Socioeconomic implications of underdiagnosing teenagers' depression.

UNLABELLED: The aim of our research was to demonstrate once again that teenagers' depression still remains way too much underdiagnosed, the last one having important socioeconomic implications. Thus it is absolutely necessary to implement depression screening in psychiatric clinics. MATERIAL AND METHOD: The study was carried out in 2 stages, I; a group of 1126 in-patients from "Sf. Maria" Hospital, and II the analysis of the socioeconomic implications of teenagers' depression. RESULTS: Only 19, 11% of the depressive patients had a previous depression diagnosis, the rest of 80, 89% were new cases, recently diagnosed; the depressive teenagers are more exposed to drugs and alcohol abuse, to antisocial behavior, and to poorer results in school. CONCLUSION: Screening depression implementation would reduce very much the risk of teenagers' depression underdiagnosing.

[Euthanasia/assisted suicide. Ethical and socio-religious aspects]. / Eutanasia/suicidul asistat. Aspecte etice si socio-religioase.

Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).

[The withdrawal syndrome in benzodiazepine dependence and its management]. / Managementul sindromului de abstinenta in dependenta la benzodiazepine.

UNLABELLED: The authors present the result of an observational study about the withdrawal syndrome in benzodiazepine dependence, and the aspect of identifying withdrawal symptoms, effective communication with the patient and the structure of withdrawal programmes. MATERIAL AND METHOD: The study included a number of 22 pacients hospitalised in the Drug-Dependence Clinic of Iasi between January 2006 - December 2008. RESULTS: The present article consists of data covering current issues in the area of withdrawal syndrome in benzodiazepine dependence. The most prescribed benzodiazepines were diazepam (10 cases), followed by alprazolam (5 cases) and nitrazepam (4 cases). The clinical manifestations such as anxiety, insomnia, concentration problems, fatigability were present at all patients.

[Aspects regarding the incidence and prevalence of vascular dementia forms]. / Aspecte privind incidenta si prevalenta formelor de dementa vasculara.

Vascular dementia is the form of dementia associated with cerebrovascular disease. It involves complex interrelationships between vascular etiologies, pathological changes in the brain, and clinical symptoms. Vascular dementia is associated with vascular and other risk factors, including cognitive ability, age, and education. Vascular dementia is the second most common cause of dementia, having a high rate of causes by itself, or in combination with Alzheimer's disease. Further complicating the diagnosis and treatment of vascular dementia is that it often coexists with Alzheimer's disease in elderly patients. It can be difficult to determine whether vascular abnormality has caused dementia, has contributed to its development, or is simply coincidental. When both vascular and degenerative changes may be contributing to the cognitive decline, term "Mixed" dementia is used. There are many questions still to be answered as to the incidence and prevalence of vascular dementia. Once there is a consensus on what diagnostic criteria should be used and how they should be implemented, or witch are the prevalence and incidence rates for vascular dementia by age, sex, region etc.

[Clinical study of patients with benzodiazepine dependence, hospitalised between 2006-2008]. / Studiu clinic asupra cazurilor de dependenta la benzodiazepine spitalizate în perioada 2006-2008.

UNLABELLED: The authors present the result of retroprospective clinical diagnosis on benzodiazepines dependence hospitalised in the Drug-Dependence Clinic from the Clinical Hospital of Psychiatry "Socola" Iasi between January 2006-September 2008. MATERIAL AND METHOD: The study included a number of 49 patients. RESULTS: The present article consists of data covering current issues in the area of benzodiazepine side effects. The most frequent clinical manifestations were depression (62.5%), anxiety (52%), perspiration (43%), insomnia (31%), cognitive symptoms (25.2%).

[The genetic polymorphism of MTHFR gene in schizophrenia]. / Polimorfismul genetic al genei MTHFR in schizofrenie.

UNLABELLED: The 677C > T polymorphism of the MTHFR gene, resulting in hyperhomocysteinemia, has been shown to be implicated in the aetiology of schizophrenia. Previous studies showed that A1298 C polymorphism seems not to be related to schizophrenia. AIM OF THE STUDY: To analyze two genetic polymorphisms of the MTHFR gene, 677C > T and A1298 C in 44 patients with schizophrenia and evaluate its relationship with the risk of schizophrenia and with some clinical aspects. MATERIAL AND METHOD: We determined the presence of the 677C > T and A1298 C mutations of the MTHFR gene in 44 inpatients with schizophrenia and in 35 normal controls. The patients were assessed by psychiatric examination and scalar evaluation. RESULTS: 28 (66,7%) of the patient group had the T allele of the 677C > T genetic polymorphism, compared to 11 (34,3%) subjects of the control group. The intensity of the positive, negative and general symptoms was slightly higher in the patients presenting the T allele. The A1298C missense mutation was more frequent between control subjects (57,5%) compared to the patient group (39%). The intensity of the positive symptoms was slightly increased in the patients with the missense mutation in the position 1298, but the intensity of the negative and general symptoms did not differ. CONCLUSIONS: Our study confirms the role of the 677C > T genetic polymorphism in the susceptibility for schizophrenia. The relationship between A1298C genetic polymorphism and schizophrenia was not demonstrated in our study.

[Effect of memantine treatment on patients with moderate-to-severe Alzheimer's disease treated with donepezil]. / Efectul tratamentului cu memantina la pacientii cu boala Alzheimer moderat--severa tratati cu donepezil.

OBJECTIVE: Investigating the behavioral and cognitive effect of memantine in moderate to severe patients with Alzheimer's disease receiving donepezil. MATERIAL AND METHOD: 43 patients were enrolled in this prospective, randomized, parallel group study. There were no significant imbalances between the treatment groups in demographic and baseline clinical characteristics. Cognitive and global measures were collected at baseline and at the end of weeks 4, 8, 12 and 24. Behavioral measures were collected at baseline, at the end of week 12 and at week 24. RESULTS: Memantine--treated patients showed significantly less deterioration in their functionality. Of patients who exhibited agitation/aggression at baseline, those treated with memantine and donepezil showed significant reduction of symptoms compared with donepezil--treated patients. CONCLUSIONS: Treatment with memantine was well tolerated and reduced agitation/aggression, irritability, and appetite eating disturbances in patients who were agitated at baseline and delazed its emergence in those who were free of agitation at baseline.

Computer use and addiction in Romanian children and teenagers--an observational study.

The computer has provided some wonderful opportunities for our children. Although research on the effects of children's use of computer is still ambiguous, some initial indications of positive and negative effects are beginning t emerge. They commonly use computers for playing games, completing school assignments, email, and connecting to the Internet. This may sometimes come at the expense of other activities such as homework or normal social interchange. Although most children seem to naturally correct the problem, parents and educators must monitor the signs of misuse. Studies of general computer users suggest that some children's may experience psychological problems such as social isolation, depression, loneliness, and time mismanagement related to their computer use and failure at school. The purpose of this study is to investigate issues related to computer use by school students from 11 to 18 years old. The survey included a representative sample of 439 school students of ages 11 to 18. All of the students came from 3 gymnasium schools and 5 high schools of Iasi, Romania. The students answered to a questionnaire comprising 34 questions related to computer activities. The children's parents answered to a second questionnaire with the same subject. Most questions supposed to rate on a scale the frequency of occurrence of a certain event or issue; some questions solicited an open-answer or to choose an answer from a list. These were aimed at highlighting: (1) The frequency of computer use by the students; (2) The interference of excessive use with school performance and social life; (3) The identification of a possible computer addiction. The data was processed using the SPSS statistics software, version 11.0. Results show that the school students prefer to spend a considerable amount of time with their computers, over 3 hours/day. More than 65.7% of the students have a computer at home. More than 70% of the parents admit they do not or only occasionally discuss computer use with their children. This indicates the fact that, although they bought a computer for their children, they do not supervise the way it is used. The family is rather a passive presence, vaguely responsible and lacking involvement. But, the parents consider that, for better school results, their children should use their computers. This study tried to identify aspects of computer addiction in gymnasium and high school students, as well.

[The effects of computer-use on adolescents]. / Efectele utilizarii calculatorului la copii si adolescenti.

Computers continue to play a vital role in today's generation. The need for information about the effects of computers on their users also increases. The purpose of this study is to investigate how children and adolescents use a computer and to explore the beneficial and harmful effects of computer use on children's mental and physical health. The studied group of samples comprised 69 subjects, aged between 13 and 18 years, who answered to a questionnaire. The parents of the children also answered another questionnaire with the same subject. Data have been statistically processed using the program SPSS. The results were obtained about computer use and the pathological use was identified. Some children spend much time on computers, 4% more than five hours/day. 41% of the parents believe that the usage of the computer is favorable to the children's mental and physical health and development, 49% of parents believe that the computer may be harmful. 1.4% of the children had pathological use of the computer.

[The clinicopsychological and therapeutic significance in the depression-pain relationship]. / Semnificatii clinico-psihologice si terapeutice în relatia depresie-durere.

The frequency of depression-pain association, gives the authors the opportunity of evaluating the actual pattern of managing pain according to its sensory-discriminatory, affective-emotional, cognitive and behavioral features. The neurophysiologic, affective and psychologic factors generally correlate in the induction and evolution of pain, being dependent on the individual reactivity environmental and socio-cultural relations. The efficacy of antidepressive drugs in the therapy of pain, explained by their action on the serotoninergic systems, advocates the clinical relationship depression-pain, but also their analgesic properties independent from the thymoanaleptic effect. The results of the clinical essays the authors have carried on some antidepressants (Imipramine, Amitryptyline, Mianserine, Maprotyline) evidenced their effect on the various forms of manifestation and localizations of pain complains. The amelioration of pain, certified by the use in dynamics of Hamilton's depression scale, occurs earlier than the improvement of depressive symptoms, thus attesting the analgesic properties of the antidepressants. The preservation and merging of these effects during the investigation interval, at the same time with an improvement in the depressive symptoms support the clinical correlation depression-pain, emphasizing the complex character of the algopathic syndrome, both somatically and mentally.

Psychopathological relationships in depressive illness.

The evolution of the clinical concepts regarding depressive syndromes underlines the need for correlating the epidemiological, clinical and etiopathogenic data for elaborating the classification, quantification and psychopathologic assessment systems. The psychological investigation, complementary to clinical examination and adapted to patient's subjective condition, requires an improvement of its methods in view of bringing more information necessary for stating the differential psychodiagnosis and for a proper psychotherapy. The analysis of motivations and the psychopathologic relationships in the depressive states render evident the factorial complexity and the need of a clinical, psychological, genetic, biochemical, experimental and therapeutic approach. Thus, a bio-medical and psychotherapeutic approach will improve the clinical research and psychopathologic assessment. The psychodiagnosis and psychotherapy, as elements of clinical care, make possible the clearing up of the therapeutic possibilities in the complex approach of personality, promoting the psychoprotective comprehension and the state of mental health.

[The dispensary care of mental diseases with a long-term evolution]. / Consideratii privind dispensarizarea bolilor psihice cu evolutie indelungata.

It is the authors belief that mental diseases follow-up is essential for the outpatient care and a requisite to inpatient care. The 5-year follow up of group of patients with longstanding mental diseases is analysed from the viewpoint of nosological groups prevalence, age and sex distribution, family and professional integration and type of care. The study in dynamics of the incidence and prevalence shows an increase of followed up cases and underlines the usefulness of follow up actions in estimating both the morbidity and the possibilities of prophylactic and curative actions.

[The genetic substrate in cases with epileptogenic potential]. / Consideratii cu substrat genetic la o cazuistica cu potential epileptogen.

Among the manifestations with convulsive aspect, those apparently induced by fever in children are very important, especially if considered in perspective. This investigation was carried out in family backgrounds and it revealed that, in many such cases, the manifestations thought to be induced by fever had a family character, thus suggesting a possible genetic susceptibility. Most often, the maternal line was affected. A positive family history can be considered as a high risk factor and should not be ignored in all these children.

[The significance of the anxiety factor in neurotiform-depressive states]. / Ponderea factorului de anxietate în starile nevrotiform-depresive.

As part of the clinical psychological investigations, tests were used for determining the share of anxiety factor in the neurotiform-depressive states. The constituent elements of anxiety factors are discussed, those which might have significance being outlined. The authors plead for the use of insight therapy, as part of the complex clinical treatment, in those cases where the performed tests indicate the likelihood of a good response to such a therapy.

[The concept of depression--its historical development]. / Conceptul de depresie--dezvoltare istoricaa.

The authors review the historical development of the concept of "depression" and the terminology used by psychiatrists in the description and limitation of various forms of depression. They bring into relief the contribution brought about by the authors who delineated and classified the syndromes of depression, constituting in this way the historical evolution of the concept of depression.

[A glossary of the terms used in psychoanalysis]. / Glosar de termeni utilizati în psihanaliza.

The psychoanalytic direction in psychopathology is considered to be necessary as an explanation of concept and methodology for the medical training concerning the study and the care of mental diseases. Irrespective of certain controverted opinions on the fund of concepts of psychoanalysis the consideration of a strict terminology belonging to this direction is necessary. In this respect a concise explanation of the meanings of a set of terms in the comments on some psychopathological states is useful.