1,720,981 research outputs found
Personality and widowhood increase the risk for incident depression in the two years following the first acute coronary syndrome
No full textObjectives: Incident depression, occurring after an acute coronary syndrome (ACS) in never depressed patients, exerts a negative effect on the cardiac prognosis. Nonetheless only a few studies have evaluated the risk factor for incident depression and, particularly, no study have investigated the role of personality disorders. Therefore, the aim of this study is to verify if personality disorders represent a risk for incident depression in patients at their first ACS.Method: The study sample was selected among never depressed patients who were consecutively admitted to the Coronary Intensive Care Unit, from January 2009 to March 2012, for the first ACS. The study sample included 262 patients. The presence of depressive disorder was assessed with the Primary Care Evaluation of Mental Disorders (DSM-IV criteria), whereas its severity was evaluated with the Hospital Anxiety and Depression Scale. Evaluations were collected at baseline and at 1, 2, 4, 6, 9, 12 and 24 months of follow-up. Moreover, at baseline personality disorders were investigated with the Structured Clinical Interview for DSM-IV Axis II disorders.Results: Out of 262 subjects, a depressive disorder was diagnosed in 56 patients (21%). At baseline risk factors for incident depression were being widowed, having a distress reaction and narcissistic personality traits.Conclusion: Clinicians should keep in mind these characteristics when facing patients at their first ACS, given the detrimental effect of depression on cardiac prognosis. A psychological support should prevent the onset of incident depression in these patients
Does Age Affect Treatment of Depressive Disorders? A systematic review of antidepressants versus placebo studies
No full textAlexithymia and Cardiac Outcome in Patients at First Acute Coronary Syndrome
No full textBackground: This cohort study was aimed to verify whether subjects at their first acute coronary syndrome (ACS) were more alexithymic than healthy controls (HC) and whether alexithymia can predispose patients with coronary artery disease to new major adverse cardiac events (MACE) during a 24-month follow-up period.
Methods: The sample included 100 HC with no history of depression or ACS and 304 never depressed patients with a first-ever ACS. A total of 266 patients completed the 2-year follow-up.
Results: Patients and HC reported similar Toronto Alexithymia Scale (TAS-20) scores. During the follow-up, 69 (22.69%) patients developed incident depression and 57 (18.75%) developed a new MACE. In a proportional hazard model, developing a first-ever depressive episode, but not alexithymia (hazard ratio = 1.008, 95% confidence interval = 0.984-1.033; p = 0.500), was associated with almost 3 times the risk of a recurrent cardiac event.
Conclusion: Incident depression, but not TAS-20 scores, represented risk factor for MACE
Pharmacology and toxicology of Cannabis derivatives and endocannabinoid agonists.
No full textFor centuries Cannabis sativa and cannabis extracts have been used in natural medicine. Delta(9)-tetrahydrocannabinol (THC) is the main active ingredient of Cannabis. THC seems to be responsible for most of the pharmacological and therapeutic actions of cannabis. In a few countries THC extracts (i.e. Sativex) or THC derivatives such as nabilone, and dronabinol are used in the clinic for the treatment of several pathological conditions like chemotherapy-induced nausea and vomiting, multiple sclerosis and glaucoma. On the other hand the severe side effects and the high abuse liability of these agents represent a serious limitation in their medical use. In addition, diversion in the use of these active ingredients for recreational purpose is a concern. Over recent years, alternative approaches using synthetic cannabinoid receptor agonists or agents acting as activators of the endocannabinoid systems are under scrutiny with the hope to develop more effective and safer clinical applications. Likely, in the near future few of these new molecules will be available for clinical use. The present article review recent study and patents with focus on the cannabinoid system as a target for the treatment of central nervous system disorders with emphasis on agonists
Developmental Traumatic Experiences, PTSD and Substance Abuse Vulnerability: The Neurobiological Link
No full textTemperament and Depression After a First Acute Coronary Syndrome
No full textFew studies assess the role of personality styles in predicting the onset of depression among cardiac patients. This study evaluates whether temperament and character can represent a risk factor for the development of incident first-ever depressive episodes in patients at their first acute coronary syndrome (ACS). Two hundred sixty-seven (72.1%) subjects (male) completed the Temperament and Character Inventory (TCI) a few days after the cardiac event. At baseline and after 1, 2, 4, 6, 9, 12, and 24 months of follow-up, the participants completed the Primary Care Evaluation of Mental Disorder (PRIME-MD) and the Hospital Anxiety and Depression Scale to establish the presence of a depressive episode and its severity. During the follow-up, 61 (22.8%) participants developed a depressive episode. Temperamental risk factors for incident depression were scored high on novelty seeking and harm avoidance at the TCI. Given the detrimental effect of depression on cardiac prognosis, clinicians should take temperament variables into account when determining the treatment plans of their patients with ACS
Risk Factors for Incident Depression and its interaction with Anxiety in predicting cardiac outcome after a first acute coronary syndrome
No full textDevelopmental Traumatic Experiences, PTSD and Substance Abuse Vulnerability: The Neurobiological Link
No full textPromising medications for cocaine dependence treatment
No full textCocaine dependence is characterized by compulsive drug seeking and high vulnerability to relapse. Overall, cocaine remains one of the most used illicit drugs in the world. Given the difficulty of achieving sustained recovery, pharmacotherapy of cocaine addiction remains one of the most important clinical challenges. Recent advances in neurobiology, brain imaging and clinical trials suggest that certain medications show promise in the treatment of cocaine addiction. The pharmacotherapeutic approaches for cocaine dependence include medications able to target specific subtypes of dopamine receptors, affect different neurotransmitter systems (i.e. noradrenergic, serotonergic, cholinergic, glutamatergic, GABAergic and opioidergic pathways), and modulate neurological processes. The systematic reviews concerning the pharmacological treatment of cocaine dependence appear to indicate controversial findings and inconclusive results. The aim of future studies should be to identify the effective medications matching the specific needs of patients with specific characteristics, abandoning the strategies extended to the entire population of cocaine dependent patients. In the present review we summarize the current pharmacotherapeutic approaches to the treatment of cocaine dependence with a focus on the new patents
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