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Addiction, depression, anxiety and antisocial personality disorder may share common biological mechanisms and changes in impulsivity may contribute to the characterization of different clinical phenotypes.
Our aim was to identify diagnostic profiles in a sample of inmates in a Portuguese prison.
Methods
We examined a sample recruited at Paços de Ferreira Penitentiary Centre (n=89). Diagnosis was performed using the International Neuropsychiatric Interview (MINI). Six Version of Addiction Severity Index – European version (EuropASI) and the Psychopathy Checklist –Revised (PCL-R) were used to assess the severity of drug addiction and the presence of psychopathy.
Results
Drug misuse was found in 61.8% of the studied subjects according to MINI. A high prevalence of psychiatric comorbidity was detected, with antisocial personality disorder (70.9%), depression (30.9%), and anxiety (32.7%) being the most common disorders. The total PCL-R score was 24. 1 (SD 8.8), 36 prisoners presented a diagnosis of psychopathy (PCL-R>30). The presence of depression in addicted individuals is associated with a lower severity of dependence (p <0.05) and lower PCL-R scores (p <0.05). The presence of addiction and depression reduces the risk of violent crime, whereas the presence of psychopathy (PCL-R> 30) increases (OR = 3.87, p <0.05).
Conclusions
Psychiatric disorders and addiction were successfully evaluated. Depression is associated with a lower addiction severity. The different types of psychiatric diagnoses produce a modulation in the frequency of violent crimes. The prevalence of psychiatric comorbidity underscores the advantages of a structured psychiatric assessment in prison inmates in order to provide the best treatment.
Borderline Personality Disorder (BPD) patients strugglewith interpersonal relationships. Although this incapacity to understandothers’ emotions and perspectives is thought to be relevant to these patients’impaired social function, the role of empathic dysfunction in BPD is still amatter of debate.
The aim of this systematic review is to examine thecurrent evidence on differences in empathy dimensions in BPD patients.
Methods
Five databases were searched for studies publishedbetween 2000 and 2012, with the keywords: social cognition, empathy, theory ofmind AND borderline personality disorder. Inclusion criteria were: BPDdiagnoses according to the International Standardized Classification, assessment of empathy and related constructs using validated instruments andpresence of a healthy control group.
Results
Fourteen studies were identified which included atotal of 463 BPD patients and 420 healthy controls. Seven studies assessedempathy in a bi-dimensional way; five of them reported lower cognitive empathyin BPD patients, but one study reported the opposite trend, and another one showedno differences between BPD and controls. Concerning emotional empathy, reducedlevels were observed among BPD patients only in two of the studies.?Anothergroup of studies measured emotion recognition ability exclusively, presentingconflicting results: in three of them, BPD patients presented higher scores thancontrols; in the other three, BPD patients had significantly lower accuracythan controls.
Conclusion
Although evidence about a specific pattern of empathydysfunction is inconclusive, a trend toward lower levels of (emotional andcognitive) empathy was detected in BPD patients.
Schizophrenia (SZ) is a severe mental disorder poor elucidated from the etiopathogenesis prism. Recently, several micro andmacro vascular abnormalities have been consistently implicated in SZ´spathophysiology. The relationship between Angiogenesis and SZ can putatively influence brain hemodynamics, pathophysiology and symptomatology due to its involvement in embryogenesis and neurogenesis. Angiogenesis can provide a framework in which some etiological factors and susceptibility genes for SZ can be linked together.
Aims
To explore the link between SZ and angiogenesis, taking into account new insights fromgenetic, molecular, neurochemical, animal, and neuroimaging functional studies.
Methods
A non-systematic review of the literature was performed to summarize current knowledge regarding Angiogenesis and SZ usingthe PubMed database.
Results
Recent molecular and neuroimaging studies indicate that angiogenesis could be involved in SZ etiopathogenesis through its role in neurogenesis during neurodevelopment, or by angiomodulation of cerebral blood flow (CBF). A complex multivariate interplay between angiogenic factors, dopamine, neurotrophins, brain angiogenic inhibitors molecules (BAI1-3) and patterns of regional blood flow mayyield to a biological effect.
Conclusions
The role of Angiogenesis in angiomodulation and angioregulation of regional CBF patterns may have direct implications in theclinical heterogeneity of SZ. Studying the effect of antipsychotics on brain microvasculature and on CBF in different stages of the disease, focusing on brain Angiogenesis activation through VEGF or by neurotrophic-based mechanisms, and by complementing the analysis determining related Angiogenesis abnormalities, could reveal more cues behind the crosstalk's between Angiogenesis, CNS development and SZ.
Shared decision-making (SDM) has shown to improve adherence, decrease hospitalization, and enhance knowledge of the illness and satisfaction with mental health services. Eliciting each patient's preferences for information allows tailoring the physician behavior according perspectives and expectations. Patients with depression (PWD) have frequently limited information regarding the availability and efficacy of psychiatric treatments.
Aims/objectives
Unveil information seeking attitudes of patients with depression and their a priori use of digital sources of information.
Methods
A convenience sample of PWD was submitted to a battery of self-report questionnaires. Standardized instruments were used to measure information seeking attitudes and the accessibility and usage of digital information resources.
Results
Thirty-six patients were inquired, with a mean age of 39.8 (13.4) years. Information-seeking preferences were high, with an API-I score of 90.1 (13.8). Preferences for information-seeking behaviors were higher in severely depressed (P = 0.010) and less educated (P = 0.026) patients. Preferences were negatively correlated with length of psychiatric treatment (r = −0.514; P = 0.002). Sixty-one percent had a priori information regarding their psychiatric problem, and 68.8% considered it was influential in the decision-making behavior. Access and use of digital resources were correlated with education level (0.644; P = 0.000 and 0.554; P = 0.003), age (−0.357; P = 0.001 and −0.559; P = 0.007) and illness severity (−0.431; P = 0.04).
Conclusion
Patients with depression want to be informed about their mental condition and treatment options. Few resources are used and decision mostly relies on health professional's opinion and guidance. Accessible resources seem scarce and future research shall address the acceptance and impact of decisional-aid instruments on this population.
Depression is a common companion of systemic lupus erythematosus that substantially contribute to patient's suffering and a decreased quality of life. The relationship between depressive symptoms and disease immune processes is not well understood.
Objectives
To further understand the relationship between lupus and depression, a patient cohort was examined for correlations between clinical presentation, biological parameters and psychosocial evaluation.
Methods
Seventy-two lupus patients were screened for depressive symptoms, clinically and psychologically characterized using a battery of instruments, including assessments for depression, anxiety, fatigue, pain and overall health. Scores from these assessments were correlated with lupus clinical profile and biological parameters namely the immune profile.
Results
Forty-two percent of the patients had scores indicative of depression using the HADS Depression scale. Strong correlation was found between pain and depression. Moderate correlation was found between several lupus symptoms, such as mouth ulcers, rash, and arthritis, and psychological evaluation. There was low to moderate correlation between complement levels, C-reactive protein and psychological indicators, but no other lab tests correlated well with the psychological tests.
Conclusion
The correlation of depressive symptoms, complement and C-reactive protein with depressive symptoms suggests that these may be mediated by disease activity and share pathophysiological mechanisms. The overall weakness of correlations with biological markers demonstrates that more specific tests need to be developed. The study of lupus associated depression may, furthermore clarify the role of immune dysfunction in the pathophysiology of this psychiatric disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
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