Fasting plasma peptide YY concentrations are increased in patients with major depression who associate weight loss.

BACKGROUND: Many patients with major depression refer a decreased appetite and weight loss among their symptoms. Peptide YY (PYY) and ghrelin belong to the family of peptides of the gut-brain axis implicated in the regulation of appetite and energy metabolism. PYY stimulates a powerful central satiety response and ghrelin increases food intake and weight gain. Brain-derived neurotrophic factor (BDNF) also contributes to the central control of food intake as an anorexigenic factor. AIM: To study fasting plasma total and acylated ghrelin, plasma PYY and serum BDNF levels in patients with major depression with weight loss as one of their symptoms and compare them with matched healthy controls. SUBJECTS AND METHODS: Fifteen adult patients, 9 male and 6 female, with recent diagnosis of major depression, and 16 healthy adult subjects, matched by age and anthropometric parameters were studied. All depressed patients referred weight loss and were not under antidepressant therapy. Fasting total PYY, total ghrelin and acylated ghrelin and BDNF were determined. RESULTS: Fasting total PYY was higher in patients than controls (2.01±0.09 vs 1.29±0.16 pmol/l). There were no differences in fasting total ghrelin, acylated ghrelin or BDNF levels. CONCLUSIONS: Major depressed patients, with weight loss at diagnosis, showed higher fasting plasma PYY levels that could contribute to their reduced appetite.

Manejo terapéutico y comorbilidades del paciente con dependencia a opiáceos, en programa de terapia sustitutiva: estudio PROTEUS / Therapeutic management and comorbid psychiatric disorders among opiate dependent patients in replacement therapy programs: The PROTEUS study

Objetivo. Analizar la necesidad de realizar un estudio epidemiológico de pacientes dependientes de opiáceos centrado en conocer más sus tratamientos, comorbilidades médicas y psiquiátricas. Material y métodos. Se examinó la necesidad de tener datos disponibles en nuestro medio sobre el manejo clínico de estos pacientes, el tipo de tratamiento y las posibles comorbilidades. No existen datos completos, representativos de los pacientes españoles. Por ello se seleccionó una muestra representativa a nivel nacional, a partir de la población de pacientes de pendientes de opiáceos en programas de mantenimiento con agonistas opiáceos que acudían a los centros asistenciales de drogodependencias. Resultados. El estudio final incluyó una población representativa de 624 pacientes dependientes a opiáceos en programas de mantenimiento con agonistas, procedentes de 74 centros de asistencia al dependiente de opiáceos de toda España. Conclusiones. Se conocen poco los datos sobre la comorbilidad psicopatológica y médica y los tratamientos farmacológicos en pacientes dependientes de opiáceos. Es necesario realizar un estudio epidemiológico amplio que actualice la realidad de la práctica clínica habitual del paciente dependiente de opiáceos en España (manejo terapéutico, comorbilidades, etc.) valore la gravedad de su adicción, la repercusión sobre el tipo de tratamiento, la presencia de patología dual y las repercusiones médicas (AU)

Background. The purpose of this study was to analyze the need for an epidemiological study of opiate-dependent patients aiming to improve the knowledge about their treatment and medical and psychiatric comorbidities. Matherial and methods. Data on clinical management, treatment type, and comorbidities in Spain were examined. There are no comprehensive data, representative of the Spanish patients. Therefore, a national representative sample was selected from opiate-dependent patients ongoing replacement therapy programs, attending care centers for opiate dependent patients. Results. The representative sample included 624 opiate-dependent patients ongoing opiate replacement therapy programs from 74 drug-dependent rehabilitation centers in Spain. Conclusions. Data on therapeutic management and psychiatric and medical comorbidities in opiate-dependent patients are not well known. There is a need for a comprehensive epidemiological study to update the reality of clinical practice of opioid dependent patients in Spain (therapeutic management, comorbidities, etc.) assessing the severity of their addiction, the impact on the type of treatment, the presence of dual pathology and medical implications (AU)