POSTTRAUMATIC STRESS DISORDER AND DEPRESSION AS COMORBID DISORDERS

Introduction: Depression is the most frequent disorder of today. It is unique for the fact that it can become a comorbid illness with almost any other psychiatric disorder. Premorbid depression is also a risk factor for the development of PTSD, while at the same time traumatic experience is a risk factor for the development of depression. These facts show us that a close connection between these two diagnostic entities exists. Aim of this research was to analyze the levels of depressiveness in patients that were hospitalized and patients that were treated in the Day hospital. Also, to establish the connection of age, time spent in combat (war), length of treatment and number of hospitalizations with the results from the Beck’s depression inventory. Subjects and methods: Participants were divided into two groups, 36 patients that were treated for PTSD in a hospital setting and 64 patients that were treated in the Day hospital. Participants completed Beck’s self-evaluation inventory for depression, as it assesses the degree of depression. Results: Two groups did not differ regarding to age, time spent in combat (war), the length of treatment and level of depressiveness assessed by Beck’s depression inventory. Score on Beck’s depression inventory was significantly positively correlated with the age of participants and the number of hospitalizations. Older participants and participants that were hospitalized more often score higher on Beck’s depression inventory. Conclusion: Results show that there is no difference between the two groups of participants of differing levels of depressiveness, but depression most often presents as severe depression in both groups of participants. Older participants and participants that were hospitalized more often are more depressed. This research points to the fact that it is necessary to treat PTSD and depression at the same time, because parallel treatment of these comorbid disorders leads to a decrease of the rate of suicide, due to the fact that depression is often the leading cause of suicide

POSTTRAUMATIC STRESS DISORDER AND DEPRESSION AS COMORBID DISORDERS

Introduction: Depression is the most frequent disorder of today. It is unique for the fact that it can become a comorbid illness with almost any other psychiatric disorder. Premorbid depression is also a risk factor for the development of PTSD, while at the same time traumatic experience is a risk factor for the development of depression. These facts show us that a close connection between these two diagnostic entities exists. Aim of this research was to analyze the levels of depressiveness in patients that were hospitalized and patients that were treated in the Day hospital. Also, to establish the connection of age, time spent in combat (war), length of treatment and number of hospitalizations with the results from the Beck’s depression inventory. Subjects and methods: Participants were divided into two groups, 36 patients that were treated for PTSD in a hospital setting and 64 patients that were treated in the Day hospital. Participants completed Beck’s self-evaluation inventory for depression, as it assesses the degree of depression. Results: Two groups did not differ regarding to age, time spent in combat (war), the length of treatment and level of depressiveness assessed by Beck’s depression inventory. Score on Beck’s depression inventory was significantly positively correlated with the age of participants and the number of hospitalizations. Older participants and participants that were hospitalized more often score higher on Beck’s depression inventory. Conclusion: Results show that there is no difference between the two groups of participants of differing levels of depressiveness, but depression most often presents as severe depression in both groups of participants. Older participants and participants that were hospitalized more often are more depressed. This research points to the fact that it is necessary to treat PTSD and depression at the same time, because parallel treatment of these comorbid disorders leads to a decrease of the rate of suicide, due to the fact that depression is often the leading cause of suicide

Структура и лабораторная диагностика немедицинского потребления современных синтетических наркотических средств

The emergence of new synthetic narcotic drugs is noted all over the world. The situation causes significant difficulties for toxicologists, resuscitators, narcologists, and clinical laboratory diagnostics doctors due to the lack of available data on the clinical picture of poisoning by these compounds and laboratory diagnostic methods. In most cases, the clinical picture of drug intoxication or poisoning with new synthetic substances differs from the symptoms caused by previously known drugs, such as cocaine or opiates. Therefore, chemical toxicological research is one of the important aspects for establishing the fact of intoxication or poisoning.Во всем мире отмечается появление новых синтетических наркотических средств, что вызывает значительные трудности в оказании помощи больным для врачей-токсикологов, реаниматологов, наркологов и врачей клинической лабораторной диагностики, связанные с отсутствием доступных данных с описанием клинической картины отравлений подобными соединениями и необходимых методов лабораторной диагностики. Клиническая картина наркотического опьянения или отравления новыми синтетическими веществами в большинстве случаев отличается от симптомов, вызываемых ранее известными наркотическими средствами, такими как кокаин, опиаты. Поэтому химико-токсикологическое исследование является одним из важных аспектов для установления факта опьянения или отравления

Percipir ana socijalna potpora veteranima Domovinskog rata s posttraumatskim stresnim poremećajem – što se nije smjelo dogoditi

The goal of this study was to evaluate the association between self-perceived social support and chronic combat-related posttraumatic stress disorder (PTSD). The study included 262 male war veterans suffering from chronic PTSD. Their diagnosis was confirmed according to DSM-IV -TR . They were given self-reported measures Trauma Symptom Inventory-A and Multidimensional Scale of Perceived Social Support. No significant correlation was found between peer and family support and PTSD. The authors hypothesize this might be the result of secondary victimization, traumatization, and enduring personality changes during the course of PTSD. The items evaluating satisfaction with health care and state institutional support were correlated with most of the PTSD symptoms indicating the possible importance of improving institutional policies toward this population.Glavni cilj ovoga istraživanja bio je procijeniti moguću povezanost percipirane socijalne potpore i kroničnog posttraumatskog stresnog poremećaja (PTSP) uzrokovanog ratom. U istraživanju je sudjelovalo 262 veterana Domovinskog rata koji pate od kroničnog PTSP-a. Psihijatrijsku dijagnozu potvrdio je psihijatar prema kriterijima DSM-IV -TR . Simptomi PTSP-a ispitani su samoocjenskim upitnikom Trauma Symptom Inventory-A, dok je socijalna potpora procijenjena ljestvicom Multidimensional Scale of Perceived Social Support. Nije pronađena značajna povezanost između percipirane socijalne potpore od strane obitelji i prijatelja sa simptomima PTSP-a. Ovakav nalaz može se objasniti kao posljedica sekundarne viktimizacije, traumatizacije te trajnih promjena ličnosti uzrokovanih PTSP-om. Istraživanjem je utvrđena značajna povezanost između institucionalne potpore, primarno državne i zdravstvene, sa simptomima PTSP-a. Važnost ovog rezultata se temelji na mogućem poboljšanju institucionalne skrbi radi smanjivanja simptoma unutar ove osjetljive populacije

Alain Michard : j'ai tout donné

Alain Michard a présenté J’ai tout donné au Centre culturel Colombier de Rennes entre avril et juin 2010. Le projet a d’abord la forme d’une école ouverte, à la participation et aux collaborations. Alain Michard constitua des binômes successifs avec Laurent Pichaud (Session 1 / In situ », pp. 24-67), Mickael Phelippeau (« Session 2 / Le Portrait », pp. 68-123), Nicolas Cadet (« Complément de programme », pp. 124-131), Judith Cahen (« Session 3 / Art et politique », pp. 132-183) et Jocelyn Cot..

Antipsychotics in treatment-resistant Obsessive-Compulsive Disorder: which antipsychotic, which dose and how long antipsychotic addition should be maintained

Objectives: Treatment-resistant Obsessive-Compulsive Disorder (OCD) patients are defined as those who undergo adequate trials of first-line therapies without achieving a satisfactory response. First line treatments for OCD include both serotonin reuptake inhibitors (SRIs) and cognitive behavior therapy (CBT). Because of the high number of OCD patients not responding to first-line treatments (40-60%) and considering the even greater prevalence rate of residual symptoms and significant impairment shown in patients previously described as \u201cclinical responders\u201d, the question of the proper treatment of resistant OCD is a clinically meaningful and a practical issue for psychiatrists. Antipsychotic augmentation proved to be an effective strategy for resistant OCD. However, there are unresolved questions concerning which antipsychotic is effective (or more effective) and how antipsychotics should be used in terms of doses and duration of treatment. The purpose of this study is to systematically review available studies on antipsychotic augmentation for treatment-resistant OCD, in order to guide the practical choice. Materials and methods: We searched on PubMed, Psychnet and Cochrane Libraries from inception to January 2016. Articles published in English and related to the use of antipsychotics in OCD were considered. We evaluated meta-analyses, systematic reviews and randomized controlled trials of adult patients with treatment-resistant OCD. Results: Antipsychotic augmentation is an evidence-based option for treatmentresistant OCD, with a response rate of approximately 50% within the first 4-to6 weeks. Aripiprazole (10-15\ua0mg/day) and risperidone (0.5-2\ua0mg/day) are effective, olanzapine (10\ua0mg/day) is possibly effective. Haloperidol addition is also a viable option, particularly in patients with comorbid tic disorders. Given results of studies performed to date quetiapine should be regarded as non-effective. Preliminary results from open label studies suggest that antipsychotic augmentation, once effective, should be maintained in order to maintain remission. Conclusions: Not all antipsychotics are effective as add-on treatments in resistant OCD. Characteristics of patients and side effects generally associated with each different antipsychotic may guide the practical choice. Further research is required concerning the comparative effectiveness among antipsychotics, the optimal target dose and the ideal duration of antipsychotic addition. In our opinion, antipsychotic augmentation in patients who responded to this treatment should be maintained in order to prevent relapses. However, clinicians must remember patients\u2019 exposure to the common and serious adverse effects associated with long-term antipsychotic administration, especially metabolic disturbances

Kysely lääkäreille : psykoosilääkkeiden off label - määräämisen käytännöt

Unettomuus ja ahdistuneisuus olivat yleisimmät syyt, joiden takia lääkärit määräsivät psykoosilääkkeitä off label -käyttöön. Eniten määrättiin ketiapiinia. Lääkärit raportoivat potilaiden saavan off label -käytöstä enemmän hyötyä kuin haittaa. Potilaiden seurantaan tulee kiinnittää nykyistä enemmän huomiota

Sexual Addiction: Definition, Etiology and Treatment

In present day, it is known that addiction does not only derive from a psychoactive substance but also from the pleasure and relief after some behaviors. Sexual addiction, having always been more difficult to accept compared to other behavioral addictions in therapeutic societies, is a psychological disease. It has devastating effects on addicted individuals and the people around them. However, compulsive sexual behavior could be understood and addicted people could be treated accordingly in the 21. century. Studies regarding sexual addiction in the international literature after 2000s have increased but there are almost no studies on the issue in Turkey. This study reviews the related literature comprehensively and presents the data in a determined frame. It explains sexual addiction disorder and describes its phenomenological aspects, characteristics and diagnostic criteria. Next, it gives naming disagreements in the literature, alternative name suggestions, classification problem, symptomatology, consequences and impacts, etiology, and etiological researches. The etiological researches are classified chronologically as 70s and 80s, 90s and 2000s and after. It is aimed to demonstrate the scientific progress and improvement regarding sexual addiction phenomenon. In the light of this information, it is discussed that sexual addiction should be researched in Turkey, and suggestions are made accordingly