Fibromyalgia syndrome (FMS) is associated with depressive disorders.

to investigate characteristics of FMS in a cohort of young women with premenstrual syndrome (PMS).

30 young patients with PMS were included and compared with 26 women who attended a gynecological outpatient clinic. Assessment included demographics, clinical health assessment questionnaire (CLINHAQ), fibromyalgia impact questionnaire (FIQ), sleep and fatigue questionnaires, Sheehan disability scales, SF-36 assessment for QoL, visual analogue scale (VAS) and MINI questionnaires were completed. Each patient underwent a physical examination.

The FIQ score of the PMS group was 33.09±18.48 vs. 8.6±12.62 (p<0.001).. The global pain scale was 3.92±2.96 vs. 1.29±2.2 (p<0.005). A sleep questionnaire scored in the PMS group compared to 12.6±7.8 vs. 7.46±5.3 (p<0.01) in the controls. The tenderness was measured by the number of tender point as defined in the ACR criteria of the FMS 3.13±4.36 v. 0.46±1.1 in the PMS groups compared to the controls (p<0.005), five PMS patients and none in the controls had clinical established FMS. Psychiatric comorbidity was significantly more common in the PMS group affecting 16 of the 30 PMS patients compared to only 3 of the 26 controls (χ2(1)=10.85) (p<0.005).

In this study group of patients PMS we detected higher levels of tenderness, higher psychiatric comorbidity, higher disabilities and lower QoL. All of these correlated with have a lower pain threshold.

Fibromyalgia syndrome (FMS) is characterized by widespread pain and diffuse tenderness. FMS is more prevalent in females rather than males, and among patients with major depression disorder (MDD).

to obtain better conception of linkage between depression, gender and FMS.

42 male and 42 age matched females, and age matched male and female healthy controls were evaluated for coexisting FMS. Each patient completed a questionnaire characterizing sleep quality, Sheehan Disability Scale (SDS) and SF-36 scale, Hamilton Depression rating scales (HDRS) and the CGI-S.

Disease parameters were worse for men as compared to women;

CGI-S: 5.4±1, vs. 4.0±1 (t=6.634, p<0.001), HDRS: 23.9±6 vs. 20.8±6 (t=2.304, p=0.024), respectively. Yet, FMS was more prevalent among depressed females. The SF-36, SDS and sleep quality scores were similar between males and females. A one way analysis of variance with gender and MDD revealed that both gender and disease were found to be significant contributing factors for the number of tender points (F=21.131, p<.0001; F=65.232, p<.0001, respectively). A one way analysis of covariance for tender points with CGI-S and HDRS as covariates revealed that gender was a significant factor regardless of depression severity. CGI-S and Hamilton scores correlated with tender points count in females but not in males.

Female gender is a risk factor for FMS in depressed population. Depression is associated with FMS among women but not among men. Among females, depression severity is significantly correlated to FMS severity. FMS is correlated to sleep quality and to QoL among depressed patients.

The frequency of organ somatization in multimedical network

The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8)

List of clinical and anamnestic behavior sign of adaptative form of disease of patients with comorbidity

Standard scales for evaluation of anxiety and depression.

Patients with somatoform pain had more complicated pharmacological treatment, complex diagnostic procedures, sometimes surgical interventions, and they more often had analgesic dependence 5,8 (P<0,05).

Patient with idiopathic pain (response to antidepressant therapy 4,2 (P<0,05) and cognitive therapy 2,8(P<0,05)) and organ somatizations (analgesic dependence 3,5 (P<0,05), effect of antidepressant therapy 4,3 (P<0,05) response to cognitive therapy 3,4(P<0,05)) almost never had an idea about the mental nature of agonizing somatic sensations, seldom collaborated with psychiatrists. The choice of group of antidepressants is preferable and is formed with the specter of secondary effects and the individual characteristics.

Nowadays there is no coordinated medical viewpoint of treatment of patients with clinical somatic symptoms.

As rule, recommendations for treatment of somatoform disorder are preliminary and have not correct psychopharmacologic studies.

Cloth and truthful contact between physician and psychiatrist particularly important in this case.

Prolongation of this problem studying will lead to creating of correct therapeutic recommendations for medicine treatment of patients with somatoform disorders in comorbid conditions.

To analyze baseline scores on individual items of the 17-item Hamilton Rating Scale for Depression (HAM-D17) in depressed outpatients by age groups approximating menopausal status.

This post-hoc, pooled analysis was conducted with populations from 7 double-blind, placebo-controlled desvenlafaxine succinate (DVS) trials in patients with major depressive disorder. The age groups, chosen as a proxy for pre-, peri-, and postmenopausal status, respectively, were 18-39, 40-55, and >55 years of age. Data from male patients were used to differentiate effects due to menopausal status from those related to age. Analysis of variance with Bonferroni adjustments was used to compare differences in baseline scores on individual HAM-D17 items.

A total of 1203 women (18-39 years [n=525]; 40-55 years [n=513]; >55 [n=165]) and 780 men (18-39 years [n=321]; 40-55 years [n=354]; >55 [n=105]) were included in this analysis. When analyzing these data by gender, women had significantly higher scores on HAM-D17 total (P=0.002), anxiety (P<0.001) and retardation subscales (P<0.001), and the somatic–anxiety (P<0.001), genital (P<0.001), and hypochondriasis (P=0.007) items. A significant age effect was observed for the HAM-D17 insomnia scale (P=0.004), and guilt (P<0.001), all insomnia items (P≤0.001), somatic–general (P<0.001), genital (P=0.019), and hypochondriasis (P≤0.001) individual items. An age effect among women was observed on the guilt (P=0.017), all insomnia items (P<0.05), somatic–general (P=0.022), and hypochondriasis (P=0.001) items.

Women in age groups approximating peri- and postmenopausal status had significantly higher baseline scores than younger women for the hypochondriasis, insomnia–middle and insomnia–late items of the HAM-D17.

Most of people suffering from both depression and sleep disturbances often require a specialist treatment. Depression and accompanying sleep disorders are a significant problems in society which need attention.

The main aim of the study is showing the correlation between the extent of depression and the intensification of sleep disorders in its course.

A group of 33 patients with diagnosed depression was examined, 20 women aged 39-68 and 13 men aged 47-63. The whole group was examined considering the period of the last month of patients’ life before starting taking medicaments. In the carried out research Beck Scale was used to estimate the extent of depression whereas Athens Insomnia Scale is utilized for describing the intensification of sleep disturbances.

In the group of men the average score of Beck's depression was 27,2 while the average score in insomnia scale was 16. In the group of women the following average scores were received, 32 in the Beck Scale and 14,17 in the Insomnia Scale. In order to show the extent of correlation between depression and sleep disorders the Spearman's coefficient of correlation was calculated and amounted to 0,27.

According to received results along with increase of the extent of the depression there is a slight increase of the intensification of sleep disorders. The research is still ongoing with the target group of 100 examined patients.

So far, the effects of chronic cannabis use on the cognitive functions and various areas of perception and behaviour were seen as a passing intoxication with quick onset and return to normalcy within a few hours or days. Recent studies, however, cast doubt on this premise. Since the discovery of the cannabinoid system, whose importance is only beginning to be understood, more attention is paid to the neurobiology of perception and behavioural disorders caused by cannabis. Interdisplinary research in this area can help better understand the complexity of cannabis-related disorders and their therapeutic relevance.

This review of the literature highlights the importance of the age of onset of regular cannabis use regarding the affective, cognitive and psychosocial functions. We will then present test hypotheses derived from our own neuropsychological research approaches with different attention paradigms (evoked potentials, control of eye movement and overall attentional shifting).

Age of onset is a significant predictor for the development of subtle neurocognitive function impairment in normal cannabis users.

The neuropsychological effects of chronic cannabis use with an early age of onset can only be detected with hypothesis-based neuroscientific studies using instruments which are sensitive to the cognitive and attentional functions. Subgroup effects may also have clinical relevance.

Patient's pre-treatment personality characteristics and interpersonal predispositions indicate suitability for psychotherapy and predict its outcome. The predictive value of reliable and valid suitability assessment scales in short- and long-term therapy has not, however, been compared. This study compares the prediction of a suitability scale on changes in psychiatric symptoms in short- and long-term psychotherapy.

In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders were randomized to short-term therapy or long-term therapy. Psychological suitability measures were assessed with a 7-item Suitability for Psychotherapy Scale (SPS) at baseline and psychiatric symptoms with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and 7 times during a 3-year follow-up.

Three patient groups were found when a suitability score based on the seven individual suitability measures was used to predict symptom development: patients with more good (4 or more) than poor values gained sufficiently from short-term therapy, patients with more poor (4-6) than good values needed long-term therapy, and patients with all 7 values poor failed to benefit from either short- or long-term therapy. Almost half of the patients received considerably auxiliary treatment besides the study treatment. For these patients, although equipped with mostly good values, short-term therapy was not sufficient.

The amount of therapy needed to recover may be predicted before start of therapy. The use of auxiliary treatment in addition to standard treatment needs, however, further clarification.

Unipolar depression has been found to associate with elevated C-reactive protein levels (CRP) in men, but findings among women have been conflicting. It has been hypothesized that this would be explained by a different hormonal environment (compared with men) and its changes throughout the lifecycle in women, but until now, the corresponding evidence has been lacking. We investigated the association between depressive symptoms and CRP levels in a population-based study in pre-, peri- and postmenopausal women, and also, whether this association is affected by the use of exogenous hormones (contraceptives and postmenopausal hormone therapy).

Initially, the entire age classes of those born in 1942, 1947, 1952, 1957 and 1962, and living in Pieksämäki, Finland were invited (N=1,294), and out of 730 women 512 (70.1 %) participated in this cross-sectional study in 1997-98. Depressive symptoms were assessed by Beck's Depression Inventory -21 (BDI-21) and C-reactive protein (CRP) was measured with a high-sensitivity CRP assay (hs-CRP).

We found a statistically significant positive correlation between hs-CRP-levels and depressive symptoms in peri- and postmenopausal women not using exogenous hormones (Spearman partial correlation coefficient, r=0.189, p=0.011; and r=0.436, p=0.033, respectively). On the contrary, no significant correlations were found in peri- and postmenopausal women using exogenous hormones, or in premenopausal women irrespective of their exogenous hormone use.

Our novel findings strongly suggest that female hormones might have a major impact on the association between elevated CRP levels and depressive symptoms in females. Further studies are, however, needed to confirm our findings.

Designing and implementing a culturally sensitive and specific education on relapse prevention messages that meet the needs for addict women in an Egyptian recovery process. To contribute to upgrading their skills and self assertion, approaching their unique problems and helping their empowerment.

25 polysubstance abuse women (24 Egyptian and 1 Arab) joined a therapeutic community rehabilitation program, where the following was assessed: Addiction severity, impulsivity, sexual orientation, co morbidity, medical complications of addiction, effect of social taboo and stigma, psychodynamic correlates and skills assessment.

Cognitive therapy, art therapy, life skills training (stressing on how to overcome stigma, codependence, etc..) and vocational training were provided.

Emphasis on skills to overcome socio-cultural challenges were found to be accompanied by significant more favorable outcome than only stressing on classic relapse prevention techniques.

It was found that Women from special cultural subgroups can face strong taboos about disclosing family secrets, especially around interpersonal violence. Women can fear abandonment if they violate cultural norms. Those disclosing sexual violations can risk severe devaluation within or expulsion from their community, and they can lack the hope for improvement that could propel them past this barrier. Gender disparities in the society was found also affecting the management outcome. Integrating assertion skills, communication skills and vocational skills to women substance dependence rehabilitation program may lead to increase sobriety rate.

Depression is the most frequent comorbid psychiatric disorder in epilepsy (40-60%)

The aim of the present study was to evaluate the prevalence of depressive disorders among patients with epilepsy, and to determine the risk factors of the occurrence of the depressive.

A prospective study conducted from epilepsy out patient consultations at Marrakech Hospital, involving 70 patients with idiopathic, cryptogenic or symptomatic epilepsy. Epilepsy was diagnosed on the clinical criteria and the electroencephalograms data. Depression were evaluated by DSM IV.

50 % of patients were men, the mean age was 30.64 ± 11,59 years, 47 % of epileptic patients were without profession, 78,3% had low socioeconomic level. The epilepsy age of onset was 15,8 ± 9, 47 years with an average duration of 14.96 years. The prevalence of depression was 32,85%. According to sex, the prevalence was 20% in women and 12 % in men. The epilepsy-depression and epilepsy-control groups did not differ significantly in the frequency of seizures, duration of epilepsy or in the type of antiepileptic drugs. 50% of patients with temporal epilepsy were depressed without significant relation.

The present study confirms the findings of previous studies that the prevalence of the comorbidity between epilepsy and depression is common in specialised outpatient units. The detection and the treatment of depressive disorders among the epileptic patients will improve the quality of life of these patients.

The loss of the facial identity through traumatic and dysmorphic factors (including the peripheral paresis of the facial nerve) is an intense psychotraumatical event associated with intense depression.

The evaluation of depression to 15 patients with hypertension and carotidian vascular changes revealed by echo-doppler associated with peripheral facial paresis therapeutically unsolved in 60 days, confirmed scores greater than 21 on Hamilton Scale (HDS). The study of the therapeutical means used in facial paresis treatment showed pharmacological type risk factors for depression (corticotherapy, antiinflamatory substances which conduct to ROS type reactions) and usual physio- and electotherapeutical techniques showed an increase of the iritative type potential on EEG standard examination.

The serotoninergical origin of the facial nerve, the high frequency of serotoninergic depression, the elevated scores on HDS justified the antidepressive serotoninergic activation treatment (escitalopram) combined with mimical facial training for 30 days with the following neurobiological action:

1. - at the amygdala level (emotional role acting and serotoninergic stimulation);

2. - at the amygdalian connections with the hippocampal zone and frontal cortex level;

3. - at the facial nerves neurons level through the reactivations of the serotoninergic input, deblocking of the ionic channels and the decrease of neuromotor inhibition.

The final evaluation demonstrated the significant amelioration of depression and an important remission of the facial motor deficit through mechanisms that suggested the potentiation of the serotoninergic action of antidepressive medication through the physical exercises and an secondary neuroprotection type effect at a hippocampal level.

The aim of the investigation was to specify criteria of diagnosis of depressive disorders in elderly patients (60-67 years old) on the base of comparison of clinical-pathopsychological and psychopathological peculiarities with middle-aged persons (35-55 years old).

97 elderly patients (moderate depressive episode (F32.1) – 35 patients; recurrent depressive disorder (F33.0) – 38 patients; mixed anxiety depressive disorder (F41.2) – 24 patients) and 73 middle-aged patients (moderate depressive episode – 25 patients; recurrent depressive disorder – 27 patients; mixed anxiety depressive disorder – 21 patients) were included.

Elderly patients showed a slow continuous debut of the disease, manifested with somatic symptoms before all (88.66% vs. 23.28% of middle-aged patients). Elderly patients demonstrated a high anxiety level concerning their somatic conditions (80.41% vs. 20.54% in middle-aged patients). 76.28% of elderly patients had a high anxiety level concerning daily life situations, when the patient perceive all negatively, vs. only 15.06% of middle-aged patients. A connection between depressive mood and somatic conditions occurred in 83.5% of elderly patients vs. 16.43% of middle-aged patients. Elderly patients more often (78.35%) demonstrated autoaggressive behavior (thinking, intentions, acts) than middle-aged patients (30.14%). Differences on all the parameters mentioned above were statistically significant (p<0.001). Elderly patients had also high levels of introversion and nervous-psychic instability (average scores on these scales were 14.8 and 47.2 vs. 16.7 and 59.6 in middle-aged patients; p<0.05).

Taking into account these peculiarities, a proposed approach contributes to an early diagnosis and effective treatment of this significant group of patients.

Researches of a suicidal risk formation are an actual medical-social problem nowadays, as suicides are one of the leading causes in the structure of premature mortality. A formation of suicidal risk in various groups of patients is studied insufficiently, so an assessment of suicidal risk in patients with neurotic (F41.2, F43) and endogenous depression (F31, F32) was the aim of this investigation.

The methods included a clinico-psychopathological examination and a psychodiagnostical examination (the method of suicidal risk detection and the method for determination of self-consciousness of death (Gavenko V.L. et al., 2001)).

It was defined that patients with neurotic depressions had a high suicidal risk level (27.75 points). The suicidal risk was manifested maximally (29.05 points) in patients with disorders of adaptation (F43), and was 26.45 points in patients with anxiety-depressive disorders (F41.2). An average suicidal risk for patients with endogenous depressions was 28.35 points. A level of self-consciousness of death by a person plays an important role in a suicidal behavior formation. Its low level enhances a risk of auto-aggression. Patients with neurotic depressions have generally higher levels of self-consciousness of death (22.72 points) in comparison with patients with endogenous depressions (21.16 points) that evidences an insufficient anti-suicidal barrier in latter patients and reflects a presence of real auto-aggressive intentions.

It is necessary to take onto account the data obtained in diagnosis and differentiated approaches to therapy and prevention of suicidal risk.

After the development of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) only one study was conducted to determine the predictive validity of the Prenatal and Full Versions of the instrument. However this study did not succeed in identifying the cut-off for the Full Version.

We aimed to determine the predictive validity of the PDPI-R as a screening instrument for post-partum depression (PPD).

Women completed the PDPI-R at the 3rd month of pregnancy and at the 1st month after childbirth. PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at multiple time points during pregnancy and during the post-partum. When the EPDS score was ≥13, a Structured Clinical Interview for DSM-IV Disorders was conducted to determine whether criteria for depression were met.

The Prenatal and Full Versions of the PDPI-R predicted accurately 80.3% and 88.2% of PPD. The Prenatal PDPI-R yielded a sensitivity of .72 and a specificity of .74 at a cut-off score of 4.5, while the Full version yielded a sensitivity of .83 and a specificity Conclusions

The PDPI-R is a useful and valid screener for PPD.

To evaluate the efficacy and tolerability of once-daily quetiapine XR (extended release) monotherapy in patients with MDD (unipolar depression) compared with placebo.

8-week (6-week active treatment, randomised phase; 2-week post-treatment drug-discontinuation/tapering phase), multicentre, double-blind, parallel-group, placebo- and active-controlled study (D1448C00002). 612 patients were randomised to quetiapine XR 150mg/day (n=152), 300mg/day (n=152), duloxetine 60mg/day (n=151) and placebo (n=157). Primary endpoint: baseline to Week 6 change in MADRS total score. Secondary variables included: baseline to Week 6 change in HAM-D total and Item 1 (depressed mood) scores. Safety assessments included AE reporting.

Mean MADRS total score (overall baseline mean, 30.15) was significantly reduced at Week 6 by quetiapine XR 150mg/day, 300mg/day and duloxetine versus placebo (−14.81, −15.29, −14.64, −11.18, respectively; p≤0.001).

At Week 6, mean HAM-D total scores (overall baseline mean, 25.25) were significantly reduced versus placebo (−10.26) by quetiapine XR 150mg/day, 300mg/day (−13.12, −14.02, respectively, p≤0.001) and duloxetine (−12.37, p<0.05). Mean HAM-D item 1 scores (overall baseline mean, 3.03) were significantly reduced versus placebo (−1.07) by quetiapine XR 150mg/day, 300mg/day (−1.49, −1.56, respectively, p≤0.001) and duloxetine (−1.53, p<0.001).

Incidence of serious AEs were low (≤2%) in all groups. Most common AEs (>10%) were dry mouth, sedation, somnolence, dizziness, headache and nausea with quetiapine; dizziness and headache with placebo; and dry mouth, sedation, somnolence, dizziness, headache, constipation, nausea, diarrhoea and insomnia with duloxetine. Most AEs were mild-to-moderate in intensity.

Quetiapine XR monotherapy at 150 and 300mg/day was effective and well tolerated in the treatment of patients with MDD.

The prevalence of depression in diabetic patients is 2-3 times more than general population. The quality of life (QOL) and glycemic control are 2 important outcome measures of diabetes management. The aim of this research is to study the relationship between depression, glycemic control and QOL in a sample of Iranian diabetic patients.

One hundred diabetic patients who were referred to diabetes clinic of Dr. Shariati Hospital were included in the study consecutively. The depression subscale of Hospital Anxiety and Depression Scale (HADS-D) were used to determine depression. The World Health Organization Quality of life brief version questionnaire (WHOQOL-BREF) was used to measure QOL. The status of glycemic control was evaluated through measuring HbA1c. Other measured variables included: demographic variables, smoking, diabetes type, body mass index, duration and complications of diabetes and previous history of depression. The linear regression method was implemented to analyze the data.

Depression was observed in 30% of the patients. Glycemic control had a reverse significant correlation with diabetes complications. No significant relationship was found between HbA1c and scores of HADS-D. WHOQOL-BREF subscales scores had no significant relationship with glycemic control. There was a significant relation between scores of HADS-D and WHOQOL-BREF subscales.

Improving quality of life (QOL) is one of the main outcomes in the management of diabetes. According to the result of this study, depression had a more prominent relationship with QOL than glycemic control. Thus, careful management of depression may be necessary to improve QOL of diabetic patients.

Affective disorder has not been considered appropriately in patients with atrial fibrillation (AF) representing a chronic disorder with reduced quality of life. Adequate ventricular rate (VR) control in permanent atrial fibrillation (AF) is not easy to accomplish. The aim was to assess whether regular moderate physical activity elevates the parasympathetic tone to the atrioventricular node and decreases VR during permanent AF but also improves psychic wellbeing.

10 patients (59±10y) with permanent AF underwent moderate physical exercise (45min walking/jogging, 2/week). To analyze VR control, we performed Holter-ECG recordings, physical exercise treadmill tests, and stepwise lactate tests before, during and after 4 months of training. Psychiatric interviews and psychometric examinations of mood and quality of life (SKID, BDI, HAM-D, SF-36) were obtained, too.

Out of 10 patients, six revealed a previous psychiatric history, four subclinical depressive symptoms and one a depressive syndrome. After training there were significant (p<0.05) improvements with decrease in VR (24 hours, exercise) and increase of lactate threshold (exercise), accompanied by improved general health perceptions in 7/8 quality of life dimensions. Enhanced global physical health was significantly higher in case of more pronounced depressive symptoms (r=0.86; p<0.01). Importantly, in three patients reductions/terminations of cardiac drugs could be undertaken.

Physical training should be accounted for VR control during AF. Regarding the high prevalence of affective symptoms in our AF patients, bodily-oriented rehabilitation might minimize comorbid chronic affective disorder.

This work was partly financed by the European research project ‘MyHeart’ (6th framework, IST 507816).