Psychiatrikē = Psychiatriki
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The treatment of bipolar disorder is a current challenge for clinicians and despite progress in psychopharmacology, options remain limited and results are often unsatisfactory. Current research focuses on finding new pharmaceutical agents for all phases of bipolar disorder, i.e. mania, bipolar depression and maintenance. Particularly, relapse prevention and longterm stabilization is a major therapeutic target. ⋯ Improving methodology aspects of clinical trials, such as diagnosis, clinical heterogeneity, monitoring time, gender differences and comorbidities, may promote research. Current studies seem promising for the development of novel pharmacological agents in the near future, although there are methodological limitations in the search for the maintenance treatment in bipolar disorder. New therapeutic targets include not only the already known mechanisms of action, but also novel pathophysiological pathways, probably implicated in bipolar disorder.
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Previous studies in bipolar disorder suggest patients' deficient performance in Theory of Mind tasks, both during manic or depressive episodes and in remission. However, most of the extant studies were cross-sectional and did not control for potential confounders such as residual symptoms or co-existent deficits in other cognitive functions. The present study is the first prospective study that assessed the effect of remission on Theory of Mind (ToM) in patients with Bipolar Disorder (BD) controlling for other cognitive deficits. ⋯ Differences in Faux Pas did not remain statistically significant when the effect of verbal memory and visuospatial working memory was controlled for. Differences in other ToM tests during episodes did not remain statistically significant, when other cognitive functions that were found impaired in patients during episodes, were controlled for. The findings of this study support the hypothesis that ToM dysfunction in BD is associated with mood symptoms and it might reflect underlying cognitive deficits rather than representing a specific trait marker of the disorder.
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The quest for existential meaning constitutes a universal phenomenon traditionally manifested in official religions (religiosity) or personal modes of transcendence (spirituality). Religiosity and spirituality have been found to be associated with a variety of mental health and illness parameters. In the last decades there is an increasing number of publications with interesting results on the relationship between religiosity and mental health, both on a theoretical and a clinical level. ⋯ Moreover, in the multiple linear regression analyses, "meaning" was independently negative associated with somatic symptoms (p=0.032), whilst "daily spiritual experiences" were positively associated with anxiety/insomnia (p=0.023). Also, "values/beliefs and the overall self-ranking were positively associated with social dysfunction (p=0.026), (p=0.01) and "daily spiritual experiences", "values/beliefs", "forgiveness", as well as the overall self-ranking with severe depression (p=0.03), (p=0.01), (p=0.017), (p=0.009). Certain religiosity dimensions ("daily spiritual experiences", "values/beliefs", "forgiveness" and "organizational religiousness") were correlated with lower morbidity, in accordance to previous reports in different populations, whereas "meaning" was correlated with more somatic symptoms.
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Comparative Study
[Depression and post-traumatic stress disorder among patients in intensive care units].
Recent progress in medicine and technology has produced a significant increase in the survival rate of critically ill patients who have been treated in Intensive Care Units (ICU). Consequently, researchers have become increasingly interested in the relationship between critical illness and psychiatric consequences. The experience of critical illness has been often associated with Major Depression (MD) and Post-Traumatic Stress Disorder (PTSD). ⋯ In this study 11.6% of the total sample (ICU: 17.6%, non-ICU group: 5.2%) was found to meet the criteria for both MD and PTSD. These results are in agreement with similar studies in the literature. Early recognition and treatment of MD and PTSD in critically ill patients could contribute to faster recovery and improved quality of life.
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Suicidal behavior is considered as the result of complex cognitive and emotional processes and it is a timeless, global and multifactorial phenomenon. Periods of financial crises in the past, such as the Great Depression in the USA in 1929 and the economic crises of Asia, Russia and Argentina in the late 1990s, have been associated with impairment of mental health of the economically affected. Unemployment, job insecurity, debts, poverty and social exclusion seems to lead to higher incidence of anxiety and depressive symptoms and increased suicidality. ⋯ The financial crisis is probably associated with upward trend in attempted suicide of the Athens population. Most affected are those who are unemployed, married, widowed, divorced. Suicide prevention programs are essential for the accurate and timely identification and the immediate and effective management of this special high risk group of attempters during the financial crisis.