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1.
Behav Sci (Basel) ; 14(7)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39062412

RESUMO

Perinatal depression (PPD) presents a significant public health concern, often influenced by psychological and personality factors. This study investigated the impact of personality traits, particularly neuroticism, and obsessive-compulsive disorder (OCD) symptoms on the severity of PPD. The primary aim was to quantify the contributions of these factors to the risk and severity of PPD to enhance early intervention strategies. A total of 47 pregnant women with depressive symptoms per DSM-5 criteria at "Pius Brinzeu" County Emergency Hospital in Timisoara, Romania, were enrolled in this cross-sectional study, as well as 49 women without depressive symptoms as controls. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI), and OCD symptoms were measured using the Obsessive-Compulsive Inventory (OCI). Depression severity was evaluated using the Edinburgh Postnatal Depression Scale (EPDS). This set of questionnaires were administered antepartum and postpartum. The logistic regression analysis highlighted neuroticism as a significant predictor of PPD severity, with an increase in neuroticism associated with a higher risk of PPD (coefficient = 0.24, p < 0.001). Conversely, openness showed a protective effect (coefficient = -0.13, p = 0.009). Higher OCD symptomatology, particularly ordering and hoarding, were linked with increased depression scores. Specifically, the total OCI score significantly predicted the EPDS score (coefficient = 0.03, p = 0.003). Furthermore, significant increases in EPDS anxiety and depression scores were observed in the perinatal period, indicating worsening of symptoms (anxiety coefficient = 0.51; p < 0.001). The findings suggest that personality traits like neuroticism and OCD symptoms significantly contribute to the severity of PPD. Interventions targeting these specific traits could potentially mitigate the risk and severity of perinatal depression, underscoring the need for personalized treatment plans that consider these psychological dimensions.

2.
Children (Basel) ; 11(6)2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38929278

RESUMO

Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic-pituitary-adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.

3.
Diseases ; 12(5)2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38785737

RESUMO

Postpartum depression (PPD) is a significant global health concern with profound implications for mothers, families, and societies. This systematic review aims to synthesize current research findings to understand better how personality traits, as assessed by the NEO Five-Factor Inventory (NEO-FFI), contribute to the development and progression of PPD. Conducted in January 2024, this review searched major databases like PubMed, PsycINFO, and Scopus up to December 2023, focusing on the NEO-FFI's role in evaluating PPD. Following PRISMA guidelines, studies were selected based on strict criteria, including the exclusive use of NEO-FFI for personality assessment and a focus on postpartum women. A total of seven studies were included after a rigorous two-step screening process, and their data were qualitatively synthesized. The review covered a total of 4172 participants, with a prevalence of clinically significant postpartum depression symptoms ranging from 10.6% to 51.7%. Notably, Neuroticism emerged as a significant predictor of PPD, with odds ratios ranging from 1.07 (95% CI: 0.96-1.20) in some studies to as high as 1.87 (95% CI: 1.53-2.27) in others. In contrast, traits like Extraversion and Conscientiousness generally showed protective effects, with lower scores associated with reduced PPD risk. For instance, Extraversion scores correlated negatively with PPD risk (Beta = -0.171) in one study. However, the impact of other traits such as Openness and Agreeableness on PPD risk was less clear, with some studies indicating negligible effects. The review highlights Neuroticism as a consistent and significant predictor of PPD risk, with varying impacts from other personality traits. The findings suggest potential pathways for targeted interventions in maternal mental health care, emphasizing the need for comprehensive personality evaluations in prenatal and postnatal settings.

4.
Clin Pract ; 14(3): 703-717, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38804388

RESUMO

(1) Background: The aim of this study was to analyze the impact of pharmacogenetic-guided antidepressant therapy on the 12-month evolution of the intensity of depressive symptoms in patients with recurrent depressive disorder (RDD) in comparison to a control group of depressive subjects who were treated conventionally. (2) Methods: This prospective longitudinal study was conducted between 2019 and 2022, and the patients were evaluated by employing the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impressions Scale: Severity and Improvement. We followed them up at 1, 3, 6, and 12 months. (3) Results: Of the 76 patients with RDD, 37 were tested genetically (Group A) and 39 were not (Group B). Although the patients from Group A had statistically significantly more severe MDD at baseline than those from Group B (p < 0.001), by adjusting their therapy according to the genetic testing, they had a progressive and more substantial reduction in the severity of RDD symptoms [F = 74.334; η2 = 0.674; p < 0.001], indicating a substantial association with the results provided by the genetic testing (67.4%). (4) Conclusions: In patients with RDD and a poor response to antidepressant therapy, pharmacogenetic testing allows for treatment adjustment, resulting in a constant and superior reduction in the intensity of depression and anxiety symptoms.

5.
Pharmaceuticals (Basel) ; 17(1)2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38256919

RESUMO

The expression of GPCRs has been associated with schizophrenia, and their expression may induce morphological changes in brain regions responsible for schizophrenia and disease-specific behavioral changes. The articles included in this review were selected using keywords and databases of scientific research websites. The expressions of GPRs have different involvements in schizophrenia, some increase the risk while others provide protection, and they may also be potential targets for new treatments. Proper evaluation of these factors is essential to have a better therapeutic response with a lower rate of chronicity and thus improve the long-term prognosis.

6.
Healthcare (Basel) ; 11(21)2023 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-37958002

RESUMO

BACKGROUND: COVID-19 has led to a global health crisis that is defining for our times and one of the greatest challenges to emerge since World War II. The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. MATERIALS AND METHODS: The study is a cross-sectional survey conducted from 1 March 2020 to 1 March 2023, during the period of the SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the "Pius Brînzeu" County Emergency Hospital in Timisoara, Romania, and online using Google Forms. RESULTS: The highest severity of postpartum depression symptoms was observed during the COVID-19 pandemic. The results of the study conducted during the period of the SARS-CoV-2 pandemic (COVID-19) showed that the prevalence of major postpartum depressive disorder (EPDS ≥ 13) was 54.2% (466 patients), while 15.6% (134) had minor depressive disorder (10 < EPDS ≤ 12) in the first year after delivery. Comparing these results with those obtained in research conducted before the onset of the pandemic period showed an alarming increase in the prevalence of postpartum depression. The risk factors associated with postpartum depression included the type of delivery, level of education, socio-economic conditions, health status, age, background, and personal obstetric history (number of abortions on demand, parity). CONCLUSIONS: The effects of the pandemic on mental health are of particular concern for women in the first year after childbirth. Observing these challenges and developing effective measures to prepare our health system early can be of great help for similar situations in the future. This will help and facilitate effective mental health screening for postpartum women, promoting maternal and child health.

7.
J Int Med Res ; 49(4): 3000605211006633, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33827323

RESUMO

OBJECTIVE: Major depressive disorder (MDD) is a recurrent disorder with an increasing incidence. Alterations in key signaling pathways of the nervous system, such as the Wnt and MAPK pathways, mediated through microRNAs (miRNAs) provide crucial information regarding the etiopathology of MDD. We aimed to analyze whether the heterogeneity of literature findings regarding differential expression of miRNAs in the blood could arise from their different distributions among blood compartments. METHODS: We performed a pilot study analyzing the differential expression of miR-26a, miR-494, miR-30c, miR-93, and miR-101 and investigated their levels in white blood cells, total plasma (TP), exosomes from plasma, and exosome depleted plasma (EDP) in patients with MDD before and after antidepressant treatment with escitalopram and in healthy controls. RESULTS: MiR-494 was more abundant in EDP, and miR-26a and miR-30c were predominantly more abundant in TP relative to other blood compartments. Moreover, miR-30c, miR-101, and miR-26a, were significantly downregulated in TP of patients with MDD compared with controls. After antidepressant treatment, only miR-494 was significantly differently expressed in EDP. CONCLUSIONS: This proof-of-principle study suggests that identifying the miRNA abundance in different blood compartments is crucial for biomarker development and could enrich the current knowledge regarding MDD pathophysiology.


Assuntos
Transtorno Depressivo Maior , MicroRNAs , Antidepressivos/uso terapêutico , Biomarcadores , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/genética , Humanos , MicroRNAs/genética , Projetos Piloto
8.
Neuropsychiatr Dis Treat ; 17: 809-820, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33776437

RESUMO

PURPOSE: The relationship between personality traits and cardiovascular disease has gathered sustained interest over the last years, type -D personality (TDP) being significantly associated with coronary artery disease (CAD). However, data regarding the connection between the TDP and the severity of CAD disease is scarce. The aim of our study was to assess the relationship between TDP and the complexity of CAD, and to compare it with other sociodemographic and clinical features. PATIENTS AND METHODS: We conducted a cross-sectional case-control clinical-based study on 221 consecutive hospitalized patients with chest pain (60 ± 10.2 years; 131 men), referred for coronary angiography. RESULTS: TDP was identified in 42 (19%) patients, using the DS 14 scale. Symptomatology profile was evaluated using the SCL-90 scale. Syntax score was greater in the subgroup of patients with TDP in comparison to non-TDP subgroup (26.21±12.03 vs 15.49±8.89, respectively, p<0.001), and most of SCL-90 symptom dimensions have significantly higher levels in the subgroup of TDP with CAD patients (all p < 0.05). Smoking (ß=0.132, p=0.037), dyslipidemia (ß=0.149, p=0.013), Diabetes Mellitus (ß=232, p<0.001), NA dimension of TDP (ß=0.255, p<0.001) and SI (ß=0.279, p<0.001) dimension of TDP have a significant contribution to the complexity of CAD assessed by Syntax score. CONCLUSION: TDP was associated with a more complex CAD assessed by Syntax score, and may represent a dynamic interface between the biological and psychological vulnerabilities and the symptoms of CAD.

9.
J Psychosom Obstet Gynaecol ; 42(3): 242-252, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32116087

RESUMO

INTRODUCTION: Increasing amount of data reveal that suicide risk is a real phenomenon among perinatal women, determined by several other psychopathological conditions with depression being just one of them. This study aimed to investigate the role of personality dimensions on the occurrence of suicide ideation during the perinatal period. METHODS: A longitudinal prospective study was performed in pregnant women who were monitored at university-based obstetrical care units in our county. Recruited women were reassessed between 6 and 8 weeks into their postnatal period. Trait and state anxiety, five-factor based dimensions of personality, and depressive symptoms were assessed using established psychometric measures. Appropriate statistical analyses were conducted, depending on the distribution of variables. RESULTS: Significant levels of state anxiety (33.7% vs. 15.5%), depressive symptoms (19.8% vs. 8.5%), and suicide risk (13.9% vs. 6.3%) have halved in the postnatal period compared to the antenatal assessment. A lower level of education was associated with the presence of postnatal suicide ideation (p = .041), while an unemployed professional status was more frequent in pregnant women presenting antenatal suicide ideation (p = .021). Trait anxiety was predictive for the appearance of suicide ideation within the entire perinatal period assessed (p < .001 and p = .007, respectively). Agreeableness and conscientiousness predicted antenatal suicide ideation (p = .033 and p = .032, respectively). DISCUSSIONS: Different dimensions of personality may play a contributing role in the development of suicide ideation in perinatal women. Consequently, personality dimensions and trait anxiety, not only depressive symptoms, should be investigated when attempting to identify perinatal women at risk of suicide.


Assuntos
Ansiedade , Ideação Suicida , Transtornos de Ansiedade , Depressão , Feminino , Humanos , Personalidade , Gravidez , Estudos Prospectivos , Fatores de Risco
10.
Medicina (Kaunas) ; 56(11)2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33167574

RESUMO

Background and objectives: Major depressive disorder (MDD) and cardiovascular diseases (CVDs) represent serious and prevalent medical conditions. Autonomic nervous system (ANS) dysfunctions, expressed by parameters of heart rate variability (HRV) and heart rate turbulence (HRT), have been repeatedly associated with depression. The aim of our study was to identify potential HRV and HRT alterations in patients with MDD, before and after selective serotonin reuptake inhibitor (SSRI) therapy, and to observe any correlations between these parameters and the severity of depressive symptoms. Another aim was to evidence if there was a normalization or improvement of HRV and HRT parameters that paralleled the reduction of the intensity of depressive symptoms. Materials and Methods: We studied heart rate variability (HRV) and heart rate turbulence (HRT) in a sample of 78 patients, aged under 51 years, who were referred to our outpatient clinic between June 2017 and December 2019, for complaints in the context of a new onset major depressive disorder (MDD), before and after therapy with SSRIs. Results: By using 24 h Holter ECG monitoring, we evidenced alterations of HRV and HRT parameters, significantly correlated with the severity of depressive symptoms (p < 0.001), as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). Our results indicated that these parameters improved following one and six months of SSRI therapy, when a partial or total remission of depressive symptoms was achieved (p < 0.001). Changes in HRV parameters were correlated with the reduction of the severity of depression. Conclusions: In our study group, we highlighted, through 24 h ECG Holter monitoring, frequent and clear HRV and HRT abnormalities that were statistically correlated with the severity of depressive symptoms. Furthermore, we were able to document a progressive improvement of these parameters, which corresponded with the improvement of depressive symptoms under SSRI therapy, when compared to the values measured before the commencement of antidepressant pharmacotherapy.


Assuntos
Transtorno Depressivo Maior , Inibidores Seletivos de Recaptação de Serotonina , Idoso , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Eletrocardiografia Ambulatorial , Frequência Cardíaca , Humanos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico
11.
Exp Ther Med ; 20(6): 193, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33101483

RESUMO

Hypoplastic left heart syndrome is a heterogeneous group of congenital cardiac malformations which associates hypoplastic/aplastic left ventricle, mitral and aortic valve, hypoplastic/atresia and severe aortic artery coarctation, and represents a medical-surgical emergency. We present a case of a newborn hospitalised in three clinics (two clinics from Timisoara and one from Vienna), and operated for hypoplastic left heart syndrome, without aortic coarctation, using a mixed technique cardiovascular repair surgery. The initial therapeutic conduct included maintaining the permeability of the arterial canal with prostaglandin E1. At the Vienna General Hospital, at the age of 17 days, bilateral banding of the pulmonary artery was performed and, at the age of 20 days, during the cardiac catheterisation, the Rashkind procedure (balloon atrial septostomy) was performed, with two stents being implanted in the arterial canal. Postoperative complications were postcardiotomy syndrome, pneumonia with Enterococcus faecalis and Stenotrophomonas maltophilia, sepsis with methicillin-resistant Staphylococcus aureus, coagulopathy, mixed anaemia, and metabolic acidosis. The patient died 1 month after the intervention due to cardiorespiratory arrest, bilateral congestive heart failure, left heart hypoplasia with shunt through the arterial canal and pulmonary artery banding, multiorgan failure, and severe secondary haemorrhagic disease. In conclusion, the initial cardiac surgical reconstruction consisted of a mixed technique, and anticoagulant medical treatment with heparin, antibiotics (bacterial endocarditis prophylaxis to be performed throughout life); postintervention hypoxic and infectious complications resulted in multiorgan failure and death.

12.
Medicina (Kaunas) ; 55(12)2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31835374

RESUMO

Background and objectives: The objective of this study was to contribute to the evaluation of the newborn (NB) cry as a means of communication and diagnosis. Materials and Methods: The study implied the recording of the spontaneous cry of 101 NBs with no intrapartum events (control sample), and of 72 NBs with nuchal cord (study sample) from the "Bega" University Clinic of Obstetrics-Gynecology and Neonatology of Timisoara, Romania. The sound analysis was based upon: Imagistic highlighting methods, descriptive statistics, and data mining techniques. Results: The differences between the cry of NBs with no intrapartum events and that of NBs affected by nuchal cord are statistically significant regarding the volume unit meter (VUM) (p = 0.0021) and the peak point meter (PPM) (p = 0.041). Conclusions: While clinically there are no differences between the two groups, the cry recorded from the study group (nuchal cord group) shows distinctive characteristics compared to the cry recorded from the control group (eventless intrapartum NBs group).


Assuntos
Choro/fisiologia , Cordão Nucal/fisiopatologia , Espectrografia do Som/métodos , Gravação em Vídeo/instrumentação , Algoritmos , Índice de Apgar , Comunicação , Mineração de Dados/métodos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Romênia/epidemiologia , Software
13.
Neuropsychiatr Dis Treat ; 14: 1891-1899, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30100724

RESUMO

PURPOSE: Medical students' personality traits, emotion regulation strategies, and empathic behavior are considered powerful predictors for their future achievements, professional adjustment, and mental strength. Coping strategies such as "self-blame," "rumination," "catastrophizing," "blaming others," lack of empathy, decreased emotion recognition abilities, and neuroticism are maladaptive and, thus, less desirable traits in medical professionals. The purpose of the study was to comparatively assess and find potential correlations between personality traits, empathy levels, emotion recognition abilities, and cognitive emotion regulation strategies of three medical student samples: general medicine (GM), dental medicine (DM), and general nursing (GN) students. PATIENTS AND METHODS: This cross-sectional comparative study was conducted throughout the second semester of 2017, during Psychiatry class, on 306 medical undergraduates of the "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania. Personality was assessed by using Neuroticism-Extraversion-Openness to Experience Five-Factor Inventory (NEO-FFI). Cognitive emotion regulation strategies were identified using the Cognitive Emotion Regulation Questionnaire (CERQ). Empathy quotient (EQ) was used to measure empathy levels. Emotion recognition abilities were evaluated with the Reading the Mind in the Eyes test (RMET). RESULTS: GM students scored significantly higher than both DM and GN students in blaming others (CERQ) and significantly higher than GN students in "neuroticism" (NEO-FFI). GM and DM students obtained significantly lower scores than their GN colleagues in "agreeableness" (NEO-FFI) and empathy (EQ). Compared to DM students, GN students gave significantly more correct answers in RMET. Neuroticism was associated with less efficient coping mechanisms (self-blame, rumination, catastrophizing, blaming others) and lower empathy scores. Empathy correlated negatively with blaming others and was positively associated with agreeableness and emotion recognition abilities. CONCLUSION: The differences found between the student samples can be consequences of several overlapping factors. Certain personality traits may predispose individuals to maladaptive coping responses, increased vulnerability to stress, and lower empathy levels. The results of this study can be viewed as baseline data for future, more comprehensive, longitudinal analyses.

14.
Rom J Morphol Embryol ; 59(1): 165-173, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29940625

RESUMO

Antidepressant medication influences cellular lipogenesis, being associated with metabolic side effects including weight gain. Due to the increasing use of antidepressants in children and adolescents, their metabolic and endocrine adverse effects are of particular concern, especially within this pediatric population that appears to be at greater risk. Genetic factors with a possible influence on antidepressant's adverse effects include CYP [cytochrome P450 (CYP450)] polymorphisms. We target to evaluate the efficacy of the pharmacogenetic testing, when prescribing antidepressants, in correlation with the occurrence of adverse events and weight gain. Our research was performed between the years 2010 and 2016, in the University Clinic of Child and Adolescent Psychiatry, Timisoara, Romania. We recruited 80 patients, children and adolescents with depressive disorders. Our study sample was divided in two groups: G1 - 40 patients took treatment after pharmacogenetic testing, and G2 - 40 patients without pharmacogenetic testing before the treatment election. Our results show statistically significant differences concerning the weight gain for groups G1 (with pharmacogenetic testing) and G2 (without pharmacogenetic testing). The CYP genotype and the pharmacogenetic testing, for choosing the personalized antidepressant therapy in children and adolescents with depressive disorders, proved to be good predictors for the response to antidepressants and the side effects registered, especially for weight gain. The significant correlations between the CYP polymorphisms for group G2 (without pharmacogenetic testing) and the weight gain/body mass index (BMI) increase, as major side effects induced by antidepressants, proved the fact that the pharmacogenetic screening is needed in the future clinical practice, allowing for individualized, tailored treatment, especially for at-risk pediatric categories.


Assuntos
Antidepressivos/efeitos adversos , Farmacogenética/métodos , Aumento de Peso/efeitos dos fármacos , Adolescente , Adulto , Antidepressivos/farmacologia , Criança , Feminino , Humanos , Masculino , Adulto Jovem
15.
J Ment Health ; 26(3): 212-219, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26925764

RESUMO

BACKGROUND: Postpartum depression represents an increasingly recognized psychiatric condition in new mothers, and even more so in recent years as its detection has improved. AIMS: This study aimed to reveal those maternal and perinatal parameters that are significantly associated with increased likelihood of postpartum depression in delivering mothers from our region. METHODS: A cross-sectional survey was conducted in 163 women between 6 and 8 weeks after delivery. Postnatal depression was assessed by the Edinburgh Postnatal Depression Scale (EPDS) using a cut-off of >12. RESULTS: Postnatal depression was detected in 39 (23.93%) new mothers. The preterm delivery [odds ratio (OR) 7.233; 95% confidence interval (CI) 1.631-32.078; p = 0.009], presence of complications during pregnancy (OR 4.579; 95% CI 1.314-15.953; p = 0.017) and being primiparous (OR 3.388; 95% CI 1.430-8.025; p = 0.006) have been associated with an increased likelihood of subsequent postpartum depression. Anxiety traits of personality were the most represented in depressive mothers. CONCLUSIONS: Postpartum depression is a frequent psychiatric condition in new mothers from our region. These results outline the critical role of mother's profile of personality which in a particular context of perinatal events could result in an increased likelihood of postpartum depression requiring a multidisciplinary approach.


Assuntos
Depressão Pós-Parto/epidemiologia , Mães/psicologia , Personalidade , Adulto , Estudos Transversais , Depressão Pós-Parto/psicologia , Feminino , Humanos , Pacientes Ambulatoriais , Romênia/epidemiologia , Inquéritos e Questionários , Adulto Jovem
16.
Rom J Morphol Embryol ; 58(4): 1165-1173, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29556605

RESUMO

Incidence of Alzheimer's disease (AD) in people over 75 years is much higher, and the progression of cognitive deficit become faster, leading to a decrease of quality of life for patients and their families. In this context, it is proposed a multifactorial pathogenic model of disconnected cognitive circuits, which is combined with genetic and vascular-cerebral vulnerability elements, allowing an aggressive progression of neurodegenerative factors, favoring onset of dementia. Data from research studies on animal model (rat) highlighted central role of cerebral cholinergic deficit (which is amplified by cerebral ischemia) on the background of apolipoprotein E4 (ApoE4) genotype, favoring multifactorial disconnected mechanisms, by excess of beta-amyloid (ß-A) or increase of vascular dysfunction. Depressive disorder, social stress and traumatic brain injury are favoring the excess in production of ß-A. Hippocampal structure disconnects the cognitive circuits, and from a neuropsychological point of view can be many patterns, which are correlated with neuroimaging (hippocampal atrophy, cerebral siderosis, white matter hyperintensity, ventriculomegaly) or biological (hyperhomocysteinemia) factors. Identifying the pathogenic model of multifactorial disconnectivity in the rapid evolution of cognitive deficit in patients with AD may create the premises for an early diagnosis and treatment, based on the biological, neuropsychological and clinical elements.


Assuntos
Doença de Alzheimer/complicações , Transtornos Cognitivos/etiologia , Neuroimagem/métodos , Qualidade de Vida/psicologia , Idoso , Doença de Alzheimer/patologia , Transtornos Cognitivos/patologia , Progressão da Doença , Feminino , Humanos , Masculino
17.
Psychiatry Investig ; 13(5): 549-557, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27757134

RESUMO

OBJECTIVE: Significant progress was made in the understanding etiopathogenic factors related to MDD, including through research on the role of micro RNAs (miRs). We investigated plasma miRs as potential markers for MDD in patients treated with antidepressants. METHODS: At the initiation and at the end of twelve weeks of treatment, blood samples were collected and a structured diagnostic interview and a standardized depression rating scale for the presence and severity of major depression were done. The average decrease in HAMD score was 76.89%. Plasma miR expression profiling was performed by real time PCR. The lists of up-regulated (cut-off=2) and down-regulated miRs were imported into the miRWalk2.0 algorithm and used for target predictions. KEGG database pathways analysis was used to retrieve the pathways significantly targeted by at least two of the miRs. RESULTS: Of the 222 miRs detected in plasma samples of MDD patients, 40 were differentially expressed after treatment. Twenty-three miRs were significantly overexpressed with fold changes between 1.85 and 25.42, and 17 miRs were significantly downregulated with fold changes from 0.28 to 0.68. Pathway analysis revealed a list of 29 pathways for up-regulated miRs, and 20 pathways for down-regulated miRs. Six dysregulated miRs are common to all the top five pathways (Wnt signaling, Cancer, Endocytosis, Axon guidance, MAPK signaling): miR-146a-5p, miR-146b-5p, miR-221-3p, miR-24-3p, miR-26a-5p. CONCLUSION: Overall, our miRWalk analysis of changes in plasma microRNAs after treatment of patients with major depression might open a new avenue for the understanding of Escitalopram mode of action and for its side effects.

18.
Artigo em Inglês | MEDLINE | ID: mdl-27382270

RESUMO

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is one of the most debilitating somatic diseases, having anxiety and depression frequently as comorbidities. The coping style, the way in which the subject manages to control the difficult and stressful situations of life, can influence its evolution and also the existence of the comorbidities. In this study, coping styles in a group of subjects with COPD and their association with the intensity of depressive and anxiety symptoms as well as medical determinants were identified. MATERIALS AND METHODS: In this cross-sectional study, 28 male patients with COPD risk class D were enrolled. The patients performed spirometry tests, Borg scale, 6-minute walking test, Hospital Anxiety and Depression Scale, and COPE Inventory were recorded. RESULTS: According to their higher coping subscale score, the depression score was the highest in patients with avoidance-type coping and the lowest in patients with problem-focused coping (11.0 vs 5.6; P=0.042), respectively, patients with social support-focused coping having the highest anxiety score in contrast to patients with emotion-focused coping, which had the lowest anxiety score (11.6 vs 5.0; P=0.006). Regarding respiratory parameters, significant differences were present for the variation of the medians between the four groups only for forced vital capacity (FVC%) (the lowest FVC% was in patients with predominant social support-focused coping and the highest in patients with problem-focused coping) and 6-minute walking test (%) (the lowest score for patients with social support-focused coping and the highest value in patients with avoidance-type coping). Problem-coping score was significantly and positively associated with FVC% (Spearman's r=0.400; P=0.035), emotion-focused coping score was significantly and positively associated with FVC% (Spearman's r=0.395; P=0.038), and social support-focused coping score was negatively and significantly correlated with forced expiratory volume in 1 second/FVC% ratio (Spearman's r=0.389; P=0.041). A significant, negative correlation was found only between depression score and forced expiratory volume in 1 second (Spearman's r=-0.435; P=0.026) with respect to psychiatric symptoms. CONCLUSION: Coping styles in patients with COPD affect the intensity of associated depressive and anxiety symptoms as well as medical determinants, thus the coping style should be considered an important part in the multidisciplinary approach of these patients.


Assuntos
Adaptação Psicológica , Ansiedade/psicologia , Efeitos Psicossociais da Doença , Depressão/psicologia , Cura Mental , Doença Pulmonar Obstrutiva Crônica/psicologia , Idoso , Ansiedade/diagnóstico , Estudos Transversais , Depressão/diagnóstico , Emoções , Volume Expiratório Forçado , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Qualidade de Vida , Fatores de Risco , Romênia , Índice de Gravidade de Doença , Apoio Social , Espirometria , Inquéritos e Questionários , Capacidade Vital , Teste de Caminhada
19.
J Psychosom Obstet Gynaecol ; 35(2): 55-61, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24824599

RESUMO

The current study aimed to investigate the rate of postpartum depression and its correlation with both state and trait anxiety. A cross-sectional study was performed on 80 mothers monitored in the Ambulatory of "Bega" Obstetrics Clinic from Timisoara. The presence of depression was assessed with the Edinburgh Postnatal Depression Scale, using a cut-off ≥ 10. State anxiety was assessed using the Beck Anxiety Inventory and anchored visual analogue scales. Trait anxiety was dimensionally assessed using the Karolinska Scale of Personality (KSP). More than half of recruited mothers presented a global score significant for postpartum depression (N = 43, 53.8%). Both perspectives of anxiety, as a state (p < 0.001) and as personality traits (e.g. p = 0.003 for psychic anxiety), were significantly correlated with postpartum depression. Furthermore, the levels of worry related to self-perceived health status of both mother and infant were significant in mothers with postpartum depression. We can conclude that postpartum depression was a highly-frequent psychopathological phenomenon among mothers from this sample set. In addition, both state and trait anxiety were common co-occurring clinical features.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Período Pós-Parto , Saúde da Mulher , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Projetos Piloto , Prevalência , Psicometria , Romênia/epidemiologia , Adulto Jovem
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