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7 results

  • Modelling the effect of minor orthopaedic day surgery on patient mood at the early post-operative period: A prospective population-based cohort study

  • Evangelia M. Tsapakis, Eleftherios Tsiridis, Alistair Hunter, Zakareya Gamie, Nikolaos Georgakarakos, Panos Thomas, Constantin Schizas, Robert M. West
  • Journal:
    European Psychiatry / Volume 24 / Issue 2 / March 2009
    Published online by Cambridge University Press:
    16 April 2020, pp. 112-118
  • Objective

    The effect of minor orthopaedic day surgery (MiODS) on patient’s mood.

    Methods

    A prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study – Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively.

    Results

    The mean physical component score of SF-36 before surgery was 45.3 (SD = ±10.1) and 8 weeks following surgery was 44.9 (SD = ±11.04) [n = 148, p = 0.51, 95% CI = (−1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov = 69.44) corresponded to a correlation coefficient, r = 0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well with χ2 (df = 1) = 0.86 for which p = 0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected.

    Conclusions

    MiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.

  • Clinical and therapeutic role of mentalization in schizophrenia—a review

  • Trisevgeni Dimopoulou, Frank I. Tarazi, Evangelia M. Tsapakis
  • Journal:
    CNS Spectrums / Volume 22 / Issue 6 / December 2017
    Published online by Cambridge University Press:
    21 February 2017, pp. 450-462

  • Recent empirical findings from clinical and genetic studies suggest that mentalization, a key area of social cognition, is a distinct construct, although it is closely related to the neurocognitive deficits and symptoms of schizophrenia. Mentalization contributes a great deal to impaired social functioning. Current measures often display methodological problems, and many aspects should be taken into account when assessing mentalization. Moreover, advances in cognitive and affective neurosciences have led to the development of more advanced behavioral methods to assess the relationship between cognitive functions, symptoms, and social cognition based on their underlying neural mechanisms. The development of assessment tools that better examine the neural circuitry of such relationships may lead to the development of new psychosocial and pharmacological treatments.

  • Authors' reply

  • Evangelia M. Tsapakis, Federico Soldani, Leonardo Tondo, Ross J. Baldessarini
  • Journal:
    The British Journal of Psychiatry / Volume 194 / Issue 2 / February 2009
    Published online by Cambridge University Press:
    02 January 2018, pp. 189-190
    Print publication:
    February 2009
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  • 25 - Biological treatments: general considerations

  • from Section 5 - Treatments in Psychiatry
  • Edited by Robin M. Murray, King's College London, Kenneth S. Kendler, Virginia Commonwealth University, Peter McGuffin, University of Wales College of Medicine, Simon Wessely, Institute of Psychiatry, London, David J. Castle, University of Melbourne
  • Book:
    Essential Psychiatry
    Published online:
    22 August 2009
    Print publication:
    18 September 2008, pp 567-585

  • Summary

    A neuropsychiatric assessment is no more or less than a good psychiatric assessment, comprising a psychiatric and medical history. Electrodiagnostic techniques have an important role in neuropsychiatric diagnosis. Magneto-encephalography (MEG) measures the small magnetic fields generated by neuronal currents and may be regarded as the magnetic counterpart of the electroencephalograms (EEG). Neuroimaging techniques can be broadly divided into structural and functional. The two major techniques of structural imaging are computed tomography (CT) and magnetic resonance imaging (MRI). Functional imaging techniques are used primarily to provide information on metabolism, blood flow, neurochemistry or activity of the brain. Mental disorder is characterised by the presence of mental symptoms that are judged to be the direct physiological consequence of a general medical condition. The essential features are prominent hallucinations or delusions that are judged to be due to the direct physiological effects of the medical condition or substance.

  • Efficacy of antidepressants in juvenile depression: meta-analysis

  • Evangelia M. Tsapakis, Federico Soldani, Leonardo Tondo, Ross J. Baldessarini
  • Journal:
    The British Journal of Psychiatry / Volume 193 / Issue 1 / July 2008
    Published online by Cambridge University Press:
    02 January 2018, pp. 10-17
    Print publication:
    July 2008
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  • Background

    The safety of antidepressants in children and adolescents is being questioned and the efficacy of these drugs in juvenile depression remains uncertain

    Aims

    To assess antidepressant efficacy in juvenile depression

    Method

    Systematic review and meta-analysis of randomised controlled trials (RCTs) comparing responses to antidepressants, overall and by type, v. placebo in young people with depression

    Results

    Thirty drug-placebo contrasts in RCTs lasting 8 weeks (median) involved 3069 participants (512 person-years) of average age 13.5 years. Meta-analysis yielded a modest pooled drug/placebo response rate ratio (RR=1.22, 95% CI 1.15–1.31), with little separation between antidepressant types. Findings were similar for response rate differences and corresponding number needed to treat (NNT): overall NNT=9; tricyclic antidepressants NNT=14 > serotonin reuptake inhibitors NNT=9 > other antidepressants NNT=8. Numbers needed to treat decreased with increasing age: children (NNT=21) > mixed ages (NNT=10) > adolescents (NNT=8)

    Conclusions

    Antidepressants of all types showed limited efficacy in juvenile depression, but fluoxetine might be more effective, especially in adolescents. Studies in children and in severely depressed, hospitalised or suicidal juvenile patients are needed, and effective, safe and readily accessible treatments for juvenile depression are urgently required

  • Clinical relevance of discoveries in psychopharmacogenetics1

  • Evangelia M. Tsapakis, Amlan Basu, Katherine J. Aitchison
  • Journal:
    Advances in Psychiatric Treatment / Volume 10 / Issue 6 / November 2004
    Published online by Cambridge University Press:
    02 January 2018, pp. 455-465
    Print publication:
    November 2004
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  • Individual genetic variation accounts for some of the variability in response to drugs used routinely in clinical psychiatry. Psychopharmacogenetics focuses on how polymorphisms in genes affecting the mechanism of action of a drug's effect and/or metabolism (both peripheral and central) can influence an individual's clinical response to the drug, in terms of both therapeutic efficacy and adverse effects. Pharmacogenetics promises to be of substantial help in the field of psychiatric pharmacotherapy, but before research findings can be applied to clinical practice, ethical and methodological problems have to be addressed and overcome. This review summarises the most robust findings in the field and outlines how psychopharmacogenetic studies could lead to treatment individualisation.