OBJECTIVE: Our study aimed to screen for obstructive sleep apnoea (OSA) in a clinical population of psychiatric patients with affective disorders and risk factors for OSA using screening devices in psychiatric clinical environments. METHODS: Inpatients admitted with mood disorders in an inpatient psychiatric department were selected via inclusion and exclusion criteria and assessed for the risk factors of OSA. The inclusion criteria were: a diagnosis of an affective disorder confirmed by two independent psychiatrists, snoring or apnoeic pauses witnessed during regular night check-ups by nurses, and BMI > 25 kg/m2. The exclusion criteria were: a comorbid psychotic disorder, previously diagnosed OSA, intellectual disability, organic mental illness, acute coronary syndrome, acute or chronic heart failure, acute pulmonary diseases, a history of stroke, neuromuscular disorders, or a myorelaxant treatment. All included patients underwent overnight monitoring by a screening device SomnoCHECK Micro Cardio. A certified somnologist assessed obtained data. RESULTS: A total of 32 subjects (23 women and nine men) were included in the study. The mean age was 49.8 ± 8.8 years. Most participants had major depressive disorder (n = 23); another nine individuals had bipolar disorder. Diagnostic criteria for OSA were found in 50% of the sample, specifically in 88% of men and 33% of women. The correlation analysis identified several risk factors and variables. CONCLUSIONS: This pilot study showed an increased risk of OSA in patients with mood disorders. Psychiatric patients with identified risk factors should be routinely screened for obstructive sleep apnoea and referred to proper treatment.
- MeSH
- bipolární porucha * diagnóza epidemiologie MeSH
- depresivní porucha unipolární * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- obstrukční spánková apnoe * diagnóza epidemiologie terapie MeSH
- pilotní projekty MeSH
- poruchy nálady diagnóza epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Predictive models for mental disorders or behaviors (e.g., suicide) have been successfully developed at the level of populations, yet current demographic and clinical variables are neither sensitive nor specific enough for making individual clinical predictions. Forecasting episodes of illness is particularly relevant in bipolar disorder (BD), a mood disorder with high recurrence, disability, and suicide rates. Thus, to understand the dynamic changes involved in episode generation in BD, we propose to extract and interpret individual illness trajectories and patterns suggestive of relapse using passive sensing, nonlinear techniques, and deep anomaly detection. Here we describe the study we have designed to test this hypothesis and the rationale for its design. METHOD: This is a protocol for a contactless cohort study in 200 adult BD patients. Participants will be followed for up to 2 years during which they will be monitored continuously using passive sensing, a wearable that collects multimodal physiological (heart rate variability) and objective (sleep, activity) data. Participants will complete (i) a comprehensive baseline assessment; (ii) weekly assessments; (iii) daily assessments using electronic rating scales. Data will be analyzed using nonlinear techniques and deep anomaly detection to forecast episodes of illness. DISCUSSION: This proposed contactless, large cohort study aims to obtain and combine high-dimensional, multimodal physiological, objective, and subjective data. Our work, by conceptualizing mood as a dynamic property of biological systems, will demonstrate the feasibility of incorporating individual variability in a model informing clinical trajectories and predicting relapse in BD.
- Klíčová slova
- Bipolar disorder, Episode prediction, Machine learning, Wearable device,
- MeSH
- bipolární porucha * diagnóza MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé MeSH
- poruchy nálady diagnóza MeSH
- recidiva MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
OBJECTIVE: Anxiety and mood disorders (AMD) are the most frequent mental disorders in the human population. They have recently shown increasing prevalence, and commonly disrupt personal and working lives. The aim of our study was to analyze the spectrum of circulating steroids in order to discover differences that could potentially be markers of affective depression or anxiety, and identify which steroids could be a predictive component for these diseases. METHODS: We studied the steroid metabolome including 47 analytes in 20 men with depression (group D), 20 men with anxiety (group AN) and 30 healthy controls. OPLS and multivariate regression models were used for statistical analysis. RESULTS: Discrimination of group D from controls by the OPLS method was absolute, as was group AN from controls (sensitivity=1.000 (0.839, 1.000), specificity=1.000 (0.887, 1.000)). Relatively good predictivity was also found for discrimination between group D from AN (sensitivity=0.850 (0.640, 0.948), specificity=0.900 (0.699, 0.972)). CONCLUSION: Selected circulating steroids, including those that are neuroactive and neuroprotective, can be useful tools for discriminating between these affective diseases in adult men.
- Klíčová slova
- Affective depression, Allopregnanolone, Anxiety, Dehydroepiandrosterone, Multivariate analysis,
- MeSH
- dehydroepiandrosteron krev MeSH
- deprese krev MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- multivariační analýza MeSH
- plynová chromatografie s hmotnostně spektrometrickou detekcí MeSH
- poruchy nálady krev diagnóza MeSH
- pregnanolon krev MeSH
- radioimunoanalýza MeSH
- steroidy krev MeSH
- úzkost krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- dehydroepiandrosteron MeSH
- pregnanolon MeSH
- steroidy MeSH
OBJECTIVES: A significant number of psychiatric patients stigmatize themselves because of their mental struggles. Such self-stigmatization has an adverse impact on patients' well-being and effectiveness of the treatment of mental disorders. The goal of this study was to standardize the brief Internalized Stigma of Mental Illness Scale (ISMI-10), which could be used in studies targeting the self-stigma among the psychiatric patients. METHOD: 354 psychiatric patients participated in the study between the years 2012 and 2014. All individuals were undergoing treatment in the outpatient care or the psychotherapeutic ward of the Department of Psychiatry, University Hospital Olomouc. The mean age of the participants was 41.5±13.3 years. The majority of them were women (n=195). The patients suffered from various mental disorders - neurotic disorders (n=166), mood disorders (n=65), substance use disorders (n=47), psychoses (n=40), personality disorders (n=32), and organic mental illness (n=4). Each patient completed a demographic questionnaire and the ISMI-10. RESULTS: The ordinal alpha of the scale was 0.86, indicating its good internal consistency. The overall scores of the full and abbreviated version of the scale were almost perfectly correlated (r=0.95, p<0.001). The factor analysis confirmed a good internal structure of the scale. The created norms for the scale score were based on stens. CONCLUSION: The ISMI-10 may be a useful method for measuring the self-stigma among adults with a mental disorder. The area of its use lies mainly in research.
- MeSH
- dospělí MeSH
- duševní poruchy diagnóza psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- poruchy nálady diagnóza MeSH
- poruchy spojené s užíváním psychoaktivních látek diagnóza MeSH
- průzkumy a dotazníky MeSH
- psychiatrické posuzovací škály MeSH
- psychometrie * metody MeSH
- reprodukovatelnost výsledků MeSH
- sebepojetí MeSH
- společenské stigma * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: This study aimed to examine differences in the clinical presentation of very-early-onset (VEO) and early-onset (EO) bipolar disorder (BD) not fully explored previously. METHODS: We selected two groups of subjects with BD from the Maritime Bipolar Registry based on age at onset of first major mood episode (VEO with onset prior to age 15 years; EO ranging from 15 to 18 years) and compared them with a reference group (onset after 18 years of age). There were 363 subjects (240 with bipolar I disorder and 123 with bipolar II disorder; mean age 44.2 ± 12.8 (SD) years), with 41 subjects in the VEO and 95 in the EO groups. RESULTS: In comparison with the EO and reference groups, more subjects in the VEO group developed major depression as an index episode (88% for the VEO group versus 61% for the EO group and 54% for the reference group), and had an unremitting clinical course (65% versus 42% and 42%, respectively), rapid cycling (54% versus 34% and 28%, respectively), and comorbid attention-deficit hyperactivity disorder (17% versus 1% and 3%, respectively); a higher proportion of the VEO group had first-degree relatives with affective disorders compared with the EO and reference groups (0.41 versus 0.32 and 0.29, respectively), and they had lower scores on the Global Assessment of Functioning scale (mean scores of 64 versus 70 and 70). Overall, the EO group was similar to the reference group on most measures, except for increased suicidal behavior VEO 53%, EO 44% and reference group 25%). The results of polychotomous logistic regression also support the view that VEO BD represents a rather specific subtype of BD. CONCLUSIONS: Our results suggest the recognized correlates of early-onset BD may be driven by subjects at the lowest end of the age at onset spectrum.
- Klíčová slova
- bipolar disorder, childhood ADHD, early course, early onset, first mood episode, rapid cycling,
- MeSH
- bipolární porucha * diagnóza epidemiologie psychologie MeSH
- depresivní porucha unipolární diagnóza epidemiologie psychologie MeSH
- dospělí MeSH
- hyperkinetická porucha * diagnóza epidemiologie psychologie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- poruchy nálady diagnóza epidemiologie psychologie MeSH
- psychiatrické posuzovací škály MeSH
- psychopatologie MeSH
- rodina psychologie MeSH
- věk při počátku nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Kanada epidemiologie MeSH
The mood and behavior of individuals result from an orchestra of many factors. Among them steroids play an important role; however, only several common hormones have been investigated in this respect. It has been demonstrated that some steroid metabolites long considered merely the products of steroid hormone metabolism in fact possess considerable activity in the CNS. For this reason we studied the steroid metabolome including 50 analytes in 20 men with depression, 20 men with anxiety and 30 healthy controls. Significant differences were found not only between controls and men with either depression or anxiety, but also between men with depression and anxiety. Particularly striking were those steroids until now not generally associated with depression or anxiety, namely conjugated steroid forms, especially sulfates.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolom fyziologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- neurotransmiterové látky krev MeSH
- poruchy nálady krev diagnóza MeSH
- úzkostné poruchy krev diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- neurotransmiterové látky MeSH
Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been confirmed by many authors, but there have been conflicting results in subjects with anxiety disorders. In the present cross-sectional study, levels of calcidiol were determined in groups of depressive men and women and in men and women with anxiety disorders and compared with age matched controls. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.
- MeSH
- depresivní poruchy krev diagnóza terapie MeSH
- lidé MeSH
- poruchy nálady krev diagnóza terapie MeSH
- průřezové studie MeSH
- úzkost krev diagnóza terapie MeSH
- vitamin D krev MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- vitamin D MeSH
OBJECTIVE: Self-stigma in psychiatric patients is an issue deserving both research and therapeutic attention. The objective of the present study was to evaluate the psychometric properties of a Czech version of the Internalized Stigma of Mental Illness (ISMI) scale assessing the levels of self-stigma in individuals with mental disorders. METHODS: It consists of 29 items classified into 5 subscales, namely alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance. The study group comprised 369 patients with a mean age of 41.5±13.3 years, of whom 210 (56.6%) were females. RESULTS: The most frequent diagnosis was neurotic disorders (46.1%), followed by affective disorders (18.4%), substance use disorders (13.3%), psychotic disorders (10.8%), personality disorders (9.5%) and organic disorders (1.6%). Reliability of the scale was evaluated by internal consistency analysis (α=0.91), the split-half method (Spearman-Brown coefficient: 0.93) and test-retest at 3 weeks from the first measurement (N=17; r=0.90, p<0.05). CONCLUSION: Exploratory factor analysis of the scale was performed, its validity was verified and norms were established that were based on T-scores and sten scores for the entire scale and individual subscales. The Czech translation of the ISMI has adequate psychometric properties.
- MeSH
- dospělí MeSH
- duševní poruchy diagnóza psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- neurotické poruchy diagnóza psychologie MeSH
- poruchy nálady diagnóza psychologie MeSH
- poruchy spojené s užíváním psychoaktivních látek diagnóza psychologie MeSH
- psychometrie metody normy MeSH
- psychotické poruchy diagnóza psychologie MeSH
- reprodukovatelnost výsledků MeSH
- sebepojetí * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stereotypizace * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
- Geografické názvy
- Česká republika MeSH
62 patients suffering from mood disorders or schizophrenia diagnosed retrospectively according to DSM-4 as 295.xx or 296.xx were followed up by the author personally for 20 years. The DSM-IV diagnosis of schizophrenia (295.xx) was changed to a diagnosis of a mood disorder in 13 patients (26%). If schizoaffective disorder is classified as a mood disorder to form a group of periodic disorders, 41% of patients diagnosed as "pure" schizophrenia (295.xx without 295.70) at the start of the observation period were re-diagnosed as periodic disorder over 20 years. This "retrogression" of schizophrenia is seen as a result of the treatment with psychotropic drugs. The Kraepelian dichotomy is based on the relationship between the symptomatic pattern (syndrome) and the course of the illness. This relationship is disrupted by long-term treatment with psychotropic drugs.
- MeSH
- antipsychotika terapeutické užití MeSH
- Diagnostický a statistický manuál mentálních poruch MeSH
- diferenciální diagnóza MeSH
- dlouhodobá péče MeSH
- lidé MeSH
- periodicita * MeSH
- poruchy nálady klasifikace diagnóza farmakoterapie MeSH
- prognóza MeSH
- psychotické poruchy klasifikace diagnóza farmakoterapie MeSH
- psychotropní léky terapeutické užití MeSH
- retrospektivní studie MeSH
- schizofrenie (psychologie) * MeSH
- schizofrenie klasifikace diagnóza farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antipsychotika MeSH
- psychotropní léky MeSH
- MeSH
- amitriptylin terapeutické užití MeSH
- dexamethason MeSH
- dospělí MeSH
- hydrokortison metabolismus MeSH
- imipramin terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- poruchy nálady diagnóza farmakoterapie patofyziologie MeSH
- systém hypofýza - nadledviny účinky léků metabolismus patofyziologie MeSH
- systém hypotalamus-hypofýza účinky léků metabolismus patofyziologie MeSH
- thyreotropin MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- amitriptylin MeSH
- dexamethason MeSH
- hydrokortison MeSH
- imipramin MeSH
- thyreotropin MeSH
