot study was noted by the Institute of Healthcare Management Quality Awards prompting the NHSSB to fund a Behaviour Sciences Nursing Service. A clinical effectiveness and full cost effectiveness analysis is now planned.
The Interface Neurology-psychiatry: A Case Report of Fronto-temporal Dementia
Authors: Silva C. , Mateus M.A. , Serra J.
Published: March 2009

The authors describe case of a male of 48 years old admitted in an acute psychiatric unit with psychomotor restlessness, temporal disorientation and severe distractibility, although prior to the admission he had shown symptoms of apathy and social retraction suggesting a depressive syndrome. This was a patient without prior psychiatric history, with a good psychosocial functioning and well adjusted prior personality. Within one year, there was a change in his personality and the appearance of an inadequate social conduct, with an insidious onset and gradual progression. CT scan and MRI showed lobar fronto-temporal atrophy. The SPECT showed also changes consistent with a fronto-temporal dementia. During the admission he manifested hyperactivity, some desinhibition, mental rigidity, inflexibility, stereotyped behaviors and persevering with continuous walking and changes in eating habits, alternating severe anorexia with hyperphagia. He also presented distractibility, poor speech with loss of spontaneity, an indifferent attitude, emotional flattening and lack of insight for his condition. In the neuropsychological evaluation initially existed only prejudice of the frontal lobes functions, with preservation of other cognitive functions, but gradually evolved. Addressing to the therapy, it were used various drugs, including SSRI"s, that until now have not proved to be effective in controlling the symptoms, highlighting the difficulty in the psychopharmacological approach of FTD.
Hypochondrial Symptoms as the First Sign of Frontotemporal Dementia (FTD)
Authors: Simões S. , Machado Á.
Published: March 2009

Introduction:

Psychiatric symptoms are very prevalent in FTD, in particular in its behavioural variant. Among these, hypochondrial symptoms can be found, usually along the course of the disease.

Clinical case:

A 70-year-old previously healthy woman was seen for progressive behavioural disturbances. Nine years before she started complaining of having almost all possible diseases. Every time that she saw a documentary or any news describing a disease, she said she had all its symptoms, so she must have the disease. The family started to find this strange, as every time she sake medical help, everything was fine. Even more strange was when she feared having completely inadequate diseases, like the “blue baby syndrome”. Several months after, she started having incomprehensible fears, refused to be left alone, locked all dors and windows and did not want to go outside because she was afraid that someone would harm her. Over the next years the full-blown FTD picture developed, with reduction of speech output, verbal and sexual disinhibition, impulsivity, hyperphagia and aggressivity, with total lack of insight. Upon examination she was coprolalic, inadequate, perseverant and had frontal release signs. MRI showed bilateral frontotemporal atrophy and PET revealed frontotemporal hypometabolism.

Conclusion:

Although hypochondrial symptoms are one of the affective classical symptoms in FTD, they are unusual in first stages of disease, and has not been, to our knowledge, reported as a presenting sign. These findings highlight the need to bear in mind this diagnosis in all patients presenting with novel psychiatric symptoms in late life.
The Social Intervention for People with Alzheimer Disease in Transylvania Region
Authors: Stoica L.
Published: March 2009

The Alzheimer disease affects mostly old people but sometimes even adults; it manifests itself as a series of brain modifications which determine several perturbations: thinking, memory, language, mood disturbances. All these disturbances take place gradually and strengthens as the illness advances. The exact causes that determine the Alzheimer disease are still unknown, that is why it can not be prevented or cured. Although, a diagnostic in the first stages and treatment as soon as possible is absolutely necessary for slowing it's evolution.

Unfortunately, the number of persons affected by Alzheimer is rising in Transylvania region. I estimated that only 12-15% of the cases are discovered in the early stages. The effect of the illness doesn't just affect the ill one, but all his family. Taking care of someone who suffers from Alzheimer means a lot of effort, because he needs permanently supervision and help in any kind of activity. Moreover, most of the times, the family is notable to take care of the sick person at home, and it has to take him to a residential center. Although, this is not always the best solution, especially that after being institutionalized, they are often having a nervous breakdown and the disease has a bad evolution. The social worker plays a very important role in helping the person who suffers from Alzheimer. The social intervention has to consider not only the specific needs of the ill, but also the family needs and it has to take place in both directions.
Assessing the Relationship Between Compliance with Antidepressant Therapy and Costs Among Employees in the United States
Authors: Birnbaum H. , Ben-Hamadi R. , Kelley D. , Hsieh M. , Seal B. , Cremieux P. , Greenberg P.
Published: March 2009

Objective:

Assess effects of antidepressant compliance on healthcare and workplace costs.

Methods:

Using workplace survey data for 2 large employers’ healthcare claims (2004-2006), patient selection criteria considered depression diagnosis and antidepressant claims history. Employed respondents working in the past month were categorized by Medication Possession Ratio into compliance groups by quartiles; bottom/top quartiles were defined as compliant/non-compliant. Direct (medical/drug) costs were measured as insurer payments to providers; indirect (absenteeism/presenteeism) costs were based on one-month recall of workplace performance (hours worked/missed, self-rated performance), estimated as (hours missed x self-reported hourly income). Annualized, inflation-adjusted (2006) costs were compared between compliant/non-compliant groups using multivariate models controlling for baseline characteristics. Analyses were conducted for all patients and a subsample of diagnosed depression patients.

Results:

Among all patients (n=1,224), medical costs were numerically lower for compliant vs. non-compliant patients ($4,857 vs. $5,926, p=0.221); drug costs were significantly higher for compliant patients ($2,329 vs. $1,570, p=0.001). Indirect costs were not statistically different between compliant/non-compliant patients ($22,278 vs. $20,714, p=0.237). Among the depression subgroup (N=488), medical costs were numerically lower for compliant vs. non-compliant patients ($5,005 vs. $7,630, p=0.152) while drug costs were numerically higher for compliant patients ($2,550 vs. $1,829, p=0.153). Absenteeism costs were 30% lower for compliant patients ($7,725 vs. $11,040, p=0.038); presenteeism costs were not significantly different ($19,079 vs. $17,457, p=0.441).

Conclusions:

Absenteeism costs decrease significantly with compliance among depressed patients as do medical costs (not significantly). Further research is warranted regarding reason for poor antidepressant compliance and influence of compliance on costs.
Treatment Emergent Sexual Dysfunction Related to Antidepressants: A Meta-analysis
Authors: Chiesa A. , Serretti A. , Calati R. , de Ronchi D.
Published: March 2009

Objective:

Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.

Methods:

A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.

Results:

Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.

Discussion:

Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.
Effectiveness and Tolerability of Escitalopram in the Treatment of Depression with or Without Mental and/or Somatic Comorbidities
Authors: Yfantis A. , Giailoglou D. , Chourdaki E. , Sotiriadou K. , Laggis N. , Markoula S. , Sotiriou M.
Published: March 2009

Purpose:

To evaluate the effectiveness and tolerability of escitalopram in patients suffering from depression with or without comorbid mental and/or physical disorders in a naturalistic setting.

Methods:

Open-label 3-month study, conducted in 186 investigational sites in Greece. Efficacy assessment was based on CGI-S, MADRS and CGI-I scales. Tolerability was evaluated by spontaneously reported adverse events and treatment discontinuation rates. Statistical analysis was based on a modified intent-to-treat dataset (at least one valid post-baseline CGI-S measurement) and the per protocol dataset (valid CGI-S measurements at all 3 visits).

Results:

The analysis dataset of the study included 3,931 patients (mean age 45.5±10.8, 65.8% women, 37.4% with any comorbidity, and baseline mean MADRS 26.7±8.4). Patients with comorbid mental disorders were more severely ill at baseline (p< 0.001, both MADRS and CGI-S). Patients showed significant improvement (p< 0.001) during the treatment period based on both MADRS and CGI-S scores. There was no significant difference between the four groups (no comorbidity, comorbid mental disorder, comorbid physical disorders, comorbid mental and physical disorders). However, for both scales, the change from baseline increased with the severity of illness. Patients in the comorbidity groups had slightly higher overall discontinuation rates (8.2% to 10%) than patients without comorbidity (6.9%), with a total of 7.8% (n=308) Discontinuation due to adverse events was 2.3% (n=92).

Conclusion:

Escitalopram was comparably effective and well tolerated in depressed patients with and without mental and/or somatic comorbidity.
A Randomized and Double- blind Clinical Trial of Venlafaxine Hydrochloride Sustained Release Capsules for Treating Juvenile Depression
Authors: Hongfen C. , Weidong J. , Guoquan Z. , Chuang Y. , Tianyou G.
Published: March 2009

Object:

To evaluate the efficacy and safety of venlafaxine hydrochloride(HCL) sustained release capsules in treating juvenile with depressive disorder.

Methods:

A randomized, double blind dummy clinical trial enrolled 60 adolescent patients with depression, who were randomizedly designed to administer venlafaxine HCL sustained release capsules 150 mg or fluoxetine 20 mg daily for 8 weeks. The efficacies of both treatment groups was evaluated based on the Hamilton Depression Scale and Clinical General impression Scale pre and post-treatment.

Results:

The scores of Hamilton Depression Scale at the end of therapy were significantly reduced compared with the baseline in both gtnups (P< 0.O1). The effective rate of venlafaxine HCL sustained release capsules versus fluoxetine treatmlent was 70.0% and 65.5%, respectively, the P value showed no statistical difference (P>0. OS). The common adverse reactions included dry mouth, insomnia, dizziness, and loss of appetite.

Conclusion:

Venlafaxine HCl sustained release capsules is an effective agent for juvenile with major depression.
The Most Severe Somatic Disorders Treated with Excitaloprim
Authors: Kaludjerovic S.
Published: March 2009

Almost all of patients treated for cancers, experience episodes of persistent depression. Which moment is the most terrible? The moment patients hear their diagnosis,or time suffer while getting chemotherapy?

The time on controls tumor markers or when their relatives give up on them? When mirror reflects damaged body and face. Or felt useless in the presence of their children?

•

diagnosis of cancers C00,E05 are difficult to accept, and go hand in hand with major depression F33/ according to ICD-10.

•

why excitaloprim as choice?

Patients age 27 to 37 need antidepressant with pharmacokinetic superiority. Excitaloprim works faster than any other antidepressant, and it is strong, thanks to its dual serotonergic bonding on primar part as well as alosteric part bonding. It is weak inhibitor of the well defined liver cytochrome P450 isoenzym, CYP2D6., EEg .EKG is ok, so its safe drug/.

In this study, I followed the results of excitaloprim treatment on 30 patients (20 females, 10 males).

During 2 months, 20 patients were diagnosed with cancer (mostly colon and breast). All this patients have already been operated. Some have anus praeternaturalis.Other patients have AIDSinitial phase, and autoimmune dg/

On Hamilton scale, 45, points, MADRS on 10 items, 40, on Becks scale 65.Zung self rating index o,6. In this project, patients without children were much more suicidal.

Cancer patients got 20 mg excitaloprim pro die, other 10 mg pro die. After 2 moths

scales showed statistically important improvements despite severity.
The Comparison Between Therapeutic Effects of Different Classes of Antidepressant Drugs in Treatment of Genetical and Reactional Depression
Authors: Molavi P. , Karimollahi M. , Faridi M.
Published: March 2009

Background:

Depression as a common psychiatric disorder can occur in two types: Endogenous or genetic and exogenous or Reactional. These two types of depression, from the point of view of response speed to treatment and type of appropriate drug for treatment are different. This study has been executed to compare therapeutic effects of different classes of anti-depressant drugs in treatment of genetic and Reactional depression.

Materials and methods:

Present survey is a clinical-trial study, a completely randomly block type, that has performed on 30 patients (male and female). Selection of study sample accomplished randomly among unipolar depressed patients that has referred to Ardabil’s psychiatry clinic diagnosed based on DSM-IV criteria. Researcher - Made questionnaire, Beck, and Catelle depression test were used to collect data. To analyze data, for completely randomly blocked designs, two-factor variance analysis method and F test were used.

Results:

This study showed that Genetical depression does not response treatment Rapidly and its response type is not good and persistent. From the point of view of time, Reactional depression has a delaying response but its response type is good and persistent. In addition, no difference was observed in efficacy of different classes of drugs for treatment of these two types of depression. The results of this research showed that there is no difference between treatment response of two types of depression (Genetical and Reactional).

Conclusions:

There is no preference in efficacy of different classes of drugs in treatment of these two types of depression.
Hepatitis C and Depression - the Effects of Tianeptine
Authors: Martinovic J.
Published: March 2009

Objective:

Infection with the hepatitis C virus is a global problem with the prevalence of around 3%and a tendency of becoming chronic with 75% of the infected people.

The latest research indicates that chronic hepatitis C is connected with a higher risk of the beginning of depression.It also indicates that depression is more common with patients who have a chronic HCV infegtion as compared with other liver diseases.

Aim:

The aim of this study was to evaluate the efficiency of tianeptine in depression treatment of people with chronic hepatitis C.

Method:

A total of 3o patients with serologically affirmed diagnosis of hepatitis C,aged 30 to 55 years,were included in this study.The level of depression with these patients was measured using MADRS scale.The minimal score value on the MADRS scale during the initial rounds was 25.The patients received 37.5 mg of tianeptine for 8 weeks without the concomitant therapy.Rounds were organized at the beginning of the treatment, after 3 weeks,and after 8 weeks of treatment for all patients.

Results:

There is a significant improvement in terms of reduction in depression on the MADRS scale with patients treated with tianeptine after 3 and 8 weeks of treatment as compared with the initial rounds.70% of patients treated with tianeptine reduced the score on the MADRS scale, to 15 and lower after 8 weeks of treatment.

Conclusion:

Tianeptine shows considerably useful effects in reduction of depression symptoms with patients with chronic hepatitis C infection.
Comparison of the Effect on 8 weeks Treatment with Fluoxetine and Imipramine on Fasting Blood Sugar of Major Depressive Patient
Authors: Salehi B.
Published: March 2009

Background:

There is a lot of interference between depression and diabetes - mellitus and vice versa. Therefore, control of blood glucose levels in depressive patients and also to knowing the effect of antidepressants on blood glucose levels is important.

This study was performed to determine the effect of 4 and 8 weeks treatment with Fluoxetine and Imipramine on the fasting blood sugar (FBS) of patient with major depressive disorder.

Material and method:

This study was a parallel randomized clinical trial that was performed in 2006 on out - patients, of the psychiatric ward of Hashemi Senejani Hospital of Arak - Iran, for major depression treatment; there were 40 subjects in each group. These patients had their F.B.S. tested three times, before beginning and 4 and 8 weeks after treatment, respectively.

Results:

There were not significant statistical differences between first and second time mean F.B.S. values in group A, but we had a significant decrement in first and third times mean F.B.S. values (p < 0.05). There was also a significant increment in second and third times mean F.B.S. values versus first time mean F.B.S. values in group B (p > 0.05).

Conclusion:

In this study, we have found that there is a decrement in F.B.S. mean value after 8 weeks of treatment with Fluoxetine and increment in FBS after 4 and 8 weeks of treatment with Imipramine. Therefore, we recommended Fluoxetine for hyperglycemic depressive patients and Imipramine for hypoglycemic one.
Evaluation of Factors Influencing Antidepressant Medication Compliance in Outpatient Treatment of Depressive Disorders in Korea
Authors: Moon-Soo L. , Jae-Won Y. , Hyonggin A. , Seung-Hyun K.
Published: March 2009

Objective:

Medication compliance is associated with the treatment outcomes. The reported consequences of non-compliance are chronification, poor psychosocial outcomes and increased suicide rates. We measured the drug compliance using medication event monitoring system (MEMS) and several compliance measures in the outpatients with depressive disorders. In addition, we tried to find out the relationship of antidepressant compliance with other clinical correlates including insight in depressive disorders.

Method:

This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as having depressive disorders were enrolled. Monitoring was performed in 76 depressive patients who were taking the mono-antidepressant therapy during the at least 4-week evaluation period. 17 item Hamilton Rating Scale for Depression (HRSD), Multidimensional Scale of Perceived Social Support (MSPSS) and the mood disorders insight scale (MDIS) were investigated. Compliance was measured using MEMS, clinician rating scale of antidepressant compliance, pill count, and patient's self-report.

Results:

A total of 76 outpatients were enrolled in this study. As the severity of depression increases, patients tended to perceive poor social support from others in the correlation analysis. Level of depression by HRSD was significantly correlated with MDIS scores. Compliance rates for MEMS, pill count, clinician rating scale of compliance and self-report were 51.9%, 71.4%, 79.2% and 75.3% respectively. We did not find any statistical significance between compliance variables and other clinical scale scores (MDIS, HRSD, and MSPSS).

Conclusion:

More severely depressed patients have higher scores of insight in case of depression. However, increased perception of insight in depressive patients was not directly related with the increase in treatment compliance. Further investigation is needed to understand other factors affecting the drug compliance especially in depressive patients.

.
Factors Associated with Premature Discontinuation of Antidepressant Drug Treatment in France
Authors: Tournier M. , Boutouaba-Combe S. , Bégaud B. , Cougnard A. , Verdoux H.
Published: March 2009

Objectives:

As practice guidelines recommend to maintain antidepressant treatments for a long duration after improvement of symptoms in order to prevent relapse or recurrence, our objectives were to explore the duration of the antidepressant drug treatment in France and to characterise the antidepressant users with a short duration of treatment.

Methods:

An observational retrospective cohort study was conducted in the community-dwelling population 18 year-old and over through claims databases of the public health insurance. A random sample of 34.663 outpatients who initiated an antidepressant treatment between the 1st January 2005 and the 31st December 2006 were selected. The dependent variable was the duration of the first episode of antidepressant treatment, categorised a priori in short duration [1-6 months[ versus long duration [6 months and more] according to guidelines. Characteristics independently associated with the treatment duration were investigated using logistic regressions.

Results:

Nearly two thirds of the individuals were females. Most patients were not on welfare. Three quarters of them did not present with chronic conditions. The duration of the antidepressant treatment complied with the international recommendations for only one patient of six. Adequate treatment duration was associated with being a female, being older, not being on welfare, presenting with a chronic condition and a treatment introduction by a psychiatrist or a hospital practitioner.

Conclusion:

The recommendations concerning the duration of an antidepressant treatment are rarely respected in a real-life setting in France. Further analyses should be conducted to characterise the patterns of prescription according to antidepressant classes and associated treatments.
Riluzole for Affective and Behavioral Disturbance in Autism
Authors: Wachtel L.
Published: March 2009

Objective:

This paper reviews the novel usage of riluzole, an antiglutamatergic and neuroprotective agent, for affective and behavioral stabilization in autism.

Method:

A review of the English-language literature on riluzole usage for pediatric and adult psychopathology, combined with the author's experience with two autistic patients who demonstrated prominent affective stabilization and reduction in self-injury with riluzole.

Results:

Riluzole was developed for usage in amyotrophic lateral sclerosis, and is the only drug to slow the progression of this devastating neurological disease. Riluzole inhibits release of glutamate, the primary excitatory amino acid in the brain, and enhances GABA-A receptor function. Riluzole has demonstrated efficacy in open-label trials of adult unipolar and bipolar depression as well as pediatric and adult obsessive-compulsive disorder. Case reports have additionally documented benefit in trichotillomania and self-injury. There is not yet published literature on riluzole usage in autism, but the following cases are presented:

Pt 1: A 20 year-old male with autism, depression with suicidality and self-injury who demonstrated a partial response to electroconvulsive therapy and traditional adjunctive psychopharmacology. Riluzole addition provided sustained remission of residual symptoms.

Pt 2: A 9 year-old male with autism, cyclical mood disturbance and extreme self-injury towards the head requiring extensive protective equipment for safety. Riluzole conferred both affective stabilization and prominent reduction in self-injury.

Conclusion:

Riluzole is a new psychopharmacological agent. Efficacy has been demonstrated for mood and anxiety disorders in the typically-developing population. Similar positive benefit may be seen for psychopathology in autism, and merits further investigation.
Hyponatremia and Selective Serotonin Reuptake Inhibitors
Authors: Rammos G. , Panutsopoulos A. , Xynos K. , Koufogeorga E. , Peppes V. , Kostopoulos K. , Turli P.
Published: March 2009

Aims:

Hyponatremia (HPN) is a potentially lethal electrolytic disturbance. Certain medical treatments are integrated in the etiology of that sodium disorder. We retrospectively studied the rate of HPN in patients examined in the emergency room (ER) of Alexandra Hospital receiving a selective serotonin reuptake inhibitor (SSRI).

Methods:

17,410 patients, 55.54% women and 44.46% men were examined in the ER over a one year period. 281 patients (1,61% of total) presented with HPN, 162 were women (57.6%) and 121 (42.3%) men. Plasma Sodium values ≤ 133mEq/l defined HPN. 13 of the 281 patients with HPN (4.6%) with no renal, heart or hepatic impairment were on an SSRI regimen.

Results:

11 of 162 women (6.8%) presented with HPN were receiving concurrently SSRI and either thiazide diuretic (3 ) or furosemide (2 ). 2 of 121 men (1.65%) were on SSRI regimen and furosemide. SSRI dosage was in all cases within suggested therapeutic limits. Table 1 demonstrates mean values and standard deviation of all the parameters examined.

PatientsAgePlasma Na+Plasma K+Plasma CreatininePlasma UreaHct1366,9 +/- 17,4 years127,2 +/- 6,1 mEq/4 +/- 0,7 mEq/l1.06 +/-0,5 mg%39,8 +/- 16,2 mg%36,7 +/ 2,9%

Conclusion:

SSRI therapy presents a potential cause for HPN principally in women older than 65 years old with increasing risk when diuretic is used concomitantly. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and expression conversion of aquaporin-2 receptors of the collecting ducts are two possible pathophysiologic mechanisms of HPN occurrence.
Association of Personality Traits and Generalised Anxiety, as Measured by the EPQ and the GADI
Authors: Argyropoulos S.
Published: March 2009

We explored the question of whether generalised anxiety is mainly defined by individual personality characteristics or by contextual influences. To that end, we analysed data obtained by a sample of 150 healthy volunteers subjected to a series of 7.5% and placebo inhalations. The participants completed the Eysenck Personality Questionnaire and the Generalised Anxiety Disorder Inventory (GADI), a new tool that has shown good reliability, convergent and divergent validity in the measurement of generalised anxiety, and comprises three factors relating to cognitive, somatic and sleep symproms of GAD (Argyropoulos et al, 2007, J Psychopharmacology, 21: 145-152). We found that the neuroticism trait was associated with all three factors of the GADI, anxiety & worry (r=0.59), sleep problems (r=0.29) as well as somatic symptoms (r= 0.33), and the total GADI score (r=0.59). We concluded that GAD, as quantified by the GADI, is partly a stable trait, but there remains substantial variation that cannot be explained by personality alone.
Sensitivity of the Generalised Anxiety Disorder Inventory (GADI) to Detect Changes in Two Experimental Models of Human Anxiety
Authors: Argyropoulos S.
Published: March 2009

We developed and validated a new questionnaire for the assessment of the symptom profile and severity of generalised anxiety, the Generalised Anxiety Disorder Inventory (GADI). The 18-item scale (Argyropoulos et al, 2007, J Psychopharmacology, 21: 145-152) showed good reliability, convergent and divergent validity. The scale comprises three factors, relating to cognitive, somatic and sleep symptoms. It distinguishes accurately GAD patients from non-patient controls. The cognitive factor also distinguishes GAD from other anxiety disorders and depression. The sensitivity of the GADI to detect changes in symptom levels was tested in two experimental models of anxiety induction; the inhalation of 7.5% CO2 over a period of 20 minutes, which models generalised anxiety, and a single vital capacity inhalation of 35% CO2, which models panic anxiety (Bailey et al, 2005, Depression & Anxiety, 21: 18-25; Bailey et al, 2007, J Psychopharmacology, 21: 42-49). We found that the GADI was able to detect the differential drug effect of a benzodiazepine (alprazolam) and placebo in the anxiety induced by these tests in healthy volunteers.
Anxiety Syndrome and Somatic Morbidity in an Italian Elderly Population
Authors: Cesano S. , Atti A.R. , Moretti F. , Bernabei V. , Morini V. , Modenese A. , Dalmonte E. , de Ronchi D.
Published: March 2009

Aims:

To evaluate anxiety syndrome prevalence and to investigate the association between anxiety and somatic morbidity in a population-based study of elderly: the “Faenza Project” (De Ronchi, 2005).

Methods:

6987 cognitively intact subjects living in the Faenza area (mean age 71,88 years; 59,2% women) underwent semi-structured interviews and were clinically assessed in order to evaluate somatic and mental health status (ICD-10 criteria). Multi-morbidity was defined as the presence of two or more somatic diseases (hypertension, diabetes, dyslipidemia, cardiovascular, gastro-intestinal, endocrine diseases, psychiatric disorders, osteoporosis, Parkinson's disease (PD) and stroke). The association between anxiety and somatic morbidity was calculated by Logistic regression analysis estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI), adjusting for age, education, gender, marital status, socio-economic status, smoking habits and alcohol consumption.

Results:

The prevalence of anxiety syndrome was 11,1% (8,6% women vs 2,5% men, p< 0.001). Taking into account possible confounders, anxiety syndrome was associated with depressive syndrome (OR,95%CI=4.55,3.73-5.54), osteoporosis (OR, 95%CI=1.37,1.13-1.65), Parkinson's disease (OR,95%CI=4.18,2.55-6.85) and multi-morbitidy (OR,95%CI=1.75,1.46-2.10). When all these conditions were included simultaneously in the logistic model, however, only depressive syndrome and PD were still significantly associated with anxiety: OR,95%CI=4.10,3.22-5.23 and OR, 95%CI=3.02,1.73-5.28 respectively.

Conclusions:

The well known association between depression and anxiety is confirmed in our elderly population independently of other medical factors. Furthermore, a strong association between PD and anxiety resulted independently of co-occurrence of depression.
Stigma and Posttraumatic Stress Disorder
Authors: Aukst-Margetić B. , Toić G. , Furjan Z. , Boban A. , Margetić B.
Published: March 2009

Goal:

To assess perception of stigma in patients suffering from combat-related posttraumatic stress disorder.

Methods:

Sixty one veterans from 1991-1995 war in Croatia (mean age 43,8 years SD 6,3) with diagnosis of PTSD according to the 10th revision of the International Classification of Diseases hospitalized consecutively on acute psychiatric department during 6 months were assessed. Stigma was measured with Internalized Stigma Mental Illness inventory that has five subscales: Alienation; Stereotype Endorsement; Perceived Discrimination; Social Withdrawal and Stigma Resistance, and with Devaluation-Discrimination Scale both rated on four possibilities Likert scale: (1-strongly disagree to 4-strongly agree). Mississippi Scale for Combat-related PTSD was used to determine the severity of PTSD symptoms. It consists of 35 statements that are rated on a 5-point Likert scale (1 - “absolutely incorrect” to 5 - “absolutely correct”). A 100mm long visual analogue scales anchored with “not at all” and “very strongly” were used for assessing religiosity, social support and family problems caused with patient's illness.

Results:

Discrimination-devaluation scale was correlated with social support (r=0,373 p=0,003) indicating less discrimination with higher social support and with intensity of PTSD (r=-0,320 p=0,017). ISMI was correlated with intensity of family problems (r=0,299; p=0,019) and M-PTSD (r=0,588; p=0,001). Regression analyses indicated social support as significant predictor of less discrimination (R=0,570; p=0,021), and intensity of symptoms as predictor of high perceived stigma (R=0,653;p=0,001). Unsolved veteran invalidity status was associated with higher number of hospitalizations (t=2,097; df=59; p=0,042).

Conclusion:

Stigma perception in PTSD depends on social support and intensity of the symptoms.
The Comorbidity of Anxiety Disorders with Depression and the Associated Risk Factors in Geriatric Psychiatry Outpatients
Authors: Beskardes F. , Ertan T. , Eker E.
Published: March 2009

Aims:

We aimed to study the prevalence of anxiety disorders with the comorbidity of depressive disorders and the effects of risk factors among the patients attending the general Geriatric Psychiatry Outpatient Unit.

Methods:

Subjects were evaluated in terms of Anxiety Disorders on the basis of DSM criteria, SCID. Each patient was asked to fill out Spielberger State-Trait Anxiety Scale, Beck Anxiety and Depression Scale. Sociodemographic features and risk factors were assesed the prepared questionnaire.

Results:

In a number of total 1209 applicants in 12 months, we found the prevalance of anxiety disorders was %9,48 with a number of 115 patients in outpatient department applications and the prevalence of Generalized Anxiety Disorder was found out to be %4,63(n:56), Panic Disorder with Agoraphobia %1,98(n:24), without Agoraphobia %0,90(n:11), the prevalence of OCD was %0,82(n:10), PTSD %0,49(n:6) and other anxiety disorders (SAD, SP, NOS) was %0,66(n:8).

In the patients with anxiety disorders, the prevalence of depression comorbidity was found out to be %73,05(n:84), with the prevalence of the comorbid major depressive disorder %26,1(n:31), and the dysthymic/minor depressive disorder was %46,95(n:53). As a result of statistical analysis,we found that the risk factors associated with STAI-I and II scores were total years spent on education, but in reverse manners, as the education level increased, the STAI-I and II scores decreased.

Conclusions:

Anxiety disorders with comorbid depression might be frequent disorders among Turkish secondary care attenders. There is a need for further studies on the epidemiology of anxiety disorders and their comorbidity with depression among elderly in Turkey.