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Journal Article 2009; 30(5): 615-623 PubMed PMID: 20035255 Citation  Keywords:  Adult, Cognitive Therapy:methods, Drug Resistance, Female, Humans, Male, Obsessive-Compulsive Disorder:psychology, Surveys and Questionnaires, Treatment Outcome, Young Adult,.   

OBJECTIVE: The aim of our study was to establish the efficacy of CBT on the sample of non-selected medication-resistant patients with OCD and to search for predictors of therapeutic response in such a group.

METHODS: The treatment was carried out under usual conditions at the department for anxiety disorders. Systematic CBT steps were tailored to the needs of each patient. Pharmacology treatment remained grossly unchanged during the trial period. We used the following outcome measures in the study: Yale-Brown Obsessive Compulsive Scale, subjective version (S-Y-BOCS), the Clinical Global Impression - Severity of Illness scale (CGI-S), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Somatoform Dissociation Questionnaire (SDQ-20) and Dissociative Experience Scale (DES). The primary outcome measure was a decrease by 35% in Y-BOCS rating. Remission was defined as a 12 point score or lower in Y-BOCS and 1 or 2 points in CGI-S.

RESULTS: 47 patients completed the study (19 male and 28 female). One female patient refused to participate. All patients completed at least 5 weeks of intensive CBT programme and showed significant improvement on Y-BOCS, CGI-S, and BDI scales. At the end of the treatment 40.4% of the patients achieved clinical remission according to the CGI-S scale. The main characteristics present at the beginning of the trial increasing probability of achieving improvement or remission during the treatment were a Y-BOCS score lower than 22, good insight, higher resistance to symptoms, low level of dissociation, and aggressive obsessions.

CONCLUSION: As negative predictors we identified higher scores in Y-BOCS, poorer insight, low resistance to symptoms, high level of dissociation, obsessions focused on control/symmetry and obsessive slowness/ambivalence as associated with poor improvement....

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Journal Article 2009; 30(5): 624-628 PubMed PMID: 20035254 Citation  Keywords:  Adolescent, Adult, Anxiety:physiopathology, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder:physiopathology, Severity of Illness Index, Young Adult,.   

OBJECTIVE: According to recent findings, clinical symptoms in patients with obsessive-compulsive disorder (OCD) seem be related with dissociation. The aim of the present study was to evaluate the relationship of psychological dissociation and clinical characteristics in OCD.

METHODS: The study sample comprised of 49 patients with OCD (55.1% females) and 45 healthy controls (66.7% females). All participants were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Dissociation was quantified by the Dissociative Experiences Scale (DES).

RESULTS: Psychological dissociation assessed with the DES was associated with the severity of anxiety symptoms (beta=0.49, t=3.89, df=47, p<0.001), but not with the level of OCD symptoms. Patients had higher level of dissociation than healthy controls.

CONCLUSION: Our results suggest that the level of psychological dissociation is associated with the severity of anxiety symptoms rather than with OCD symptoms. Further investigation of association between dissociative and anxiety states is needed....

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Journal Article 2009; 30(5): 643-646 PubMed PMID: 20035253 Citation  Keywords:  Adolescent, Choice Behavior:physiology, Decision Making:physiology, Emotions:physiology, Female, Games, Experimental, Humans, Neuropsychological Tests, Saliva:enzymology, Salivary alpha-Amylases:metabolism, Young Adult,.   

OBJECTIVES: This study aimed to examine the role of emotions in rejection of unfair offers in an ultimatum game, which is of interest in neuroeconomics of fairness.

METHODS: Thirty-seven participants played a one-shot ultimatum game as responders and decided whether to accept or reject the unfair offers by the proposers. Salivary alpha-amylase (sAA) was assessed before and after the ultimatum game.

RESULTS: Forty-four percent of the participants rejected the unfair offers. While sAA levels of the participants who rejected the unfair offers increased between pre- and post-experiment, sAA levels of the participants who accepted the unfair offers remain unchanged.

CONCLUSIONS: Emotional stress response was observed when participants rejected the unfair offers. Our results indicated that rejection of the unfair offers is a reflection of emotional arousal associated with adrenergic activations....

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Case Reports 2009; 30(5): 562-563 PubMed PMID: 20035252 Citation  Keywords:  Adult, Antidepressive Agents, Tricyclic:therapeutic use, Female, Humans, Narcolepsy:drug therapy, Thiazepines:therapeutic use, Treatment Outcome,.   

: Modafinil and Methylphenidate are proven to be effective in treating Narcolepsy, but also antidepressants that enhance synaptic levels of noradrenaline and serotonin have been reported as having some therapeutic efficacy. The patient reported in this article received Tianeptine 37.5 mg for two consecutive months. One week after start of treatment improvement of both sleepiness and cataplexy could be noticed. He showed an improvement of the Epworth Sleepiness Scale Score from 22 up to 16....

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Journal Article 2009; 30(5): 564-573 PubMed PMID: 20035251 Citation  Keywords:  Adult, Cluster Analysis, Depressive Disorder:diagnosis, Depressive Disorder, Major:diagnosis, Fatigue:diagnosis, Female, Humans, Male, Middle Aged, Pain:diagnosis,.   

BACKGROUND: Major depression is characterized by multifarious symptoms and symptoms clusters, such as the melancholic and anxiety symptom clusters. There is a strong comorbidity and a biological similarity between major depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

OBJECTIVE: The aim of the present study was to examine "psychosomatic" symptoms reminiscent of ME/CFS in major depression.

METHODS: Toward this end, we examined the 12-item Fibromyalgia and Chronic Fatigue Syndrome Rating (FF) Scale and the Hamilton Depression Rating Scale (HDRS) in 103 major depressed patients by means of multivariate pattern recognition methods. results: Our findings support the existence of two factors, i.e. a fatigue and somatic (F&S) factor, i.e aches and pain, muscular tension, fatigue, concentration difficulties, failing memory, irritability, irritable bowel, headache, and a subjective experience of infection; and a depression factor, i.e. sadness, irritability, sleep disorders, autonomic symptoms, and a subjective experience of infection. Cluster analysis performed on the 12 FF items found two different clusters, which were separated by highly significant differences in the F&S items, the most significant being a subjective experience of infection, aches and pain, muscular tension, fatigue, concentration difficulties and failing memory. Multivariate analyses showed that the differences between both clusters were quantitatively, and not qualitatively, and reflected the severity of the F&S dimension. There was a strong association between the F&S symptoms and melancholia and chronic depression. Treatment resistant depression was characterized by higher scores on the depression factor score. There was a strong correlation between the HDRS score and the FF items, fatigue, a subjective experience of infection, and sadness. Our findings show that F&S symptoms are a major feature of depression and largely predict severity of illness, and chronic and melancholic depression.

CONCLUSIONS: It is concluded that the diagnostic criteria of depression and melancholia and rating scales to measure severity of illness should be modified to include the F&S symptom profile....

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Journal Article 2009; 30(Suppl 1): 230-235 PubMed PMID: 20027176 Citation  Keywords:  Aging, Animals, Biomarkers:blood, Carps:metabolism, Dose-Response Relationship, Drug, Herbicides:administration & dosage, Male, Random Allocation,.   

OBJECTIVES: We investigated the effects of the herbicide preparation Successor 600 on biochemical and haematological indices and the histolopathological parameters of common carp after 28 day exposure. Furthermore, the hepatosomatic index and induction of xenobiotic metabolizing enzymes and biomarkers were assessed.

DESIGN: Juvenile fish were exposed to sublethal concentrations of Successor(R) 600 (0.06 mg L-1, 0.22 mg L-1 or 0.60 mg L-1) for 28 days. Haematological indices were assessed using unified methods of haematological examination in fish. Plasma biochemical indices were measured by biochemical analyzer, the vitellogenin concentration in male fish plasma was estimated by direct sandwich ELISA. In hepatopancreas, ethoxyresorufin-O-deethylase (EROD) activity was measured spectrofluorimetrically, concentration of total cytochrome P450 (CYP), glutathion (GSH) content and glutathion-S-transferase (GST) activity were determined spectrophotometrically. Histological changes in samples of hepatopancreas, skin, gills, spleen, head kidney and trunk kidney were examined by light microscopy.

RESULTS: Haemoglobin, MCH and MCHC were significantly (p<0.05) reduced in fish treated with Successor(R) 600 of 0.22 and 0.60 mg L-1. LDH was enhanced (p<0.05), in the highest concentration of the preparation. Vitellogenin was detected in all male fish, with no difference between groups. HSI, GSH and GST were elevated (p<0.05), owing to the exposure, whereas CYP and EROD were not affected. Slight histopathological changes were demonstrated in skin, gills and hepatopancreas, with steroid tissue in head kidney samples of 0.60 mg L-1 treated fish.

CONCLUSION: Successor 600 affected the haematological profile of the treated fish, while the effects on biochemical indices were less expressed. Male plasma vitellogenin concentrations were not indicative of estrogen disruptive effects after 28 days. The importance of GSH and GST for the metabolisation were demonstrated. In contrast, CYP and EROD were not influenced by any concentration tested. HSI was found to reflex pollution with Successor 600. Histopathological indices caused by the treatment were observed in various tissue samples of the treated fish....

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Journal Article 2009; 30(Suppl 1): 225-229 PubMed PMID: 20027175 Citation  Keywords:  Animals, Cyprinidae:blood, Endocrine Disruptors:toxicity, Estradiol:toxicity, Female, Male, Oocytes:drug effects, Ovary:drug effects, Sex Characteristics, Testis:drug effects, Testosterone:toxicity, Vitellogenins:blood,.   

OBJECTIVES: A controlled laboratory study was carried out to quantify vitellogenin (VTG) concentrations in a common cyprinid freshwater fish, the chub (Leuciscus cephalus L.), exposed to steroid hormones.

DESIGN: The effect of 17betaestradiol, testosterone and testosterone-estradiol mixture was investigated on vitellogenin induction. Gonad status was also determined.

RESULTS: Oral exposure to estradiol and a testosterone-estradiol mixture increased (p < 0.01) blood plasma concentrations of VTG in blood plasma of both sexes. The testosterone-estradiol mixture had a negative effect on the investigated chub gonads. The effects were signified by histological changes when compared to control fish.

CONCLUSION: Our results showed a significant VTG increase in blood plasma of both sexes, indicating that vitellogenic response in the chub is sensitive to steroid hormones....

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Journal Article 2009; 30(Suppl 1): 219-224 PubMed PMID: 20027174 Citation  Keywords:  Cholesterol:blood, Chronic Disease:epidemiology, Environmental Pollutants:blood, Follow-Up Studies, Humans, Male, Middle Aged, Occupational Exposure, Polychlorinated Dibenzodioxins:blood, Prevalence, Triglycerides:blood,.   

OBJECTIVES: The aim of this study, performed in 2008, was to evaluate the consequences of severe occupational intoxication with 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) that occurred during production of the herbicide trichlorophenoxyacetic acid in the period 1965-1968.

DESIGN: Examination of 11 men, mean age 64.4+/-1.5 years, included: internal and neurological examination, eye fundus examination, TCDD in plasma, thyroid-stimulating hormone (TSH), testosterone and serum lipids, ultrasonography of the carotid artery, nerve conduction study (NCS), electroencephalography (EEG), visual evoked potential (VEP), Lanthony test of acquired visual impairment, single photon emission computer tomography (SPECT) of the brain, neuropsychological examination and carbohydrate-deficient transferrin (CDT), a marker of chronic ethanol intake.

RESULTS: Mean TCDD level in 2008 was still 274.0+/-181.2 pg/g blood lipids (reference level is 2-3 pg/g). All (100%) patients had residues of chloracne/chloracne consequences, atherosclerotic changes on the eye fundus and plaques in the carotid arteries. Progression of intima-media thickness (IMT) from a mean of 0.84+/-0.14 mm in 2003 to 1.09+/-0.18 mm in 2008 was observed. Ninety-one per cents of patients had impairment in SPECT of the brain; and 55% of patients had hyperfixation of the perfusion indicator as a measure of increased neuronal activity. Additionally, 91 % of patients were treated for hyperlipidaemia, 73 % for hypertension, 55 % for diabetes type 2, 45 % for ischemic heart disease, and 36 % for psychological disorders. The Lanthony test demonstrated acquired dyschromatopsia in 80 % of patients. Mean colour confusion index (CCI) was 1.438, which indicates impairment since 2003, when the index was 1.302. CDT was in the normal range and did not correlate with CCI. Neuropsychological status appeared stabilized in all 8 patients examined, with impairment in one or more parameter (memory, attention, verbal fluency, psychomotor speed, motorics) in comparison to the norm.

CONCLUSION: Forty years after intoxication, the blood level of TCDD is still 100 times higher than in the general population. Other PCDD/Fs were not elevated. A high percentage of subjects suffer from neurological and vascular disorders. No association of alcohol consumption with neurological impairment was seen, and the highly significant correlation between CCI and TCDD blood concentration suggests that acquired colour impairment was associated with TCDD but not with alcohol consumption. IMT significantly increased during past 5 years. The patients obviously need complex treatment, including intense hypolipidaemic and antidepressant therapy....

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