- Publikační typ
- abstrakt z konference MeSH
OBJECTIVES: This study aimed to explore the relationship between plasma proteome and the clinical features of Major Depressive Disorder (MDD) during treatment of acute episode. METHODS: In this longitudinal observational study, 26 patients hospitalized for moderate to severe MDD were analyzed. The study utilized Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS) alongside clinical metrics, including symptomatology derived from the Montgomery-Åsberg Depression Rating Scale (MADRS). Plasma protein analysis was conducted at the onset of acute depression and 6 weeks into treatment. Analytical methods comprised of Linear Models for Microarray Data (LIMMA), Weighted Correlation Network Analysis (WGCNA), Generalized Linear Models, Random Forests, and The Database for Annotation, Visualization and Integrated Discovery (DAVID). RESULTS: Five distinct plasma protein modules were identified, correlating with specific biological processes, and uniquely associated with symptom presentation, the disorder's trajectory, and treatment response. A module rich in proteins related to adaptive immunity was correlated with the manifestation of somatic syndrome, treatment response, and inversely associated with achieving remission. A module associated with cell adhesion was linked to affective symptoms and avolition, and played a role in the initial episodes and treatment response. Another module, characterized by proteins involved in blood coagulation and lipid transport, exhibited negative correlations with a variety of MDD symptoms and was predominantly associated with the manifestation of psychotic symptoms. CONCLUSION: This research points to a complex interplay between the plasma proteome and MDD's clinical presentation, suggesting that somatic, affective, and psychotic symptoms may represent distinct endophenotypic manifestations of MDD. These insights hold potential for advancing targeted therapeutic strategies and diagnostic tools. LIMITATIONS: The study's limited sample size and its naturalistic design, encompassing diverse treatment modalities, present methodological constraints. Furthermore, the analysis focused on peripheral blood proteins, with potential implications for interpretability.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Interpersonal difficulties of patients with borderline personality disorder (BPD) are closely related to rejection sensitivity. The aim of the present study was to gain further insight into the experience and cerebral processing of social interactions in patients with BPD by using fMRI during experimentally induced experiences of social exclusion, inclusion, and overinclusion. METHODS: The study involved 30 participants diagnosed with BPD (29 female and 1 male; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 female and 1 male; age: M = 24.66, SD = 5.28) with no current or lifetime psychiatric diagnoses. In the fMRI session, all participants were asked to complete a Cyberball task that consisted of an alternating sequence of inclusion, exclusion, and overinclusion conditions. RESULTS: Compared to healthy controls, participants with BPD reported higher levels of inner tension and more unpleasant emotions across all experimental conditions. At the neural level, the participants with BPD showed lower recruitment of the left hippocampus in response to social exclusion (relative to the inclusion condition) than the healthy controls did. Lower recruitment of the left hippocampus in this contrast was associated with childhood maltreatment in patients with BPD. However, this difference was no longer significant when we added the covariate of hippocampal volume to the analysis. During social overinclusion (relative to the inclusion condition), we observed no significant differences in a group comparison of neural activation. CONCLUSIONS: The results of our study suggest that patients with BPD experience more discomfort than do healthy controls during social interactions. Compared to healthy participants, patients with BPD reported more inner tension and unpleasant emotions, irrespective of the extent to which others included them in social interactions. At a neural level, the participants with BPD showed a lower recruitment of the left hippocampus in response to social exclusion than the healthy controls did. The reduced activation of this neural structure could be related to a history of childhood maltreatment and smaller hippocampal volume in patients with BPD.
- Publikační typ
- časopisecké články MeSH
- MeSH
- antidepresiva * farmakologie terapeutické užití MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- rozhovory MeSH
Psychiatrie pro praxi, ISSN 1213-0508 Supplementum B
11 stran : tabulky ; 21 cm
Publikace obsahuje přednášku, která zazněla na sjezdu, který se zaměřil na léčbu schizofrenie. Obsahuje kazuistiku. Určeno odborné veřejnosti.
- MeSH
- farmakoterapie MeSH
- mladý dospělý MeSH
- obezita MeSH
- psychotropní léky terapeutické užití MeSH
- schizofrenie farmakoterapie MeSH
- služby péče o duševní zdraví MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- kongresy MeSH
- přednášky MeSH
- zprávy MeSH
- Konspekt
- Psychiatrie
- NLK Obory
- psychiatrie
- NLK Publikační typ
- brožury
Smíšená úzkostná a depresivní porucha je diagnóza v 10. i 11. edici Mezinárodní klasifikace nemocí (MKN), kterou lze stanovit pokud se u pacienta současně vyskytuje úzkostná a depresivní symptomatologie, která působí významné potíže, ale není vyjádřena v takové tíži, aby bylo možno stanovit jinou úzkostnou nebo afektivní poruchu. Někdy je existence této poruchy zpochybňována pro nízkou tíži příznaků, obtížné ohraničení od podobných stavů a nízkou diagnostickou spolehlivost. Například v poslední, páté, edici Diagnostického a statistického manuálu se nevyskytuje. V kontextu MKN se ale jedná o jednu z nejčastějších psychiatrických diagnóz zejména v primární péči. V diferenciální diagnostice je nutné nejprve vyloučit možnou tělesnou příčinu potíží a následně také jiné situace, kdy se může depresivní a úzkostná symptomatologie vyskytovat současně, například komorbidní depresivní a úzkostnou poruchu. Ve farmakologické terapii se uplatňují v první řadě antidepresiva ze skupiny selektivních inhibitorů zpětného vychytávání serotoninu a při neúspěchu lze užít jiné preparáty se současnou účinností na depresivní a úzkostné příznaky. Jako adjuvantní terapii lze podávat po omezenou dobu anxiolytika. Nezbytnou terapeutickou modalitou je psychoterapie, zejména kognitivně behaviorální psychoterapie.
Mixed anxiety and depressive disorder is a diagnostic category in the 10th and 11th editions of the International Classification of Diseases (ICD). It can be made when a patient shows co-occurring anxiety and depressive symptoms causing significant distress but not expressed in such severity that another anxiety or affective disorder can be diagnosed. Sometimes the existence of this disorder is questioned because of the low severity of symptoms, the difficulty of delineating it from similar conditions and the low diagnostic reliability. For example, it does not appear in the most recent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. However, in the context of the ICD, it is one of the most common psychiatric diagnoses, particularly in primary care. In the differential diagnosis, it is necessary first to exclude a possible physical cause of the disorder and then to rule out other situations where depressive and anxiety symptomatology may occur together, such as comorbid depressive and anxiety disorders. In pharmacological therapy, antidepressants from the group of selective serotonin reuptake inhibitors are primarily used. If unsuccessful, other agents with simultaneous efficacy on depressive and anxiety symptoms may be used. As adjuvant therapy, anxiolytics may be given for a limited time. Psychotherapy, particularly cognitive behavioural psychotherapy, is an essential therapeutic modality.
