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1.
Psychiatr Pol ; 51(4): 735-750, 2017 Aug 29.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-28987061

RESUMO

OBJECTIVES: The aim of the project was to assess the differences in the white matter (WM) fiber structure between patients with early onset schizophrenia (EOS), their first degree relatives and controls using Fractional Anisotropy (FA), and an independent evaluation of the severity of working memory disturbances in the study groups. METHODS: The study included 20 patients diagnosed with paranoid EOS (diagnosed before the age of 18), a group of 20 parents of patients, matched for gender, and 18 healthy controls. All study participants were examined with Diffusion Tensor Imaging (DTI,1.5 T) and selected neuropsychological tests to assess working memory, immediate memory and attention (Trail Making Test parts A and B: TMT-A and TMT-B, Digit Span Forward and Backward). RESULTS: No significant differences in FA parameters were found between the analyzed groups. The group of patients took significantly longer to perform the TMT-A and TMT-B than the control group, and achieved worse outcomes in Digit Span tests. The relatives of the patients achieved lower scores in Digit Span tests and needed more time to perform TMT-B compared to controls. There were no significant differences between all groups in terms of the number of errors when performing TMT-A and TMT-B. CONCLUSIONS: The results of our study indicate a reduction in the capacity of immediate memory, working memory, cognitive plasticity and divided attention, both in EOS patients and their first degree relatives compared to healthy subjects. The reported neuropsychological deficits were not reflected in WM integrity, as assessed with FA.


Assuntos
Encéfalo/patologia , Esquizofrenia/patologia , Substância Branca/patologia , Adulto , Cognição , Imagem de Difusão por Ressonância Magnética , Função Executiva , Feminino , Humanos , Masculino , Vias Neurais/patologia , Testes Neuropsicológicos , Psicologia do Esquizofrênico , Adulto Jovem
2.
Acta Neuropsychiatr ; 28(1): 38-44, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26286703

RESUMO

BACKGROUND: It has been reported that lithium may inhibit lipid peroxidation and protein oxidation. Lithium salts also appear to stimulate cell proliferation, increase neurogenesis, and delay cell death. Oxidative stress and neurodegeneration may play an important role in the pathophysiology of bipolar disorder and the disease course thereof. The aim of this research is to estimate the influence of lithium (alone and in combination with haloperidol) on the parameters of oxidative stress and viability of SH-SY5Y cell lines in neutral and pro-oxidative conditions. METHODS: The evaluated oxidative stress parameter was lipid peroxidation. The viability of the cell lines was measured utilising the MTT test. RESULTS: In neutral conditions, higher levels of thiobarbituric acid reactive substances were observed in those samples which contained both haloperidol and lithium than in other samples. However, these differences were not statistically significant. Cell viability was significantly higher in therapeutic lithium samples than in the controls; samples of haloperidol alone as well as those of haloperidol with lithium did not differ from controls. CONCLUSIONS: The results of our study may indicate that lithium possess neuroprotective properties that may be partly due to antioxidative effects. The combination of lithium and haloperidol may generate increased oxidative stress.


Assuntos
Antipsicóticos/farmacologia , Haloperidol/farmacologia , Compostos de Lítio/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Animais , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/metabolismo , Transtorno Bipolar/fisiopatologia , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Humanos , Peroxidação de Lipídeos/efeitos dos fármacos , Neuroblastoma/metabolismo , Neuroblastoma/patologia , Neurogênese/efeitos dos fármacos , Oxirredução , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo
3.
Redox Rep ; 21(1): 45-49, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26193071

RESUMO

OBJECTIVES: Lithium may inhibit lipid peroxidation (LP) and protein oxidation, stimulate cell proliferation, increase neurogenesis, and delay cell death. Oxidative stress (OxS) is a state of imbalance between oxidative processes and antioxidant defenses, which may play an important role in the pathophysiology and disease course of bipolar disorder (BD). The aim of this study was to estimate the influence of lithium, administered alone or in combination with haloperidol, on selected OxS parameters in human plasma in vitro. METHODS: The OxS parameters evaluated were thiobarbituric acid reactive substances (TBARS) and total antioxidant capacity (TAC). Plasma samples from healthy volunteers were incubated with drug concentrations used in psychiatry. RESULTS: Incubation of plasma with lithium or haloperidol alone did not produce statistically significant changes of TBARS levels in comparison with control samples. However, significantly higher TBARS levels were observed in samples incubated with haloperidol plus lithium compared to control, haloperidol, or lithium samples. The TAC value did not differ between samples. CONCLUSIONS: Lithium does not influence OxS parameters in human plasma in vitro during short-term observation when applied at concentrations used in psychiatry. However, lithium increased the TBARS level in the samples when given in combination with haloperidol, which may be one of the mechanisms behind the neurotoxicity associated with combined lithium and haloperidol administration.

4.
Psychiatr Pol ; 49(2): 349-61, 2015.
Artigo em Polonês | MEDLINE | ID: mdl-26093598

RESUMO

OBJECTIVES: In schizophrenia, the most repeatable DTI findings concern reduced FA in temporal and frontal lobes with associated abnormalities in connecting neural fibers. The goal of study was to evaluate the differences in FA of the internal capsule in EOS-patients and healthy controls and to place emphasis on the sex as a potential factor determining a predominant pathological pattern of described changes. METHODS: 30 EOS patients and 30 healthy controls were studied using DTI. FA measures within internal capsules were performed in selected ROIs. For statistical analyses the one-way ANOVA test was used (p<0.05). RESULTS: Significant differences of FA between EOS-patients and controls in the right ALIC with lower values of FA in EOS were observed. Within the women sub-groups, statistical differences of FA were observed only for the right ALIC. There were no statistically significant differences within men sub-groups. CONCLUSIONS: 1. Statistically significant differences were found between EOS - subjects (subgroups of woman only) and the control group within the WM diffusivity of the brain in the right ALIC. 2. These results indicate possible involvement of the structures of internal capsule in the EOS development.


Assuntos
Encéfalo/patologia , Cápsula Interna/patologia , Vias Neurais/patologia , Esquizofrenia/patologia , Adulto , Idade de Início , Análise de Variância , Mapeamento Encefálico , Imagem de Tensor de Difusão/métodos , Feminino , Lobo Frontal/patologia , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Valores de Referência , Fatores Sexuais , Adulto Jovem
5.
J Nerv Ment Dis ; 203(3): 182-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25668655

RESUMO

An analysis of literature shows that there is still little evidence concerning the efficacy of electroconvulsive therapy (ECT) combined with antipsychotic therapy in a group of treatment-resistant schizophrenia patients. More precisely, its influence on cognitive functions is still equivocal. The aim of this study was to assess the influence of ECT combined with antipsychotic therapy on working memory, attention, and executive functions in a group of treatment-refractory schizophrenia patients. Twenty-seven patients completed the study: 14 men and 13 women, aged 21 to 55 years (mean age, 32.8 years), diagnosed with treatment-resistant schizophrenia. Each patient underwent a course of ECT sessions and was treated with antipsychotic medications. Before the ECT and within 3 days after the last ECT session, the participants were assessed with the following neuropsychological tests: Trail Making Test (TMT) and Wisconsin Cart Sorting Test (WCST). There were no significant differences in the TMT and WCST results after combined ECT and antipsychotic therapy in treatment-refractory schizophrenia patients. According to the results of the neuropsychological tests, there was no decline in attention, executive functions, or working memory. The current study shows no significant difference in attention, working memory, or executive functions after treatment with a combination of electroconvulsive and antipsychotic therapy. This suggests that combined electroconvulsive therapy may not have a negative influence on the neuropsychological functioning of patients with treatment resistant schizophrenia.


Assuntos
Antipsicóticos/efeitos adversos , Atenção/fisiologia , Eletroconvulsoterapia/efeitos adversos , Função Executiva/fisiologia , Memória de Curto Prazo/fisiologia , Esquizofrenia/terapia , Adulto , Atenção/efeitos dos fármacos , Terapia Combinada/efeitos adversos , Função Executiva/efeitos dos fármacos , Feminino , Humanos , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento , Adulto Jovem
6.
Early Interv Psychiatry ; 9(4): 324-30, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24373200

RESUMO

AIM: Although a number of cognitive functions have been assessed in the ultra-high risk (UHR) population, only one study has reported on figural fluency. Visual memory was measured by different tests providing inconsistent results. The aim of the present study was to compare figural fluency and visual immediate memory performance in UHR patients and normal subjects. METHODS: The UHR sample consisted of 55 help-seeking individuals meeting CAARMS criteria. The control group consisted of 65 subjects. They were matched as a group by age, gender and education level. Figural fluency (RFFT) and immediate visual memory (BVRT) were assessed within 2 weeks after inclusion in the study in the UHR patient group. RESULTS: Significant differences were obtained in RFFT and BVRT results. In BVRT, UHR patients scored lower in number of correct designs (P < 0.001) and higher in number of errors (P < 0.0001), especially omissions (P < 0.001) and distortions (P < 0.0001). UHR subjects accurately recalled fewer designs, omitted and distorted more test figures. In RFFT, they scored lower in production of novel designs (P < 0.0001) and higher in the error ratio index (P < 0.008). They produced fewer novel designs and made more preservative errors. CONCLUSIONS: The current study concerns non-verbal cognitive functions in UHR samples. Our results suggest that figural fluency and visual immediate memory are impaired in help-seeking UHR individuals as compared with matched controls.


Assuntos
Memória de Curto Prazo , Reconhecimento Visual de Modelos , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/fisiopatologia , Fatores de Risco , Adulto Jovem
7.
Early Interv Psychiatry ; 9(4): 339-42, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24725353

RESUMO

AIM: To present the activities of the first early intervention centre in Poland and the Programme of Recognition and Therapy (PORT) run by the centre. METHODS: An overview of the admission process, diagnostic procedures and therapeutic interventions offered to individuals with an at-risk mental state. RESULTS: The PORT programme, developed in 2010, included 81 individuals, aged 15-29 years so far. The diagnostic procedures consists of evaluation of symptoms with the use of the Comprehensive Assessment of At-Risk Mental State (CAARMS), assessment of premorbid and current personality traits and the evaluation of cognitive functions. Therapeutic interventions include cognitive behavioural therapy, diet supplementation with omega-3 fatty acids and pharmacological treatment. Overall rate of conversion into psychosis within the years 2010-2103 was 18.5%. The programme has also been a source of research in the field of early psychosis. CONCLUSIONS: The PORT programme enables young people with an ARMS an easy access to the specialized service offering treatment tailored to their specific needs.


Assuntos
Intervenção Médica Precoce/organização & administração , Transtornos Mentais/diagnóstico , Adolescente , Adulto , Intervenção Médica Precoce/métodos , Humanos , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Polônia , Sintomas Prodrômicos , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia , Adulto Jovem
8.
Neuropsychobiology ; 70(3): 158-64, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25358377

RESUMO

OBJECTIVES: The aim of the study was to determine the effectiveness of the augmentation of antipsychotics (AP) with electroconvulsive therapy (ECT) in treatment-resistant schizophrenia (TRS) patients with dominant negative symptoms. METHODS: The study encompassed 34 patients aged 21-55 years, 47.1% of whom were female, who were diagnosed with TRS. Each patient underwent a course of ECT sessions combined with AP medications which had previously been found to be ineffective. Prior to ECT and within 3 days after the final ECT session, the participants were evaluated on the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia and the Clinical Global Impression scales. RESULTS: Augmentation of AP therapy with ECT led to a significant decrease in symptom severity in TRS patients with dominant negative symptoms, 58.8% of whom demonstrated at least a 25% decrease in the total PANSS score. The greatest reductions were observed in the general and positive PANSS subscales (mean ± SD: 11.35 ± 7.43 and 6.79 ± 5.23 patients), and the least significant in the negative symptoms subscale (5.03 ± 4.36 patients). CONCLUSION: Augmentation of AP therapy with ECT in a group of TRS patients with dominant negative symptoms induced a significant decrease in symptom severity. The greatest reductions were obtained in general and positive symptoms and the least in negative symptoms.


Assuntos
Antipsicóticos/uso terapêutico , Eletroconvulsoterapia , Esquizofrenia/terapia , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Esquizofrenia/tratamento farmacológico , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
9.
Teach Learn Med ; 26(4): 387-92, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25318035

RESUMO

BACKGROUND: Personality traits may also be associated with preference for a particular specialty. However, little is known about the relationship between the surgical career preferences of medical students and their temperament traits. PURPOSES: The aim of the study was to explore the relationship between surgical or nonsurgical specialties and temperament in 6th-year medical students. METHODS: The study included 409 students (283 women, 126 men) of the 6th year at the Medical University of Lodz. The subjects fulfilled a career preference and demographic questionnaire as well as the Formal Characteristics of Behaviour-Temperament Inventory by Zawadzki and Stelau. RESULTS: The surgical specialty was preferred by 30.1% of the students and by 64.5% of the nonsurgical; 5.4% were undecided. The specialty preference of the medical students was associated with temperament traits. An analysis of variance showed differences in Emotional Reactivity, F(1, 380)=3.888, p=049, η2=01; Endurance, F(1, 380)=10.973, p=001, η2=028; and Briskness, F(1, 380)=10.252, p=001, η2=026. Students preferring surgical specialty scored significantly higher on Endurance (M=11.21, SD=4.8) and Briskness (M=16.54, SD=2.82) scales than students choosing a nonsurgical specialty (M=9.12, SD=4.51) and (M=15.19, SD=3.21), respectively. Those preferring a surgical specialty scored lower on the Emotional Reactivity (M=8.91, SD=4.55) scale than students choosing nonsurgical specialty (M=10.53, SD=4.22). CONCLUSIONS: The findings suggest that certain temperament traits may be related to preference of surgical or nonsurgical specialties. This knowledge of temperament traits could be a useful tool in helping graduates choose a fulfilling career best suited to their psychological well-being and diagnosing work related issues in the medical profession.


Assuntos
Escolha da Profissão , Cirurgia Geral/educação , Inventário de Personalidade , Especialização , Estudantes de Medicina/psicologia , Adulto , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários
10.
J Psychiatr Pract ; 20(5): 329-37, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25226193

RESUMO

OBJECTIVE: The goals of this study were to determine the serum level of 25 hydroxyvitamin D (25[OH]D), a vitamin D metabolite, in patients with recurrent depression, to assess risk factors for vitamin D deficiency, and to evaluate whether the severity of symptoms of depression and response to treatment were associated with serum vitamin 25(OH)D level. METHOD: Ninety-one patients 18 to 65 years of age meeting the ICD-10 criteria for recurrent depression were evaluated for depressive symptoms using the Hamilton Depression Rating Scale. The control group consisted of 89 healthy subjects matched according to sex and age. Serum levels of 25(OH)D, parathyroid hormone (PTH), and calmodulin-dependent protein kinase II (Ca) were determined in all group members. RESULTS: A significantly decreased serum level of 25(OH)D was observed in the group of patients with recurrent depression compared with healthy subjects. PTH and Ca levels were within the reference values in a substantial majority of patients. No correlation was found between 25(OH)D serum level and age, sex, height, body mass index, disease duration, number of depressive episodes, type of pharmacotherapy, or effectiveness of treatment. CONCLUSIONS: Low serum levels of 25(OH)D in patients with recurrent depression suggest that these patients are an important risk group for vitamin D deficiency. However, no relationship was found between these low levels of 25(OH)D and response to treatment for depression. Nevertheless, the results indicate the need to monitor the concentration and supplementation of products containing calciferol in such patients.


Assuntos
Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/complicações , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Vitamina D/análogos & derivados , Adolescente , Adulto , Idoso , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Recidiva , Fatores de Risco , Índice de Gravidade de Doença , Vitamina D/sangue , Adulto Jovem
11.
Psychiatry Res ; 220(1-2): 175-80, 2014 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-25129562

RESUMO

The effectiveness and predictors of response to electroconvulsive therapy (ECT) combined with antipsychotics (AP) in treatment-resistant schizophrenia patients with the dominance of negative symptoms (TRS-NS) have not been studied systematically so far. 29 patients aged 21-55 years diagnosed with TRS-NS underwent ECT combined with antipsychotics (ECT+AP). Prior to the ECT, the symptom profile and severity were evaluated using Positive and Negative Syndrome Scale (PANSS). Demographic and medical data was collected; ECT parameters and pharmacotherapy results were evaluated. After the combined ECT+AP therapy a significant decrease in symptom severity was found. A response to treatment was achieved by 60% of patients. The greatest reductions were obtained in general and positive PANSS subscale (median change: 11 and 7 pts.) and the smallest, but still significant, ones in negative symptoms subscale (median: 3.5 pts.). Patients who responded to ECT+AP demonstrated a significantly shorter duration of the current episode in comparison with patients who did not experience at least a 25% reduction in symptom severity (median: 4 vs. 8 months). A combination of ECT and antipsychotic therapy can provide a useful treatment option for patients with TRS-NS. The only significant predictor of response to treatment was a shorter duration of the current episode.


Assuntos
Antipsicóticos/uso terapêutico , Eletroconvulsoterapia/métodos , Esquizofrenia/terapia , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
J Psychiatr Pract ; 20(4): 301-7, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25036587

RESUMO

Olanzapine induced a marked elevation in triglyceride and cholesterol levels and in liver transaminase enzymes after 12 weeks of treatment in a patient with schizophrenia. These changes were not seen in an earlier 10-week course of treatment with risperidone, and improved substantially 1 week after the patient stopped olanzapine and began treatment with aripiprazole. The patient did not exhibit weight gain or hyperglycemia with any of the medications. This case and a review of the literature suggest that olanzapine may have unique properties that affect hepatic enzyme pathways, independent of any effects on weight and glucose, that may lead to hyperlipidemia and transaminitis in some patients.


Assuntos
Antipsicóticos/efeitos adversos , Benzodiazepinas/efeitos adversos , Hipertrigliceridemia/induzido quimicamente , Esquizofrenia/tratamento farmacológico , Transaminases/efeitos dos fármacos , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/farmacologia , Aripiprazol , Benzodiazepinas/administração & dosagem , Humanos , Hipertrigliceridemia/sangue , Fígado/efeitos dos fármacos , Fígado/enzimologia , Masculino , Olanzapina , Piperazinas/administração & dosagem , Piperazinas/farmacologia , Quinolonas/administração & dosagem , Quinolonas/farmacologia , Transaminases/sangue , Resultado do Tratamento
13.
Psychiatr Pol ; 48(1): 5-18, 2014.
Artigo em Polonês | MEDLINE | ID: mdl-24946431

RESUMO

A concept of an endophenotype, also termed as an internal endophenotype, is used in genetic studies on psychiatric disorders. Neurological soft signs are also considered candidates for endophenotypes of schizophrenia. Neurological soft signs are, objectively measured, non-localizing abnormalities, not related to impairment of a specific brain region, reflecting improper cortical-subcorical and intercortical connections. This paper presents the main domains of NSS, methods of measurement of NSS, their neuroanatomical substrate, association of NSS with schizophrenia symptoms the and analysis of the literature in order to check whether NSS meet the criteria of the phenotype. A marker can be considered a phenotype if it meets the following criteria: 1) association with a disease in a population, 2) heritability, 3) state-independence, 4) familial association (the endophenotype is more prevalent in the affected individuals, their affected and non-affected family members in comparison to the normal population), 5) co-segregation (the endophenotype is more prevalent among ill family members of ill probands compared with healthy relatives). Currently, there is an ample evidence that the NSS, especially these representing impaired motor coordination, meet certain criteria of an endophenotype. However, there are still several unresolved questions concerning NSS: studies on relatives of schizophrenic patients included small groups of subjects, many of the studies included individuals with schizophrenia, as well as schizophrenia spectrum disorders, the available date-base of twins (schizophrenia-concordant and schizophrenia non -concordant) is not sufficiently large, there are too few studies evaluating the relationship of NSS and individual genes, there are no objective and quantitative methods of measurement of NSS. Therefore, NSS still represent only candidates for an endophenotype of schizophrenia. Finding correlations of selected NSS with other endophenotypes and their genetic correlates also needs further investigation and may provide a definitive answer to the question of the usefulness of NSS as the endophenotype of schizophrenia.


Assuntos
Endofenótipos , Predisposição Genética para Doença , Exame Neurológico/métodos , Esquizofrenia/diagnóstico , Esquizofrenia/genética , Avaliação de Sintomas/métodos , Humanos , Fenótipo , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Transtorno da Personalidade Esquizotípica/diagnóstico , Transtorno da Personalidade Esquizotípica/genética
14.
Neuropsychiatr Dis Treat ; 10: 263-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24523591

RESUMO

Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important role in the pathogenesis of schizophrenia. Therefore, glutamatergic agents such as N-methyl-D-aspartate receptor co-agonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine) are studied for their efficacy in ameliorating negative and cognitive symptomatology in patients with schizophrenia. We report the case of a 23-year-old schizophrenic patient treated with quetiapine and citalopram, who was offered concomitant sarcosine treatment. After obtaining an informed consent, we started administration of 2 g of sarcosine per day to treat persistent negative and cognitive symptoms. The patient's activity and mood improved within 2 weeks, but in the following 2 weeks the patient reported increased drive, activity, libido, unpleasant inner tension, and irritability. We ruled out hypomania and decided to decrease the daily dose of sarcosine to 1 g, which resulted in reduction of drive and irritability. Activity and mood improved compared with his state before adding sarcosine. We suggest a sarcosine dose between 1 g and 2 g per day with an initial dose of 2 g, but if side effects occur, the dose should be decreased to 1 g per day. We would like to emphasize the clinically important glutamate-serotonin interaction during concomitant use of sarcosine, citalopram, and quetiapine in our patient, which may lead to serious discomfort.

15.
Neurocase ; 20(4): 452-5, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23679561

RESUMO

Safety of electroconvulsive therapy (ECT) in depressive patients with multiple sclerosis (MS) is still discussed and based solely on case reports. This kind of therapy was used in both unipolar depression and depression in bipolar disorder. It was suggested that ECT might cause the deterioration of neurological state (new MS lesions in magnetic resonance imaging). Moreover, there were also data indicating some anesthesiological complications and difficulties in patients with MS. We have presented a case of a patient who was treated with ECT and developed grand mal seizure after 14th electroconvulsive treatment.


Assuntos
Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/terapia , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/métodos , Esclerose Múltipla/complicações , Anestesia/efeitos adversos , Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Epilepsia Tônico-Clônica/etiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade
16.
J Psychiatr Res ; 48(1): 79-85, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24157247

RESUMO

The objective of the study was to identify associations between a history of obstetrical complications (OCs) and the future development of symptoms indicating risk of psychosis (At Risk Mental State - ARMS). The frequency of OCs was assessed in 66 ARMS subjects, 50 subjects with the first episode of schizophrenia (FES) and 50 healthy controls. Obstetrical data was obtained from medical documentation and evaluated with the Lewis and Murray Scale. Definite OCs, according to the Lewis and Murray Scale, occurred significantly more frequently in the ARMS group compared to the controls (χ(2) = 7.79, p = 0.005; OR = 4.20, 95% CI = 1.46-12.11), as well as in the FES subjects compared to the controls (χ(2) = 8.39, p = 0.004; OR = 4.64, 95% CI = 1.56-13.20). Apgar scores in the first (Apgar 1) and the fifth minute after birth (Apgar 5) were significantly lower in the FES subjects compared to the controls (for Apgar 1 score Z = 4.439, p < 0.0001; for Apgar 5 score Z = 5.250, p < 0.0001). The ARMS subjects demonstrated significantly lower Apgar 5 scores compared to the healthy controls (Z = 3.458, p = 0.0016). The results indicate that OCs and low Apgar 5 score should be considered important factors in identifying subjects at risk of developing psychosis.


Assuntos
Índice de Apgar , Complicações do Trabalho de Parto/fisiopatologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/etiologia , Adolescente , Adulto , Análise de Variância , Peso ao Nascer , Feminino , Humanos , Masculino , Complicações do Trabalho de Parto/etiologia , Gravidez , Fatores de Risco , Fumar/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto Jovem
17.
J Psychiatr Pract ; 19(6): 501-4, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24241505

RESUMO

Normal pressure hydrocephalus is characterized by gait disturbance, urinary incontinence, cognitive impairment, and the finding of ventriculomegaly in imaging studies. It is one of the causes of potentially reversible dementia. The authors present the case of a patient with depression complicated by hydrocephalus. The combination of symptoms led to a delay in proper diagnosis and treatment.


Assuntos
Transtorno Depressivo/diagnóstico , Hidrocefalia de Pressão Normal/diagnóstico , Antidepressivos/administração & dosagem , Antidepressivos/farmacologia , Derivações do Líquido Cefalorraquidiano/métodos , Comorbidade , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/fisiopatologia , Feminino , Humanos , Hidrocefalia de Pressão Normal/epidemiologia , Hidrocefalia de Pressão Normal/fisiopatologia , Hidrocefalia de Pressão Normal/cirurgia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento
18.
Psychiatr Pol ; 47(4): 609-20, 2013.
Artigo em Polonês | MEDLINE | ID: mdl-24946468

RESUMO

AIM: The objective of this study was to analyze the changes in depressive and extrapyramidal symptomatology during glycine augmentation of antipsychotic treatment in patients with schizophrenia. MATERIALS AND METHODS: Twenty-nine schizophrenic patients (ICD-10) with predominant negative symptoms in stable mental state participated in a 10-week open-label prospective study. Patients received stable doses of antipsychotic drugs for at least 3 months before glycine application. During the next 6 weeks patients received augmentation of antipsychotic treatment with glycine (up to 60 g per day). The first and last two weeks of observation were used to assess stability of mental state. Symptom severity was assessed using the Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), and the Simpson-Angus Extrapyramidal Symptom Rating Scale (SAS). RESULTS: In the studied group after 6 weeks of administration ofglycine a significant improvement in depressive symptoms (reduced scores by 25.8% in HDRS, p < 0.001) and reduced scoring in mood symptoms of PANSS were observed. In SAS a reduction of extrapyramidal symptoms' severity (p < 0.05) was also noted. Two weeks after the glycine augmentation the symptom severity in the HDRS, PANSS, and SAS remained at similar levels. CONCLUSIONS: Glycine augmentation of antipsychotic treatment may reduce the severity of depressive and extrapyramidal symptoms. Glycine use was safe and well tolerated.


Assuntos
Antipsicóticos/administração & dosagem , Glicina/administração & dosagem , Esquizofrenia/tratamento farmacológico , Adulto , Doenças dos Gânglios da Base/etiologia , Doenças dos Gânglios da Base/prevenção & controle , Depressão/etiologia , Depressão/prevenção & controle , Sinergismo Farmacológico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
19.
Psychiatry Investig ; 10(4): 421-4, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24474993

RESUMO

Memantine and other glutamatergic agents have been currently investigated in some off-label indications due to glutamatergic involvement in several psychoneurological disorders. We assumed that memantine similarly to ketamine may positively influence mood, moreover having a potential to improve cognition and general quality of life. We report a case of a 49-year-old male hospitalized during a manic and a subsequent moderate depressive episode. After an ineffective use of lithium, olanzapine and antidepressive treatment with mianserin, memantine was added up to 20 mg per day for 10 weeks. The mental state was assessed using the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Hamilton Anxiety Scale, the Clinical Global Inventory, the World Health Organization Quality of Life Scale and psychological tests. After 10 weeks the patient achieved a partial symptomatic improvement in mood, anxiety and quality of sleep, but his activity remained insufficient. We also observed an improvement in the parameters of cognitive functioning and quality of life. There was neither significant mood variations during the memantine use nor mood changes after its termination. No significant side effects were noted during the memantine treatment. We conclude that using memantine in bipolar depression may improve mood, cognitive functioning and quality of life.

20.
Psychiatr Pol ; 46(4): 571-84, 2012.
Artigo em Polonês | MEDLINE | ID: mdl-23214160

RESUMO

AIM: Amphetamine and its derivates can induce, usually after many intoxications, schizophrenia-like psychosis. These disorders appeared only in part patients with amphetamine dependence. Aim of the study was to establish prevalence of selective risk factors of schizophrenia development in amphetamine users: 1) with amphetamine-induced schizophrenia-like psychosis, 2) with schizophrenia, and 2) without psychotic symptoms. MATERIAL: In the study 3 groups of subjects were included: 30 amphetamine users with amphetamine induced schizophrenia-like psychosis, 30 amphetamine users with schizophrenia and 30 amphetamine users without psychotic symptoms (37 female and 53 male in mean age = 17.78 years). METHODS: Amphetamine dependence, schizophrenia and schizophrenia-like psychosis induced amphetamine were diagnosed according to ICD-10 criteria after at least 1 year of amphetamine abstinence. The next procedure was used: 1) Structured interview with subjects and their mothers/caregivers regarding: a) amphetamines use (duration of abuse, doses of psychoactive substance) b) family history of psychosis (especially schizophrenia) 2) The Questionnaire of Child Development for assessment of prevalence of selected risk factors of schizophrenia development 3) The Premorbid Adjustment Scale (Cannon--Spoor) for assessment of premorbid psychosocial functioning in thelast year before psychosis. CONCLUSIONS: Amphetamines users with amphetamine-induced psychosis were more similar in prevalence of selective risk factors of schizophrenia development to subjects with schizophrenia and amphetamine dependence than to amphetamine users without psychosis. Amphetamine-induced psychosis developed more frequently in amphetamine users who used higher amphetamine doses and with familial history of psychosis.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/diagnóstico , Anfetamina/efeitos adversos , Estimulantes do Sistema Nervoso Central/efeitos adversos , Psicoses Induzidas por Substâncias/diagnóstico , Esquizofrenia/induzido quimicamente , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Desenvolvimento do Adolescente/efeitos dos fármacos , Feminino , Humanos , Masculino , Polônia , Fatores de Risco
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