RESUMO
BACKGROUND: Neuropsin (NP, kallikrein 8, KLK8) - a kallikrein gene-related (KLK) endoprotease - plays a key role in neuroplasticity processes, since intracellular signal cascades and regulation of gene expression are engaged in long-term synaptic plasticity. The main aim of this paper is to compare expression of the human neuropsin gene on the mRNA level in a group of patients diagnosed with depression and in a group of healthy subjects who have never been treated psychiatrically. SUBJECTS AND METHODS: 291 people, aged 18-67, were qualified to participate in the experiment: major recurrent depression group (MRD) and the control group (CG). Designations were carried out for the human NP gene (hNP). RESULTS: For hNP gene expression at the mRNA level was higher in patients with depression than in the CG (p<0.005). A Spearman's rank correlation analysis did not reveal any statistically significant relationship between the intensity of the disease measured using the HDRS scale and expression on the mRNA level for the hNP gene. Expression for the hNP gene in the entire group analysed increased with age of the examined individuals (p<0.005). CONCLUSION: Expression of the hNP gene on the mRNA level, evaluated based on peripheral blood, is significantly higher in the patients with MRD than in the healthy subjects.
Assuntos
Transtorno Depressivo Maior/genética , Expressão Gênica/genética , Calicreínas/genética , RNA Mensageiro/genética , Adolescente , Adulto , Idoso , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plasticidade Neuronal/fisiologia , Reação em Cadeia da Polimerase em Tempo Real , Recidiva , Valores de Referência , Adulto JovemRESUMO
BACKGROUND Depression is one of the most common mental disorders and often co-exists with somatic diseases. The most probable cause of comorbidity is a generalized inflammatory process that occurs in both depression and somatic diseases. Matrix metalloproteinases MMPs play a role in modulating inflammation and their impact in many inflammatory diseases has been investigated. The purpose of this study was to evaluate gene expression for selected polymorphisms of MMP-2 (C-735T), MMP-7 (A-181G), and MMP-9 (T-1702A, C1562T), which have been confirmed to participate in development of depression, and TIMP-2 (G-418C, tissue inhibitor of MMP). Activity variability of pro-MMP-2 and pro-MMP-9 was measured in a group of people with depression and a group of healthy individuals. MATERIAL AND METHODS The examined population comprised 142 individuals suffering from depression and 100 individuals who formed a control group (CG). Designations were carried out for MMP-2 (C-735T), MMP-7 (A-181G), MMP-9 (T-1702A, C1562T), and TIMP-2 (G-418C). RESULTS For all examined and tested MMPs and for TIMP-2, gene expression at the mRNA level was higher in patients with depression than in the CG. Similar results were recorded for gene expression at the protein level, while expression on the protein level for TIMP-2 was higher in the CG. Change in activity of MMP-2 and pro-MMP-2 was statistically more significant in the group with depression. The opposite result was recorded for MMP-9 and pro-MMP-9, in which the change in activity was statistically more significant in the CG. CONCLUSIONS Changes in MMPs and TIMP expression may be a common element in, or perhaps even a marker for, recurrent depressive disorders and somatic diseases.
Assuntos
Depressão/enzimologia , Depressão/genética , Metaloproteinases da Matriz/genética , Adulto , Estudos de Casos e Controles , Feminino , Regulação Enzimológica da Expressão Gênica , Humanos , Masculino , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 7 da Matriz/genética , Metaloproteinase 7 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Metaloproteinases da Matriz/metabolismo , Pessoa de Meia-Idade , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Inibidor Tecidual de Metaloproteinase-2/genética , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Adulto JovemRESUMO
BACKGROUND Depressive disorder, including recurrent type (rDD), is accompanied by increased oxidative stress and activation of inflammatory pathways, which may induce DNA damage. This thesis is supported by the presence of increased levels of DNA damage in depressed patients. Such DNA damage is repaired by the base excision repair (BER) pathway. BER efficiency may be influenced by polymorphisms in BER-related genes. Therefore, we genotyped nine single-nucleotide polymorphisms (SNPs) in six genes encoding BER proteins. MATERIAL AND METHODS Using TaqMan, we selected and genotyped the following SNPs: c.-441G>A (rs174538) of FEN1, c.2285T>C (rs1136410) of PARP1, c.580C>T (rs1799782) and c.1196A>G (rs25487) of XRCC1, c.*83A>C (rs4796030) and c.*50C>T (rs1052536) of LIG3, c.-7C>T (rs20579) of LIG1, and c.-468T>G (rs1760944) and c.444T>G (rs1130409) of APEX1 in 599 samples (288 rDD patients and 311 controls). RESULTS We found a strong correlation between rDD and both SNPs of LIG3, their haplotypes, as well as a weaker association with the c.-468T>G of APEXI which diminished after Nyholt correction. Polymorphisms of LIG3 were also associated with early onset versus late onset depression, whereas the c.-468T>G polymorphism showed the opposite association. CONCLUSIONS The SNPs of genes involved in the repair of oxidative DNA damage may modulate rDD risk. Since this is an exploratory study, the results should to be treated with caution and further work needs to be done to elucidate the exact involvement of DNA damage and repair mechanisms in the development of this disease.
Assuntos
Dano ao DNA , Reparo do DNA , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/genética , Transtorno Depressivo/genética , Estresse Oxidativo/genética , Adulto , Idoso , Estudos de Casos e Controles , DNA/genética , DNA/metabolismo , DNA Ligase Dependente de ATP/genética , DNA Ligase Dependente de ATP/metabolismo , DNA Ligases/genética , DNA Ligases/metabolismo , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/metabolismo , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Depressão/genética , Depressão/metabolismo , Transtorno Depressivo/metabolismo , Feminino , Endonucleases Flap/genética , Endonucleases Flap/metabolismo , Predisposição Genética para Doença , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Poli(ADP-Ribose) Polimerase-1/genética , Poli(ADP-Ribose) Polimerase-1/metabolismo , Proteínas de Ligação a Poli-ADP-Ribose , Polimorfismo de Nucleotídeo Único , Proteína 1 Complementadora Cruzada de Reparo de Raio-X , Proteínas de XenopusRESUMO
OBJECTIVE: Among the 28 metalloproteinases described so far, 23 can be found in the human organism, but only few are expressed in the human brain. The main objective of this study was to analyse the relationship between MMP-2, MMP-9 and TIMP-2 gene expression and cognitive performance. METHODS: The study comprised 234 subjects: patients suffering from recurrent depressive disorder (rDD, n=139) and healthy subjects (HS, n=95). The cognitive function assessment was carried out with the help of the following tests: Trail Making Test, The Stroop Test, Verbal Fluency Test and Auditory Verbal Learning Test. Gene expression on the mRNA and protein level was evaluated for MMP-2, MMP-9 and TIMP-2 in both groups using RNA extraction, reverse transcription and enzyme-linked immunosorbent assay. RESULTS: Both mRNA and protein expression levels of all the genes were significantly lower in rDD subjects as compared with HS. Having analysed the entire experimental group (N=234), significant interrelations were found between the expression of the analysed genes and the results of the tests used to measure cognitive functions. Increased expression on both the mRNA and the protein level was associated in each case with better performance of all the tests conducted. After carrying out a separate analysis on the people from the rDD group and the HS group, similar dependencies were still observed. CONCLUSIONS: The results of our study show decreased expression of MMP-2, MMP-9 and TIMP-2 genes on both mRNA and protein levels in depression. Elevated expression of MMP-2, MMP-9, TIMP-2 positively affects cognitive efficiency: working memory, executive functions, attention functions, direct and delayed auditory-verbal memory, the effectiveness of learning processes and verbal fluency. The study highlights the important role of peripheral matrix metalloproteinases genes in depression and cognitive functions.
Assuntos
Cognição/fisiologia , Transtorno Depressivo/metabolismo , Transtorno Depressivo/psicologia , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 9 da Matriz/genética , Inibidor Tecidual de Metaloproteinase-2/genética , Adulto , Idoso , Transtorno Depressivo/genética , Feminino , Regulação da Expressão Gênica , Humanos , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Adulto JovemRESUMO
BACKGROUND: Many clinical studies have shown that oxidative stress pathways and the efficiency of the oxidative DNA damage base excision repair (BER) system are associated with the pathogenesis of Alzheimer's disease (AD). Reduced BER efficiency may result from polymorphisms of BER-related genes. In the present study, we examine whether single nucleotide polymorphisms (SNPs) of BER genes are associated with increased risk of AD. METHODS: SNP genotyping was carried out on DNA isolated from peripheral blood mononuclear cells obtained from 120 patients with AD and 110 healthy volunteers. Samples were genotyped for the presence of BER-related SNPs, i.e. XRCC1-rs1799782, rs25487; MUTYH-rs3219489, and PARP1-rs1136410. RESULTS: We found a positive association between AD risk and the presence of G/A genotype variant of the XRCC1 rs25487 polymorphism [odds ratio (OR) = 3.762, 95% CI: 1.793-7.891]. The presence of the A/A genotype of this polymorphism reduced the risk of AD (OR = 0.485, 95% CI: 0.271-0.870). In cases of the PARP1 gene rs1136410 polymorphism, we observed that the T/C variant increases (OR = 4.159, 95% CI: 1.978-8.745) while the T/T variant reduces risk (OR = 0.240, 95% CI: 0.114-0.556) of AD. CONCLUSIONS: We conclude that BER gene polymorphisms may play an important role in the etiology of AD. Diagnosing the presence or absence of particular genetic variants may be an important marker of AD. Further research on a larger population is needed. There is also a need to examine polymorphisms of other BER in the context of AD risk.
Assuntos
Doença de Alzheimer/genética , DNA Glicosilases/genética , Proteínas de Ligação a DNA/genética , Predisposição Genética para Doença/genética , Poli(ADP-Ribose) Polimerases/genética , Polimorfismo de Nucleotídeo Único/genética , Idoso , Idoso de 80 Anos ou mais , Feminino , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Moleculares , Razão de Chances , Poli(ADP-Ribose) Polimerase-1 , Fatores de Risco , Proteína 1 Complementadora Cruzada de Reparo de Raio-XRESUMO
Faced with the growing frequency of mental disorders occurrence and considering the necessity of improving the patient care, it is particularly important that physicians of different specialties knew the general principles of effective communication with patients who are mentally ill. Equally important is to spread the knowledge of the symptomatology of various mental illnesses. Studies published by the Institute of Psychiatry and Neurology involving persons between 18 and 64 years old, show that 8 millions Poles suffers or suffered from mental disorders. This represents almost 25% of Polish society. The above data confirm, that basic knowledge of criteria for diagnosing mental disorders and their treatment by primary care physicians, determines the success of the entire health care system. It must be taken into consideration that frequently patients seeing general practitioner (GP) are suffering from more than one mental illness or it is accompanied by somatic disease. Adequate communication determines effective treatment. Simple yet exact message, ability to adapt it to patient and problems reported by him, is a valuable means in daily medical practice. It reduces the risk of iatrogenic disorder, encourages the efficiency of the entire therapeutic process. Good cooperation with the patient is also determined by patience, empathy, understanding, and competence. The aim of this study is to present the principles of effective communication between doctor and patient suffering from selected mental disorders. The article defines the concept of communication. It shows symptomatology of primary psychiatric disorders. Moreover, the most common difficulties in relationship between the doctor and the patient had been pointed.
Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Relações Médico-Paciente , Padrões de Prática Médica , Atenção Primária à Saúde/métodos , Comunicação , Humanos , Transtornos Mentais/epidemiologia , Polônia/epidemiologia , PrevalênciaRESUMO
Data show that up to 38.2% of the European population have a mental disorder and that recurrent depressive disorder (rDD) is among the most commonly diagnosed disabling diseases. Over the last few years, neurocognitive impairments in rDD have become a new research front focusing on the role of cognitive decline during the course of rDD and in relation to its clinical presentation and prognosis. Both immune-inflammatory and oxidative and nitrosative stress (O&NS) processes potentially play a role in development of cognitive dysfunction in rDD. New evidence shows that chronic inflammatory and O&NS reactions occur in the brains of patients with neurodegenerative disorders and those with rDD. This narrative review presents the current state of knowledge on the possible impact of selected inflammatory and O&NS enzymes on cognitive functioning in patients with rDD. We focus on manganese superoxide dismutase (MnSOD), inducible nitric oxide synthase (iNOS), and myeloperoxidase (MPO).
Assuntos
Cognição/fisiologia , Transtorno Depressivo/patologia , Inflamação/patologia , Estresse Oxidativo/fisiologia , Espécies Reativas de Nitrogênio/efeitos adversos , Europa (Continente) , Humanos , Inflamação/etiologia , Óxido Nítrico Sintase Tipo II/metabolismo , Peroxidase/metabolismo , Recidiva , Superóxido Dismutase/metabolismoRESUMO
UNLABELLED: In recent years, the research for the relation between depression and obesity is the basis of many studies. Interest in this subject results from the continuous increase in the incidence of both diseases and complications thereof, which constitute a serious social and economic problem. The aim of the study is to establish the dependence between depressive disorders and BMI. MATERIAL AND METHODS: One hundred twenty three patients aged 18-67 years with a diagnosis of depressive episode (F32) and recurrent depressive disorder (F33.0-F33.8) were used in the study. 21 items Hamilton Depression Rating Scale (HDRS21) was used to evaluate intensification of depressive disorders. Appraisal of psychiatric conditions with HDRS21 was performed twice: at the beginning of the study and after receiving the response on pharmacotherapy (averagely after 8 weeks). RESULTS: No relation between depressive disorders and BMI has been observed. CONCLUSIONS: Study did not demonstrated explicit link between BMI value and increase in depressive disorders. Considering the complexity of this problem, another studies should be carried out.
Assuntos
Transtorno Depressivo/epidemiologia , Obesidade/epidemiologia , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Comorbidade , Transtorno Depressivo/classificação , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Polônia , Adulto JovemRESUMO
BACKGROUND: Depressive disorders are multifactorial diseases in which cognitive impairments are one of typical features. Thiol protein groups (TPGs) are elements of chemical structure of compounds having antioxidative properties (glutathione peroxidase, metallothioneins) and their oxidation reflects the lost of compensatory capacity of antioxidative mechanisms. The purpose of this study was to determine the level of TPGs in patients with recurrent depressive disorder (rDD) and to define relationship between plasma levels of TPGs and the cognitive performance. MATERIAL AND METHODS: The study comprised 76 subjects: patients with rDD (n=43) and healthy subjects (comparison group, CG - n=33). Cognitive function assessment was based on the following 4 tests: the Trail Making Test (TMT), the Stroop Test, Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT). RESULTS: The level of TPGs was higher in patients with rDD. In rDD group, the elevated concentration of TPGs in plasma was associated with a decrease in efficiency of declarative-memory, working memory and verbal fluency. The higher was the concentration of plasma TPGs, the greater was the severity of depressive symptoms measured by 21-item Hamilton Depression Rating Scale (HDRS), before and after pharmacotherapy. In CG group, the elevated TPGs levels were associated with worse cognitive test performance (AVLT and VFT tests). CONCLUSIONS: 1) Our study confirms previous results showing increased TPGs level in depression. 2) Our data suggest relation between increased plasma TPGs level in depression and cognitive impairment. 3) The elevated levels of plasma TPGs are related to impairment of the short-term and delayed declarative memory, verbal fluency and working memory.
Assuntos
Proteínas Sanguíneas/metabolismo , Transtornos Cognitivos/metabolismo , Transtorno Depressivo/metabolismo , Estresse Oxidativo/fisiologia , Compostos de Sulfidrila/metabolismo , Adulto , Feminino , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Recidiva , Índice de Gravidade de Doença , Teste de Stroop , Teste de Sequência Alfanumérica , Adulto JovemRESUMO
OBJECTIVES: Deterioration of the working memory is regarded as one of the most important deficits in a number of somatic diseases. The purpose of the present study was to compare the effectiveness of working memory in 4 groups of patients: 1) diagnosed with recurrent depressive disorder (rDD), 2) with diabetes type 1 (DM1), 3) with diabetes type 2 (DM2), 4) with arterial hypertension (HA) and in healthy controls (HC). METHODS: The study comprised 300 subjects: rDD (n=99), DM1 (n=31), DM2 (n=31), HA (n=30) and HC (n=109).Cognitive function assessment was based on Trail Making Test (TMT) and the Stroop test. RESULTS: Analysis of variance (ANOVA) indicated statistically significant differences of the mean values among particular groups for each of the analysed results of the Stroop Test and TMT (p<0.0001). Patients with DM1 performed better in both TMT and Stroop tests, when compared to those diagnosed with HA. Patients with HA obtained better results than patients with DM2. Patients with rDD performed significantly worse than those with DM1 in both parts of TMT (A/time: p=0.022, B/time: p<0.001) and in the Stroop test (RCNb/time: p<0.001; NCWd/time: p=0.001; NCWd/errors: p=0.443). They also obtained worse results than patients with DM2 and HA, however, the differences were not statistically significant. CONCLUSIONS: 1) Our study has confirmed previous results showing association between depressive disorder and cognitive impairment. 2) Patients with rDD had worse performance on working memory tasks than the patients with DM type 1, DM type 2 and HA. 3) Further investigation is needed to clarify the role of inflammatory and oxidative and nitrosative stress (O&NS) processes in neurocognitive dysfunctions occurring in recurrent depression and somatic disease.
Assuntos
Transtorno Depressivo/complicações , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Hipertensão/complicações , Transtornos da Memória/complicações , Memória de Curto Prazo , Adulto , Idoso , Transtorno Depressivo/psicologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Hipertensão/psicologia , Masculino , Transtornos da Memória/diagnóstico , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
UNLABELLED: Depressive disorder is a multifactorial diseases, that one of the typical feature are cognitive impairments. The aim of this study was to determine the total antioxidant status (TAS) in patients with recurrent depressive disorder (rDD) and to define relationship between plasma levels of TAS and the cognitive performance. DESIGN AND METHODS: the study comprised 74 subjects: patients with rDD (n = 45) and healthy subjects (n = 29). Cognitive function assessment was based on: Trail Making Test, The Stroop Test, Verbal Fluency Test and Auditory Verbal Learning Test. Statistically significant differences were found in the intensity of depression symptoms, measured by the Hamilton Depression Rating Scale (HDRS) on therapy onset versus the examination results after 8 weeks of treatment (p < 0.001). The level of TAS was substantially higher in patients with rDD (p = 0.01). For rDD patients, elevated TAS levels were associated with worse cognitive test performance. The higher was the concentration of plasma TAS, the greater was the severity of depressive symptoms measured by HDRS before and after pharmacotherapy. (1) Higher concentration of plasma TAS in rDD patients is associated with the severity of depressive symptoms. (2) Elevated levels of plasma TAS are related to impairment of short-term declarative memory, long-term declarative-memory, verbal fluency and working memory.
Assuntos
Antioxidantes/metabolismo , Transtornos Cognitivos/etiologia , Transtorno Depressivo/sangue , Adulto , Antidepressivos/uso terapêutico , Cognição , Transtornos Cognitivos/sangue , Transtorno Depressivo/tratamento farmacológico , Feminino , Humanos , Masculino , Memória de Longo Prazo , Memória de Curto Prazo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Aprendizagem VerbalRESUMO
Oxidative stress has been implicated in the cognitive decline, especially in memory impairment. The purpose of this study was to determine the concentration of malondialdehyde (MDA) in patients with recurrent depressive disorders (rDD) and to define relationship between plasma levels of MDA and the cognitive performance. The study comprised 46 patients meeting criteria for rDD. Cognitive function assessment was based on: The Trail Making Test , The Stroop Test, Verbal Fluency Test and Auditory-Verbal Learning Test. The severity of depression symptoms was assessed using the Hamilton Depression Rating Scale (HDRS). Statistically significant differences were found in the intensity of depression symptoms, measured by the HDRS on therapy onset versus the examination results after 8 weeks of treatment (P < 0.001). Considering the 8-week pharmacotherapy period, rDD patients presented better outcomes in cognitive function tests. There was no statistically significant correlation between plasma MDA levels, and the age, disease duration, number of previous depressive episodes and the results in HDRS applied on admission and on discharge. Elevated levels of MDA adversely affected the efficiency of visual-spatial and auditory-verbal working memory, short-term declarative memory and the delayed recall declarative memory. 1. Higher concentration of plasma MDA in rDD patients is associated with the severity of depressive symptoms, both at the beginning of antidepressants pharmacotherapy, and after 8 weeks of its duration. 2. Elevated levels of plasma MDA are related to the impairment of visual-spatial and auditory-verbal working memory and short-term and delayed declarative memory.
Assuntos
Transtorno Depressivo/sangue , Transtorno Depressivo/fisiopatologia , Malondialdeído/sangue , Memória de Curto Prazo/fisiologia , Adulto , Cognição/fisiologia , Demografia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estatísticas não Paramétricas , Adulto JovemRESUMO
The coexistence of two or more diseases in one patient, especially in old age, is a common situation. The problem of drug effects, specifically speaking, their interaction and impact on the second condition still remains not fully explored and thus is very interesting. At the same time, it is commonly known that depression and cancer are some of the most frequently met disorders and following the WHO forecasts, their prevalence will constantly increase. In addition, it is worth noting that both the psychological and physical health of the patient suffering from cancer, are essential for proper co-operation, especially when it comes to adoption of recommended drugs. The case is aggravated by the fact that no standards of conduct in case of coexistence of the two diseases have been established and the results of research are very often contradictory. Therefore the issue discussed in this study seems to be very important and still valid. In this monograph the problem of the influence of antidepressant pharmacotherapy on the course of disease will be presented.
Assuntos
Antidepressivos/efeitos adversos , Transtorno Depressivo/tratamento farmacológico , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Fatores Etários , Idoso , Antidepressivos/uso terapêutico , Transtorno Depressivo/epidemiologia , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Fatores de RiscoRESUMO
The problem of addiction to psychoactive substances (SPA) is an important aspect of modem psychiatric treatment. This is due to the increasing number of addicts, and reducing their increasing age. It is estimated that in the United States in 2006, people aged over 12 years of meeting criteria for dependence on SPA was 20-25 million. Other statistics report that in the same age group over the last year contact with these substances were 8-10 percent of the U.S. population. Therefore, it becomes an important issue the appropriate therapeutic treatment of addicts. The result of the search of drugs that help people to alcoholism treatment program, were studies involving trazodone. Counted among the SARI (serotonin reuptake inhibitor and antagonist), shows antagonism to serotonergic receptors (5-HT2 receptors), while an inhibitor of serotonin reuptake. Its performance was analyzed in individuals dependent on alcohol, benzodiazepines and opiates, as well as mixed addictions. Also raised the problem of influence of trazodone on the experience of pain, which maybe helpful in relieving withdrawal symptoms. The data show a positive effect of trazodone in individuals addicted to the SPA, although the mechanism by which trazodone works in the body is very complex and not yet fully understood. Its advantage is the relatively small panel of side effects. Although many of the analyzed studies were not placebo-controlled, the results are so promising that you can recommend on the basis of trazodone therapy in individuals addicted to the SPA.
Assuntos
Comportamento Aditivo/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Trazodona/uso terapêutico , Alcoolismo/tratamento farmacológico , Humanos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêuticoRESUMO
Reactive oxygen species (ROS) may contribute to the pathogenesis of depressive disorder (DD). Functional genetic polymorphisms of manganese superoxide dismutase (MnSOD) are candidates for DD susceptibility. The study examined the relationship between MnSOD gene polymorphisms (Ala-9Val, Ile-58Thr) and DD in the Polish population. The association study was conducted in a case-control design in DD patients (n=149) and healthy controls (CG; n=149) by genotyping. Assessment of Ala-9Val genotype distribution and disease odds ratio demonstrated a statistically significant difference between the compared groups only in the female subgroup. The obtained results suggest a role of the MnSOD polymorphism in the development and course of depression.
Assuntos
Aminoácidos/genética , Depressão/genética , Predisposição Genética para Doença , Polimorfismo Genético/genética , Superóxido Dismutase/genética , Alanina , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Isoleucina , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Treonina , ValinaRESUMO
Restless legs syndrome (RLS) is characterised by daily dynamic sensorial and motor syndromes. It is a relatively little known syndrome among neurologists as well as psychiatrists. In spite of a growing number of researches on this issue, the problem seems to be underdiagnosed. Because of a subjective character of the symptoms and also their appearance in the evening hours, they are difficult to observe among outpatients. In the case of diagnosing the restless legs syndrome, therapists pay attention to sleep disorders, which usually remain as the only one being treated and others are omitted. Some are convinced of little harmfulness of this syndrome, however sleep disorders themselves worsen social functioning and those disorders lasting longer, increase the probability of other, not only psychiatric disorders appearing. A separate issue is the not yet established pathogenesis of the restlessness legs syndrome, especially its genetic background. It is important because of the possible ways of treatment. Undoubtedly RLS needs more research and promoting knowledge on this issue not only among doctors but also in the whole society.
Assuntos
Medicina Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Exame Neurológico , Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/terapia , Diagnóstico Diferencial , Humanos , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapiaRESUMO
UNLABELLED: Mentally retardated patients are considered to be the worst treated and medical cared group of psychiatric patients. Mentally impaired patients are diagnosed following the same diagnostic criteria as patients with normal intellectual abilities. The diagnosis stated should determine adequate pharmacological treatment schemes, the same as for general population. The aim of paper was to analyse pharmacological treatment administered to mentally retarded patients during psychiatric hospitalization. MATERIAL AND METHODS: The medical documentation of patients hospitalized in Babinski's Hospital in Lodz in 2006 with diagnosis of mental retardation (F70-F79 according to ICD-10). The patients hospitalized throughout the year 2006 with co-morbid psychiatric diagnosis as well as those with only stated mental retardation were taken into account. The analysis was based on questionnaire specially prepared for that paper. The results were statistically analyzed. RESULTS: The most frequent administered treatment among mentally retarded patients during psychiatric hospitalization were antipsychotics of the first generation and mood stabilizers independently on co-morbid psychiatric disorders. CONCLUSIONS: Regardless the level of mental retardation the most rarely administered group of medicines seemed to be antidepressive drugs (statistical importance) and atypical antipsychotics. Mood stabilizers were statistically more frequently administered in patients with severe level of mental retardations.
Assuntos
Ansiolíticos/uso terapêutico , Antipsicóticos/uso terapêutico , Deficiência Intelectual/complicações , Transtornos Mentais/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/complicaçõesRESUMO
UNLABELLED: Although the knowledge of psychiatric disorders appearing in course of mental retardation is wider, there is still no straightforward data concerning their frequency, symptomatology, and factors responsible for their appearance. Symptomatology of disorders and psychiatric illnesses presented by mentally retarded patients may differ from the one presented by healthy control. Nowadays it is commonly considered that the same disorders and illnesses are diagnosed among mentally retarded as well as among general population. THE AIM OF THE STUDY: To analyze of psychopthologic symptoms observed during the admission of mentally retarded patients to psychiatric hospital, to analyze comorbid psychiatric disorders and stated diagnoses. MATERIAL AND METHODS: The medical documentation of patients hospitalized in Babinski's Hospital in Lódz (SPZOZ) in 2006 with diagnosis of mental retardation (F70-F79 according to ICD-10). The patients hospitalized throughout the year 2006 with comorbid psychiatric diagnosis as well as those with only stated mental retardation were taken into account. The analysis was based on questionnaire specially prepared for that paper. The results were statistically analyzed. RESULTS: In mentally retarded patients admitted to psychiatric hospital behavior disorders were the most frequently observed ones, subsequently psychosis and impulse control disorders. Psychiatric disorder were mainly demonstrated by aggression and psychomotor agitation. Psychiatric disorders at mentally retarded patients are expressed by nonspecific syndromes, among which the most common are aggression, mood lowering, psychomotor agitation, dysphoria, irritability. CONCLUSIONS: Nonspecific syndromes, communication difficulties and low prevalence of standardized diagnostic methods for mentally retarded patients are the reasons for still low number of precise psychiatric stated diagnoses in comparison to the described syndromes and disorders. This results in treating psychiatric syndromes as the consequence of mental retardation itself, not as the consequence of present psychiatric disorder.
Assuntos
Deficiência Intelectual/epidemiologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pessoas com Deficiência Mental/estatística & dados numéricos , Adulto , Comorbidade , Feminino , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Polônia/epidemiologiaRESUMO
UNLABELLED: The aim of environmental model of psychiatric care, which is nowadays functioning in developed countries, is not only improve the quality of life of people with psychiatric disorders, among which there are mentally retarded patients, but also decrease the number and duration of psychiatric hospitalization. Mentally retarded patients have basically weaker adjustment abilities to changing conditions of the daylife routines, as well as they are more susceptible to psychiatric disorders than general population. Taking that into consideration it seems interesting to investigate the reasons of psychiatric hospitalization. THE AIM OF THE STUDY: To investigate the reason of psychiatric hospitalization among mentally retarded patients. MATERIAL AND METHODS: The medical documentation of patients hospitalized in Babiriski's Hospital in Lódz (SPZOZ im.Babinskiego) in 2006 with diagnosis of mental retardation (F70-F79 according to ICD-10). The patients hospitalized throughout the year 2006 with comorbid psychiatric diagnosis as well as those with only stated mental retardation were taken into account. The analysis was based on questionnaire specially prepared for that paper. The results were statistically analyzed. CONCLUSIONS: Analysis of results allowed to form the following conclusions: (1) The most frequent indirect reasons of psychiatric hospitalization were: aggression, appearance or worsening of psychotic symptoms, worsening or change of behavior. Directly hospitalizations were determined by environmental reasons among which conflicting relationships and lack of personal support were the most common. (2) Behavior and impulse disorders were the most frequently observed among men, psychotic disorders among women. Psychotic decompensations were the most frequent at mentally retarded in light degree, behavior disorders among severe mentally retarded. 3) The occurrence of psychiatric disorders which determine psychiatric hospitalization is mainly the consequence of adverse environment factors and difficulties in adjustment to them.
Assuntos
Hospitalização/estatística & dados numéricos , Hospitais Psiquiátricos/estatística & dados numéricos , Deficiência Intelectual/classificação , Admissão do Paciente/estatística & dados numéricos , Adulto , Feminino , Humanos , Deficiência Intelectual/epidemiologia , Tempo de Internação , Masculino , Polônia/epidemiologia , Inquéritos e QuestionáriosRESUMO
UNLABELLED: Mental retardation is a common phenomena in general population. Mentally retarded patients have basically weaker adjustment abilities to changing conditions of the day life routines. Since the risk of mental disorders is four times higher among mentally retarded than in general population, it seems interesting to investigate suicidal behavior at mentally retarded patients. As the literature shows the frequency of committed and attempted suicides is lower than in general population, however it cannot be ignored. THE AIM OF THE STUDY: To investigate suicidal behaviors in the group of mentally retarded patients who have been admitted to psychiatric hospital. MATERIAL AND METHODS: The medical documentation of patients hospitalized in Babinski's Hospital in Lodz in 2006 with diagnosis of mental retardation (F70-F79 according to ICD-10). The patients hospitalized throughout the year 2006 with co morbid psychiatric diagnosis as well as those with only stated mental retardation were taken into account. The analysis was based on questionnaire specially prepared for that paper. The results were statistically analyzed. RESULTS: 71 medical histories of in-patients, of which 32 were women (45%) and 39 were men (54.9%) were analyzed. The average age was 34.2 +/- 12.9. There was no statistical significance in attempting suicides depending on sex, however there was statistical significance depending on the level of mental retardation--more patients with impaired in light degree attempted suicides. In analyzed community both women and men attempted suicides mainly by self-injuries, however there was no statistical significance. There was statistical significance between the level of mental retardation and the chosen way of attempting suicide: patients impaired in light degree more often chosen self-injuries. CONCLUSIONS: Suicidal behaviors are not frequent reason of admission to psychiatric hospital among mentally retarded patients. The study shows the statistical significance between the level of mental impairment and attempting suicides in general as well as the chosen method of attempting suicide. There was not statistical significance neither between the sex of mentally retarded patients and attempting suicide in general nor between sex and the chosen method.