Adverse reactions to duloxetine in depression.

INTRODUCTION: Untreated or inadequately treated depression is the largest risk factor for suicide. However, treatment with different antidepressants can have considerable adverse effects, including the increase of the frequency of suicidal thoughts and behavior. This review summarizes the frequency and severity of adverse events observed during the treatment of depression with duloxetine and considers their relevance to clinical practice. AREAS COVERED: A comprehensive review of the literature was conducted using PubMed and Medline databases listing data published until December 2010. Articles describing safety and tolerability of duloxetine were selected and reference lists of these articles were scrutinized for further relevant papers. In addition, US and EU Summaries of Product Characteristics were studied. EXPERT OPINION: Treatment with duloxetine was associated with mild to moderate adverse events; sexual dysfunction, nausea, headache, dry mouth, somnolence and dizziness being the most frequent among them. No increase in death from suicide and suicidal thoughts and behavior were detected as compared to placebo. So as to avoid discontinuation syndrome as a consequence of abrupt withdrawal of duloxetine, 2 weeks tapering has been recommended before discontinuation. Overall, duloxetine was found to be well tolerated and can be safely administered even in older patients and in those with concomitant illnesses.

What is the relationship between the recognition of emotions and core beliefs: Associations between the recognition of emotions in facial expressions and the maladaptive schemas in depressed patients.

BACKGROUND: Depressed patients are both characterized by social reality distorting maladaptive schemas and facial expression recognition impairments. The aim of the present study was to identify specific associations among symptom severity of depression, early maladaptive schemas and recognition patterns of facially expressed emotions. METHODS: The subjects were inpatients, diagnosed with depression. We used 2 virtual humans for presenting the basic emotions to assess emotion recognition. The Symptom Check List 90 (SCL-90) was used as a self-report measure of psychiatric symptoms and the Beck Depression Inventory (BDI) was applied to assess symptoms of depression. The Young Schema Questionnaire Long Form (YSQ-L) was used to assess the presence of early maladaptive schemas. RESULTS: The recognition rate for happiness showed significant associations with both the BDI and the depression subscale of the SCL-90. After performing the second order factor analysis of the YSQ-L, we found statistically significant associations between the recognition indices of specific emotions and the main factors of the YSQ-L. CONCLUSIONS: In this study we found correlations between maladaptive schemas and emotion recognition impairments. While both domains likely contribute to the symptoms of depression, we believe that the results will help us to better understand the social cognitive deficits of depressed patients at the schema level and at the emotion recognition level.

[Violent behaviour and stigmatisation among psychiatric patients]. / Eroszakos viselkedés és megbélyegzés a pszichiátriai betegek körében.

The prejudices existing in public opinion, such as mentally disordered people are dangerous, violent and unpredictable, form the basis of the stigmatisation of this patient population. The connection between mental illness and violence is a complicated problem, and its clarification is in the interest not only of the patients but of therapists and policy-makers as well. In this review we have used studies of foreign authors to find the answer to the question: do severe mental illnesses elevate the risk of committing violent acts and what are the main risk factors for that. We have summarised the results of numerous studies examining birth cohorts, inpatient and outpatient settings and prison populations, and have looked for variables deriving from or independent of the illness that could contribute to the violent behaviour of patients. We have been looking for the most effective ways to prevent people with severe mental illness from becoming violent criminal offenders and the manner to abate the stigmatization of this population.