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1.
Eur J Neurol ; 30(10): 3142-3148, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37392418

RESUMEN

BACKGROUND AND PURPOSE: COVID-19 is associated with multiple neurological manifestations. The clinical presentation, trajectory, and treatment response for three cases of myoclonus during COVID-19 infection, with no previous neurological disease, are decsribed. METODS: Analysis of cerebrospinal fluid from the cases using indirect immunohistochemistry. RESULTS: Antibodies against rodent brain tissue, and similarities in staining patterns were observed, indicating the presence of antineuronal immunoglobulin G autoantibodies targeting astrocytes in the hippocampus. CONCLUSION: Our results demontrate cerebrospinal fluid antineuronal antibodies indicating an an autoimmune involvment in the pathogenesis in COVID-19 associated myoclonus.


Asunto(s)
COVID-19 , Mioclonía , Enfermedades del Sistema Nervioso , Humanos , Autoanticuerpos , Mioclonía/etiología , COVID-19/complicaciones , Encéfalo
2.
Nord J Psychiatry ; 77(3): 312-318, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35968653

RESUMEN

OBJECTIVE: Physiological parameters that predict electroconvulsive therapy (ECT) effectiveness may reflect propagation of the induced epileptic seizure. As an indication of seizure propagation to the diencephalon, we here examined the correlation between prolactin increase after ECT and clinical seizure evaluation parameters, focusing on peak heart rate. As a proxy for peripheral endocrine stress response, we examined the correlation to postictal cortisol increase. METHODS: Participants were consecutively recruited from clinical ECT patients (n = 131, age 18-85 years). The first ECT session in a series was examined. For each participant, blood serum concentrations of prolactin and cortisol were measured immediately before and within 30 min after the seizure. Physiological parameters were extracted from clinical records: peak heart rate (HR) during seizure, electroencephalography (EEG) seizure duration, and motor seizure duration. Correlations were calculated using non-parametric tests. RESULTS: Serum prolactin increased after ECT and correlated with peak HR, EEG seizure duration, and motor seizure duration. Peak HR during seizure also correlated positively with both EEG seizure duration and motor seizure duration. Correlations were unaffected by age, sex, baseline prolactin levels, antipsychotics, or beta-blocking agents. Serum cortisol increased after ECT but did not correlate with the seizure evaluation parameters, nor with prolactin concentrations. CONCLUSIONS: Our findings of a positive correlation between peak HR and prolactin that was independent from the peripheral endocrine stress response might be in line with the idea that tachycardia during ECT seizures reflects seizure propagation to the diencephalon. This supports the practice of monitoring cardiovascular response for ECT seizure evaluation.


Asunto(s)
Terapia Electroconvulsiva , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Prolactina , Hidrocortisona , Convulsiones/terapia , Electroencefalografía
3.
J Infect Dis ; 225(6): 965-970, 2022 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33744954

RESUMEN

Antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serum and cerebrospinal fluid (CSF) samples from 16 patients with coronavirus disease 2019 and neurological symptoms were assessed using 2 independent methods. Immunoglobulin G (IgG) specific for the virus spike protein was found in 81% of patients in serum and in 56% in CSF. SARS-CoV-2 IgG in CSF was observed in 2 patients with negative serological findings. Levels of IgG in both serum and CSF were associated with disease severity (P < .05). All patients with elevated markers of central nervous system damage in CSF also had CSF antibodies (P = .002), and CSF antibodies had the highest predictive value for neuronal damage markers of all tested clinical variables.


Asunto(s)
Anticuerpos Antivirales/sangre , COVID-19/diagnóstico , Inmunoglobulina G/sangre , Enfermedades del Sistema Nervioso/sangre , Enfermedades del Sistema Nervioso/líquido cefalorraquídeo , SARS-CoV-2/aislamiento & purificación , Anciano , Anticuerpos Neutralizantes/sangre , Formación de Anticuerpos , Biomarcadores/sangre , Biomarcadores/líquido cefalorraquídeo , COVID-19/sangre , COVID-19/líquido cefalorraquídeo , COVID-19/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades del Sistema Nervioso/etiología , SARS-CoV-2/genética , SARS-CoV-2/inmunología , Glicoproteína de la Espiga del Coronavirus
4.
J Neurosci Res ; 99(1): 407-418, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32729199

RESUMEN

Lithium is widely used to treat bipolar disorder. However, the efficacy and vulnerability as to its side effects are known to differ. Although the specific biochemical mechanism of action is still elusive, lithium may influence mitochondrial function, and consequently, metabolism. Lithium exposure in this study was conducted on a unique set of mito-nuclear introgression lines of Drosophila subobscura to disentangle the independent effects of mitochondrial DNA (mtDNA) against a common nuclear DNA background. The study addressed three issues: (a) whether lithium has a dose-dependent effect on whole-organism metabolic rate, (b) whether mtDNA haplotypes show divergent metabolic efficiency measured by metabolic rate to lithium exposure and (c) whether lithium influences the whole-organism metabolic rate across sexes. The results confirm that lithium influenced the whole-organism metabolic rate, showing a subtle balance between efficacy and adverse effects within a narrow dose range. In addition, lithium exposure was found to influence metabolism differently based on mtDNA haplotypes and sex. This preliminary research may have a range of biological implications for the role of mitochondrial variability in psychiatric disease and treatment by contributing to the understanding and predicting of the lithium treatment response and risk for toxic side effects.


Asunto(s)
Metabolismo Energético/efectos de los fármacos , Compuestos de Litio/toxicidad , Mitocondrias/efectos de los fármacos , Sulfatos/toxicidad , Animales , Drosophila , Femenino , Masculino
5.
Psychosom Med ; 83(7): 693-699, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34267089

RESUMEN

OBJECTIVE: Short-chain fatty acids (SCFAs) are produced by the gut microbiota and may reflect health. Gut symptoms are common in individuals with depressive disorders, and recent data indicate relationships between gut microbiota and psychiatric health. We aimed to investigate potential associations between SCFAs and self-reported depressive and gut symptoms in young adults. METHODS: Fecal samples from 164 individuals (125 were patients with psychiatric disorders: mean [standard deviation] age = 21.9 [2.6] years, 14% men; 39 nonpsychiatric controls: age = 28.5 [9.5] years, 38% men) were analyzed for the SCFA acetate, butyrate, and propionate by nuclear magnetic resonance spectroscopy. We then compared SCFA ratios with dimensional measures of self-reported depressive and gut symptoms. RESULTS: Depressive symptoms showed a positive association with acetate levels (ρ = 0.235, p = .003) and negative associations with both butyrate (ρ = -0.195, p = .014) and propionate levels (ρ = -0.201, p = .009) in relation to total SCFA levels. Furthermore, symptoms of diarrhea showed positive associations with acetate (ρ = 0.217, p = .010) and negative associations with propionate in relation to total SCFA levels (ρ = 0.229, p = 0-007). Cluster analysis revealed a heterogeneous pattern where shifts in SCFA ratios were observed in individuals with elevated levels of depressive symptoms, elevated levels of gut symptoms, or both. CONCLUSIONS: Shifts in SCFAs are associated with both depressive symptoms and gut symptoms in young adults and may have of relevance for treatment.


Asunto(s)
Depresión , Microbioma Gastrointestinal , Adulto , Ácidos Grasos Volátiles , Heces , Femenino , Humanos , Masculino , Adulto Joven
6.
Eur J Neurol ; 28(10): 3324-3331, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33369818

RESUMEN

BACKGROUND AND PURPOSE: Neurological symptoms have been frequently reported in hospitalized patients with coronavirus disease 2019 (COVID-19), and biomarkers of central nervous system (CNS) injury are reported to be increased in plasma but not extensively studied in cerebrospinal fluid (CSF). This study examined CSF for biomarkers of CNS injury and other pathology in relation to neurological symptoms and disease severity in patients with neurological manifestations of COVID-19. METHODS: Nineteen patients with neurological symptoms and mild to critical COVID-19 were prospectively included. Extensive analysis of CSF, including measurement of biomarkers of CNS injury (neurofilament light chain [NfL] protein, glial fibrillary acidic protein [GFAp], and total tau), was performed and compared to neurological features and disease severity. RESULTS: Neurological symptoms included altered mental status (42%), headache (42%), and central (21%) and peripheral weakness (32%). Two patients demonstrated minor pleocytosis, and four patients had increased immunoglobulin G levels in CSF. Neuronal autoantibody testing using commercial tests was negative in all patients. Increased CSF levels of NfL protein, total tau, and GFAp were seen in 63%, 37%, and 16% of patients, respectively. Increased NfL protein correlated with disease severity, time in intensive care, and level of consciousness. NfL protein in CSF was higher in patients with central neurological symptoms. CONCLUSIONS: Although limited by the small sample size, our data suggest that levels of NfL protein, GFAp, and total tau in CSF are commonly elevated in patients with COVID-19 with neurological symptoms. This is in contrast to the standard CSF workup where pathological findings are scarce. NfL protein, in particular, is associated with central neurological symptoms and disease severity.


Asunto(s)
COVID-19 , Proteínas de Neurofilamentos , Biomarcadores , Sistema Nervioso Central , Proteína Ácida Fibrilar de la Glía , Humanos , SARS-CoV-2 , Índice de Severidad de la Enfermedad
7.
Acta Neurol Scand ; 143(6): 602-607, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33626181

RESUMEN

OBJECTIVE: To identify serum proteins associated with MS and affected by interferon beta treatment. METHODS: Plasma samples from 29 untreated relapsing-remitting MS patients and 15 healthy controls were investigated with a multiplexed panel containing 92 proteins related to inflammation. Follow-up samples were available from 13 patients at 1 and 3 months after initiation of treatment with interferon beta-1a. RESULTS: Ten proteins were differentially expressed in MS patients. Five of these were altered by treatment with IFN-ß 1a: uPA, CX3CL1, CCL2, TRAIL and IL18. CONCLUSION: CCL2 and TRAIL were confirmed to be modulated with interferon beta treatment in MS. As novel findings, we now report that uPA and CX3CL1 were differentially expressed in MS and increased after IFN-beta-1a treatment. Conflicting results have been reported on how interferon beta affects IL-18.


Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Citocinas/sangre , Citocinas/efectos de los fármacos , Interferón beta-1a/uso terapéutico , Esclerosis Múltiple Recurrente-Remitente/sangre , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adulto , Quimiocina CCL2/sangre , Quimiocina CCL2/efectos de los fármacos , Quimiocina CX3CL1/sangre , Quimiocina CX3CL1/efectos de los fármacos , Femenino , Humanos , Interleucina-18/sangre , Masculino , Proteínas de la Membrana/sangre , Proteínas de la Membrana/efectos de los fármacos , Persona de Mediana Edad , Ligando Inductor de Apoptosis Relacionado con TNF/sangre , Ligando Inductor de Apoptosis Relacionado con TNF/efectos de los fármacos
8.
Health Expect ; 24 Suppl 1: 20-29, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-31605443

RESUMEN

BACKGROUND: Meaningful and generalizable research depends on patients' willingness to participate. Studies often fail to reach satisfactory representativeness. OBJECTIVE: This paper aims to investigate reasons for not participating in research among young adult patients with psychiatric illness. METHOD: A quantitative cross-sectional study was performed based on questionnaires reported on by 51 psychiatric patients (14 males, 35 females and two unspecified) who had previously declined participation in an ongoing research project. Thereafter, a qualitative interview with subsequent content analysis was conducted with ten additional patients (five males, five females). RESULTS: The questionnaires indicate being 'too tired/too sick to participate' as the most common barrier. Lack of time and fear of needles were other common barriers. Lack of trust or belief in the value of research was less inhibitive. In the interviews, disabling psychiatric symptoms were confirmed as the main reason for not participating. Several potential ways to increase participation were identified, such as simplification of procedures and information as well as providing rewards and feedback, and building relationships before asking. CONCLUSION: This study is unusual as it focuses on the group of young people attending psychiatry outpatient clinics we know very little about - those who do not partake in research. Our results indicate that fatigue and sickness reduce research participation and identify factors that may facilitate enrolment of this important group.


Asunto(s)
Trastornos Mentales , Adolescente , Estudios Transversales , Fatiga , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Confianza , Adulto Joven
9.
J Neurosci Res ; 98(7): 1309-1321, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-30252150

RESUMEN

Postpartum depression (PPD) is a devastating disorder affecting not only more than 10% of all women giving birth, but also the baby, the family, and the society. Compiling evidence suggests the involvement of the immune system in the pathophysiology of major depression; yet, the immune response in perinatal depression is not as well studied. The aim of this study was to investigate the alterations in peripheral levels of inflammatory biomarkers in 169 Swedish women with and without depressive symptoms according to the Edinburgh postnatal depression scale or the M.I.N.I neuropsychiatric interview at eight weeks postpartum. Among the 70 markers analyzed with multiplex proximity extension assay, five were significantly elevated in women with postpartum depressive symptoms in the adjusted LASSO logistic regression analysis: Tumor necrosis factor ligand superfamily member (TRANCE) (OR-per 1 SD increase = 1.20), Hepatocyte growth factor (HGF) (OR = 1.17) Interleukin (IL)-18 (OR = 1.06), Fibroblast growth factor 23 (FGF-23) (OR = 1.25), and C-X-C motif chemokine 1 (CXCL1) (OR 1.11). These results indicate that women with PPD have elevated levels of some inflammatory biomarkers. It is, therefore, plausible that PPD is associated with a compromised adaptability of the immune system.


Asunto(s)
Quimiocina CXCL1/sangre , Depresión Posparto/sangre , Factores de Crecimiento de Fibroblastos/sangre , Factor de Crecimiento de Hepatocito/sangre , Interleucina-18/sangre , Ligando RANK/sangre , Adulto , Biomarcadores/sangre , Femenino , Factor-23 de Crecimiento de Fibroblastos , Humanos , Inflamación/sangre
10.
BMC Psychiatry ; 20(1): 535, 2020 11 11.
Artículo en Inglés | MEDLINE | ID: mdl-33176747

RESUMEN

BACKGROUND: >Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls. METHODS: Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa). RESULTS: Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups. CONCLUSION: Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.


Asunto(s)
Depresión , Enfermedades Gastrointestinales , Ansiedad/complicaciones , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Enfermedades Gastrointestinales/complicaciones , Enfermedades Gastrointestinales/epidemiología , Humanos , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Suecia , Adulto Joven
11.
Psychosom Med ; 81(1): 51-56, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30299401

RESUMEN

OBJECTIVE: The pathophysiology of irritable bowel syndrome (IBS) is not completely understood, although we do know that patients with IBS have a high prevalence of psychiatric comorbidity (mainly depression and anxiety disorders). Melatonin, produced in the gastrointestinal tract, influences gut motility. Psychiatric conditions are associated with circadian disturbances in peripheral melatonin levels. This study aimed to investigate associations between daytime salivary melatonin and gastrointestinal symptoms in young adult psychiatric patients. METHODS: Ninety-six patients (86% women), aged 18-25 years (M (SD) = 21 (2)), seeking psychiatric care with primarily anxiety disorders, affective disorders, or both were included in the study. Total scores from the Gastrointestinal Symptoms Rating Scale - IBS were compared with salivary melatonin measured at three time points (30 minutes after waking up, at 11:00 hours and 30 minutes after lunch) during the waking hours of 1 day. RESULTS: After adjustment for potential confounders, melatonin levels in saliva 30 minutes after lunch remained significantly correlated to the total Gastrointestinal Symptoms Rating Scale - IBS score after correction for multiple testing (B = 0.016, SE = 0.006, p = .015, q = 0.045). In a post hoc analysis, symptoms of gastrointestinal pain and bloating contributed most to this association. CONCLUSIONS: In young adult psychiatric patients, salivary melatonin levels after lunch are associated with gastrointestinal symptoms, which is consistent with the proposed effect of elevated levels of gastrointestinal melatonin on gut motility. This result suggests a link between IBS symptoms and regulation of melatonin in patients with psychiatric disorders.


Asunto(s)
Trastornos de Ansiedad/metabolismo , Síndrome del Colon Irritable/metabolismo , Melatonina/metabolismo , Trastornos del Humor/metabolismo , Adolescente , Adulto , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/fisiopatología , Ritmo Circadiano/fisiología , Comorbilidad , Femenino , Humanos , Síndrome del Colon Irritable/epidemiología , Síndrome del Colon Irritable/fisiopatología , Masculino , Trastornos del Humor/epidemiología , Trastornos del Humor/fisiopatología , Saliva , Adulto Joven
12.
Nord J Psychiatry ; 73(2): 81-89, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30900487

RESUMEN

PURPOSE: Childhood trauma in an important public health concern, and there is a need for brief and easily administered assessment tools. The Early Trauma Inventory (ETI) is one such instrument. The aim of this paper is to test the psychometric properties of the Swedish translation of the short, self-rated version (ETISR-SF), and to further validate the instrument. MATERIALS AND METHODS: In this cross-sectional study, 243 psychiatric patients from an open care unit in Sweden and 56 controls were recruited. Participants were interviewed and thereafter completed the ETISR-SF. Internal consistency was calculated using Cronbach's alpha, a confirmatory factor analysis (CFA) was performed and goodness-of-fit was determined. Intra Class Correlation (ICC) was used to calculate test-retest reliability. Discriminant validity between groups was gauged using the Mann-Whitney U-test. RESULTS: Cronbach's alpha varied between 0.55 and 0.76, with higher values in clinical samples than in controls. Of the four domains, general trauma showed a lower alpha than the other domains. The CFA confirmed the four-factor model previously seen and showed good to acceptable fit. The ICC value was 0.93, indicating good test-retest reliability. According to the Mann-Whitney U-test, the non-clinical sample differed significantly from the clinical sample, as did those with PTSD or borderline diagnosis from those without these diagnoses. CONCLUSIONS: The Swedish translation of the ETISR-SF was found to have similar psychometric properties as both the original version and translations. ETISR-SF scores could also distinguish between different diagnostic groups associated with various degrees of trauma, which supports its discriminant validity.


Asunto(s)
Trauma Psicológico/diagnóstico , Trauma Psicológico/epidemiología , Autoinforme/normas , Traducciones , Adulto , Niño , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Masculino , Trauma Psicológico/psicología , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Suecia/epidemiología , Adulto Joven
13.
Int J Mol Sci ; 20(24)2019 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-31817800

RESUMEN

Immunomodulation is increasingly being recognised as a part of mental diseases. Here, we examined whether levels of immunological protein markers changed with depression, age, or the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). An analysis of plasma samples from patients with a major depressive episode and control blood donors (CBD) revealed the expression of 67 inflammatory markers. Thirteen of these markers displayed augmented levels in patients compared to CBD. Twenty-one markers correlated with the age of the patients, whereas 10 markers correlated with the age of CBD. Interestingly, CST5 and CDCP1 showed the strongest correlation with age in the patients and CBD, respectively. IL-18 was the only marker that correlated with the MADRS-S scores of the patients. Neuronal growth factors (NGFs) were significantly enhanced in plasma from the patients, as was the average plasma GABA concentration. GABA modulated the release of seven cytokines in anti-CD3-stimulated peripheral blood mononuclear cells (PBMCs) from the patients. The study reveals significant changes in the plasma composition of small molecules during depression and identifies potential peripheral biomarkers of the disease.


Asunto(s)
Biomarcadores/sangre , Biomarcadores/metabolismo , Trastorno Depresivo Mayor/sangre , Trastorno Depresivo Mayor/metabolismo , Inflamación/sangre , Inflamación/metabolismo , Leucocitos Mononucleares/metabolismo , Ácido gamma-Aminobutírico/metabolismo , Adulto , Factores de Edad , Anciano , Depresión , Trastorno Depresivo Mayor/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad
14.
BMC Psychiatry ; 18(1): 157, 2018 05 29.
Artículo en Inglés | MEDLINE | ID: mdl-29843679

RESUMEN

BACKGROUND: Treatment of Hepatitis C virus (HCV) infection has evolved from interferon (IFN)-based treatments to direct-acting antivirals (DAAs). Patients with HCV have an elevated psychiatric morbidity (including substance abuse) and patients with such comorbidity have often been excluded from treatment with IFN. To date, little is known about psychiatric adverse effects of DAA-based regimens. We therefore aimed to study the psychiatric side effects of new IFN-free treatment for HCV (including depressive symptoms and sleep) in real world patients also including those with a history of psychiatric diagnosis, substance abuse or drug dependence. METHODS: Consecutive patients were monitored during treatment with three of the latest DAA agents (sofosbuvir, simeprevir and daclatasvir). Repeated expert psychiatric assessments from baseline to 12 weeks post-treatment were performed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) clinical version and the self-report versions of the Montgomery Åsberg Depression Rating Scale (MADRS-S) and the Pittsburgh Sleep Quality Index (PSQI). Friedman's test was performed to calculate differences in the MADRS-S and PSQI over time. In a post-hoc analysis Wilcoxon's test was used to compare baseline depressive symptoms with those at post-treatment. Spearman's rank correlation test was conducted in another post-hoc analysis to evaluate the correlation between symptoms of depression and HCV viral load at baseline. RESULTS: At baseline, 15/17 patients (88%) had a history of any psychiatric diagnosis; 11 (65%) had a history of substance abuse or dependence; and 11 (65%) had previously been treated with IFN and six of those had experienced psychiatric side effects. There was no correlation between depressive symptoms and HCV viral load at baseline. Symptoms of depression did not increase during DAA treatment and were lower 12 weeks post-treatment compared with baseline: MADRS-S 10.7 vs. 8.3 (p = 0.01). This observation held when excluding patients taking antidepressant medication. Sleep quality did not significantly change during treatment. Adherence to treatment was estimated to 95% and sustained virological response was 88%. CONCLUSIONS: Despite high psychiatric morbidity, including previous substance abuse, patients successfully completed DAA treatment without increasing depressive symptoms or sleep disturbance. Symptoms of depression were significantly reduced 12 weeks after DAA treatment.


Asunto(s)
Antivirales/efectos adversos , Depresión , Hepatitis C , Sueño/efectos de los fármacos , Trastornos Relacionados con Sustancias , Adulto , Antivirales/clasificación , Antivirales/uso terapéutico , Correlación de Datos , Depresión/diagnóstico , Depresión/epidemiología , Depresión/etiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/diagnóstico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología , Femenino , Hepacivirus/fisiología , Hepatitis C/diagnóstico , Hepatitis C/tratamiento farmacológico , Hepatitis C/epidemiología , Hepatitis C/psicología , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Estudios Prospectivos , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiología , Suecia/epidemiología , Carga Viral/métodos
15.
Cephalalgia ; 37(5): 435-441, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27165492

RESUMEN

Background Migraine is a prevalent disorder characterised by recurrent headache attacks preceded or accompanied by aura in a subgroup of patients. Migraine often occurs together with major depressive disorder (MDD). Alterations of adipokine levels have been reported both in migraine and in MDD. In this cross-sectional study, we aimed to assess the associations between serum leptin and adiponectin levels and migraine or migraine subtypes. Analyses were adjusted for a lifetime history of MDD in order to investigate the association between adipokines and migraine under consideration of depression status. Methods We included 3025 participants from the CoLaus/PsyCoLaus study. The impact of leptin and adiponectin levels on a diagnosis of migraine was analysed by binary regression analyses, adjusting for variables known to influence adipokine levels. Subgroup analyses were conducted based on the presence of aura. Results Crude leptin levels were significantly higher in subjects with migraine than controls (Mann-Whitney U = 515,102, p = 6 × 10-7). When performing adjusted analyses, leptin levels were found to be significantly higher in subjects with migraine (odds ratio = 1.22, p = 0.024) and migraine with aura (odds ratio = 1.34, p = 0.004). Conclusion High leptin levels might play a role in the pathogenesis of migraine and migraine with aura.


Asunto(s)
Leptina/sangre , Migraña con Aura/sangre , Migraña con Aura/diagnóstico , Adulto , Anciano , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Migraña con Aura/epidemiología , Distribución Aleatoria , Suiza/epidemiología
16.
BMC Psychiatry ; 17(1): 21, 2017 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-28095825

RESUMEN

BACKGROUND: Research in vulnerable individuals must insure voluntariness and minimize negative reactions caused by participation. This study aimed to describe consent and completion rate in young psychiatric patients in relation to study components, degree of disability and to compare response to research participation in patients and controls. METHODS: Between 2012 and 2015, 463 patients with psychiatric disorders between the ages of 18-25 from the Dept. of General Psychiatry at Uppsala University Hospital and 105 controls were recruited to donate data and samples to a biobank. Consent and completion in relation to questionnaires, biological sampling of blood, saliva or feces, were monitored. Both groups were also asked about their perceived disability and how research participation affected them. RESULTS: Most patients who participated consented to and completed questionnaires and blood sampling. The majority also consented to saliva sampling, while less than half consented to collect feces. Of those who gave consent to saliva and feces only half completed the sampling. Both patients and controls reported high voluntariness and were positive to research participation. Within the patient group, those with greater perceived disability reported greater distress while participating in research, but there was no difference in consent or completion rates or level of regret. CONCLUSIONS: With the described information procedures, psychiatric patients, regardless of perceived disability, reported high voluntariness and did not regret participation in biobanking. Compared to questionnaires and blood sampling, given consent was reduced for feces and completion was lower for both saliva and feces sampling.


Asunto(s)
Bancos de Muestras Biológicas , Emociones , Consentimiento Informado/psicología , Trastornos Mentales/psicología , Participación del Paciente/psicología , Servicio de Psiquiatría en Hospital , Adolescente , Adulto , Bancos de Muestras Biológicas/tendencias , Femenino , Humanos , Masculino , Participación del Paciente/métodos , Participación del Paciente/tendencias , Servicio de Psiquiatría en Hospital/tendencias , Encuestas y Cuestionarios , Adulto Joven
18.
Nursing ; 45(2): 25-30, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25585219

RESUMEN

BACKGROUND: Falls are a persistent problem in all healthcare settings, with rates in acute care hospitals ranging from 1.3 to 8.9 falls per 1,000 inpatient days, about 30% resulting in serious injury. METHODS: A 30-day prospective pilot study was conducted on two units with pre- and postimplementation evaluation to determine the impact of patient-centered proactive hourly rounding on patient falls as part of a Lean Six Sigma process improvement project. Nurse leaders and a staff champion from Unit 1 were involved in the process from the start of the implementation period, while Unit 2 was introduced to the project for training shortly before the intervention began. RESULTS: On Unit 1, where staff and leadership were engaged in the project from the outset, the 1-year baseline mean fall rate was 3.9 falls/1,000 patient days. The pilot period fall rate of 1.3 falls/1,000 patient days was significantly lower than the baseline fall rate (P = 0.006). On Unit 2, where there was no run-in period, the 1-year baseline mean fall rate was 2.6 falls/1,000 patient days, which fell, but not significantly, to 2.5 falls/1,000 patient days during the pilot period (P = 0.799). DISCUSSION: Engaging an interdisciplinary team, including leadership and unit champions, to complete a Lean Six Sigma process improvement project and implement a patient-centered proactive hourly rounding program was associated with a significant reduction in the fall rate in Unit 1. Implementation of the same program in Unit 2 without engaging leadership or front-line staff in program design did not impact its fall rate. CONCLUSIONS: The active involvement of leadership and front-line staff in program design and as unit champions during the project run-in period was critical to significantly reducing inpatient fall rates and call bell use in an adult medical unit.


Asunto(s)
Accidentes por Caídas/prevención & control , Personal de Enfermería en Hospital/organización & administración , Atención Dirigida al Paciente/métodos , Pautas de la Práctica en Enfermería , Accidentes por Caídas/estadística & datos numéricos , Delaware , Estudios de Seguimiento , Unidades Hospitalarias/organización & administración , Humanos , Investigación en Evaluación de Enfermería , Investigación Metodológica en Enfermería , Evaluación de Resultado en la Atención de Salud , Proyectos Piloto , Estudios Prospectivos
19.
Nursing ; 44(11): 58-62, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25321438

RESUMEN

BACKGROUND: In U.S. hospitals, from 700,000 to 1 million inpatients fall each year. About a third of these falls could have been prevented. OBJECTIVES: This project's purpose was to document patient perceptions of their inpatient fall risk and determine how these perceptions were associated with clinical indicators of fall risk. METHODS: From six medical-surgical units, 193 patients were randomly selected and surveyed about their perceived fall risk during their hospital stay. For 101 of them, the Schmid fall risk assessment score, age, and gender were recorded. A retrospective review of the Schmid scores of all patients who fell during a 6-month historical sample period was reviewed for comparison. RESULTS: Most patients (88%) reported that they didn't feel at risk for falling during their hospital stay. No correlation between their Schmid score and their perceived fall risk was found. Historical review of all inpatients who'd fallen in a prior period showed that the 358 patients with known Schmid scores had a full range of scores. These are normally distributed from 0 to 6, with over 40% of patients experiencing falls having Schmid scores of less than 3. CONCLUSIONS: Patient perceptions of falls match neither their clinical risk nor their actual likelihood of falling. When designing fall prevention strategies, it may be important to remind providers of this gap in patient knowledge, which includes overconfidence in the role of the care team in preventing falls


Asunto(s)
Accidentes por Caídas , Conocimientos, Actitudes y Práctica en Salud , Accidentes por Caídas/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo
20.
Sci Rep ; 14(1): 11635, 2024 05 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773198

RESUMEN

Evidence links immune system alterations to major psychiatric disorders. The few previous studies on personality traits or personality disorders (PDs) indicate that immunometabolic dysregulation may be prevalent in this population. This study aimed to investigate relationships between personality traits, PDs, and immunometabolic markers in peripheral blood. We hypothesized that neuroticism would be correlated with elevated leptin. Participants were recruited as young adults seeking care for general psychiatric disorders. They responded to a personality inventory and were assessed for PDs, and reevaluated again at a 12 years follow-up. Blood samples were collected at the follow-up and analyzed for 29 immunometabolic markers. A positive correlation was found between the personality trait neuroticism and leptin (ρ = 0.31, p = 0.02). An exploratory analysis also revealed a positive correlation between brain-derived neurotrophic factor (ρ = 0.36, p < 0.01) and neuroticism. These findings remained after adjusting for other variables in general linear models. There were no relationships between PDs and any immunometabolic markers. Results both confirm previous findings of correlations between the immunometabolic system and personality traits and suggest directions for future research.


Asunto(s)
Biomarcadores , Neuroticismo , Trastornos de la Personalidad , Personalidad , Humanos , Femenino , Masculino , Trastornos de la Personalidad/sangre , Trastornos de la Personalidad/psicología , Biomarcadores/sangre , Adulto , Adulto Joven , Leptina/sangre , Factor Neurotrófico Derivado del Encéfalo/sangre , Inventario de Personalidad , Adolescente
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