70 research outputs found
Anger attacks and «anger disorders»: clinical relevance, problem of classification, comorbidity and therapy (review)
No full textThe review of literature data addresses the problem of diagnosis, classification, comorbidity, basic neurobiological mechanisms, as well as therapy of pathological manifestations of anger (“anger disorders”, anger attacks), considering into account the results of current epidemiological and clinical-biological studies
Probabilistic diagnosis of bipolar affective disorder: possibilities and limitations (literature review)
No full textThe literature review presents the main modern data on the epidemiology and socio-economic significance of bipolar affective disorder (BD), discusses the difficulties of early diagnosis of bipolar spectrum disorders, predictors of the bipolar course of affective disorders and a probabilistic approach to the diagnosis of BD, discusses controversial issues in the diagnosis of mixed affective states, the use of potential biomarkers both for the diagnosis of bipolar disorder and for the differential diagnosis of unipolar and bipolar depression, as well as possible therapeutic approaches for the probabilistic diagnosis of bipolar disorder
P01-94 - Social Adaptation Level among Inpatients with Atypical and Non-atypical Depression
No full textExpansion of depressive disorders and widespread of atypical depression (AD) (by DSM-IV) are the major problems of contemporary psychiatry. The level of social adaptation disturbance may be one of indices of severity depressive impairments.ObjectivesTo compare social adaptation level among psychiatric inpatients with an atypical and non-atypical depression.Methods140 inpatients at the age of 18-65 years were evaluated with SIGH-SAD (Williams J. et al., 1991) and Social Adaptation Self-evaluation Scale (SASS) (Bosc M. et al., 1997). Patients who got more than 7 points by SIGH-SAD atypical features were considered as AD-patients, they formed the main group. Patients who got 7 or less scores by SIGH-SAD atypical features formed the comparison group. Mann-Whitney test was used.Results10 men and 60 women (1:6) at the average age 44.5±11.4 generated the main group. The comparison group was generated by 20 man and 50 women (2:5) at the average age of 48±10.7. Significant difference at the age was not observed. The average age for women of main and comparison groups are 44.6±11.2 and 49.6±10.6 years (p=0.01891). The middle score on SIGH-SAD at admission was 31.4±6.2 in main group and 24.9±6.2 in the comparison group (p=0.0000). The middle score on the SASS in the main and comparison group was 30.4±8 and 33±7.2 properly (p=0.04687). Significant differences in social adaptation level subject to gender among and in the groups were not found.ConclusionsWomen with AD were younger than non-AD women. More severe impairments on SASS were found in a group with AD.</jats:sec
Genes of neurotrophic factors and responsiveness to antidepressive psychopharmacotherapy in patients with depressive disorders
No full textMajor depressive disorder (MDD) is a clinically and biologically heterogeneous disorder with a heavy personal and socio-economic burden [1]. The neurotrophic theory of the development of depression most fully explains the morphological changes that occur in the brain of patients [2,3]. Among the various neurotrophic factors brain-derived neurotrophic factor (BDNF) and prolactin play an important role in pathogenesis of depression [4]. Objective of the study was to investigate the association of genes polymorphisms of BDNF and prolactin with responsiveness to therapy in patients with MDD. Methods The study group included 185 MDD patients (F32,F33,ICD-10) and 134 healthy persons. Severity of depressive symptoms on the baseline and on the 14th and 28th day of therapy was assessed using Hamilton Depression Scale (HDRS-17) and Clinical Global Impression – Severity scale (CGI-S). Antidepressive therapy response on the 14th and 28th day of therapy was evaluated using Clinical Global Impression – Improvement scale (CGI-I). Genotyping was carried out on polymorphic variants of BDNF genes (rs6265, rs7124442, rs11030104) and PRL gene (rs1341239). The SPSS software was used for statistical analysis. The Hardy-Weinberg equilibrium (HWE) of genotypic frequencies was tested by the chi-square test. Results The study found no deviation of genotype frequencies from HWE (р > 0.05), except for the SNP rs11030104 in the group of patients (χ2 = 37.540; p = 0.001). Important differences in frequency of genotypes and alleles of SNPs rs11030104 of BDNF and rs1341239 of PRL genes between patients and healthy persons at entry have been found. The final multivariate binary logistic regression analysis shows that the A/A genotype of SNP rs11030104 has a more than 6 times higher risk of developing depression than G/G or G/A genotype (p = 0.009). Allele G of SNP rs1341239 gene was more common in patients (63%) compared to control (59%) (p <0.001). We studied the association between the scores on the HDRS-17, CGI-S and CGI-I scales and gene polymorphisms. A statistically significant reduction in scores on all scales during therapy was observed (p <0.01). A decreased scores on the HDRS-17 is associated with G/G genotype of SNP rs6265 (p = 0.049), C/C genotype of SNP rs7124442 (р = 0.009) and A/A genotype of SNP rs11030104 (p = 0.07), patients with these genotypes are characterized by mild depressive disorder on the 14th day of therapy. We showed a relationship between the carriage of the C allele of SNP rs7124442 (p = 0.014) and the G/G genotype of SNP rs6265 (p = 0.078) and a reduced CGI-S score indicating a good response to therapy in this patients. There was a correlation between the presence of the T allele of SNP rs1341239 and the absence of remission according to the CGI-S scale (p = 0.004) and the worst response to antidepressant therapy. Conclusions Our results suggest that SNPs rs11030104 of BDNF gene and rs1341239 of PRL gene are associated with higher risk of developing depression, SNPs rs6265 and rs7124442 of BDNF gene are probably related to the clinical characteristics of the disorder and the response to pharmacotherapy. Disclosure statement: This study was supported by the Russian Foundation Basic Research, grant No. 17-29-02205 “Development of a molecular-genetic panel of depressive disorders based on polymorphisms of the genes of neuronal kinases, neurotrophic proteins and genes of the serotonergic system
Association of polymorphic variants of serotonin receptor genes, serotonin synthesis and metabolism enzymes genes with depressive disorder and clinical remission
No full textThe article presents the results of studies of associations of polymorphic variants of serotonin receptor genes and serotonin synthesis and metabolism enzymes genes with depressive disorders and the presence of clinical remission. The associations of polymorphic variants rs130058 of HTR1B gene and rs1176744 of HTR3B gene with depressive disorders was shown. Clinical remission assessed according to the CGI-S scale on the 28th day of therapy, associated with the polymorphic variant rs6298 of HTR1B gene, with remission in women, evaluated according to the HDRS-17 scale, associated polymorphic variants rs3813929 and rs1737429 of HTR2C gene. The data obtained confirm the participation of the serotonergic system in the pathogenesis of depressive disorders
The functional variant rs334558 of GSK3B is associated with remission in patients with depressive disorders
No full textAnastasia Levchenko,1,* Innokentiy S Losenkov,2,* Natalia M Vyalova,2 German G Simutkin,2 Nikolay A Bokhan,2,3 Bob Wilffert,4,5 Anton JM Loonen,4,6 Svetlana A Ivanova2,7 1Institute of Translational Biomedicine, Saint Petersburg State University, Saint Petersburg, Russia; 2Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia; 3Department of Psychotherapy and Psychological Counseling, National Research Tomsk State University, Tomsk, Russia; 4Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands; 5University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 6GGZ Westelijk Noord-Brabant, Bergen op Zoom, the Netherlands; 7Division for Control and Diagnostics, School of Non-Destructive Testing & Security, National Research Tomsk Polytechnic University, Tomsk, Russia *These authors contributed equally to this work Purpose: GSK3B and AKT1 genes have been implicated in the pathogenesis of a number of psychiatric and neurological disorders. Furthermore, their genetic variants are associated with response to antidepressant pharmacotherapy. As the evidence is still incomplete and inconsistent, continuing efforts to investigate the role of these two genes in the pathogenesis and treatment of brain disorders is necessary. The aim of our study was thus to evaluate the association of variants of these two genes with depressive disorders and drug treatment response.Patients and methods: In the present study, 222 patients with a depressive disorder who underwent pharmacological antidepressant treatment were divided into remitters and non-remitters following a 28-day course of pharmacotherapy. The association of a depressive disorder and remission rates with polymorphisms rs334558 in the GSK3B gene and rs1130214 and rs3730358 in the AKT1 gene was evaluated with a chi-square test.Results: Neither of the studied genetic variants was associated with a depressive disorder. Furthermore, frequencies of alleles and genotypes for rs1130214 and rs3730358 were not different in the groups of remitters and non-remitters. However, the activating allele T of the functional polymorphism rs334558 was significantly associated with remission, when all types of antidepressant drugs were included. This association continued as a trend when only patients taking selective serotonin reuptake inhibitors were considered.Conclusion: The present study provides support that the functional polymorphism rs334558 of GSK3B may play a role as a useful genetic and pharmacogenetic biomarker in the framework of personalized medicine approach. Keywords: depressive disorder, association study, AKT1, GSK3B, genetic biomarke
Depressive disorders in women of climacteric age (review of foreign literature for 2012–2016)
No full textObjective: to systematically review foreign literature and interpret results of the review. Tasks: to review foreign papers where factors are considered which provoke development of depression: hormonal, psychological, social as well as neuromediators, hormonal and immune disturbances in depressive disorders in women with physiological climacteric and climacteric syndrome; issues of differential diagnostics of depressions, psychopharmaco- and psychotherapy with subsequent evaluation of clinical efficiency; personality profile of pateints with affective psychopathology.Methods of search: by keywords in Web of Science Core Collection database across foreign journals (2012– 2016). Criteria of inclusion of papers in the review are determined by themes of studies: 1) women of climacteric age; 2) presence of depression or depressive symptoms; 3) presence of climacteric disturbances. In the abstract-bibliographic and scientometric database Web of Science Core Collection 70 bibliographic sources are selected across foreign journals between 2012 and 2016, including journals with high Impact Factor. Studies included in the review are performed at the university clinics, specialized centers. Clinical and sociodemographic characteristics of female patients meet the criterion of compatibility. Most discussed papers are devoted to study of clinical and social-psychological factors of development of climacteric depression. In a number of papers the efficiency of antidepressant therapy, alternative methods and supplementary therapy in women with depressive disorders, climacteric disturbances and co-occurring physical diseases is shown. Most works are performed with involvement of questionnaires (sociodemographic data, anamnesis) and international clinical scales. The main results of the discussed papers are outlined in thematic rubrics.Conclusion. The European and American papers are used in this review more frequently; studies from Asian countries are used more seldom. Reviewed foreign publications reflect worldwide trend to increase of climacteric depression (CD) in the female population with presence in the anamnesis of adolescent (psychoendocrine alteration) and postpartum depression, premenstrual syndrome. Low timely diagnostics of depressions, high incidence rate of somaticized CD are noted. In the structure of climacteric syndrome the psychoemotional disturbances predominate above neurovegetative and metabolic-endocrine or are combined with vegetative dysfunction. The participation in formation of CD (with predominance of mild/moderate severity) of neurohormonal, genetic, biochemical, social-environmental, psychological factors is shown. In the reviewed sources low mood, loss of previous priorities, decrease of productivity and concentration of attention, position of being unprotected, dependence, lack of confidence, self-humiliation, repentance, unbelief in future, insomnias, hypo-/hyperrexia with change of body mass are described in CD but there are no publications on suicidal ideation. It is indicated that CD can flow with hysteric- and nosophobic, somatohypochondriac and asthenohypochondriac component. The authors consider that somatization as an experience of climacteric stress leads to somaticized CD with accent on physical symptoms and repression of depression and anxiety although an association of specific somatic nosologies with symptoms of CD is not described. The association of CD with social-environmental factors (gender, education, profession, social position, financial wealth) is discussed, achievement of the woman is considered as a actor of reduction of CD risk. The authors are highly interested in search for genetic markers (heredity, suicides in relatives), impairment of neuromediator exchange (neurotransmitters serotonin, dopamine, adrenaline, and noradrenaline), neuromorphologic alterations in brain sensorimotor cortex (motor function, attention, perception, memory, and emotional-motivational response), hormonal disturbances (neuroendocrine and metabolic) and psychoneuroimmunological patterns of association with CD. Psychopharmacotherapy in CD is constructed with account for depressive symptoms (antidepressants of activating/sedative action in long-term maintenance regime), background and co-occurring diseases (adequate and pathogenetic and immunotherapy) with involvement in case of absence of contraindications of substitutive hormonotherapy (estrogen, progesterone). Beyond conventional schemes of the therapy the alternative therapy of CD (acupuncture, yoga, phytoestrogen collections, and food additives) is discussed. For heightening the efficiency and safety of the therapy of CD the training in detection of CD signs both for female patients and nurses, psychologists, social workers is proposed
Polymorphisms in the adrenergic neurotransmission pathway impact antidepressant response in depressed patients
No full textMood disorders are a prevalent mental health disorder. The adrenergic neurotransmission pathway presents an opportunity to determine whether genetic mutations impact antidepressant response. For this study, 163 patients with major depressive disorders were enrolled to measure treatment response using the Hamilton Depression Rating Scale (HAMD-17). More than half of the patients had never been treated with antidepressants previously. Patients were genotyped for 14 SNPs within ADRA1A, SLC6A2, ADRβ1, MAOA and COMT to determine the impact of adrenergic neurotransmission polymorphisms related in antidepressant response. Patients were treated mainly with SSRIs and TCAs. The difference in HAMD-17 scores between the measurement periods were defined as the outcome measure. Multiple linear regression was conducted to determine the association between the genotypes and difference in HAMD-17 across the study period. Covariates of age, sex, antidepressant medication and depression diagnoses were included in the regression. Throughout the study HAMD-17 scores were measured at initiation, at two weeks and at four weeks for each patient. The difference in HAMD-17 scores was found to be 11.2 ± 4.4 between initiation and two weeks, 7.8 ± 5.3 between two week and four week, and 19.0 ± 5.3 throughout the entire study. SLC6A2 rs1532701 homozygous G/G Patients were associated with improved ΔHAMD-17 across week 2–4 and the entire study (B = 7.1, p = 0.002; B = 6.7, p = 0.013) compared to homozygous A/A patients. SLC6A2 rs1532701 homozygous A/G patients were further associated with improved ΔHAMD-17 compared to homozygous A/A patients at week 2–4 (B = 2.8, p = 0.023). Through our investigation, we were able to determine the genes within the adrenergic pathway to investigate further. To further elucidate these findings, replication and combination with other neurotransmitter pathways to better map the mechanism of actions of antidepressant for tailored treatment would be suggested
Clinical description of affective disorders and efficiency of antidepressant therapy
No full textObjective: to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials and мethods. At a heart center, 1,131 patients with ChCAD were examined: in 290 persons (25.6%) AD were revealed, among them 72.1% were men (n = 209) and 27.9% were women (n = 81). Mean age of women was (63.5 ± 9.4) years and in men (57.9 ± 7.2) years (р = 0.004). AD structure, main syndromes, severity of depression and anxiety according to data of self-questionnaires and clinical scales before and after antidepressant therapy (predominantly with selective serotonin reuptake inhibitors (SSRI)) were studied. Comparative analysis of clinical indices of CAD respective from AD, presence of antidepressant therapy and its efficiency was performed.Results. Chronic AD were found in 45% of patients. Newly diagnosed depressive episodes made up 24.5% and recurrent depressive disorder (RDD) was 24%. 6.5% were bipolar affective disorders (BAD), predominantly bipolar II disorders. Depressive syndrome in 91.7% of patients had the second significant component (more frequently 54.8%). Characteristic of the clinical picture was dominance of complaints of bodily discomfort and pain, anergy and anhedonia. Moderate mental disturbances made up 49.0% (CGI). AD manifested at the age of 48 (40–55) years and preceded development of ChCAD. Natural course of AD was observed in 52.4% of cases. 47.6% (138/290) of patients received antidepressants, and only in 42% (58/138) clinically significant improvement was noted (more than 50% according to CGI). It was difficult to encourage patient adherence to long-term therapy (30–50% according to CGI). Physical activity tolerance (PAT) according to data of veloergometry increased in responders. Psychopharmaco- and psychotherapy should be included into rehabilitative programs for patients with ChCAD and AD
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