Search

Introduction Depression is often observed in schizophrenia, in all phases of the disorder. Age of illness onset and sex have been found to correlate with depressive symptomatology in many but not all studies. Aims In the present work the relation between depressive symptoms and age of onset and sex was investigated, in a sample of patients with paranoid schizophrenia. Methods Eighty-eight (88) patients with paranoid schizophrenia according to DSM-IV-TR criteria were examined, 21 of which became ill at ≥35 years of age (late onset), whereas 60 had age of onset < 30 years (young onset). During the active phase the Calgary Depression Scale for Schizophrenia (CDSS) was applied. Comparisons were performed by using the two-tailed Wilcoxon rank-sum and Chi-squared tests. Results The percentage of patients with depression (CDSS > 6) in the whole sample was 27.2%. There was a trend for higher scores in early awakening in late onset patients ( P = 0.060). In men, there was a trend for heavier depression in late onset patients, and higher scores in early awakening ( P = 0.082, 0.019, respectively). In young onset patients, there was a trend for heavier symptomatology in women compared with men, and heavier pathological guilt ( P = 0.073, 0.007, respectively), whereas in late onset patients, there was a trend for heavier self depreciation in men ( P = 0.072). Conclusions Although the frequency of depression does not seem to be influenced by age of onset or sex, more subtle differences are found in the severity of certain depressive symptoms, in relation to these factors, possibly warranting further investigation. [ABSTRACT FROM AUTHOR]

Introduction Athena possesses a special place among the Greek Gods, as she was born from her father, according to an extreme patriarchal model with a marked depreciation of the maternal role. Zeus had swallowed and absorbed the mother of Athena, Mites, because of an oracle that if Mites gave birth to a boy, the boy would take his throne. When the time comes, Zeus commands Hephaestus to cleave his forehead with an axe, and then Athena leaps fully armed and shouting her cry of war, in front of the astonished Gods. The next moment she puts her weapons down, as a token of obedience and devotion. The exceptionally close bond between father and daughter is evident through their uniquely confidential relationship. The ancient myth is paralleled, from a psychodynamic aspect, with the case of a narcissistic patient receiving psychodynamic psychotherapy. Methods Case report. Results A case of a woman with narcissistic personality features and depressive symptoms is described, presenting with the complaints of withdrawal, self-depreciation, passivity, and agoraphobia. Psychodynamic factors defining her pathology are her narcissistic and sexualized relationship with her father, whereas the relationship with her mother has been depreciated. The patient experiences an intrapsychic conflict of reciprocal idealization, against her anger and fear for her father, resulting in the symptoms of agoraphobia and passivity. Conclusion Like Athena, who puts her weapons down, the patient resigns from her will for autonomy and moves to a passive position, as a result of her entrapment in her idealized relationship with the father. [ABSTRACT FROM AUTHOR]

Introduction: Premenstrual dysphoric disorder is a premenstrual syndrome comprising physical and psychic symptoms. Bipolar disorders, particularly “soft” forms, share symptoms such as depressive mood, irritability or mood reactivity with premenstrual dysphoric disorder, posing challenges on differential diagnosis. In the present work a case of a woman suffering from cyclothymia is reported, with mood episodes confined in the luteal phase of the menstrual cycle. Methods: Case Report. Results: A 42-year-old married Caucasian woman is presented, suffering from mood disorder episodes lasting for 10-12 days each, during the luteal phase of the menstrual cycle, and remitting after the beginning of her menses. The mood episodes occurred since the age of 20, in almost every menstrual cycle. The patient described hypomanic symptoms during the first 4-5 days of the luteal phase, reporting irritable mood, pressured speech, increased libido as well as vividness of her perceptions and excessive goal-directed activity. The hypomanic symptoms were followed by irritable and depressive mood, fatigue, hypersomnia, tearfulness, decreased self-esteem and pessimism, lasting for another 6-7 days. The patient also reported migraine and binge-eating episodes during each depressive phase. A full range of examinations, including blood and hormonal tests, yielded normal results. Lamotrigine was titrated at 200mg/day, with subsequent amelioration of symptoms. Conclusions: The exact relationship between premenstrual dysphoric disorder and other disturbances, which either coexist, or deteriorate premenstrually, or even synchronize with the menstrual cycle, has not been elucidated yet. Studies aiming at a better understanding of this relationship could aid at accurate diagnosis and treatment. [Copyright &y& Elsevier]

Introduction: Oral isotretinoin is presently regarded as the drug of choice for the treatment of severe and recalcitrant acne. Objectives: Although its use has been associated with various psychiatric side effects, the casual relationship between these manifestations and oral isotretinoin still remains in dispute. Aims: The purpose of this study was to investigate the incidence of psychopathological reactions in patients with severe acne orally treated with isotretinoin. Methods: Seventy-two (72) patients with severe acne and thirty-six (36) healthy volunteers acne enrolled in the study from January 2003 and August 2009. Acne patients were allocated either to oral isotretinoin (1mg/kg/day) (N=36) or to topical treatment (N=36). All patients and controls were separately interviewed by two psychiatrists before and 1, 3 and 6 months after onset of treatment. Their psychological status was evaluated using SCID-I, SCID-II (DSM-IV) and Hamilton Scale for Depression and Anxiety. Results: A statistical significant increase in the incidence of depression, mood and/or anxiety disorders was observed in the group of isotretinoin-treated acne patients as compared to the group of those topically treated and to healthy controls. No association between development of symptoms of mental disorder and duration of treatment with isotretinoin was detected. Conclusions: In view of the above findings it seems reasonable to suggest that oral isotretinoin may be capable of causing anxiety and/or depressive or other mood disorders in patients with severe acne. Close psychiatric monitoring should be included in the investigations that are routinely performed throughout oral isotretinoin treatment of these patients. [Copyright &y& Elsevier]

Introduction Schizophrenia (SZ) is a serious mental disorder that significantly affects patients’ quality of life (QoL). Its etiology is still unknown; however, both environmental and genetic factors play important role. Atypical antipsychotics, fight mainly against its psychotic symptoms but can also cause various side effects. Objectives/aims The study was based on a literature review and a meta-analysis which revealed pharmacogenomic biomarkers for the individualization of treatment with atypical antipsychotics. Main aim was to investigate emerging polymorphisms, in Caucasian healthy individuals and schizophrenics. Materials & methods Four hundred and eighty-five schizophrenic patients and 393 matched controls of healthy donors were studied. Patients were of Greek, Italian, Croatian and Slovenian origin. The group of patients was divided into two subgroups; TRS (treatment resistant schizophrenia) and responders in atypical antipsychotics. Genotyping was performed by Sanger sequencing and PCR/BpEI-based method. Results rs6313 and rs1799978 were indicated as potential biomarkers of patients’ response on antipsychotics. Experimental results suggest non-correlation of polymorphisms with patients’ response to these drugs in Greek, Italian, Croatian and Slovenian populations. Conclusions SZ's etiology is highly complex, however, pharmacogenomic studies can lead to the identification of genetic loci important for disease pathobiology and management as well as patient stratification. Herein, no correlation was evident regarding rs6313 and rs1799978 and drug response in the Caucasian populations studied. Next, sample number will be extended and a more wide cross-population assessment will occur. Knowledge acquired and technology improvement, will lead to a better understanding of the underlying mechanisms, and will subsequently contribute to the improvement of patients’ QoL. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, many relevant gene-drug associations have been discovered, but pharmacogenomics (PGx)-guided treatment needs to be cost-effective as well as clinically beneficial to be incorporated into standard health-care. Objectives: To address current challenges, this systematic review provides an update regarding previously published studies, which assessed the cost-effectiveness of pharmacogenomics testing for the prescription of antidepressants and antipsychotics. Methods: Our initial screening revealed 1159 articles, which was subsequently reduced to 32 articles, deducted by analysis of their abstract. Full-text analysis performed by all authors resulted in 18 papers that were further included in the analysis. Results: Of the 18 studies evaluations, 16 studies (88.89%) drew conclusions in favor of PGx testing, of which 9 (50%) were costeffective and 7 (38.9%) were less costly based on cost analysis. In brief, we found sufficient evidence on the cost-effectiveness of PGx in psychiatric disease care. More precisely, supportive evidence exists for CYP2D6 and CYP2C19 gene-drug associations and for combinatorial PGx panels, but evidence is limited for many other drug-gene combinations. Amongst the limitations of the field are the unclear explanation of perspective and cost inputs inmany economic studies, aswell as the underreporting of study design elements, which can influence significantly the economic evaluations. Conclusions: Overall, this systematic review highlights the need for additional research on economic evaluations of PGx implementation with an emphasis on psychiatric pharmacogenomics. [ABSTRACT FROM AUTHOR]