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Journal Article 2013; 34(6): 464-481 PubMed PMID: 24378444 Citation  Keywords:  Diagnostic and Statistical Manual of Mental Disorders, Humans, International Classification of Diseases, Models, Psychological, Prevalence, Psychotherapy, Risk Factors, Stress Disorders, Post-Traumatic:diagnosis,.   

: The diagnostic category of posttraumatic stress disorder (PTSD) has its place in the newest American diagnostic system DSM-V. The authors compare its definition with the former manual DSM-IV and the international classification ICD-10. They reflect difficulties in defining the concept of traumatic event. They summarize epidemiological findings, highlight the possible significant role of traumatogenesis in other psychiatric disorders without PTSD symptoms. The biopsychosocial model seems to be the most adequate for the study of trauma-related disorders, while in therapy the specific shaping of psychotherapy seems to be crucial. Good experiences in relationships before the trauma increase resilience and the availability of supportive empathetic relationships may favourably influence the development of the disorder and its therapy....

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Journal Article 2011; 32(3): 264-273 PubMed PMID: 21712776 Citation  Keywords:  Adult, Age Factors, Analysis of Variance, Biomarkers, Depressive Disorder:genetics, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Indoleamine-Pyrrole 2,3,-Dioxygenase:genetics, Kynurenic Acid:metabolism, Male, Psychiatric Status R.   

BACKGROUND: Reduced plasma tryptophan occurs in depression and somatization. Induction of indoleamine 2,3-dioxygenase (IDO) with consequent synthesis of tryptophan catabolites (TRYCATs) and lowered tryptophan are associated with the onset of depression in the puerperium and during interferon-alpha treatment. Depression is accompanied by lowered kynurenic acid, a neuroprotectant, or increased kynurenine, a neurotoxic TRYCAT.

AIMS AND METHODS: To examine plasma tryptophan; kynurenine; kynurenic acid; the kynurenine / tryptophan (KY/TRP) ratio, indicating IDO activity; and the kynurenine / kynurenic acid (KY/KA) ratio, indicating kynurenine aminotransferase (KAT) activity, in somatization; depression; somatization + depression; and controls. Illness severity is measured by the Somatic Symptom Index (SSI), the Screening for Somatoform Symptoms (SOMS), and the Beck Depression Inventory (BDI).

RESULTS: Tryptophan is significantly lower in patients than in controls and lower in somatization than in depression. KY/TRP is significantly increased in somatization. Kynurenic acid is significantly lower in patients than in controls, and lower in somatization than in depression. KY/KA is significantly higher in somatization and somatization + depression than in depression and controls. There are significant correlations between the severity of somatization, but not depression, and KY/TRP and KY/KA (positive) and tryptophan (negative). Kynurenine and kynurenic acid are significantly correlated in controls, somatization + depression, and depression, but not in somatization.

CONCLUSIONS: Somatization is characterized by increased IDO activity and disorders in KAT activity and an increased neurotoxic potential. The TRYCAT pathway may play a role in the pathophysiology of somatizing and "psychosomatic" symptoms through effects on pain, gut motility, the autonomic nervous system, peripheral NMDA receptors, etc. Even more, biological disorders, such as aberrations in the TRYCAT pathway, which are considered to be a hallmark for depression, are in fact attributable to somatization rather than to depression per se. Future research in depression on the TRYCAT pathway should always control for the possible effects of somatization....

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Journal Article 2009; 30(3): 396-399 PubMed PMID: 19855366 Citation  Keywords:  Adult, Antipsychotic Agents:administration & dosage, Cerebral Cortex:drug effects, Diagnostic and Statistical Manual of Mental Disorders, Electromyography, Evoked Potentials, Motor:drug effects, Humans, Isoxazoles:administration & dosage, Male, Neural Inh.   

: Transcranial magnetic stimulation is a neurophysiological method which enables direct quantitative in vivo assessment of cortical excitability and inhibition. The aim of the study was to assess the impact of paliperidone on the motor threshold and cortical silent period, in a drug-naive patient, with first episode schizophrenia using this technique. Paliperidone monotherapy caused a significant reduction of severity of schizophrenic symptomatology in the patient. At the same time, a significant prolongation of the cortical silent period, from 118.68 ms before to 185.13 ms after therapy, occurred. Because the cortical silent period is a function of GABA(B) receptors, we can assume that paliperidone may have the ability to enhance GABA(B) receptor-mediated neurotransmission....

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Journal Article 2009; 30(3): 387-395 PubMed PMID: 19855365 Citation  Keywords:  Adiponectin:blood, Adult, Aged, Antidepressive Agents:therapeutic use, Blood Glucose:metabolism, Body Mass Index, Chi-Square Distribution, Citalopram:therapeutic use, Depression:blood, Diagnostic and Statistical Manual of Mental Disorders, Drug Therapy, C.   

BACKGROUND: Depressive disorder (DD) is associated with an increased risk of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). It was suggested, that metabolic syndrome (MetS), cluster of metabolic and hormonal changes, such as insulin resistence (IR), abdominal obesity, dyslipidemia, arterial hypertension and elevated fasting glycaemia, could stand behind the connection. Recent findings have shown, that adipocytokines leptin and adiponectin might play a role in both depression and MetS.

AIM: The aim of this pilot study was to observe the plasma concentrations of leptin, adiponectin, leptin-to-adiponectin ratio and indices of IR in women with depressive disorder.

MATERIALS AND METHODS: The plasma leptin, adiponectin, parameters of lipid and glucose homeostasis and indices of IR were investigated in a group of 38 women with DD. The results were compared with those of 38 healthy women of the control group, matched for age.

RESULTS: Depressive women differed significantly from the controls in higher concentrations of plasma leptin (p <0.05), insulin (p <0.01), C-peptide (p <0.01), value of HOMA-IR (p <0.01), and the leptin-to-adiponectin ratio (p <0.05).The QUICKI index of insulin sensitivity was lower (p <0.01). HAM-D score of DD cases correlated negatively with adiponectin (r = - 0.3505; p < 0.05), independently of HOMA-IR. We have not found in DD group any differences between the drug free patients and those treated either with escitaloprame alone or in the combination with mirtazapine.

CONCLUSIONS: The results of the pilot study presented support the hypothesis that at least part of DD cases has increased leptin serum levels and certain features of MetS. It could be the factor connecting depression with an increased risk of either DM2 or CVD....

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