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1.
Biomed Pharmacother ; 143: 112087, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34474339

RESUMEN

Stress during pregnancy is not only detrimental to a woman's own physical and mental health, but can also cause changes in the intrauterine environment and even have an impact on later growth and development, this study was designed to understand the changes of gut microbiota in the maternal and offspring caused by prenatal chronic stress, and to explore the regulatory effect of LBP on gut microbiota, and then to improve the emotional damage caused by prenatal chronic stress in the offspring. A rat model of prenatal chronic stress was made and used LBP to intervene by gavage. Fresh feces of offspring were collected, the concentration of microbial metabolites were tested by ELISA. Illumina MiSeqPE300 sequencing technology was used to determine the sequence of 16S rRNA V3-V4 of microorganisms. On the PND 42, the emotional function of offspring were tested by open-field test (OFT), sucrose preference test (SPT) and tail of suspend test (TST). Results indicated that stress factors increased the plasma corticosterone level of rats during pregnancy and they appeared depressive behaviors. The body weight of offspring during prenatal chronic stress was lower than the control group, and the plasma corticosterone level was increased. Prenatal chronic stress had a significant impact on emotional performance of the offspring on OFT, SPT and TST. Alpha diversity of gut microbiota and microbiota composition in offspring of prenatal chronic stress was attenuated and some relationships existed between these parameters. LBP treatment reduced offspring's plasma corticosterone level and improved their body weight, changed the emotional function, increased the diversity of gut microbiota. Collectively, these findings disclose that prenatal chronic stress not only causes emotional injury on the offspring, but also changes the gut microbiota of the mother and offspring; LBP may regulate the intestinal flora of the mother, then reducing the influence of stress factors on the emotional injury of offspring.


Asunto(s)
Bacterias/efectos de los fármacos , Conducta Animal/efectos de los fármacos , Medicamentos Herbarios Chinos/farmacología , Emociones/efectos de los fármacos , Microbioma Gastrointestinal/efectos de los fármacos , Efectos Tardíos de la Exposición Prenatal , Estrés Psicológico/tratamiento farmacológico , Síntomas Afectivos/etiología , Síntomas Afectivos/microbiología , Síntomas Afectivos/prevención & control , Síntomas Afectivos/psicología , Animales , Bacterias/crecimiento & desarrollo , Eje Cerebro-Intestino/efectos de los fármacos , Enfermedad Crónica , Modelos Animales de Enfermedad , Disbiosis , Femenino , Preferencias Alimentarias/efectos de los fármacos , Masculino , Prueba de Campo Abierto/efectos de los fármacos , Embarazo , Ratas Sprague-Dawley , Estrés Psicológico/complicaciones , Estrés Psicológico/microbiología , Estrés Psicológico/psicología
2.
Mol Neurobiol ; 58(11): 5564-5580, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34365584

RESUMEN

Traumatic brain injury (TBI) causes neuroinflammation and neurodegeneration leading to various pathological complications such as motor and sensory (visual) deficits, cognitive impairment, and depression. N-3 polyunsaturated fatty acid (n-3 PUFA) containing lipids are known to be anti-inflammatory, whereas the sphingolipid, ceramide (Cer), is an inducer of neuroinflammation and degeneration. Using Fat1+-transgenic mice that contain elevated levels of systemic n-3 PUFA, we tested whether they are resistant to mild TBI-mediated sensory-motor and emotional deficits by subjecting Fat1-transgenic mice and their WT littermates to focal cranial air blast (50 psi) or sham blast (0 psi, control). We observed that visual function in WT mice was reduced significantly following TBI but not in Fat1+-blast animals. We also found Fat1+-blast mice were resistant to the decline in motor functions, depression, and fear-producing effects of blast, as well as the reduction in the area of oculomotor nucleus and increase in activated microglia in the optic tract in brain sections seen following blast in WT mice. Lipid and gene expression analyses confirmed an elevated level of the n-3 PUFA eicosapentaenoic acid (EPA) in the plasma and brain, blocking of TBI-mediated increase of Cer in the brain, and decrease in TBI-mediated induction of Cer biosynthetic and inflammatory gene expression in the brain of the Fat1+ mice. Our results demonstrate that suppression of ceramide biosynthesis and inflammatory factors in Fat1+-transgenic mice is associated with significant protection against the visual, motor, and emotional deficits caused by mild TBI. This study suggests that n-3 PUFA (especially, EPA) has a promising therapeutic role in preventing neurodegeneration after TBI.


Asunto(s)
Síntomas Afectivos/prevención & control , Conmoción Encefálica/sangre , Cadherinas/fisiología , Ácidos Grasos Omega-3/sangre , Traumatismos Cerrados de la Cabeza/sangre , Trastornos del Movimiento/prevención & control , Trastornos de la Visión/prevención & control , Síntomas Afectivos/sangre , Síntomas Afectivos/etiología , Animales , Química Encefálica , Conmoción Encefálica/complicaciones , Conmoción Encefálica/psicología , Cadherinas/genética , Ceramidas/biosíntesis , Depresión/sangre , Depresión/etiología , Depresión/prevención & control , Resistencia a la Enfermedad , Ácidos Grasos Omega-3/fisiología , Miedo , Femenino , Traumatismos Cerrados de la Cabeza/complicaciones , Traumatismos Cerrados de la Cabeza/psicología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Trastornos del Movimiento/sangre , Trastornos del Movimiento/etiología , Enfermedades Neuroinflamatorias , Prueba de Campo Abierto , Estrés Oxidativo , Proteínas Recombinantes/metabolismo , Esfingolípidos/análisis , Esfingomielina Fosfodiesterasa/análisis , Trastornos de la Visión/sangre , Trastornos de la Visión/etiología
3.
Medicine (Baltimore) ; 100(23): e26306, 2021 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-34115040

RESUMEN

BACKGROUND: Infertility causes emotional and psychological problems, including anxiety, depression, low self-efficacy, and chronic mental stress in women. These emotional problems can negatively affect fertility treatment. Numerous studies have reported the clinical therapeutic effects of acupuncture on emotional problems; however, the efficacy and safety of acupuncture treatment for emotional problems in infertile women remain unclear. This protocol aims to evaluate the efficacy and safety of acupuncture for treating emotional problems in infertile women. METHODS: We will search the following databases from their inception to April 30, 2021: MEDLINE, EMBASE, Cochrane Library, Korean Medical Databases (KoreaMed, Korean studies Information Service System, Korean Traditional Knowledge Portal, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, and National Digital Science Library), and Chinese databases (CNKI and Wan Fang Database). We will include randomized controlled trials on acupuncture for emotional problems in infertile women. There will be no restrictions regarding language or publication date. The primary outcome will be assessed using an emotion-related assessment scale. The risk of bias of the included studies will be measured using the Cochrane risk of bias assessment tool. For meta-analysis, RevMan Version 5.4 software will be used to combine the relative risks for dichotomous outcomes, as well as the mean differences or standardized mean differences for continuous outcomes, with both having 95% confidence intervals. RESULTS: Based on current evidence, this study will assess the effectiveness and safety of acupuncture for emotional problems in infertile women. CONCLUSION: This study will provide evidence for evaluating the acupuncture efficacy for infertile women with emotional problems. REGISTRATION NUMBER: INPLASY202150082.


Asunto(s)
Terapia por Acupuntura/métodos , Síntomas Afectivos , Infertilidad Femenina/psicología , Síntomas Afectivos/etiología , Síntomas Afectivos/terapia , Femenino , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
4.
J Clin Psychiatry ; 82(3)2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-34004088

RESUMEN

OBJECTIVE: Several promising studies investigated marine omega-3 fatty acids (ie, fish oil) in borderline personality disorder (BPD), but overall effects remain unclear. The aim of this study was to obtain estimates of effectiveness of omega-3 fatty acids in BPD using meta-analysis, with a priori differentiation of affective, impulsive, and cognitive-perceptual symptom domains. DATA SOURCES: We performed a literature search in PubMed, EMBASE, PsycINFO, and MEDLINE, using terms related to BPD and omega-3 fatty acids. Publication date was not a restriction. STUDY SELECTION: We included randomized controlled trials (RCTs) that compared omega-3 fatty acids to placebo or any active comparator and pooled data using meta-analysis. Five studies were included in the meta-analysis, describing 4 RCTs testing effects of omega-3 fatty acids in 137 patients with BPD or BPD-related behavior. DATA EXTRACTION: Using a pre-piloted data extraction form, we obtained data including intervention dose, duration, and BPD symptom scale scores, differentiating affective, impulsive, and cognitive-perceptual symptom domains. RESULTS: Random effects meta-analysis showed an overall significant decreasing effect of omega-3 fatty acids on overall BPD symptom severity (0.54 standardized difference in means [SDM]; 95% CI = 0.91 to 0.17; Z = 2.87; P = .0041), without heterogeneity (I2 = 0.00; Q = 2.63; P = .45). A priori differentiation of relevant symptom domains showed significant effects on affect dysregulation (0.74 SDM; 95% CI = 1.21 to 0.27; Z = 3.11; P = .002) and impulsive behavior (0.45 SDM; 95% CI = 0.84 to 0.059; Z = 2.26; P = .024). However, effects on cognitive-perceptual symptoms did not reach the significance threshold. CONCLUSIONS: Available data indicate that marine omega-3 fatty acids improve symptoms of BPD, particularly impulsive behavioral dyscontrol and affective dysregulation. Marine omega-3 fatty acids could be considered as add-on therapy.


Asunto(s)
Síntomas Afectivos/dietoterapia , Trastorno de Personalidad Limítrofe/dietoterapia , Suplementos Dietéticos , Regulación Emocional , Ácidos Grasos Omega-3/farmacología , Conducta Impulsiva , Evaluación de Resultado en la Atención de Salud , Síntomas Afectivos/etiología , Trastorno de Personalidad Limítrofe/complicaciones , Ácidos Grasos Omega-3/administración & dosificación , Humanos
5.
Climacteric ; 24(3): 246-252, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33016149

RESUMEN

OBJECTIVE: This study aimed to investigate the safety and efficacy of Xiangshao granules for treating emotional disorders in perimenopausal and postmenopausal women. METHODS: The current investigation was a double-blind, randomized, placebo-controlled, multicenter trial that included 300 perimenopausal and postmenopausal Chinese women aged 40-60 years. Participants received either a placebo (n = 150) or Xiangshao granules (n = 150) for 8 weeks. Outcome measures included Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores, which were assessed at baseline, 4 weeks, and 8 weeks. The primary efficacy variables were changes in HAMD and HAMA scores after 8 weeks. RESULTS: After 8 weeks, the mean HAMD scores decreased from 15.0 to 7.9 in the Xiangshao group and from 16.3 to 10.0 in the placebo group, and the respective mean reductions in HAMA scores were from 16.0 to 8.5 and from 17.1 to 10.9. Clinical improvements in symptoms of both depression and anxiety after 8 weeks differed significantly in the two groups (p < 0.05). The cure rate was significantly higher in the Xiangshao group. There were no significant differences in the rates of adverse events in the two groups. CONCLUSIONS: Xiangshao granules can relieve symptoms of depression and anxiety significantly and safely.


Asunto(s)
Síntomas Afectivos/tratamiento farmacológico , Ansiedad/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Menopausia/psicología , Adulto , Síntomas Afectivos/etiología , Ansiedad/etiología , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento
6.
NeuroRehabilitation ; 46(3): 433-435, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32333559

RESUMEN

BACKGROUND: Emotionalism, i.e. uncontrolled episodes of crying (or less commonly laughing) post stroke that are not triggered by situations that would have previously provoked such behavior occur in stroke survivors, may persist in some, and can be socially embarrassing. OBJECTIVE: To evaluate whether pharmacological interventions are beneficial, acceptable, and safe in the treatment of emotionalism post stroke. METHODS: A Cochrane review by Allida et al. was summarized with comments. RESULTS: From a total of 7 eligible trials with a total of 239 participants included in the review, five with 213 participants could be used for data extraction. Very low to moderate quality evidence pointed to some beneficial effects of antidepressants in the treatment of emotionalism after stroke. CONCLUSIONS: The available data suggest that antidepressants may reduce the frequency and severity of crying or laughing episodes in stroke survivors with emotionalism.


Asunto(s)
Síntomas Afectivos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/complicaciones , Síntomas Afectivos/tratamiento farmacológico , Síntomas Afectivos/etiología , Antidepresivos/uso terapéutico , Llanto , Humanos , Risa
7.
Mult Scler Relat Disord ; 41: 102039, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32172214

RESUMEN

OBJECTIVES: Alexithymia is a multicomponent personality construct that could occur in up to 53% of patients with multiple sclerosis (MS), with recent works proposing higher rates of alexithymia in progressive MS. Among the available models of alexithymia, some propose a deficient interhemispheric communication and an aberrant GABAergic transmission at its origin. However, no single study has addressed the underlying physiological mechanisms of alexithymia in MS. The aim of this work was to assess the relationship between GABAergic neurotransmission and alexithymia in progressive MS by means of transcranial magnetic stimulation (TMS). METHODS: Twelve patients with high alexithymia and fifteen patients with low alexithymia were included based on Toronto Alexithymia Scale (TAS). Sociodemographic, clinical and neuropsychological data were recorded. The following corticospinal excitability measures were obtained: resting motor threshold, cortical silent period (CSP which reflects cortical GABAergic function), and interhemispheric inhibition (i.e., GABAergic function mediated by interhemispheric fibers). RESULTS: No significant group differences were observed regarding sociodemographic, clinical or neuropsychological variables. Patients with high alexithymia scores exhibited shorter CSP than those with low alexithymia scores (81.87 ± 45.72 ms vs. 145.27 ± 77.26 ms, respectively, p < 0.05). A significant inverse correlation was also found between TAS scores and CSP duration (r = -0.59, p < 0.05). CONCLUSION: This study offers insights into the neurophysiological mechanisms of alexithymia in MS. Reduced GABAergic transmission, as reflected by short CSP, seems to be associated with alexithymia in this population. Future studies would benefit from a more comprehensive evaluation of cortical and interhemispheric mechanisms in MS patients with alexithymia.


Asunto(s)
Síntomas Afectivos/fisiopatología , Potenciales Evocados Motores/fisiología , Corteza Motora/fisiopatología , Esclerosis Múltiple Crónica Progresiva/fisiopatología , Inhibición Neural/fisiología , Médula Espinal/fisiopatología , Transmisión Sináptica/fisiología , Adulto , Síntomas Afectivos/etiología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Crónica Progresiva/complicaciones , Estimulación Magnética Transcraneal , Ácido gamma-Aminobutírico/metabolismo
9.
J Vestib Res ; 29(4): 205-219, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31282447

RESUMEN

BACKGROUND: Dizziness and imbalance are common after mild traumatic brain injury (mTBI). Hyperbaric oxygen (HBO2) has been proposed for persistent post-concussive symptoms after mTBI, but its effect on vestibular function is unknown. OBJECTIVE: To describe balance function in military service-members before and after intervention, and to explore the influence of post-traumatic stress disorder (PTSD), anxiety, and depression on vestibular outcomes. METHODS: Seventy-one participants with mTBI and seventy-five healthy adults without brain injury were enrolled (NCT01611194 and NCT01925963). mTBI participants were randomized to 40 HBO2 sessions or 40 sham chamber sessions over 12 weeks. Normative controls received no intervention. Balance and neuropsychological function were measured at baseline, 13 weeks, and 6 months. RESULTS: The mTBI cohort performed worse than healthy controls on balance and gait measures and reported more affective symptoms. Some within-group improvements were noted at 13 weeks and 6 months. Significant between-intervention differences on balance measures were minimal but effects on postural control generally favored HBO2. Those with affective symptoms, particularly PTSD, had the most improvement in postural control and otolith function following 13 weeks of HBO2. CONCLUSION: HBO2 may influence balance function after mTBI, particularly in those with affective symptoms.


Asunto(s)
Síntomas Afectivos/etiología , Oxigenoterapia Hiperbárica/estadística & datos numéricos , Síndrome Posconmocional/terapia , Equilibrio Postural/fisiología , Adulto , Ansiedad/complicaciones , Estudios de Casos y Controles , Depresión/complicaciones , Femenino , Humanos , Estudios Longitudinales , Masculino , Personal Militar , Síndrome Posconmocional/complicaciones , Trastornos por Estrés Postraumático/complicaciones
11.
J Neuroinflammation ; 15(1): 299, 2018 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-30373627

RESUMEN

BACKGROUND: Although studies have reported an increased risk for mood disorders in Hashimoto's thyroiditis (HT) patients even in the euthyroid state, the mechanisms involved remain unclear. Neuroinflammation may play a key role in the etiology of mood disorders in humans and behavioral disturbances in rodents. Therefore, this study established a euthyroid HT model in mice and investigated whether HT itself was capable of triggering neuroinflammation accompanied by emotional alterations. METHODS: Experimental HT was induced by immunizing NOD mice with thyroglobulin and adjuvant twice. Four weeks after the last challenge, mice were tested for anxiety-like behavior in the open field and elevated plus maze tests and depression-like behavior in the forced swimming and tail suspension tests. Then, animals were sacrificed for thyroid-related parameter measure as well as detection of cellular and molecular events associated with neuroinflammation. The changes in components of central serotonin signaling were also investigated. RESULTS: HT mice showed intrathyroidal monocyte infiltration and rising serum thyroid autoantibody levels accompanied by normal thyroid function, which defines euthyroid HT in humans. These mice displayed more anxiety- and depressive-like behaviors than controls. HT mice further showed microglia and astrocyte activation in the frontal cortex detected by immunohistochemistry, real-time RT-PCR, and transmission electron microscopy (TEM). These observations were also accompanied by enhanced gene expression of proinflammatory cytokines IL-1ß and TNF-α in the frontal cortex. Despite this inflammatory response, no signs of neuronal apoptosis were visible by the TUNEL staining and TEM in the frontal cortex of HT mice. Additionally, IDO1 and SERT, key serotonin-system-related genes activated by proinflammatory cytokines, were upregulated in HT mice, accompanied by reduced frontal cortex serotonin levels. CONCLUSIONS: Our results are the first to suggest that HT induces neuroinflammation and alters related serotonin signaling in the euthyroid state, which may underlie the deleterious effects of HT itself on emotional function.


Asunto(s)
Síntomas Afectivos/etiología , Encefalitis/etiología , Enfermedad de Hashimoto/complicaciones , Animales , Encéfalo/patología , Encéfalo/ultraestructura , Proteínas de Unión al Calcio/metabolismo , Citocinas/genética , Citocinas/metabolismo , Modelos Animales de Enfermedad , Encefalitis/patología , Conducta Exploratoria/efectos de los fármacos , Conducta Exploratoria/fisiología , Femenino , Adyuvante de Freund/toxicidad , Proteína Ácida Fibrilar de la Glía/metabolismo , Enfermedad de Hashimoto/etiología , Enfermedad de Hashimoto/patología , Suspensión Trasera , Etiquetado Corte-Fin in Situ , Aprendizaje por Laberinto/efectos de los fármacos , Ratones , Ratones Endogámicos NOD , Proteínas de Microfilamentos/metabolismo , Microscopía Electrónica de Transmisión , Neuroglía/patología , Neuroglía/ultraestructura , Neuronas/patología , Neuronas/ultraestructura , Natación/psicología
12.
JBI Database System Rev Implement Rep ; 16(9): 1739-1757, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30204664

RESUMEN

REVIEW OBJECTIVE/QUESTION: The objective of this systematic review is to synthesize current evidence on the effectiveness of pharmacotherapy as compared to all comparators for the management of pseudobulbar affect in adults 16 years and over who have sustained a traumatic brain injury. The specific review question is: What is the effectiveness of pharmacotherapy for the management of pseudobulbar affect in adults 16 years and over who have sustained a traumatic brain injury?


Asunto(s)
Síntomas Afectivos/tratamiento farmacológico , Lesiones Traumáticas del Encéfalo/psicología , Llanto , Risa , Trastornos Mentales/tratamiento farmacológico , Neurotransmisores/uso terapéutico , Afecto , Síntomas Afectivos/etiología , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/tratamiento farmacológico , Humanos , Trastornos Mentales/etiología , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
13.
Parkinsonism Relat Disord ; 50: 42-47, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29449185

RESUMEN

OBJECTIVE: Coffee consumption has an inverse association with the risk of Parkinson's disease (PD). The aim of this study was to investigate the association between coffee consumption and non-motor symptoms (NMSs) in patients with PD. METHODS: In this cross-sectional study, we included 196 early-stage, treatment-naïve PD patients. Coffee consumption history was obtained via semi-structured interviews. NMSs were assessed using the Non-Motor Symptom assessment scale (NMSS). RESULTS: Of the 196 patients with PD, 136 (69.3%) were categorized as coffee drinkers and 60 (30.6%) were non-drinkers. Coffee drinkers were younger, predominantly male, were younger in age at symptom onset, had lower Unified Parkinson's Disease Rating Scale motor and Beck Depression Inventory scores, and higher Mini-Mental State Examination scores than non-coffee drinkers. After adjustment, coffee drinking was significantly inversely associated with the prevalence of lack of motivation, anhedonia, and lack of pleasure, which were less frequent in coffee drinkers. Total NMSS scores were lower in coffee drinkers than in non-drinkers (p = 0.047). In particular, coffee drinking was significantly associated with a reduced severity of the mood/cognition domain of NMSS (p = 0.003). After correcting for multiple testing, there were no significant differences in the prevalence of NMSs, but there were significant differences in the severity of NMSs between coffee drinkers and non-drinkers. CONCLUSION: There is a negative association between coffee consumption and the severity of the mood/cognition domain of NMSS in patients with PD. Clinicians should consider the history of coffee consumption in the assessment of NMSs in PD.


Asunto(s)
Síntomas Afectivos/fisiopatología , Anhedonia/fisiología , Apatía/fisiología , Café , Disfunción Cognitiva/fisiopatología , Enfermedad de Parkinson/fisiopatología , Índice de Severidad de la Enfermedad , Síntomas Afectivos/etiología , Factores de Edad , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/etiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Factores Sexuales
14.
Br J Dermatol ; 176(5): 1195-1203, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27995617

RESUMEN

BACKGROUND: Single-centre studies show that alexithymia, defined as difficulty in recognizing and describing emotions, is more prevalent among patients with psoriasis than in the general population. However, its prevalence and the consequences of the association between alexithymia and psoriasis are unclear. OBJECTIVES: The primary objective of this study was to determine the prevalence of alexithymia, as defined by a score ≥ 61 in the 20-item Toronto Alexithymia Scale, in a large sample of patients who had plaque psoriasis for ≤ 10 years and were eligible for phototherapy or systemic treatment. The secondary objectives were to investigate the relationship between alexithymia and the clinical and psychological aspects of psoriasis. METHODS: Data were collected in the framework of an observational, multicentre, international study, the EPidemiological Study In Patients With Recently DiagnosEd PSOriasis (EPIDEPSO), aiming at investigating the prevalence of alexithymia and other psychosocial comorbidities in patients with psoriasis of ≤ 10 years' disease duration. RESULTS: The prevalence of alexithymia within a cohort of 670 patients was 24·8% (95% confidence interval 21·7-28·2). Patients with alexithymia had a higher burden of psoriasis, including significant impairment of quality of life, higher levels of anxiety and depression, a higher risk of alcohol dependency and impairment of work productivity, compared with patients without alexithymia. CONCLUSIONS: It is important to identify alexithymic patients with psoriasis in clinical practice as they experience a higher disease burden and have a lower ability to express their feelings.


Asunto(s)
Síntomas Afectivos/etiología , Costo de Enfermedad , Psoriasis/psicología , Adulto , Síntomas Afectivos/epidemiología , Estudios de Casos y Controles , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Psoriasis/epidemiología , Escalas de Valoración Psiquiátrica , Calidad de Vida , Factores de Riesgo , Índice de Severidad de la Enfermedad , Sudáfrica/epidemiología
15.
Pediatr Neonatol ; 58(2): 171-177, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-27502424

RESUMEN

BACKGROUND: Carbon monoxide (CO) poisoning is one of the common causes of poisoning in patients and can result in significant morbidity and mortality. However, few studies have focused on the pediatric group. METHODS: We retrospectively reviewed children (age < 18 years) with CO poisoning from nonfire accidents at a tertiary medical center in Taiwan from 2002 to 2010. We analyzed the patients' characteristics, management, and outcome; compared the data of patients who received hyperbaric oxygen (HBO) to those who received normobaric oxygen (NBO) therapy; and identified the ri0sk factors for patients who developed delayed neurological sequelae (DNS) or permanent neurological sequelae (PNS). RESULTS: A total of 81 children were enrolled. The annual case number increased from five cases in 2002 to 20 in 2010, particularly during the cold months (December to February). The most common source of exposure was an indoor heating system (54.3%). The most common presenting symptoms were vomiting (32.1%) and consciousness changes (30.9%). HBO treatment tended to be administered to patients with a higher initial COHb (%) (p < 0.001), an initial Glasgow coma scale change (p < 0.001), and admission to the hospital (p = 0.002). After multivariate analysis, treatment in the intensive care unit because of prolonged loss of consciousness (p = 0.002) was the only independent risk factor for patients with DNS; only rescue by a ventilator (p < 0.001) was an independent risk factor for patients with PNS. In comparison to the NBO therapy, HBO treatment did not show benefit or harm to patients according to the incidence of inducing DNS or PNS after multivariate analysis. CONCLUSION: For those with treatment in the intensive care unit because of prolonged loss of consciousness and rescue by a ventilator, special attention should be given and follow-up should be performed to determine whether DNS or PNS occurs, particularly epilepsy and cognitive deficits.


Asunto(s)
Intoxicación por Monóxido de Carbono/complicaciones , Intoxicación por Monóxido de Carbono/terapia , Síntomas Afectivos/etiología , Niño , Preescolar , Trastornos del Conocimiento/etiología , Epilepsia/etiología , Femenino , Humanos , Oxigenoterapia Hiperbárica , Lactante , Masculino , Trastornos del Movimiento/etiología , Trastornos del Neurodesarrollo/etiología , Terapia por Inhalación de Oxígeno , Estudios Retrospectivos , Factores de Riesgo , Taiwán
16.
J Clin Psychiatry ; 77(9): e1155, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27780330

RESUMEN

Pseudobulbar affect (PBA) is a socially debilitating condition that primarily affects people with neurologic diseases, such as Alzheimer's disease or multiple sclerosis. This condition is characterized by uncontrolled, exaggerated expressions of laughing or crying-often when the situation does not warrant this behavior. Although the true prevalence of PBA is surprisingly high, this condition remains widely misdiagnosed and underdiagnosed. While its exact etiology is unknown, PBA likely results from disruptions in the brain structures and/or neurotransmitters that regulate emotions. Differential diagnosis of PBA includes ruling out depression or other psychiatric conditions. Treatment of PBA has traditionally centered on antidepressant therapies, but newer therapeutic options include combination agents employing multiple modalities. Therapy should include patient counseling to reassure patients and families that PBA is not the fault of the individual. Counseling should also emphasize safety precautions to minimize adverse events and maximize appropriate adherence to the selected therapies.


Asunto(s)
Síntomas Afectivos/fisiopatología , Llanto/fisiología , Dextrometorfano/uso terapéutico , Risa/fisiología , Esclerosis Múltiple/fisiopatología , Neurotransmisores/uso terapéutico , Quinidina/uso terapéutico , Síntomas Afectivos/tratamiento farmacológico , Síntomas Afectivos/etiología , Combinación de Medicamentos , Femenino , Humanos , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones
17.
Pain ; 156 Suppl 1: S42-S49, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25789436

RESUMEN

Much evidence from pain patients and animal models shows that chronic pain does not exist in a vacuum but has varied comorbidities and far-reaching consequences. Patients with long-term pain often develop anxiety and depression and can manifest changes in cognitive functioning, particularly with working memory. Longitudinal studies in rodent models also show the development of anxiety-like behavior and cognitive changes weeks to months after an injury causing long-term pain. Brain imaging studies in pain patients and rodent models find that chronic pain is associated with anatomical and functional alterations in the brain. Nevertheless, studies in humans reveal that lifestyle choices, such as the practice of meditation or yoga, can reduce pain perception and have the opposite effect on the brain as does chronic pain. In rodent models, studies show that physical activity and a socially enriched environment reduce pain behavior and normalize brain function. Together, these studies suggest that the burden of chronic pain can be reduced by nonpharmacological interventions.


Asunto(s)
Síntomas Afectivos/etiología , Dolor Crónico/complicaciones , Dolor Crónico/psicología , Ambiente , Animales , Encéfalo/fisiopatología , Dolor Crónico/patología , Dolor Crónico/rehabilitación , Modelos Animales de Enfermedad , Humanos , Estudios Longitudinales , Terapias Mente-Cuerpo
18.
Psychiatry Res ; 220(1-2): 51-7, 2014 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-25066964

RESUMEN

Two alternative models of impaired cognitive and affective processing that may underlie reduced social quality of life (SQoL) of persons with schizophrenia, were examined. According to the parallel process model, impaired cognitive empathy and affective empathy make relatively independent contributions to the symptoms of schizophrenia and to the consequent reduction in SQoL. According to the integrative mediation model, the symptoms of schizophrenia and the reduction in SQoL associated with these symptoms are the products of a process by which impairments of cognitive empathy are contingent on impairments of affective empathy. 90 persons with schizophrenia were assessed for SQoL, symptoms and cognitive and affective empathy. Results support the integrative mediation model only for cognitive empathy and negative psychiatric symptoms. Only the negative links between cognitive empathy and negative symptoms served to mediate the positive relation between affective empathy and SQoL. Positive symptoms had a limited negative impact on SQoL and did not play a role in the paths that linked affective empathy to SQoL. Age had a statistically significant and negative indirect relationship to SQoL. Results are consistent with recent approach that distinguish between cognitive and affective empathy and specify how these two processes are integrated.


Asunto(s)
Síntomas Afectivos/fisiopatología , Trastornos del Conocimiento/fisiopatología , Empatía/fisiología , Modelos Psicológicos , Esquizofrenia/fisiopatología , Psicología del Esquizofrénico , Adulto , Síntomas Afectivos/etiología , Anciano , Trastornos del Conocimiento/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Esquizofrenia/complicaciones , Adulto Joven
19.
Curr Med Res Opin ; 30(11): 2255-65, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25062507

RESUMEN

BACKGROUND: Pseudobulbar affect (PBA) is associated with neurological disorders or injury affecting the brain, and characterized by frequent, uncontrollable episodes of crying and/or laughing that are exaggerated or unrelated to the patient's emotional state. Clinical trials establishing dextromethorphan and quinidine (DM/Q) as PBA treatment were conducted in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). This trial evaluated DM/Q safety in patients with PBA secondary to any neurological condition affecting the brain. OBJECTIVE: To evaluate the safety and tolerability of DM/Q during long-term administration to patients with PBA associated with multiple neurological conditions. METHODS: Fifty-two-week open-label study of DM/Q 30/30 mg twice daily. Safety measures included adverse events (AEs), laboratory tests, electrocardiograms (ECGs), vital signs, and physical examinations. CLINICAL TRIAL REGISTRATION: #NCT00056524. RESULTS: A total of 553 PBA patients with >30 different neurological conditions enrolled; 296 (53.5%) completed. The most frequently reported treatment-related AEs (TRAEs) were nausea (11.8%), dizziness (10.5%), headache (9.9%), somnolence (7.2%), fatigue (7.1%), diarrhea (6.5%), and dry mouth (5.1%). TRAEs were mostly mild/moderate, generally transient, and consistent with previous controlled trials. Serious AEs (SAEs) were reported in 126 patients (22.8%), including 47 deaths, mostly due to ALS progression and respiratory failure. No SAEs were deemed related to DM/Q treatment by investigators. ECG results suggested no clinically meaningful effect of DM/Q on myocardial repolarization. Differences in AEs across neurological disease groups appeared consistent with the known morbidity of the primary neurological conditions. Study interpretation is limited by the small size of some disease groups, the lack of a specific efficacy measure and the use of a DM/Q dose higher than the eventually approved dose. CONCLUSIONS: DM/Q was generally well tolerated over this 52 week trial in patients with PBA associated with a wide range of neurological conditions.


Asunto(s)
Síntomas Afectivos/tratamiento farmacológico , Inhibidores del Citocromo P-450 CYP2D6/uso terapéutico , Dextrometorfano/uso terapéutico , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Parálisis Seudobulbar/tratamiento farmacológico , Parálisis Seudobulbar/psicología , Quinidina/uso terapéutico , Adolescente , Adulto , Síntomas Afectivos/etiología , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Llanto , Combinación de Medicamentos , Femenino , Humanos , Risa , Masculino , Persona de Mediana Edad , Parálisis Seudobulbar/etiología , Resultado del Tratamiento , Adulto Joven
20.
Artículo en Ruso | MEDLINE | ID: mdl-24665594

RESUMEN

We have developed the method for the treatment of the patients presenting with arterial hypertension and concomitant chronic psychoemothional overtension. The method consists of the application of the baths containing the Siberian Stag velvet antler extracts in combination with exercise therapy and massage. A total of 35 patients with arterial hypertension and concomitant chronic psychoemothional overtension were enrolled in the study. It was shown that inclusion of the baths containing the Siberian Stag velvet antler extracts in the combined treatment of arterial hypertension and concomitant chronic psychoemothional overtension has positive effect on the parameters of the main homeostatic systems, enhances the working capacity of the patients, promotes their psychological stability, and increases the adaptive potential of the organism.


Asunto(s)
Síntomas Afectivos/rehabilitación , Cuernos de Venado/química , Baños , Mezclas Complejas/administración & dosificación , Hipertensión/rehabilitación , Reno , Adulto , Síntomas Afectivos/etiología , Síntomas Afectivos/fisiopatología , Síntomas Afectivos/psicología , Animales , Enfermedad Crónica , Mezclas Complejas/química , Ejercicio Físico , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Masaje , Persona de Mediana Edad
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