1,721,001 research outputs found
[Phenelzine: legacy or current psychiatric practice?]
No full textMonoamine oxidase inhibitors (MAO-I) are the first drugs of antidepressant classes discovered. Phenelzine is a worldwide prescribed MAO-I, studied in a variety of mood and anxiety disorders. Purpose of the present paper is to critically review the results reported in the scientific international literature focusing on efficacy and safety of phenelzine in clinical psychiatric practice, in order to achieve a better understanding of the relationship between pharmacological data, therapeutic approach and side or adverse effects. We performed a careful PubMed (1980-2012) search on clinical pharmacology and clinical use of phenelzine in various psychiatric disorders. We reported our findings discussing separately clinical pharmacology data and systematic controlled, randomised and not randomised, clinical studies
Parasomnias
No full textParasomnias are defined undesirable physical events or experiences that occur during entry into sleep, within sleep or during arousals from sleep. Parasomnias occur more frequently in children than in adults. All parasomnias can be diagnosed based on subjective
reports from the patient, parent or caregiver, except for REM sleep behavior disorder where diagnosis requires polysomnographic investigation. This chapter also addresses the main clinical features and most recent treatments of parasomnias
Sleep disturbance in anxiety disorders
No full textAnxiety disorders are the most frequent psychiatric disorder with a lifetime prevalence of 29% in the general population. Anxiety-related hyperarousal can often lead to persistent circadian rhythm and sleep disturbances. Patients affected by anxiety disorders, including post-traumatic stress disorder, panic disorder, obsessive compulsive disorder, generalized anxiety disorder, and phobias, often manifest sleep disturbances or complaints. Sleep disorders/disturbances are commonly associated with anxiety: impaired sleep can damage
neurocognitive performance and increase daily anxiety. Restoring a correct circadian rhythm is essential and basic. The study of multiple relationships between sleep disturbances and anxiety symptoms is of considerable importance in medical practice
Fundamentals of human chronobiology
No full textChronobiology is the study of biological temporal rhythms, including the circadian, weekly, seasonal, and annual rhythms. The term “circadian” comes from the Latin words “circa”, meaning “around”, and “dies [-ēi]”, meaning "day". A circadian rhythm can be defined as any biological process that manifests an endogenous entrainable oscillation of about 24 hours. Circadian rhythm affects physiology, behavior, cognition, and the sleep-wake cycle in mammalians and humans. The master clock located in the suprachiasmatic nuclei (SCN) of the hypothalamus has a central role in circadian rhythm preservation. The human circadian time-keeping system is characterized by a composite architecture, with the central brain’s SCN pacemaker and subsidiary clocks in nearly every cell. The
sleep-wake cycle is a complex and dynamic phenomenon involving numerous cerebral structures, neuronal network, and neurotransmitters. Sleep is generally divided into non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. NREM and REM phases occur in the course of the sleep with cyclicity. Each phase has typical characteristics, including variations in brain wave patterns, eye movement type, and muscle tone. This chapter provides a general overview of the human circadian-generating systems and sleep physiology
Sleep disturbances and related psychopathologies
No full textClinical and neurophysiopathological correlates of sleep disorders/disturbances often precede and predispose to psychiatric disorders or psychological distress. Sleep disturbances can constitute, for each psychiatric disorder, a genuine worsening factor and a motor for illness. For this reason, it is useful to consider clinical intervention aimed at restoring normal sleep as a preventive intervention, both on sleep alterations as well as on mental disorders and psychological distress. The mutual relationships between the patient's personal aspects, sleep habits, and manifested sleep disturbances require further clarification. This chapter will analyze the prominent clinical impact of sleep disturbances and circadian rhythm alterations in major psychiatric disorders
Neuroimaging in sleep medicine
No full textFunctional and structural neuroimaging provide a means to understand brain function in patients affected by sleep disorders. Herein, we describe neuroimaging findings of primary sleep disorders, including types of dyssomnia related to intrinsic sleep impairments (i.e., idiopathic insomnia, narcolepsy, and obstructive sleep apnea) and abnormal motor behaviors during sleep (i.e., periodic limb movement disorder, restless legs syndrome and rapid-eye-movement sleep behavior disorder). We also include functional neuroimaging studies in sleep complaints secondary to specific psychiatric disorders. Functional neuroimaging may address different kinds of issues in sleep medicine. Functional and structural neural changes can have a causal role in the pathophysiology of sleep disorders. Other changes in brain structure or regional activity can be considered as secondary consequences of long-term sleep disruption.
Neuroimaging studies can help to better understand the cognitive and neural responses to various therapeutic approaches. In the future, neuroimaging studies will probably lead to modify the nosography of sleep disorders on the basis of their underlying and characteristic neural correlates
Circadian rhythm sleep disorders
No full textCircadian rhythm sleep disorders, according to the ICSD-2, comprise a list of complaints sharing a common pathophysiological basis of misalignment between internal circadian rhythms and the desired or required time for sleep. The sleep disturbance produces sleep and wake periods that occur at inappropriate times, resulting in a complaint of insomnia or excessive sleepiness for patients.
Diagnostic criteria include social or occupational impairment, and a diagnosis of CRSDs is appropriate only in the absence of other primary sleep disorders. The CRSDs recognized by ICSD-2 are: 1) Delayed sleep phase syndrome; 2) Advanced sleep-phase syndrome; 3) Non-24 hours sleepwake syndrome; 4) Jet lag syndrome; 5) Shift work disorder; 6) Irregular sleep-wake pattern; 7) Circadian rhythm sleep disorder due to medical condition; 8) Circadian rhythm sleep disorder due to drug or substance; 9) Circadian rhythm sleep disorder, not otherwise specified
Behavioral genetics and criminal responsibility at the courtroom
No full textSeveral questions arise from the recent use of behavioral genetic research data in the courtroom. Ethical issues concerning the influence of biological factors on human free will, must be considered when specific gene patterns are advocated to constrain court's judgment, especially regarding violent crimes. Aggression genetics studies are both difficult to interpret and inconsistent, hence, in the absence of a psychiatric diagnosis, genetic data are currently difficult to prioritize in the courtroom. The judge's probabilistic considerations in formulating a sentence must take into account causality, and the latter cannot be currently ensured by genetic data. (c) 2014 Elsevier Ireland Ltd. All rights reserved
NEUROCOGNITION UNDER HYPNOSIS: Findings From Recent Functional Neuroimaging Studies
No full textFunctional neuroimaging studies show that hypnosis affects attention by modulating anterior cingulate cortex activation and uncoupling conflict monitoring and cognitive control function. Considering functional changes in the activation of the occipital and temporal cortices, precuneus, and other extrastriate visual areas, which account for hypnosis-induced altered reality perception, the role of mental imagery areas appears to be central under hypnosis. This is further stressed by the fact that motor commands are processed differently in the normal conscious state, deviating toward the precuneus and extrastriate visual areas. Functional neuroimaging also shows that posthypnotic suggestions alter cognitive processes. Further research should investigate the effects of hypnosis on other executive functions and personality measures
Psychoeducation in sleep medicine
No full textInsomnia is a frequent complaint that involves one-third of the adult population and is associated with a reduction in the quality of life, increased risk of medical and psychiatric comorbidities, and abuse of hypnotic medications.
Psychological and behavioral therapies are increasingly used in the last decades as they have been recognized to be valid and effective options in the treatment of chronic primary and secondary insomnia, with many advantages over pharmacological interventions, including fewer side effects and better maintenance of clinical progress over time.
Several non-pharmacological strategies, comprising the most widely known educational, behavioral and cognitive interventions, are described in terms of their effectiveness and recommendations. These therapies are suitable for adults of all ages and should be considered as first line intervention in the treatment of chronic insomnia
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