Relationships between depression and cognitive deficits in the opinions of psychiatrists

Wstęp: Deficyty funkcji poznawczych stanowią integralną część objawów depresji, ale jak dowodzą dotychczasowe badania są uważane przez większość praktyków za wtórne do jej podstawowych objawów. Są one jedną z głównych przyczyn pogorszenia poziomu funkcjonowania osób z depresją, zarówno w okresie epizodu, jak w okresie remisji. Występują już w trakcie pierwszego epizodu depresji, mogą korelować z jej nasileniem i nie ustępować pomimo ustąpienia podstawowych objawów zespołu depresyjnego. Celem badania było opisanie opinii i postępowania psychiatrów w kontekście występowania i wyboru terapii deficytów poznawczych w depresji. Materiał i metody: Dla potrzeb prezentowanego badania opracowano kwestionariusz skierowany do lekarzy psychiatrów. Wyniki: Uzyskano 41 odpowiedzi lekarzy psychiatrów (23 kobiet i 14 mężczyzn, 4 formularze brak danych), w większości specjalistów psychiatrów, pracujących w ośrodkach miejskich o średniej wielkości. Według 95% respondentów deficyty poznawcze występują co najmniej u połowy lub u większości pacjentów z depresją. Wszyscy pacjenci są pytani o trudności poznawcze przez 28% osób ankietowanych, a prawie wszyscy przez 59% osób. Jeśli temat jest podejmowany przez pacjenta, prawie wszyscy psychiatrzy podejmują rozmowę na ten temat, jednak 25% z nich nie robi tego w każdym przypadku. Według badanych psychiatrów deficyty poznawcze są w 57% „zawsze” i w 21% „w połowie” wtórne do objawów depresji. Zdaniem 21% osób nie mają charakteru wtórnego. Konsekwentnie psychiatrzy są przekonani, że ustępują one wraz z osiągnięciem remisji i nie występują w jej trakcie, 82% osób pytanych deklaruje jednak, że bierze pod uwagę wpływ leku na funkcje poznawcze, przy wyborze leczenia u osoby z depresją. Większość ankietowanych nie doświadcza ani braku wiadomości, ani braku umiejętności w odniesieniu do tematyki dysfunkcji poznawczych w depresji i ich terapii. Wnioski: Zdaniem psychiatrów deficyty poznawcze w depresji nie są jej niezależnym wymiarem, są wtórne od objawów depresyjnych i ustępują wraz z poprawą stanu psychicznego, ale lekarze deklarują, że uwzględniają ich znaczenie przy wyborze konkretnego leczenia.Introduction: Cognitive deficits constitute an integral part of depressive symptomatology and are mainly considered by practitioners as secondary to typical depressive symptoms. Cognitive impairment is one of the main causes of depressive patients’ poor functioning during the episode of depression and in remission. They are observed already in the first depressive episode and may correlate with the severity of depression and may persist regardless of the improvement of depression during treatment. The aim of the study was to investigate psychiatrist opinions and practice in the treatment of patients with depression in the context of cognitive symptoms in this disorder. Material and methods: Special questionnaire was designed for the purpose of this study. Results: 41 psychiatrist (23 women and 14 men, 4 record missed) answered the questionnaire. Respondents we mainly experienced consultant psychiatrists from medium size urban centers. According to 95% of them cognitive deficits are manifested by at least half or most of the patients with depression. All patients with depression are actively questioned by psychiatrist about the cognitive deficits in 28% of cases, and most of them in 59% of cases. Nearly all psychiatrist discuss the cognitive deficits in case of complains of the patients, but 25% of them not in every single case. According to psychiatrist’ opinions cognitive symptoms in depression are secondary to basic depressive, “always” in 57% and in 21% “in half” of the patients, and are not secondary in 21% opinions. Consequently psychiatrist are convicted that they disappear with the clinical remission and will not be present in the remission period of the disorder. But anyway 82% of psychiatrist considers the impact of medication on cognitive deficits as an important factor in the process of medication choice for the patients with depression. Most of respondents do not experience difficulties in relating to this topic both in the sphere of knowledge and everyday practice. Conclusion: according to psychiatrists cognitive deficits in schizophrenia are secondary to depressive symptoms and are not independent dimension of this disorder, the diaper with the clinical remission regardless the particular medication chosen, but they declare that they take into account the impact of medication on cognitive deficits in the process of choice of particular drug

Symptoms of overactive bladder (OAB) in patients treated for depressive disorders

Aim: The aim of the study was to investigate the correlation between symptoms of overactive bladder (OAB) and severity of depressive symptoms in patients treated for depression. Method: 102 patients (43 males, 59 females) aged 20–67 (M = 46.1±11,3) treated for depression were included in this cross-sectional analysis. OAB symptoms were examined with the International Prostate Symptom Score (IPSS) and International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB). OAB-related quality of life was assessed with the International Consultation on Incontinence Questionnaire Overactive Bladder Quality of Life Module (ICIQ-OABqol). Depressive symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HDRS) and Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). Results: Symptoms of OAB assessed with IPSS and ICIQ-OAB were more severe in women than in men. In the entire group highest scores in IPSS of assessed OAB symptoms were observed in nocturia (1,53±1,64) followed by urinary frequency (1,19±1,48) and lowest in urgency (0,80±1,28). Symptoms of OAB (based on the ICIQOABqol total score) were more bothersome in women (48,74±29,18), than in men (39,18±17,70). In the whole group and in women the QIDS-SR total score correlated with the ICIQ-OAB score ( p < 0,05). The total QIDS-SR score correlated with the ICIQ-OABqol score in entire group (p < 0,05), in women (p < 0,05) and in men (p < 0,05). Patients suffering from at least moderate depression assessed with QIDS-SR had significantly more pronounced symptoms of urinary frequency (p = 0,005) and urgency (p = 0,039). A number of other significant (p < 0.05) correlations were observed between the total ICIQ-OAB score and certain items’ scores in the GHQ-30 both in women. Conclusions: OAB symptoms are common among patients treated for depressive disorders. There is a correlation between severity of depressive symptoms and OAB. OAB is bothersome and affects the quality of life in patients treated for depression. Comorbidity of OAB and depression has clinical significance and that should enhance interdisciplinary treatment approaches. Due to limitations of this study, further researches are essential to reveal more details of the correlation between OAB and depression

On the nature of spin- and orbital-resolved Cu+−NOCu^{+}-NO charge transfer in the gas phase and at Cu(I) sites in zeolites

Electronic factors essential for NO activation by Cu(I) sites in zeolites are investigated within spin-resolved analysis of electron transfer channels (natural orbitals for chemical valence). NOCV analysis is performed for three DFT-opti- mized models of Cu(I)–NO site in ZSM-5: [CuNO] ? , (T1)CuNO, and (M7)CuNO. NO as a non-innocent, open- shell ligand reveals significant differences between inde- pendent deformation density components for a and b spins. Four distinct components are identified: (i) unpaired electron donation from NO p k * antibonding orbital to Cu s,d ; (ii) backdonation from copper d yz to p \ * antibonding orbital; (iii) donation from occupied p k and Cu d xz to bonding region, and (iv) donation from nitrogen lone-pair to Cu s,d . Channel (i), corresponding to one-electron bond, shows-up solely for spin majority and is effective only in the interaction of NO with naked Cu ? . Channel (ii) dominates for models b and c: it strongly activates NO bond by populating antibonding p * orbital and weakens the N–O bond in contrast to channel (i), depopulating the antibonding orbital and strengthening N–O bond. This picture perfectly agrees with IR experiment: interaction with naked Cu ? imposes small blue-shift of N stretching frequency while it becomes strongly red-shifted for Cu(I) site in ZSM-5 due to enhanced backdonation