1,721,031 research outputs found
Psychiatric conditions in Parkinson disease: a comparison with classical psychiatric disorders
No full textPsychiatric conditions often complicate the outcome of patients affected by Parkinson disease (PD), but they differ from classical psychiatric disorders in terms of underlying biological mechanisms, clinical presentation, and treatment response. The purpose of the present review is to illustrate the biological and clinical aspects of psychiatric conditions associated with PD, with particular reference to the differences with respect to classical psychiatric disorders. A careful search of articles on main databases was performed in order to obtain a comprehensive review about the main psychiatric conditions associated with PD. A manual selection of the articles was then performed in order to consider only those articles that concerned with the topic of the review. Psychiatric conditions in patients with PD present substantial differences with respect to classical psychiatric disorders. Their clinical presentation does not align with the symptom profiles represented by Diagnostic and Statistical Manual for Mental Disorders and International Classification of Diseases. Furthermore, psychiatry treatment guidelines are of poor help in managing psychiatric symptoms of patients with PD. Specific diagnostic tools and treatment guidelines are needed to allow early diagnosis and adequate treatment of psychiatric conditions in comorbidity with PD
Is Internet Addiction a Clinical Symptom or a Psychiatric Disorder? A Comparison With Bipolar Disorder
No full textThe general purpose of this review is to present an updated literature overview of neurobiological/clinical aspects of Internet addiction (IA), particularly of overlaps and differences with bipolar affective disorder (BPAD). Articles with clinical/neurobiological aspects of IA or similarities/differences with BPAD as main topics, from 1990 to present and written in English language, were included. Comorbidity between IA and other psychiatric disorders, including BPAD, is common. Dysfunctions in dopaminergic pathways have been found both in IA and in mood disorders. Most of investigations in IA support a chronic hypodopaminergic dysfunctional state in brain reward circuit and an excessive reward experience during mood elevation. Neuroimaging studies show prefrontal cortex abnormalities shared between addictive and bipolar patients. BPAD and IA present numerous overlaps, such as polymorphisms in nicotinic receptors genes, anterior cingulate/prefrontal cortex abnormalities, serotonin/dopamine dysfunctions, and good response to mood stabilizers. The future is to clarify diagnostic criteria to better define the IA/BPAD relationship
Pharmacokinetic evaluation of pregabalin for the treatment of generalized anxiety disorder
No full textIntroduction: Pregabalin is an alternative compound to SSRIs and SNRIs for the first-line treatment of generalized anxiety disorder (GAD). Areas covered: We describe the pharmacokinetic properties of pregabalin and their implications for the treatment of GAD. A search in the main database sources (Medline, ISI, Web of Knowledge and Medscape) was performed in order to obtain a comprehensive and balanced evaluation about the clinical implications of the pharmacokinetic properties of pregabalin in the treatment of GAD. The word “pregabalin” was associated with “pharmacokinetics”, “interactions”’, “GAD”, “anxiety” and “tolerability”. No restriction criteria were established in relation to methodology or publication year. Only English-language articles were selected. Expert opinion: Pregabalin is a safe and efficacious compound for GAD treatment. Short half-life (preventing persistence of side effects), absence of active metabolites and no interactions with CYP450 enzymatic system are all favorable pharmacokinetic properties for the treatment of GAD patients, including those with comorbid depressive symptoms or medical conditions. On the other hand, prescription of pregabalin should be handled with caution to minimize the incidence of renal impairment (especially in elderly patients), where a history of substance misuse or concomitant medications (e.g. anti-hypertensives or some antibiotics) are risk factors that can affect renal function
Psychotic versus non-psychotic major depressive disorder : a comparative naturalistic study
No full textOBJECTIVE: Psychotic depressed patients were found to have more severe cognitive deficits, poorer treatment response and higher suicidal risk respect to non-psychotic depressives. Aim of the present research was to compare clinical variables and outcome between psychotic and non-psychotic major depressive patients.
METHOD: A sample of 36 major depressed patients was divided into two groups according to the presence of psychotic symptoms. Structured Clinical Interview for DSM (SCID-I) and Hamilton Depression Rating Scale (HAM-D) were administered to the patients at baseline by trained raters. One-way analysis of variance (ANOVAs) and chi-square tests were performed to compare the two groups. Binary logistic regression was performed to assess the risk of lack of response/remission in patients with psychotic symptoms and the risk of developing psychotic symptoms in major depressives with a family history of schizophrenia or bipolar disorder.
RESULTS: Psychotic major depressives presented more severe illness as showed by HAM-D baseline scores (F=17.20, p<0.001), a longer duration of hospitalization (F=7.64, p=0.009) and they were more frequently treated with clomipramine (χ(2)=16.22, p=0.027). Psychotic symptoms were predictive of lack of remission (OR=4.09, p=0.05) and family history of schizophrenia/psychotic bipolar disorder was associated with psychotic major depression (OR=10.81, p=0.04).
CONCLUSIONS: Patients with psychotic symptoms present a more severe course of illness as showed by long hospitalizations and lower rates of remission. Psychotic depressives show more frequently a family history of "major psychoses" suggesting a continuum in psychotic disorders and a genetic association of major psychotic depression with bipolar disorder and schizophrenia
Commentary on "Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders"
No full textThe impact of mood episodes and duration of illness on cognition in bipolar disorder
No full textObjective: A number of studies showed cognitive impairment in bipolar patients but few researches have studied the impact of mood episodes or duration of illness on neuropsychological functioning.
Methods: Cognitive functioning was examined in 110 bipolar 1 outpatients with different mood state (mania, major depression, mixed episode and euthymia). The neuropsychological battery included The Visual Search Test, Trail Making Test, Corsi Test, Frontal Assessment Battery (FAB), Cognitive Estimation Task (CET) and Tower of London and it assessed attention, memory and executive/planning functions. Failures in the different cognitive tests were compared between groups using chi(2) tests with Bonferroni's corrections. Finally a binary logistic regression was performed in order to find an eventual association between age and duration of illness and CET bizarreness.
Results: All the symptomatic patients (manic, depressed, mixed) failed more frequently The Visual Search Test in comparison with euthymics (chi(2) = 9.882, df = 3, p = 0.017, phi = 0.30; rate of failures: manic patients 32.2%, depressed patients 30.6%, euthymics 0%, mixed patients 18.2%). CET was performed worse by manic and euthymic patients (chi(2) = 10.086, df = 3, p 0.015, phi = 0.31; rate of failures: manic patients 46.4%, depressed patients 22.9%, euthymics 52.1%, mixed patients 18.2%). Finally, a longer duration of illness was found to be predictive of more bizarreness at CET (OR = 1.06, p = 0.01).
Conclusions: Bipolar patients present impairment in different cognitive domains even in euthymic phases. Frontal dysfunction might be associated with a long duration of illness as shown by number of bizarreness at CET in chronic bipolar patients
Evaluation of the knockdownactivity of some pyrethroids on different types of surface against larvae of Plodia interpunctella (Hbn.) (Lepidoptera Pyralidae)
No full textProminent clinical dimension, duration of illness and treatment response in schizophrenia : a naturalistic study
No full textObjective Preliminary data indicate that predominant positive symptoms are predictive of subsequent treatment response, while negative and cognitive symptoms are associated with poor outcome. Purpose of the present study was to investigate the relation between the predominant clinical dimension, duration of illness and acute antipsychotic response in a sample of schizophrenic inpatients.
Methods Fifty-one schizophrenic inpatients, receiving an antipsychotic mono-therapy, were dimensionally assessed at the admission in the Acute Psychiatric Unit of the University of Milan. Treatment response was selected as parameter of outcome and defined as a reduction >50% of baseline total The Positive and Negative Syndrome Scale (PANSS) score. Demographic and clinical variables between responders and non-responders were compared using one-way analysis of variance for continuous variables and chi(2) test for dichotomous ones. Binary logistic regression was performed to find if dimensional scores and duration of illness were associated with acute antipsychotic response.
Results A longer duration of illness was found in non-responders respect to responders (15.61 years vs. 8.28 years)(F=4.98, p=0.03). Higher scores on PANSS positive sub-scale (OR=1.3, p=0.03), lower scores on cognitive PANSS scores (OR=0.75, p=0.05) and shorter duration of illness (OR=0.93, p=0.04) were found to be predictive of acute antipsychotic response.
Conclusion These preliminary results show that a long duration of illness as well as a more severe cognitive impairment is predictive of treatment non-response, indicating a worse outcome for chronic patients with predominant cognitive symptom
Are antidepressants equally effective in the long-term treatment of major depressive disorder?
No full textOBJECTIVE: Few studies have compared simultaneously different antidepressants in long-term treatment of major depressive disorder (MDD). Long-term prevention of recurrences should be the main goal of MDD treatment. The purpose of this study was to compare antidepressants of different pharmacological classes in terms of retention in treatment (no discontinuation for recurrences, hospitalizations, side effects).
METHODS:One hundred and fifty outpatients with an MDD diagnosis, treated with antidepressants in mono-therapy, were included. Follow-up period was set at 24 months, and information have been obtained from charts, interviews with patients and their relatives, and from the Lombardy regional register. A survival analysis (Kaplan-Meier) was performed, considering recurrences, hospitalizations, or discontinuation due to side effects as 'death' events.
RESULTS: In our sample, 48.7% of the patients presented a recurrence within the first 2 years of treatment. Bupropion appears less effective in long-term treatment of MDD than the other compared antidepressants, with exception of fluoxetine (p = 0.09), amitriptyline (p = 0.13), fluvoxamine (p = 0.83), venlafaxine (p = 0.5), and trazodone (p = 0.58). Fluvoxamine appears to be less effective than citalopram (p = 0.036), paroxetine (p = 0.037), clomipramine (p = 0.05), sertraline (p = 0.011), and duloxetine (p = 0.024).
CONCLUSIONS: Bupropion and fluvoxamine appear less effective in long-term treatment of MDD. These results should be confirmed by randomized placebo-controlled prospective studies with larger samples
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