Intérêt de la duloxétine (Cymbalta®) en pratique clinique quotidienne

Major depressive disorder is a huge public health problem. Despite the existence of a range of effective antidepressants, many patients fail to achieve complete remission of their symptoms, or if they do, they go on to suffer relapse or recurrence. Broad remission is more likely to be achieved using double action antidepressants that address a wider range of symptoms. It is also important to continue therapy beyond the acute stage into maintenance therapy, if complete remission is to be achieved and maintained in the long term

Anxiety and depression, attention, and executive functions in hypothyroidism

Background: Divergences in cognitive disturbances in hypothyroidism reported in the literature are a result of a methodological bias. Methods: By using a precise methodology, we examined attention and executive functions in hypothyroidism, verified the presence of anxiety and depressive symptoms in hypothyroidism, and examined the possible link between these symptoms and the cognitive disturbances (searching for attentional bias for words with a negative emotional valence). We administered a battery of cognitive tests to 23 participants who had undergone thyroidectomy for thyroid carcinoma: for the first time in an euthyroid state, then 3 weeks later (still in the euthyroid state) to assess the test/retest effect, and finally 4 weeks later in an hypothyroid state. We compared their performance with that of a group of 26 control participants who were also administered the same cognitive tests, also 3 times. Results: In hypothyroidism, the thyroid participants were more anxious and depressed than the controls and presented attentional and executive disturbances that reflected general slowing and difficulties in using their capacities of inhibition. However, they did not exhibit an attentional bias for words with a negative emotional valence. Conclusions: Contrary to what was expected, symptoms of anxiety and not symptoms of depression interfered with the cognitive performance of participants in hypothyroidism

Hypothyroidism and Major Depression: A Common Executive Dysfunction?

Little is known about the possible link between the cognitive disorders associated with hypothyroidism and those encountered in depression. This study examines attentional and executive functions as well as the intensity of anxiety and depressive symptoms in hypothyroidism and major depression and the possible link between these symptoms and cognitive disturbances. This study confirms the existence of psychomotor slowing associated with attentional and executive disturbance in major depression as well as in hypothyroidism. However, while depressed subjects manifested a conscious bias with material of negative emotional valence, no such bias was found in the hypothyroid subjects. While the hypothyroid state is accompanied by anxiety/depressive symptoms, it seems that the latter are too discrete for an attentional bias to be observed with material with a negative emotional valence