The spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) pandemic has led to numerous negative consequences on the mental health of the ...population throughout the world. The main aim of our study was to compare the risk for depression, anxiety, and stress during the second wave of the pandemic in Slovenia. An additional goal was to analyze the association of depression, anxiety, and stress, with the most relevant subjective factors that define the quality of life. Furthermore, we aimed at determining whether health workers have a higher risk for depression following the course of the pandemic. The study was conducted on the general population, between July 2020 and January 2021 through an online survey. The data of 1,728 respondents in two samples of respondents (782 at baseline - first measurement point and 946 during the second measurement point) of the second wave were analyzed using zero-inflated negative binomial regression and Mann-Whitney
-test. The findings of this study show that the rise the second wave was associated with a higher risk for depression, anxiety and stress. The risk for all three was higher for younger participants. Women showed a higher risk for anxiety and stress. Finances, relationships, and housing dissatisfaction were relevant predictors for depression, anxiety and stress. Health workers in our sample showed a higher risk for stress, but not for depression or anxiety, than the general population. Our findings highlight the urgent need for coordinating and developing mental health services and tailored interventions to reduce the mental health burden, especially in the younger.
Aim: The majority of available data on safety and tolerability issues regarding cholinesterase inhibitors used for the treatment of Alzheimer's disease has been available for orally administered ...formulations. The objective of this prospective, 24 week, observational, non‐interventional post‐marketing surveillance study was to evaluate the safety and tolerability, as well as the efficacy, of the rivastigmine transdermal patch formulation in newly diagnosed patients with Alzheimer's dementia in naturalistic conditions.
Methods: Safety and tolerability assessment included the monitoring and recording of adverse events and withdrawals at any time during the study. The efficacy parameter was determined based on the score of the Mini‐Mental State Examination.
Results: Out of the 433 patients, 11 patients (2.54%) suffered serious adverse events. Non‐serious adverse events were reported in 179 patients (41.34%). As adverse event is defined as any untoward medical occurrence that may present during treatment with a pharmaceutical product but that does not necessarily have a causal relationship with this treatment. The most common adverse event in the present study was a decline in the Mini‐Mental State Examination score in 97 patients (22.40%). The second most common non‐serious adverse event was a skin reaction in 61 patients (14.09%). Treatment with rivastigmine continued in 139 cases (32.10%) and was discontinued in 40 cases (9.24%). The median Mini‐Mental State Examination score observed at the time of inclusion was 21.0, and after 6 months, it was 22.0 (W 63441; P < 0.001). Because of several limitations, the open‐label design of the present study necessitates caution when interpreting the results.
Conclusions: The results of this study suggest that the rivastigmine transdermal patch is safe and tolerable for Alzheimer's dementia patients in naturalistic conditions.
Introduction
Patients with schizophrenia typically exhibit deficits in working memory (WM) associated with abnormalities in brain activity. Alterations in the encoding, maintenance and retrieval ...phases of sequential WM tasks are well established. However, due to the heterogeneity of symptoms and complexity of its neurophysiological underpinnings, differential diagnosis remains a challenge. We conducted an electroencephalographic (EEG) study during a visual WM task in fifteen schizophrenia patients and fifteen healthy controls. We hypothesized that EEG abnormalities during the task could be identified, and patients successfully classified by an interpretable machine learning algorithm.
Methods
We tested a custom dense attention network (DAN) machine learning model to discriminate patients from control subjects and compared its performance with simpler and more commonly used machine learning models. Additionally, we analyzed behavioral performance, event-related EEG potentials, and time-frequency representations of the evoked responses to further characterize abnormalities in patients during WM.
Results
The DAN model was significantly accurate in discriminating patients from healthy controls,
ACC
= 0.69, SD = 0.05. There were no significant differences between groups, conditions, or their interaction in behavioral performance or event-related potentials. However, patients showed significantly lower alpha suppression in the task preparation, memory encoding, maintenance, and retrieval phases
F
(1,28) = 5.93,
p
= 0.022, η
2
= 0.149. Further analysis revealed that the two highest peaks in the attention value vector of the DAN model overlapped in time with the preparation and memory retrieval phases, as well as with two of the four significant time-frequency ROIs.
Discussion
These results highlight the potential utility of interpretable machine learning algorithms as an aid in diagnosis of schizophrenia and other psychiatric disorders presenting oscillatory abnormalities.
Abstract Background Brain-derived neurotrophic factor (BDNF) mediates neural plasticity, mood, different behaviours, and stress response. A functional BDNF polymorphism (BDNF Val66Met) was reported ...to influence the effects of stressful life events or childhood adversity on depression and suicidal behaviour in various psychopathologies. The study evaluated the association between BDNF Val66Met variants and suicide, committed with violent or non-violent methods, in victims with or without stressful childhood experience. Methods BDNF Val66Met polymorphism was genotyped on 560 DNA samples from 359 suicide victims and 201 control subjects collected on autopsy from unrelated Caucasian subjects and subdivided according to gender, method of suicide, and influence of childhood adversity. Results A similar frequency of BDNF Val66Met variants was found between all included suicide victims and the control groups, and also between the male groups. The frequency of the combined Met/Met and Met/Val genotypes and the homozygous Val/Val genotype was significantly different between the female suicide victims and female controls, between the female suicide victims who used violent suicide methods and female controls, and between all included suicide victims with or without stressful life events. The combined Met/Met and Met/Val genotypes contributed to this significance. Limitation A small group of suicide victims with available data on childhood adversity was studied. Conclusions The combined Met/Met and Met/Val genotypes of the BDNF Val66Met variant could be the risk factor for violent suicide in female subjects and for suicide in victims exposed to childhood trauma. These results confirm a major role of BDNF in increased vulnerability to suicide.
Depression is a common mental disorder with a high burden of disease worldwide and requires effective treatment. On behalf of the General Advisory Council for Psychiatry, clinical recommendations ...were formed to help clinicians make decisions to improve the treatment of patients with unipolar depressive disorder; several international guidelines served as the basis for developing these recommendations. In terms of therapeutic approaches, pharmacological treatment is discussed with additional recommendations on the management of a partial response to treatment and treatment resistance. Psychotherapy, psychoeducation, and other psychosocial approaches represent non-pharmacological interventions for the treatment of depressive disorder. Biological methods for treating depression include non-invasive brain stimulation methods. The second part of the recommendations addresses special populations: children and adolescents, the elderly, and the treatment of depression in the perinatal period.
Inappropriate verbal and physical sexual behaviour is not common among individuals with dementia, but when it does occur, it can have profound consequences. We report a case of 79‐year‐old woman with ...dementia of the Alzheimer's type who complained of increased libido after an increased dose of donepezil, which was being used along with tianeptine. Donepezil withdrawal led to the resolution of increased libido, but when it was reintroduced, increased libido reappeared once again (Naranjo score: 7). Increased libido was not reported by the patient during the 6‐year follow‐up period after donepezil withdrawal. A potential mechanism of acetylcholinesterase inhibitor‐induced increased libido and the current literature on hypersexuality as a side‐effect of donepezil treatment are discussed.
CIRCADIAN RHYTMICITY AND DEPRESSION Peter Pregelj
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
11/2008, Letnik:
77, Številka:
11
Journal Article
Recenzirano
Odprti dostop
BACKGROUND Depression is the most common psychiatric syndrome treated on the primary level. Abnormal patterns of circadian rhythms are associated with a large variety of affective disorders including ...depression. Sleep disruption is one of the major symptoms in depression,with majority of patients with major depression reporting difficulties with their sleep. Inhumans, the »biological clock« is the site of generation of entrainment of circadian rhythms.It is located in the suprachiasmatic nuclei of the anterior hypothalamus and is functionally interconnected with the melatonergic system. Melatonergic receptors type 1 and 2participate in the regulation of the suprachiasmatic nucleus activity. When stimulated,receptors type 1 mediate the amplitude of the suprachiasmatic nucleus activity while receptors type 2 control phase shifting of the same activity. On the neurobiological level, depression is complex mood disorder that is also associated with the functional impairment ofseveral central nervous systems including noradrenergic, serotonergic and dopaminergictransmitters and several hormonal systems. CONCLUSIONS There is a grooving evidence that dysfunction in circadian rhythm regulation andmelatonergic system function is involved in depression pathogenesis. It is known thatclinically used antidepressants have influence on melatonergic system, probably throughchanged ratio between melatonergic type 1 and 2 receptors. With the clinical use of newcompounds like agomelatine that directly regulates melatonergic system new opportunities in depression treatment emerged
Background Antipsychotic medications have been reduced severity and duration of acute psychotic episode and the number of recurrent psychotic episodes among persons with schizophrenia by long-term ...use of this medication. However, poor adherence to antipsychotic medication in schizophrenia has been associated with increased rate of rehospitalisation and relapse. The nonadherence to antipsychotic medication is often underestimated. Good adherence to antipsychotic medication is one of the corner stones of long remissions. Conclusions On the basis of different studies it could be concluded that around one half of the schizophrenia patients have poor adherence to antipsychotic medication. To increase adherence to antipsychotic medication good therapeutic alliance should be established with positive emotions, bilateral communication and patient involvement in decision making. The adherence to the antipsychotic medication could be improved with the agreement about psychopharmacotherapy. Antipsychotic therapy should be understandable, tolerable and acceptable for the patient
Psychotropic drugs could influence psychophysical performance and driving skills. Impaired psychophysical performance can therefore represents an important cause of traffic accidents. Most patients ...are treated as outpatients and are more likely to drive a vehicle than hospitalized patients. The paper presents different categorizations of psychotropic drugs that are currently in use. The impact of various classes of psychotropic drugs on driving skills is described.
PDF
