Psychological care over patients with lymphoma and lymphoma survivors.

Lymphomas are characterized by a relatively favorable prognosis and a good five-year survival rate, but they are associated with increased psychosocial distress. There is insufficient evidence on the efficacy of psychological interventions for lymphoma patients. This review aimed to present the research findings on currently used psychological interventions for (non-) Hodgkin lymphoma patients and survivors. A literature search on English language peer-reviewed original publications on psychological interventions for lymphoma patients published prior to December 2021 was performed in PubMed, Medline, Web of Science, Scopus and ResearchGate. Titles and abstracts were screened for the relevant terms including psychological intervention and psychological management along with (non-) Hodgkin lymphoma. The retrieved articles were evaluated by independent reviewers, the lists of eligible publications were compared, and disagreements were resolved by discussion. Of the 50 publications sought for retrieval, 8 articles were shortlisted based on their content. The papers were classified according to their content and the methodology employed. Research themes including "promoting resilience in lymphoma survivors", "web-based self-management interventions for patients with lymphoma", "addressing unmet needs whilst undergoing chemotherapy", and "mind-body interactive exercise" were identified and presented in this review. As the number of lymphoma survivors is increasing, future research on evidence-based interventions addressing patients' and survivors' unmet psychological needs is warranted.

Application of Eye-tracking in research on the theory of mind in ASD.

Autism spectrum disorder (ASD) is a broad diagnostic category describing a group of neurodevelopmental disorders which includes the autistic disorder. Failure to develop normal social relationships is a hallmark of autism. An inability to understand and cope with the social environment can occur regardless of IQ. One of the hypotheses of the appearance of ASD symptoms is associated with the theory of mind (TOM). ASD patients do not have the ability to attribute the full range of mental states (goal states and epistemic states) to themselves and to others. Eye-tracking allows for observation of early signs of TOM in ASD individuals, even before they are 1 year old, without the need of developed motor and language skills. This provides a window for looking at the very basics of mindreading - detecting intentionality and eyes in our environment. Studies show that ASD children fail to recognize biological motion, while being highly sensitive to physical contingency within the random movement. Their perception of faces seems disorganized and undirected, while object recognition is intact. Evidence suggests that this orientation of attention following gaze cues is diminished in ASD patients. Available data also show deficits in emotion recognition, that cannot be accounted for by impairments in face processing or visual modality alone. Such observations provide an insight into disturbances of information processing and offer an explanation for poor social functioning of ASD patients. When combined with other methods, Eye-tracking has the potential to reveal differences in processing information on a neural circuitry level. Thus, it may help in understanding the complexity of TOM mechanisms, and their role in social functioning.

Pain as a mediator in the temperament-alexithymia relationship in individuals suffering from rheumatoid arthritis.

OBJECTIVE: The study aims to establish a relationship between temperament traits, symptoms of alexithymia, and pain intensity in rheumatoid arthritis. Despite the significant progress seen in the area of RA treatment, pain, often life-long, remains the predominant symptom. This constant pain and progressing disability, as well as dependence upon other people cause RA patients to experience psychological stress that can be modified by individual patient traits. Recently, several authors have underlined the need to relate personality and temperament constructs to neurobiological processes that may underlie individual differences. It seems then that patient characteristics may play a significant role in the course of the disease. PATIENTS AND METHODS: The study was performed on a group of patients (N=317) with rheumatoid arthritis diagnosed according to the current criteria of the American-European Consensus of 2010. All patients expressed voluntary consent to participate, and the study protocol was approved by the Local Ethics Committee. This was a survey-based study. It involved the application of the adult version of the Buss and Plomin EAS Temperament Questionnaire (EAS-D), which tests 3 main temperament domains: sociability, activity, and emotionality. The pain was measured on the Visual Analogue Scale (VAS). VAS is used to measure pain intensity. The level of alexithymia was tested using the Toronto Alexithymia Scale-20. The scale consists of 20 statements and includes 3 subscales that measure difficulty in describing feelings/emotions, difficulty in identifying feelings/emotions, and operational externally oriented thinking. RESULTS: The analysis revealed that alexithymia is positively correlated only with one dimension of temperament, i.e., emotionality, and with pain intensity. Moreover, high emotionality was positively correlated with pain. A simple mediation analysis revealed that pain intensity functioned as a mediator in the emotionality-alexithymia relationship. CONCLUSIONS: The observed correlations indicate that RA patients with a high level of emotionality exhibit high alexithymia as they perceive pain related to the disease symptoms more intensely. The observed mediation is partial, meaning that there are also other mediating factors in this relationship.

Who is happier: smoker or non-smoker? Smoking in medical students from the perspective of positive psychology.

OBJECTIVE: The aim of this study was to analyze the correlation of nicotine dependence with perceived happiness and experienced emotions in three groups, namely non-smokers, smokers, and those who quitted smoking. PATIENTS AND METHODS: The total of 552 Poznan University of Medical Sciences students aged 21.84 ± 3.95 (women: 83.3%, men: 16.7%) participated in this study. They were asked to fill out 4 questionnaires. Two were originally designed by the authors of this paper - one asked about some demographic information and the other described cigarette smoking. Happiness and its dimensions were measured using Fordyce's Happiness Measure and the Positive and Negative Affect Schedule (PANAS). RESULTS: The obtained results point out some significant differences between smokers, non-smokers, and those who quitted smoking as to the levels of negative affect with respects to its two dimensions: Unpleasant and Frustrated. Smokers were characterized by a higher level of a negative affect than non-smokers, as well as higher scores for the Unpleasant and Frustrated dimensions compared to non-smokers and those who quitted smoking. As far as the positive affect of smokers and those who quitted smoking is concerned, a significant difference was observed for 5 dimensions: Interested, Inspired, Attentive, Determined and Active. CONCLUSIONS: The findings of this paper can help us understand better the nicotine-dependent population in the context of positive psychology, and provide us with some basic information helpful in designing preventive programmes for nicotine addicts.

Dielectric study of interaction of water with normal and osteoarthritis femoral condyle cartilage.

The main goal of this paper is the in vitro study of healthy and osteoarthritis (OA) human cartilage using the dielectric spectroscopy in the alpha-dispersion region of the electric field and in the temperatures from 25 to 140°C. The activation energy of conductivity needed to break the bonds formed by water in the extracellular matrix takes the average values of 61kJ/mol and 44kJ/mol for the control and OA cartilages, respectively. At 28°C, the small difference appears in the permittivity decrement between the control and OA cartilages, while the conductivity increment is about 2 times higher for the control tissue than that for the OA tissue. At 75°C, the conductivity increment for both of these samples is 8 times higher than their respective permittivity decrement. In addition, at 140°C the values of these both parameters for the OA tissue decrease by 8 times as compared to those recorded for the control sample. The relaxation frequency of about 10kHz is similar for both of these samples. The knowledge on dielectric properties of healthy and OA cartilage may prove relevant to tissue engineering focused on the repair of cartilage lesions via the layered structure designing.

Correlation between depression and burden observed in informal caregivers of people suffering from dementia with time spent on caregiving and dementia severity.

OBJECTIVE: The aim of the study is to compare data on the examined population of informal caregivers of people suffering from dementia with previous studies, as well as to assess the correlation between (i) depression determined on the basis of the Center for Epidemiologic Studies Depression Scale and (ii) caregiver burden measured by means of the Zarit Caregiver Burden Scale and some chosen parameters, such as total time devoted to caregiving, time of caregiving in hours per week and level of dementia severity measured by Global Deterioration Scale. PATIENTS AND METHODS: 41 informal caregivers of people suffering from dementia from different backgrounds were evaluated using the Zarit Caregiver Burden Scale and the Center for Epidemiologic Studies Depression Scale. Demographic data about the time devoted to caregiving and the number of hours spend on caregiving weekly were gathered. The type of dementia and its stage were registered using the Global Deterioration Scale (GDS). With the aid of the Statistica StatSoft program, mutual correlations between the parameters were measured. The study was conducted within the framework of AAL UnderstAID--a platform that supports and helps to understand and assist caregivers in the care of a relative with dementia. The international project is co-founded by the Joint Programme Ambient Assisted Living (Grant code: ESR-aal 2012 5 107). RESULTS: No significant correlations between the level of depression severity evaluated in caregivers and the total time of taking care of a demented person or time of caregiving in hours per week were observed. Similarly, no significant correlation between depression severity level and dementia severity level measured on the GDS scale were noted. There was also no significant correlation between Zarit Caregiver Burden Scale scores and the above-mentioned parameters. CONCLUSIONS: The level of depression among caregivers do not depend on socio-demographic factors.

Do urban and rural residents living in Poland differ in their ways of coping with chronic diseases?

OBJECTIVE: Chronic disease is a critical life event which demands significant psychological adjustment. Coping strategies and resources such as sense of coherence, self-efficacy, etc. remain factors affecting stress response. PATIENTS AND METHODS: The examined group included patients with ischemic heart disease (n = 134), type 1 diabetes mellitus (n = 109) or rheumatoid arthritis (n = 92). 159 patients came from urban area whereas 176 came from rural setting. All patients filled up inventories of life satisfaction, severity of depression, coping strategies, self-efficacy, social support and sense of coherence. RESULTS: The analysis showed that patients from rural areas had higher levels of well-being, i.e., were characterized by lower severity of depression. The predictors of satisfaction with life included two types of resources i.e. self-efficacy, social support and two coping strategies i.e. turning to religion and self-distraction (R2 = 0.39; F = 26.87**). Life satisfaction was determined by social support, sense of coherence and positive reappraisal (R2 = 0.36; F = 29.11**). CONCLUSIONS: Rural/urban differences in the use of coping strategies may be associated with environmental or lifestyle differences. Patients with IHD, T1D or RA in Polish rural areas are high risk for depression so they may need help in finding systematic contact with specialists of healthcare.

Certolizumab pegol in rheumatoid arthritis patients with low to moderate activity: the CERTAIN double-blind, randomised, placebo-controlled trial.

OBJECTIVES: This 52-week, randomised, double-blind phase IIIb study assessed efficacy and safety of certolizumab pegol (CZP) as add-on therapy to non-biologic disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) patients with low to moderate disease activity, and stopping therapy in patients in sustained remission. METHODS: Patients were randomised 1:1 to CZP (400 mg at weeks 0, 2 and 4, then 200 mg every 2 weeks) or placebo (every 2 weeks) plus current non-biologic DMARDs. At week 24, patients who achieved the primary endpoint of Clinical Disease Activity Index (CDAI) remission at both weeks 20 and 24 stopped study treatment and continued in the study until week 52. RESULTS: Of 194 patients (CZP=96; placebo=98), >90% had moderate disease activity at baseline. Significantly more CZP patients met the primary endpoint than placebo patients (week 20 and 24 CDAI remission rates: 18.8% vs 6.1%; p≤0.05). At week 24, 63.0% vs 29.7% of CZP versus placebo patients (p<0.001) achieved LDA. Disease activity score (ESR) based on 28-joint count and Simplified Disease Activity Index remission rates were also significantly higher with CZP versus placebo (19.8% vs 3.1%; p≤0.01 and 14.6% vs 4.1%; p≤0.05). CZP patients reported improvements in physical function versus placebo (mean Health Assessment Questionnaire-Disability-Index change from baseline: CZP, -0.25 vs placebo, -0.03; p≤0.01). During the period following withdrawal of CZP or placebo, only 3/17 prior CZP patients and 2/6 prior placebo patients maintained CDAI remission until week 52, but CZP reinstitution allowed renewed improvement. Adverse and serious adverse event rates were comparable between CZP and placebo groups. CONCLUSIONS: Addition of CZP to non-biologic DMARDs is an effective treatment in RA patients with predominantly moderate disease activity, allowing low-disease activity or remission to be reached in a majority of the patients. However, the data suggest that CZP cannot be withdrawn in patients achieving remission. TRIAL REGISTRATION NUMBER: NCT00674362.

Dielectric relaxation of normothermic and hypothermic rat corneas.

This paper aims at the presentation of the results of in vitro research on the dielectric properties of the cornea specimen collected from the rats subjected to in vivo hypothermia. The average values of the relative permittivity and dielectric loss are about 40% higher for the hypothermic cornea than those for the normothermic tissue at the same water content of 12% for both samples and at 25°C. Whereas, at 50°C this effect of increase in the dielectric properties of the hypothermic cornea when compared to the normothermic one is observed clearly only in the relative permittivity of about 19%. In the temperature range of 25-50°C, the activation energy of conductivity associated with the release of loosely bound water takes the average values of 45kJ/mol and 30kJ/mol for the normothermic and hypothermic corneas, respectively. The study provided information on dielectric polarization and conductance mechanisms in the cornea which may be helpful in interpreting clinical results of human cornea examination, currently obtained by means of such electrodiagnostic methods as conductive keratoplasty, electroretinography or electrooculography.

The evaluation of selected serum mineral concentrations and their association with insulin resistance in obese adolescents.

BACKGROUND: In obesity, elevated insulin resistance is observed, which may be associated with disturbances in mineral status in the body. The few studies concerning the status of minerals and their relationships with insulin resistance and body composition in adolescent populations have brought inconclusive results. AIM: of this study is, thus, to assess serum mineral concentration in obese adolescents, and to evaluate their potential association with insulin resistance. SUBJECTS AND METHODS: Seventy-eight obese adolescents and 20 healthy volunteers aged 12-18 years were recruited for the study. Selected anthropometrical measurements and levels of iron, zinc, copper, calcium, and magnesium were assessed in serum. Insulin resistance in the participants was evaluated according to the homeostatic model of assessment for insulin resistance (HOMA-IR) protocol. Levels of iron, zinc, copper, calcium, and magnesium were assessed in serum. RESULTS: Obese subjects had significantly higher HOMA-IR indices than the control group. Compared to healthy subjects, the serum concentration of zinc, calcium, and magnesium was significantly lower in obese subjects. A significant inverse relation was found between HOMA-IR and zinc levels in serum. CONCLUSIONS: Obese adolescents have a poorer mineral status (especially zinc) than adolescents of normal weight, which can contribute to insulin resistance.

Dielectric phenomena associated with the keratin-glucose interactions of nail plate.

In this study, we analyzed the effect of water and frequency on the dielectric properties of the nail plate in healthy individuals and in diabetic patients. The temperature dependencies of the loss tangent for both healthy and diabetic nail represent the relation between the electrical energy lost and stored in keratin-glucose-water complexes of this tissue. The differences between these materials concern the temperature ranges in which there appears the decomposition of loosely bound water. The effect of glycation on the loss tangent of the wet and the dry nail is supported by higher values of this parameter than in those describing the healthy samples in the whole temperature range and above 100°C, respectively. In addition, glycation lead to distinct increase in the dielectric relaxation decrement in permittivity and dielectric loss between the frequency of 500 Hz and 100 kHz for the wet and the dry nail. The results of this study indicate that the dielectric spectroscopy may be useful in observing the decomposition of water in the diabetic nail plate.

Dielectric properties of hypothermic rat artery.

The temperature and frequency dependencies of the dielectric parameters for the rat artery are used to analyse effects of hypothermia on this tissue. Measurements were performed over the frequency range 500 Hz to 100 kHz and at temperatures from 19 to 60°C. The artery samples contained about 12% water by mass at room temperature at a relative humidity of 70%. The frequency dependencies of the loss tangent for the control, mild hypothermic and moderate hypothermic artery exhibit two peaks at 2 kHz and 35 kHz in the α-dispersion region. The results were discussed in terms of the distribution of relaxation frequencies and the activation energy for the conduction and polarization mechanisms particularly in the elastin-water and collagen-water systems. The knowledge about dielectric behavior of the hypothermic rat artery in vitro is important due to clinical application of local and systemic hypothermia.

Implications of the alpha dispersion for studies on interaction of tobacco smoke--corneal tissue.

In this work, we have carried out a dielectric study to determine the effect of tobacco smoke on the rat corneal function. Measurements were performed over the frequency range of 500 Hz-100 kHz in air and at the temperature of 35°C. The frequency dependencies of the loss tangent for both healthy and smoky cornea exhibit two peaks with different width occurring as a narrow at 2 kHz and a broad at around 16 kHz. The distribution parameter α at 2 kHz has a value of about 0.3, which increases to 0.6 at 16 kHz. The magnitude of the permittivity decrement at 2 and 16 kHz is about two and four times higher, respectively, for the smoky cornea than that for the healthy one. These dielectric studies indicate that the present method is useful in detection of the effect of tobacco smoke exposure on the corneal behavior.

Neurophysiological assessment of the electrostimulation procedures used in stroke patients during rehabilitation.

The aim of this study was to evaluate the effectiveness of the associated electrotherapeutical and kinesiotherapeutical treatment in patients after ischemic stroke (N=24), mainly by means of neurophysiological tests. All patients underwent the same 20 days of neurorehabilitation procedures. Particular attention was paid to three-stage modified electrotherapy procedures such as: oververtebral functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) and the alternate neuromuscular functional electrical stimulation (NMFES) of antagonistic muscles of the wrist and the ankle (N=16). Electrotherapy was supplemented with kinesiotherapeutic (mainly PNF) procedures acting as an amplifier. Clinical assessment included muscle tension (Ashworth's scale), muscle force (Lovett's scale) and reflex scoring at wrist and ankle. However, the effectiveness of the procedures was measured by the assessment of results in complex and repetitive, bilaterally performed global electromyography (EMG) and electroneurography (ENG; M-wave studies). The statistical analysis obtained from results in clinical and neurophysiological examinations suggested that the dorsiflexion of wrist and ankle was improved in the majority of patients who took part in this study. EMG and ENG examinations showed that 20 days of therapy improved both activity in muscle motor units on the more paralyzed side (mainly within upper extremities) and to a lesser degree in the transmission of efferent impulses within motor fibers of nerves. The results obtained suggest that patients after ischemic strokes never show an isolated unilateral disability in motor functions. No definite similarities between the results of clinical and neurophysiological studies were found, which may suggest greater accuracy of the neurophysiological evaluation.

Body posture in women after mastectomy and its changes as a result of rehabilitation.

PURPOSE: The aim of the study is: 1) to analyse selected features of body posture in women after mastectomy, 2) to compare them with body posture of healthy women, 3) to determine the effect of rehabilitation physical exercises on the changes in body posture in women after mastectomy. MATERIAL AND METHODS: The research material consisted of 85 women after mastectomy examined once, including 40 of them who were additionally examined twice at six-monthly intervals. Moreover, a group of 20 women was isolated who regularly attended rehabilitation classes for a period of one year in question. A comparative group was a group of 85 healthy women. The examinations were performed using photogrametric assessment of body posture. RESULTS: Distinct adverse changes in body posture of women after mastectomy in comparison with healthy women were found, manifested mainly in asymmetry of trunk and shoulder girdle and greater forward leaning of the trunk. Significant relationship was indicated between the operation of mastectomy and the asymmetry of position of scapulas. CONCLUSIONS: When comparing the changes in the features of body posture in the group of women who exercised regularly with other women for the period of one year it was found that a positive effect of regular rehabilitation was keeping the angle of body inclination on the same level and improvement in trunk symmetry, position of scapulas and shoulder girdle.

Acute phase proteins serum concentrations in children are related to urinary iodine excretion.

PURPOSE: The paper presents links between iodine provision and selected acute phase proteins' (APP) serum concentrations as well as their glycosylations profiles (investigated with the use of affinity immunoelectrophoresis with Concanavalin A as ligand) in children. MATERIAL AND METHOD: 116 children (58 girls and 58 boys) were enrolled. Iodine level was measured in the morning (7:30-8:30) urine portion, using Cr-As method. According to iodine level children were divided into two groups. The first one consisted of 56 children with decreased iodine level (lower than 100 micrograms/L), second--60 children with iodine level higher than 100 micrograms/L. In serum the concentration of ferritin, beta2-microglobulin (beta2-MG), thyroxin (T4), triiodothyronin (T3), thyrotrophic hormone (TSH) were measured by radioimmunoassay (BELORIS, Belarus). Concentrations of APP: C-reactive protein (CRP), alphal-acid glycoprotein (AGP), alphal-antichymotrypsin (ACT), alphal-antitrypsin (AT), haptoglobin (Hp), alpha2-macroglobulin (A2-M), ceruloplasmin (Cp) and transferrin (Tf) were measured in sera samples by rocket immunoelectrophoresis acc. to Laurell with antibodies and standard from DakoCytomation, Denmark. Microheterogeneity of AGP, ACT and Tf was estimated using affinity immunoelectrophoresis with ConA as a ligand, acc. to Bøg-Hansen. RESULTS: It was established, that CRP level was lower than upper limit of normal range. Levels of other investigated proteins were reliably dependent on the level of iodine. Especially for AGP lower level was observed for children of the group with low iodine level. In children with low iodine level along with the decrease of serum AGP concentration altered glycosylations profile was observed, namely decrease in the content of variant non-reactive to ConA (W0) and increase in content of weakly reactive (W1) and reactive (W2) variants content, which resulted in increase of the reactivity coefficient (AGP-RC). Similar tendency in alterations of distinctly glycosylated variants in relation to iodine level could be shown for ACT. Serum concentration of any investigated protein was not dependent on the concentration of the hormones of pituitary-thyroid system. CONCLUSIONS: It seems that the influence of the iodine level is direct, not via thyroid hormones. It could be suggested that in euthyroid children with low iodine excretion with urine a hidden iodine deficiency is already registered by the regulatory mechanisms and a kind of acute phase reaction is started, may be in order to increase iodine uptake and storage.

Alterations of lymphocyte subpopulations in choroidal melanoma patients undergoing surgery.

PURPOSE: The alterations of lymphocyte subpopulations assessment after surgery in choroidal melanoma patients compared to cataract patients. MATERIAL AND METHODS: 12 patients with malignant melanoma of the choroid, 10 patients subjected to surgery due to cataract. Methods--flow cytometric measurement of absolute lymphocyte count, the number of all T cells (CD3+), T helper lymphocytes (CD3+ CD4+), T cytotoxic lymphocytes (CD3+CD8+), B lymphocytes (CD19+), NK cells (CD3-CD16+) and T cells (CD3+) cells with gammasigma TCR, on the day of surgery and two days after it. RESULTS: Comparable numbers of cells were observed in both groups prior to surgery, but the behavior of some populations differed: CD3+, CD3+CD4+ cells increased in melanoma patients whereas they decreased in reference group, the number of T lymphocytes with gammasigma TCR was significantly higher in melanoma patients before surgery and it did not differ after it. CONCLUSIONS: Though there were no significant differences in lymphocyte subpopulations between melanoma patients and the reference group, it seems that the presence of tumour influences the reactivity of the immune system to the trauma (surgery).

Development and psychokinetic therapy of children suffering from West Syndrome--an overview.

Paper presents reasons leading to the West Syndrome, disturbances occurring in the child's development and possible rehabilitation programmes. Psychological rehabilitation of a child with West Syndrome is multilateral, but its main aim is to improve the quality of life, social adaptation and optimizing of the cognitive functioning. Taking into consideration the psychokinetic retardation occurring in the West Syndrome because of prenatal, perinatal or postnatal disturbances apart from pharmacotherapy an intensive psychokinetic stimulation based on plasticity of the brain should be stressed out. Only the complex, intensive and long lasting rehabilitation of a child may secure to it the best possible development.

Intra-articular treatment of arthritides and activated osteoarthritis with the 5-HT3 receptor antagonist tropisetron. A double-blind study compared with methylprednisolone.

BACKGROUND: Since the good effect of intra-articular injections of the 5-HT3 receptor antagonist tropisetron in patients with arthritides and activated osteoarthritis has already been demonstrated in pilot studies, the effect of tropisetron is compared with that of methylprednisolone here. OBJECTIVES: In a double-blind study, 34 patients with gonarthritides or activated osteoarthritis (18 patients with rheumatoid arthritis, 16 patients with osteoarthritis) were treated with a single intra-articular injection of 10 mg tropisetron (18 patients) or 40 mg methylprednisolone (16 patients). Before treatment as well as one and three weeks later, the intensity of rest pain and pain following exercise was measured with the visual analog scale (VAS) for pain and the clinical findings in the knee joint were recorded. RESULTS: By means of the intra-articular tropisetron treatment, the inflammatory joint process with arthritides and activated arthroses could be influenced in a similar way as with corticosteroid treatment. No significant differences were detected. CONCLUSION: According to the results presented here, the intra-articular treatment with the 5-HT3 receptor antagonist tropisetron in patients with gonarthritides and activated arthroses was about equally effective as those for treatment with corticosteroids. Therefore, it can be used as an alternative in patients for whom concomitant diseases like diabetes and hypertension make it difficult to use corticosteroids. Whether increasing the tropisetron dose may further improve the results remains to be determined in future studies.

Open trial of mirtazapine in patients with fibromyalgia.

BACKGROUND: Some positive therapeutic effects in fibromyalgia syndrome (FS) were reported with both tricyclic and new antidepressant drugs as well as serotonergic agents (5HT2 and 5HT3 receptor blockers). METHODS: In the present study, a novel antidepressant drug mirtazapine, 15-30 mg/day, has been used in 29 patients with FS in an open trial. RESULTS: Twenty-six patients completed the six-week study. Ten (38%) were considered responders on account of the reduction of > or =40% on pain, fatigue and sleep disturbances and remission of depressive symptoms at the end of study. Eighteen patients had at least moderate depression before mirtazapine treatment and 8 patients presented mild depressive symptoms. Reduction on main symptoms of FS after 6 weeks of mirtazapine treatment significantly correlated with the reduction in depression. However, the percentage of responders and patients with > or = 40% reduction on main symptoms of fibromyalgia was similar in high and low depression groups. CONCLUSIONS: The results obtained suggest that mirtazapine may be promising method of FS treatment. Further double-blind placebo-controlled studies are required to confirm these results.