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1.
Front Psychiatry ; 10: 675, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31681027

RESUMO

Background: Autism spectrum disorders (ASD) are complex psychiatric disorders, with gene environment interaction being in the basis of their etiology. The association of perinatal complications and ASD is well established. Recent findings suggested that oxidative stress and polymorphism in genes encoding antioxidant enzymes might be involved in the development of ASD. Glutathione transferases (GSTs) have an important role in the antioxidant defense system. We aimed to establish whether the predictive effects of prenatal and perinatal complications (as possible oxidative stress inducers) on ASD risk are dependent on GST polymorphisms. Methods: The study included 113 ASD cases and 114 age- and sex group-matched healthy controls. All participants were genotyped for GSTA1, GSTM1, GSTT1, and GSTP1 polymorphisms. The questionnaire regarding prenatal and perinatal risk factors and complications was administered for all the subjects in the study. Results: The evaluated perinatal complications as a group significantly increased the risk of ASD [odds ratio (OR) = 9.415; p = 0.000], as well as individual perinatal complications, such as prematurity (OR = 11.42; p = 0.001), neonatal jaundice (OR = 8.774; p = 0.000), respiratory distress syndrome (OR = 4.835; p = 0.047), and the use of any medication during pregnancy (OR = 2.413; p = 0.03). In logistic regression model, adding GST genotypes did not modify the significant effects found for prematurity and neonatal jaundice as risk factors in ASD. However, there was a significant interaction of GST genotype with medication use during pregnancy and the use of tocolytics during pregnancy, which was predictive of ASD risk only in carriers of GSTM1-null, as opposed to carriers of GSTM1-active genotype. Conclusion: Specific perinatal complications may be significant risk factors for ASD. GSTM1 genotype may serve as a moderator of the effect of some prenatal factors on the risk of ASD such as using medication during pregnancy. It may be speculated that different oxidative stress-related genetic and environmental factors could lead to development of ASD. Apart from etiological mechanisms, possible therapeutic implications in ASD are also discussed.

2.
Psychiatr Danub ; 31(2): 182-188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31291222

RESUMO

BACKGROUND: Despite relatively consistent findings regarding the number of personality pathology domains, differences in domain structure remain. Recently the proposed ICD-11 domains were partially validated in a sample of patients with major depression producing five domains: Detached, Anankastic, Negative Emotional, Antisocial and Borderline. The aim of our study was to attempt to cross-validate these findings in a sample of patients primarily diagnosed with personality disorder (PD). SUBJECTS AND METHODS: All subjects were assessed by Structured Clinical Interview for the DSM-IV Axis II PD. Exploratory factor analysis (EFA) was applied on fifty seven DSM PD symptoms selected to represent the five proposed domains. RESULTS: SCID II data were collected from a total of 223 subjects. The EFA extracted five factors. The first factor labeled as borderline-internalizing constituted of borderline together with avoidant and dependent items, the second, labeled as disinhibited/ borderline externalizing, incorporated narcissistic and histrionic items. The other three separate factors in our study labeled as antisocial, anankastic and detached, were less robust. CONCLUSIONS: In our study five personality pathology domains were partly replicated. The most robust findings support the existence of the two factors, borderline-internalizing and disinhibited/borderline externalizing. However, the EFA was performed on a relatively low prevalence symptoms distribution, particularly for antisocial and schizoid factors.


Assuntos
Transtornos da Personalidade/psicologia , Personalidade , Adolescente , Adulto , Idoso , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos da Personalidade/diagnóstico , Adulto Jovem
3.
Front Public Health ; 7: 143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281806

RESUMO

Introduction: Combining a successful career with family planning has become increasingly important in recent years. However, maintaining a relationship, deciding upon the optimal time for pregnancy and other family planning decisions can still be quite challenging, especially for junior doctors whose training is long and demanding. Currently, women form an important part of the medical workforce, and there is noticeable feminization in migration. However, little is known about the personal characteristics of junior doctors in Europe and how these play a role in their decision to migrate. Methods: Survey of psychiatric trainees in 33 European countries, exploring how personal characteristics, such as gender, relationship status and parenthood, impact their attitudes toward migration. Results: 2,281 psychiatric trainees in Europe took part in the study. In this sample, the majority of psychiatric trainees were in a relationship, but only one quarter had children, although there were variations across Europe. Both men and women indicated personal reasons as their top reason to stay. However, women ranked personal reasons as the top reason to leave, and men financial reasons. Single woman were the most likely of all subgroups to choose academic reasons as their top reason to leave. Interestingly, when women were in a relationship or had children, their attitudes toward migration changed. Conclusions: In this study, a low number of psychiatric trainees in Europe had children, with differences across Europe. These findings raise awareness as to the role of parental conditions, which may be favoring or discouraging parenthood in junior doctors in different countries.

4.
Sci Rep ; 9(1): 3206, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30824761

RESUMO

Autism spectrum disorders (ASD) are a group of complex psychiatric disorders, with a proposed gene-environment interaction in their etiology. One mechanism that could explain both the genetic and environmental component is oxidative stress. The aim of our study was to investigate the potential role of common polymorphisms in genes for glutathione transferase A1, M1, T1 and P1 in susceptibility to ASD. We also aimed to explore the possible oxidative stress - specific gene-environment interaction, regarding GST polymorphisms, maternal smoking tobacco during pregnancy (TSDP) and the risk of ASD. This case-control study included 113 children with ASD and 114 age and sex-matched controls. The diagnosis was made based on ICD-10 criteria and verified by Autism Diagnostic Interview - Revised (ADI-R). We investigated GSTA1, GSTM1, GSTP1 and GSTT1 genotypes and explored their individual and combined effects in individuals with ASD. Individual effect of GST genotypes was shown for GSTM1 active genotype decreasing the risk of ASD (OR = 0.554, 95%CI: 0.313-0.983, p = 0.044), and for GSTA1 CC genotype, increasing susceptibility to ASD (OR = 4.132, 95%CI: 1.219-14.012, p = 0.023); the significance was lost when genotype-genotype interactions were added into the logistic regression model. The combination of GSTM1 active and GSTT1 active genotype decreased the risk of ASD (OR = 0.126, 95%CI: 0.029-0.547, p = 0.006), as well as combination of GSTT1 active and GSTP1 llelle (OR = 0.170, 95%CI: 0.029-0.992, p = 0.049). Increased risk of ASD was observed if combination of GSTM1 active and GSTP1 llelle was present (OR = 11.088, 95%CI: 1.745-70.456, p = 0.011). The effect of TSDP was not significant for the risk of ASD, neither individually, nor in interaction with specific GST genotypes. Specific combination of GST genotypes might be associated with susceptibility to ASD, while it appears that maternal smoking during pregnancy does not increase the risk of ASD.

5.
Psychiatr Danub ; 30(Suppl 6): 354-364, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30235173

RESUMO

BACKGROUND: Autism spectrum disorders (ASD) significantly impact lives of affected individuals and their families. They confront daunting challenges and multiple demands in their daily life, when compared to parents of children with other disabilities or parents of typically developing children. SUBJECTS AND METHODS: Participants completed The Caregiver Needs Survey, the survey intended for parents or primary caregivers of children with a diagnosis of ASD. During the study, 231 parents were interviewed; 167 mothers and 64 fathers. Parents were recruited from the patient database comprised of families from the two largest cities in Serbia. All of them were contacted before the study, either via phone or at the child's regular check-in visit. RESULTS: Over 90 percent of the parents reported that additional support at schools, home, and improved relationships with service providers are necessary and important. The most important challenges related to care were child's communication difficulties, social interaction difficulties, and problems with daily living skills. The significant predictors of lower overall satisfaction were parent's higher education, having a first concern related to problems of the child's interaction with others or playing alone, and parent frustration with accessing services in the past 12 months. Greater overall satisfaction, on the other hand, was related to having an in-school tutor training or assistance in managing child's needs or implementing treatments, and having primary care doctor or pediatrician as a source of information on autism. CONCLUSIONS: Future efforts to develop ASD-related policies and services should also take the following into consideration: the low level of awareness among caregivers and health care providers about the early signs of autism; disparities in access to services; educational problems and significant levels of dissatisfaction with the overall care and stigma.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Relações Pais-Filho , Adulto , Transtorno Autístico/psicologia , Cuidadores , Criança , Saúde da Família , Pai , Feminino , Humanos , Masculino , Pais , Sérvia
6.
J Nerv Ment Dis ; 206(7): 537-543, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29905664

RESUMO

There is an ongoing debate on the relationship between depression and anxiety, but data on similarities and differences in their predictor profiles are scarce. The aim of our study was to compare family and personality predictors of these disorders among 220 "emerging adults." As such, two clinical groups with noncomorbid depressive and anxiety disorders, and one healthy control group were assessed by sociodemographic questionnaires, Structured Clinical Interview for DSM-IV Disorders and NEO Personality Inventory, Revised. We found significant overlap in family and personality risk profiles, with increasing effect size for predictors common to anxiety and depression when the categories "no disorder-anxiety disorder-depressive disorder" were considered as existing along a continuum. Among the contributing factors we assessed, family psychiatric history, family structure and conflicts with parents were more significant than personality traits. Our study indicates that emerging adults may be more vulnerable to depression than anxiety in the presence of family and personality risk factors.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Família/psicologia , Personalidade , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Psicometria , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
8.
Curr Psychiatry Rep ; 19(8): 50, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28664328

RESUMO

PURPOSE OF REVIEW: Still obscure mechanisms of intergenerational child maltreatment (ITCM) have been investigated partially, from various psychological and biological perspectives and from various time perspectives. This review is aimed at integrating the findings on different temporal ITCM pathways, emphasizing the mind-brain-body interplay. RECENT FINDINGS: Psychological mediators of ITCM involve attachment, mentalization, dissociation, social information processing, personality traits, and psychiatric disorders. Neurobiological findings mostly refer to the neural correlates of caregiving and attachment behaviors, affected by several physiological systems (stress-response, immune, oxytocin), which also affect physical health. The latest research clusters around the epigenetic pathways of ITCM, suggesting the additional, prenatal, and preconception forms of transmission. Data suggest that ITCM needs to be conceptualized as a longitudinal process, with various interrelated psychological, neurodevelopmental, and somatic paths. Future research and prevention should take into account both, each path and each phase of ITCM, in an integrative way.


Assuntos
Maus-Tratos Infantis/psicologia , Vítimas de Crime/psicologia , Relação entre Gerações , Agressão/psicologia , Criança , Humanos , Transtornos Mentais/psicologia , Neurobiologia , Apego ao Objeto , Poder Familiar/psicologia
9.
Curr Psychiatry Rep ; 19(8): 52, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28681355

RESUMO

PURPOSE OF REVIEW: This review aims to provide a brief description of the complex etiology of autism spectrum disorders (ASD), with special emphasis on the recent findings of impaired redox control in ASD, and to suggest a possible model of oxidative stress-specific gene-environment interaction in this group of disorders. RECENT FINDINGS: Recent findings point out to the significance of environmental, prenatal, and perinatal factors in ASD but, at the same time, are in favor of the potentially significant oxidative stress-specific gene-environment interaction in ASD. Available evidence suggests an association between both the identified environmental factors and genetic susceptibility related to the increased risk of ASD and the oxidative stress pathway. There might be a potentially significant specific gene-environment interaction in ASD, which is associated with oxidative stress. Revealing novel susceptibility genes (including those encoding for antioxidant enzymes), or environmental factors that might increase susceptibility to ASD in carriers of a specific genotype, might enable the stratification of individuals more prone to developing ASD and, eventually, the possibility of applying preventive therapeutic actions.


Assuntos
Transtorno do Espectro Autista/metabolismo , Interação Gene-Ambiente , Estresse Oxidativo , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/genética , Criança , Dano ao DNA , Exposição Ambiental/estatística & dados numéricos , Feminino , Predisposição Genética para Doença , Glutationa Transferase/genética , Humanos , Exposição Materna/estatística & dados numéricos , Oxirredução , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/genética
10.
Psychiatr Serv ; 67(9): 943-5, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27133728

RESUMO

The dynamics of adolescence require adjustments in psychiatric treatment because of the challenges of this developmental stage in life. This column describes the Day Hospital for Adolescents (DHA) of the Institute of Mental Health in Belgrade, Serbia, which was established in December 2007. The DHA is a holistic program for the treatment of youths ages 15-25 with emotional disorders. The multicomponent therapeutic program includes individual treatment, several group therapeutic activities, and work with patients' families and the school system. An evaluation of data obtained for 102 patients indicated that DHA treatment was associated with significant reductions in depression symptom severity and improved functioning. The adolescents reported a high level of treatment satisfaction. The results suggest that a multicomponent day hospital is an effective treatment modality for adolescents with emotional disorders.


Assuntos
Hospital Dia/métodos , Transtornos Mentais/terapia , Psicoterapia/métodos , Adolescente , Adulto , Humanos , Avaliação de Programas e Projetos de Saúde , Sérvia , Adulto Jovem
11.
Psychiatry Res ; 238: 150-152, 2016 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-27086225

RESUMO

Access to medical information is important as lifelong scientific learning is in close relation with a better career satisfaction in psychiatry. This survey aimed to investigate how medical information sources are being used among members of the European Federation of Psychiatric Trainees. Eighty-three psychiatric trainees completed our questionnaire. A significant variation was found, and information availability levels were associated with training duration and average income. The most available sources were books and websites, but the most preferred ones were scientific journals. Our findings suggest that further steps should be taken to provide an equal access to medical information across Europe.


Assuntos
Acesso à Informação , Psiquiatria/educação , Europa (Continente) , Humanos , Comportamento de Busca de Informação , Inquéritos e Questionários
12.
Lab Med ; 47(3): 195-204, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27114251

RESUMO

OBJECTIVE: To examine glutathione S-transferase (GST) deletion polymorphisms in development of early-onset severe mental disorders, with the hypothesis that patients with GSTM1-null and GSTT1-null genotypes will develop psychotic disorders at a younger age. METHODS: We identified GSTM1 and GSTT1 deletion polymorphisms by multiplex polymerase chain reaction (PCR) in 93 patients with early onset severe mental disorders and 278 control individuals. The diagnoses were confirmed by Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Schedule for Affective Disorders and Schizophrenia-Life-Time Version (K-SADS-PL) interviews. RESULTS: Individuals with the GSTM1-null genotype were at 3.36-fold higher risk of developing early-onset severe mental disorders than carriers of a corresponding active genotype. The risk of those disorders was increased by 6.59-fold in patients with GSTM1-null/GSTT1-active genotype. Patients with the GSTM1-null genotype were at approximately 2-fold increased risk for developing early-onset schizophrenia-spectrum disorder (EOS), early-onset bipolar disorder (EOBD) with psychotic symptoms, or early-onset first-episode psychosis (EOFEP), compared with patients with the GSTM1-active genotype. CONCLUSION: The GSTM1-null genotype might be associated with higher risk for early onset severe mental disorders.


Assuntos
Glutationa Transferase/genética , Transtornos Mentais/genética , Polimorfismo Genético , Deleção de Sequência , Adolescente , Adulto , Animais , Estudos de Casos e Controles , Feminino , Técnicas de Genotipagem , Humanos , Masculino , Reação em Cadeia da Polimerase , Adulto Jovem
13.
Sci Rep ; 5: 10418, 2015 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-25988942

RESUMO

We explored sex differences in diagnostic categories, clinical symptoms and adaptive behavior of persons with autism spectrum disorders, as well as sex-specific correlations of clinical and adaptive caracteristics. The study involved 108 patients (83 males, 6.73 ± 4.33 years old) diagnosed with autism spectrum disorders (ASD). Assessment included ADI-R and Vineland Adaptive Behavior Scale II. Males were more often diagnosed with typical autism. There were no sex differences in the autistic symptoms, while females showed better functioning in Daily living skills, without reaching statistically significant difference (p = 0.062). We have found different associations of autistic symptoms with different aspects of adaptive behavior in males and females. Social reciprocity in females correlated with social domain of adaptive behavior, in a positive direction. Our findings have shown that although there are no sex differences in autistic symptoms, females tend to be somewhat more functional, and are also less frequently diagnosed with typical autism. Our results have also shown that sex might moderate the way clinical symptoms are expressed in adaptive behavior. Social reciprocity might be the core feature regarding sex differences in ASD. Our findings might have diagnostic and therapeutical implications, pointing out to the need for individualized, sex-specific treatment in this group of disorders.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Atividades Cotidianas/psicologia , Adaptação Psicológica , Criança , Feminino , Humanos , Masculino , Fatores Sexuais , Comportamento Social
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