The aim of the present review was to examine objective and subjective burdens in primary caregivers(usually family members) of patients with bipolar disorder(BD) and to list which symptoms of the patients are consider...The aim of the present review was to examine objective and subjective burdens in primary caregivers(usually family members) of patients with bipolar disorder(BD) and to list which symptoms of the patients are considered more burdensome by the caregivers. In order to provide a critical review about caregiver's burden in patients with bipolar disorder, we performed a detailed Pub Med, Bio Med Central, ISI Web of Science, Psyc INFO, Elsevier Science Direct and Cochrane Library search to identify all papers and book chapters in English published during the period between 1963 and November 2011. The highest levels of distress were caused by the patient's behavior and the patient's role dysfunction(work, education and social relationships). Furthermore, the caregiving role compromises other social roles occupied by the caregiver, becoming part of the heavy social cost of bipolar affective disorder. There is a need to better understand caregivers' views and personal perceptions of the stresses and demands arising from caring for someone with BD in order to develop practical appropriate interventions and to improve the training of caregivers.展开更多
AIM: To investigate factors related to hopelessness in a sample of epileptic patients, including measures of depression and quality of life(QOL). METHODS: Sixty-nine participants were administered the following psycho...AIM: To investigate factors related to hopelessness in a sample of epileptic patients, including measures of depression and quality of life(QOL). METHODS: Sixty-nine participants were administered the following psychometric instruments: Beck Depression Inventory-Ⅱ, Beck Hopelessness Scale(BHS), and QOLin Epilepsy(QOLIE)-89. Patients were dichotomized into two categories: those affected by epilepsy with generalized tonic-clonic seizures vs those having epilepsy with partial seizures. RESULTS: The groups differed on the QOLIE Role Limitation/Emotional dimension. Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems than patients with other types of epilepsy(89.57 ± 25.49 vs 72.86 ± 36.38; t 63 =-2.16; P < 0.05). All of the respondents reported moderate to severe depression, and 21.7% of patients with generalized seizures and 28.6% of patients with other diagnoses had BHS total scores ≥ 9 indicating a higher suicidal risk. The study did not control for years of the illness. CONCLUSION: Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems compared to patients with other types of seizures. Patients at increased suicide risk as evaluated by the BHS were older than those who had a lower suicidal risk. Future studies are required to further investigate the impact of hopelessness on the outcome of epileptic patients.展开更多
The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactiv...The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactive medications and duration of illness. Al-though findings from the current literature are quite conflicting, we proposed that subjects with WMHs may be at higher suicidal risk when compared to other sub-groups without. Based on the Fazekas modified scale, the severity of WMHs may serve as a trait marker of disease. Interestingly, the presence of WMHs may rep-resent a neurobiological marker between the underlying vulnerability and clinical presentation of major affective disorders.展开更多
Risperidone is a safe second-generation antipsychotic which is rarely associated with the emergence of a few adverse effects,such as oral lesions and stomatitis.We report the case of a 77-year-old woman affected by a ...Risperidone is a safe second-generation antipsychotic which is rarely associated with the emergence of a few adverse effects,such as oral lesions and stomatitis.We report the case of a 77-year-old woman affected by a neurocognitive disorder with psychotic features and treated with risperidone 2 mg/day.After 1 week,she showed a burning mouth syndrome with oral lesions and risperidone was discontinued.Antipsychotic-induced oral ulcerations may be caused by the reduction of saliva protection with minor adverse effects related to oral movement disorders or impairment of the bacterial flora of saliva.展开更多
AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus(HIV) patients. METHODS: A detailed MEDLINE search was carried out to identi...AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus(HIV) patients. METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015. RESULTS: Based on the main findings, the prevalence of major depressive disorder(MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV. CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV.展开更多
According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.Ho...According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.However,MRI findings may be limited by low spatial resolution;therefore,an important contribution to the understanding of the role and significance of WM alterations derived by the development of the most recent magnetic resonance techniques,such as diffusion tensor imaging(DTI).Several DTI studies reported an association between altered WM integrity and MDD/suicidal behavior.Microstructural WM abnormalities may be located in neural circuits critically implicated in emotional processes and mood regulation resulting in enhanced vulnerability to psychiatric morbidity.WM abnormalities detected using DTI may contribute to functional deficits and help to clarify the pathophysiological mechanisms underlying MDD as well as suicidal behavior.By a clinical point of view,research also suggested that affective temperaments may play a relevant role in the psychopathological characteristics of mood disorders,clinical trajectory of episodes and polarity,long‑term outcome and suicidality.Unfortunately,only few studies investigated the association between affective temperaments and WM abnormalities and discussed their possible implications in patients with MDD and suicidal behavior.Using a comprehensive search of Medline database,the aim of the present study was to critically review the current literature on the association between WM alterations as assessed by MRI and DTI techniques,affective temperaments,MDD and suicidal behavior.展开更多
Major depressive disorder(MDD)is associated with a significant disability worldwide,relevant psychosocial impairment,and increased risk of suicidal behavior.[1]Although multiple psychoactive compounds are now availabl...Major depressive disorder(MDD)is associated with a significant disability worldwide,relevant psychosocial impairment,and increased risk of suicidal behavior.[1]Although multiple psychoactive compounds are now available,[2]more than 20%of MDD patients treated with traditional antidepressant drugs do not benefit from complete recovery and are affected by treatment-resistance.[3]Traditional antidepressant medications may be ineffective and sometimes worsen depressive symptoms in a vulnerable subpopulation of patients with subthreshold hypomanic symptoms that may be better included in the bipolar spectrum rather than MDD.[4]展开更多
文摘The aim of the present review was to examine objective and subjective burdens in primary caregivers(usually family members) of patients with bipolar disorder(BD) and to list which symptoms of the patients are considered more burdensome by the caregivers. In order to provide a critical review about caregiver's burden in patients with bipolar disorder, we performed a detailed Pub Med, Bio Med Central, ISI Web of Science, Psyc INFO, Elsevier Science Direct and Cochrane Library search to identify all papers and book chapters in English published during the period between 1963 and November 2011. The highest levels of distress were caused by the patient's behavior and the patient's role dysfunction(work, education and social relationships). Furthermore, the caregiving role compromises other social roles occupied by the caregiver, becoming part of the heavy social cost of bipolar affective disorder. There is a need to better understand caregivers' views and personal perceptions of the stresses and demands arising from caring for someone with BD in order to develop practical appropriate interventions and to improve the training of caregivers.
文摘AIM: To investigate factors related to hopelessness in a sample of epileptic patients, including measures of depression and quality of life(QOL). METHODS: Sixty-nine participants were administered the following psychometric instruments: Beck Depression Inventory-Ⅱ, Beck Hopelessness Scale(BHS), and QOLin Epilepsy(QOLIE)-89. Patients were dichotomized into two categories: those affected by epilepsy with generalized tonic-clonic seizures vs those having epilepsy with partial seizures. RESULTS: The groups differed on the QOLIE Role Limitation/Emotional dimension. Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems than patients with other types of epilepsy(89.57 ± 25.49 vs 72.86 ± 36.38; t 63 =-2.16; P < 0.05). All of the respondents reported moderate to severe depression, and 21.7% of patients with generalized seizures and 28.6% of patients with other diagnoses had BHS total scores ≥ 9 indicating a higher suicidal risk. The study did not control for years of the illness. CONCLUSION: Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems compared to patients with other types of seizures. Patients at increased suicide risk as evaluated by the BHS were older than those who had a lower suicidal risk. Future studies are required to further investigate the impact of hopelessness on the outcome of epileptic patients.
文摘The presence of white matter hyperintensities(WMHs) has been commonly associated with poor outcome in subjects with major affective disorders. Unfortunately, WMHs may be frequently confounded by the use of psychoactive medications and duration of illness. Al-though findings from the current literature are quite conflicting, we proposed that subjects with WMHs may be at higher suicidal risk when compared to other sub-groups without. Based on the Fazekas modified scale, the severity of WMHs may serve as a trait marker of disease. Interestingly, the presence of WMHs may rep-resent a neurobiological marker between the underlying vulnerability and clinical presentation of major affective disorders.
文摘Risperidone is a safe second-generation antipsychotic which is rarely associated with the emergence of a few adverse effects,such as oral lesions and stomatitis.We report the case of a 77-year-old woman affected by a neurocognitive disorder with psychotic features and treated with risperidone 2 mg/day.After 1 week,she showed a burning mouth syndrome with oral lesions and risperidone was discontinued.Antipsychotic-induced oral ulcerations may be caused by the reduction of saliva protection with minor adverse effects related to oral movement disorders or impairment of the bacterial flora of saliva.
文摘AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus(HIV) patients. METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015. RESULTS: Based on the main findings, the prevalence of major depressive disorder(MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV. CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV.
文摘According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.However,MRI findings may be limited by low spatial resolution;therefore,an important contribution to the understanding of the role and significance of WM alterations derived by the development of the most recent magnetic resonance techniques,such as diffusion tensor imaging(DTI).Several DTI studies reported an association between altered WM integrity and MDD/suicidal behavior.Microstructural WM abnormalities may be located in neural circuits critically implicated in emotional processes and mood regulation resulting in enhanced vulnerability to psychiatric morbidity.WM abnormalities detected using DTI may contribute to functional deficits and help to clarify the pathophysiological mechanisms underlying MDD as well as suicidal behavior.By a clinical point of view,research also suggested that affective temperaments may play a relevant role in the psychopathological characteristics of mood disorders,clinical trajectory of episodes and polarity,long‑term outcome and suicidality.Unfortunately,only few studies investigated the association between affective temperaments and WM abnormalities and discussed their possible implications in patients with MDD and suicidal behavior.Using a comprehensive search of Medline database,the aim of the present study was to critically review the current literature on the association between WM alterations as assessed by MRI and DTI techniques,affective temperaments,MDD and suicidal behavior.
文摘Major depressive disorder(MDD)is associated with a significant disability worldwide,relevant psychosocial impairment,and increased risk of suicidal behavior.[1]Although multiple psychoactive compounds are now available,[2]more than 20%of MDD patients treated with traditional antidepressant drugs do not benefit from complete recovery and are affected by treatment-resistance.[3]Traditional antidepressant medications may be ineffective and sometimes worsen depressive symptoms in a vulnerable subpopulation of patients with subthreshold hypomanic symptoms that may be better included in the bipolar spectrum rather than MDD.[4]
