During the first month postpartum, 85% of women experience some form of mood disorders. The most common are: postpartum blues, non-psychotic postpartum depression, puerperal psychosis. Delivery of a ...child can be traumatic for some women. Several authors have found that women could get symptoms of one form of posttraumatic stress disorder (PTSD) after childbirth. However, etiology of established postpartum disorders is still unknown. The aim of this study is to detect symptoms of acute stress reaction and acute depressive state as a consequence of peripartal complications, as early as three days postpartum using Impact of Events Scale revised (IES-R) and the Edinburgh Postnatal Depression Scale (EPDS) questionnaires and to demonstrate their potential usage for the early detection of vulnerable mothers with greater risk to develop any of postpartum psychiatric disorder, including PTSD. For that purpose 103 subjects, without previous medical history of psychiatric illness, were included in the investigation. Long duration of delivery (> or = 12 h), very painful delivery, complication and illness of mother during and after delivery as a consequence of delivery, preterm delivery (before week 36) and/or illness of the child (as a consequence of delivery or congenital) are considered to be risk factors for acute stress reaction and acute depressive state after delivery. Sixty one out of 103 investigated mothers had one or more researched peripartal complications. A statistically significant difference has been found between the control (n=42) and the peripartal complications (n=61) groups in both the mean IES-R (4.67 +/- 5.43 and 13.50 +/- 14.12, respectively, p < 0.01) as well as in the mean EPDS (3.85 +/- 2.76 and 7.03 +/- 3.90, respectively, p < 0.01) scores. Additionally, while there were 4 cases of acute stress reactions and 3 cases of acute depressive state in the peripartal complications group there were no cases of these states in the control group. Based on our findings we conclude that using IES-R and EPDS questionnaires as early as three days after delivery could provide an early detection of previously healthy mothers with greater risk for development of postpartum psychiatric disorders.
Despite the growing number of different therapeutic options, treatment of depression is still a challenge. A broader perspective reveals the benefits of bright light therapy (BLT). It stimulates ...intrinsically photosensitive retinal ganglion cells, which induces a complex cascade of events, including alterations in melatonergic, neurotrophic, GABAergic, glutamatergic, noradrenergic, serotonergic systems, and HPA axis, suggesting that BLT effects expand beyond the circadian pacemaker.
In this review, the authors present and discuss recent data of BLT in major depressive disorder, non-seasonal depression, bipolar depression or depressive phase of bipolar disorder, and seasonal affective disorder, as well as in treatment-resistant depression (TRD). The authors further highlight BLT effects in various depressive disorders compared to placebo and report data from several studies suggesting a response to BLT in TRD. Also, the authors report data showing that BLT can be used both as a monotherapy or in combination with other pharmacological treatments.
BLT is an easy-to-use and low-budget therapy with good tolerability. Future studies should focus on clinical and biological predictors of response to BLT, on defining specific populations which may benefit from BLT and establishing treatment protocols regarding timing, frequency, and duration of BLT.
Research on the effects of treating sub-threshold depression in persons with diabetes is scarce in spite of the findings indicating that this condition is highly prevalent in the diabetic population ...and may increase the risk of developing a subsequent major depression. This study was aimed at exploring the effects of a psycho-educational intervention on depression- and diabetes-related outcomes in patients with mild to moderate depressive symptoms.
A randomized controlled study design with a one-year follow-up was used. Fifty patients with mild to moderate depressive symptoms (74% female, aged 57 +/- 9 yrs, diabetes duration of 10 +/- 8 yrs, BMI 31 +/- 6 kg/m2, HbA1C 7.7% +/- 1.4, 53% insulin treated) were randomly assigned to either an intervention or a control group. The intervention group underwent four psycho-educational sessions aimed at enabling self-management of depressive symptoms. The control group was informed about the screening results and depression treatment options while continuing diabetes treatment as usual. Both groups were contacted by phone in 2-3-month intervals, and re-assessed for depression after 6 and 12 months. Changes in depressive symptoms and glycaemic control were considered primary outcomes. Mann-Whitney U test and Friedman ANOVA were used to compare between- and within-group indicators at 6- and 12-month follow-ups.
Both the intervention and the control group reported a significant decrease in depressive symptoms as measured by the CES-D scale (Friedman ANOVA chi2 = 10.8 p = .004 and chi2 = 7.3 p = 0.03, respectively). The 6-month and 1-year indicators of glycaemic control as compared to baseline HbA1C values were also improved in both groups (chi2 = 11.6 p = 0.003 and chi2 = 17.1 p = 0.0002, respectively). Between-group differences in depressive symptoms and HbA1C values were not statistically significant either at 6- or at 12-month follow-up (all p > 0.05).
Psycho-educational treatment appears to be beneficial in diabetic patients with mild to moderate depressive symptoms, but its effects are comparable with the non-specific support given to the subjects in the control group.
Current Controlled Trials ISRCTN58745372.
The aim of the study was to determine the possible differences in quantitative EEG parameters of schizophrenic patients before and during therapy with neuroleptics. First EEG recordings were obtained ...from schizophrenic patients (n = 50) who had not been taking any medicaments during the preceding 2 months. Second EEG recordings were obtained during the administration of neuroleptic therapy. Amplitude values of particular spectral segment, i.e. delta, theta, alpha 1, alpha 2, beta 1 and beta 2 (after fast Fourier transformation) were analyzed. The F3, F4, C3, C4, T3, T4, P3, P4, O1 and O2 regions were observed. The effect of pharmacotherapy manifested as a decrease in delta and beta 2 activities. The alterations of the delta spectrum were recorded in each patient subgroup (regardless of the neuroleptic used). The changes in beta 2 activity were registered in patients on haloperidol and fluphenazine.
The Behavioral Subcommittee of the Bárány Society Committee for Classification of Vestibular Disorders recently established the diagnostic criteria for a persistent postural-perceptive dizziness ...(PPPD).
This study aims to determine how significant the degree of anxiety and depression of PPPD patients is, compared to the patients with other dizziness.
The study was conducted on 78 patients, 39 (50%) of whom suffer from PPPD, and of a control group consisting of the same number of patients with other types of dizziness. All the patients filled out the DHI and HADS questionnaire and were subjected to a VNG and VEMP examination.
The DHI showed significant disability in the majority of patients, slightly more in the control group. The HADS showed an equal degree of anxiety in both groups of patients, but significantly higher pathological anxiety in the PPPD group (49%:31%).
Majority of the patients in both groups experienced mild anxiety, while those with the pathological degree were more represented in the PPPD group. Depression was more expressed in the group of other dizziness. We can consider only the patients with a pathological degree of anxiety as predisposed to the emergence of PPPD.
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