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13 results

Fundamentals of Clinical Psychiatry
  • A Practical Handbook
  • Edited by Marsal Sanches, Jair C. Soares
  • Coming soon
  • Expected online publication date:
    October 2024
    Print publication:
    31 October 2024
  • A practical pocketbook providing a succinct overview of the different aspects of mental health disorders, facilitating a solid base knowledge of the field of psychiatry. Offering a systematic, straightforward approach, the book covers the importance and relevance of mental health disorders, their causes, presentation, and the best approaches for their treatment. Written by mental health professionals with a high level of expertise and practical experience in the treatment of patients with mental health issues, the book includes numerous clinical vignettes, bulleted lists, tables, diagrams, and algorithms to facilitate understanding. It covers the important topics across psychiatry including the psychiatric interview, psychosocial theories and their implications for psychiatry; neurostimulation treatments; the suicidal patient; dementias as well as full coverage of the depressive, bipolar, anxiety, and psychotic disorders. Essential reading for medical students, trainees in psychiatry, and other healthcare professions interested in expanding their knowledge of psychiatry and mental health.

  • Chapter 16 - Inflammation and Metabolic Issues in Mood Disorders

  • Edited by Allan Young, Institute of Psychiatry, King's College London, Marsal Sanches, Baylor College of Medicine, Texas, Jair C. Soares, McGovern Medical School, The University of Texas, Mario Juruena, King's College London
  • Book:
    Clinical Textbook of Mood Disorders
    Published online:
    16 May 2024
    Print publication:
    23 May 2024, pp 163-171

  • Summary

    Over the past few decades, the role of inflammation in the pathophysiology of depressive disorder and bipolar disorder has been the focus of considerable attention. In this chapter, we provide an update on the association between inflammatory processes and mood disorders, in light of available evidence. The pathophysiological and clinical implications of this association are critically discussed, as well as the interaction between inflammation, metabolic abnormalities, and medical comorbidities, which have important prognostic consequences for patients with mood disorders.

  • Chapter 1 - Mood Disorders in the Twenty-First Century

  • Edited by Allan Young, Institute of Psychiatry, King's College London, Marsal Sanches, Baylor College of Medicine, Texas, Jair C. Soares, McGovern Medical School, The University of Texas, Mario Juruena, King's College London
  • Book:
    Clinical Textbook of Mood Disorders
    Published online:
    16 May 2024
    Print publication:
    23 May 2024, pp 1-9

  • Summary

    Mood disorders are among the most prevalent and potentially severe mental disorders. These conditions are associated with important psychological morbidity and functional impact, as well as elevated rates of suicide. While the past several decades have produced valuable contributions to the understanding of the pathophysiology of mood disorders, currently available treatments at times fail to produce full remission and restore patient’s premorbid level of function. Nevertheless, promising new agents and novel therapeutic targets are currently under investigation. The twenty-first century is looking at an individualized approach for the management of mood disorders, with the proper integration of evidence-based, effective biological and psychosocial therapeutic modalities.

  • Chapter 19 - Treatment-Resistant Depression: Pharmacological Approach

  • Edited by Allan Young, Institute of Psychiatry, King's College London, Marsal Sanches, Baylor College of Medicine, Texas, Jair C. Soares, McGovern Medical School, The University of Texas, Mario Juruena, King's College London
  • Book:
    Clinical Textbook of Mood Disorders
    Published online:
    16 May 2024
    Print publication:
    23 May 2024, pp 193-205

  • Summary

    There is no consensus for the concept of treatment-resistant depression (TRD). Although some authors argue considering TRD a depression subtype is not supported by evidence, its impact on the individual and society is clear. This chapter discusses the concept of TRD, presents evidence about its neurobiology, pharmacological interventions, and describes drugs currently under investigation. Among the pharmacological strategies to manage TRD, guidelines include increasing the antidepressant dose, switching to another new antidepressant, combining two or more antidepressants, and augmentation of the current medication. Several new components have been investigated for TRD targeting, for instance, the glutamatergic system, inflammatory system, the opioid system, the cholinergic system, dopaminergic system, and neurotrophin signaling. Finally, machine-learning techniques using clinical and neurobiological data provide promising information about treatment outcomes prediction that could change the current approach to a more personalized one.

Clinical Textbook of Mood Disorders
  • Edited by Allan Young, Marsal Sanches, Jair C. Soares, Mario Juruena
  • Published online:
    16 May 2024
    Print publication:
    23 May 2024
  • Mood disorders affect around 1 in 5 people, but the diagnosis and management of these conditions can be challenging. This practical handbook presents a comprehensive overview of these disorders, as well as detailed guidelines for their treatment. The handbook takes a transdisciplinary approach to mood disorders, focusing not only on the biological aspects but also on psychosocial features of importance for optimal diagnosis and management. Content covers nosological considerations, historical aspects, peculiarities along the lifespan, and the associations between mood disorders and other conditions, with a focus on their implications for the optimal management of patients. Practical and evidence-based information is discussed on the role of guidelines related to treatment in selected population groups, including youth, the elderly, and women. With a practical, reader-friendly approach, this book will be invaluable for mental health professionals involved in the treatment of patients with mood disorders, including trainees from different mental health areas.

  • Correlations between peripheral levels of inflammatory mediators and frontolimbic structures in bipolar disorder: an exploratory analysis

  • Satyajit Mohite, Haitham Salem, Thiago Cordeiro, Jonika Tannous, Benson Mwangi, Sudhakar Selvaraj, Jair C. Soares, Marsal Sanches, Antonio L. Teixeira
  • Journal:
    CNS Spectrums / Volume 27 / Issue 5 / October 2022
    Published online by Cambridge University Press:
    14 June 2021, pp. 639-644
  • Background

    Altered peripheral immune/inflammatory system and brain volumetric changes have been implicated in the pathophysiology of bipolar disorder (BD). This study aimed to evaluate how peripheral levels of cytokines are related to volumetric brain changes in euthymic patients with BD.

    Methods

    Euthymic patients with BD (n = 21) and healthy controls (n = 22) were enrolled in this exploratory study. Blood samples were collected on the same day of clinical assessment and neuroimaging. Cytokines were measured through cytometric bead array method. Neuroimaging data were acquired using a sagittal three-dimensional magnetic resonance imaging T1-weighted fast field echo sequence and was processed using FreeSurfer.

    Results

    Compared to controls, BD patients had significantly lower volumes in the cingulate, medial-orbitofrontal (MOF) and parahippocampal regions. We found a negative correlation between right MOF volume and interferon-gamma levels (β = −0.431, P = .049) and a positive correlation between interleukin-10 levels and left posterior cingulate volume (β = 0.457, P = .048).

    Conclusion

    Our results support the involvement of inflammatory pathways in structural brain changes in BD.

  • Investigation of endophenotype potential of decreased fractional anisotropy in pediatric bipolar disorder patients and unrelated offspring of bipolar disorder patients

  • Mehmet A. Camkurt, Tomas Melicher, Benson Mwangi, Mon-Ju Wu, Bo Cao, Cristian P. Zeni, Jonika Tannous, Giovana Zunta-Soares, Khader Hasan, Marsal Sanches, Jair C. Soares
  • Journal:
    CNS Spectrums / Volume 27 / Issue 6 / December 2022
    Published online by Cambridge University Press:
    28 May 2021, pp. 709-715
  • Background

    Bipolar disorder (BD) is a severe psychiatric disorder associated with structural and functional brain abnormalities, some of which have been found in unaffected relatives as well. In this study, we examined the potential role of decreased fractional anisotropy (FA) as a BD endophenotype, in adolescents at high risk for BD.

    Methods

    We included 15 offspring of patients with BD, 16 pediatric BD patients, and 16 matched controls. Diffusion weighted scans were obtained on a 3T scanner using an echo-planar sequence. Scans were segmented using FreeSurfer.

    Results

    Our results showed significantly decreased FA in six brain areas of offspring group; left superior temporal gyrus (LSTG; P < .0001), left transverse temporal gyrus (LTTG; P = .002), left banks of the superior temporal sulcus (LBSTS; P = .002), left anterior cingulum (LAC; P = .003), right temporal pole (RTP; P = .004) and left frontal pole (LFP; P = .017). On analysis, LSTG, LAC, and RTP demonstrated a potential to be an endophenotype when comparing all three groups. FA values in three regions, LBSTS, LTTG, and LFP were increased only in controls.

    Conclusion

    Our findings point at decreased FA as a possible endophenotype for BD, as they were found in children of patients with BD. Most of these areas were previously found to have morphological and functional changes in adult and pediatric BD, and are thought to play important roles in affected domains of functioning. Prospective follow up studies should be performed to detect reliability of decreased FA as an endophenotype and effects of treatment on FA.