Real World Experience of Disease Activity in Patients With Rheumatoid Arthritis and Response to Treatment With Varios Biologic DMARDs

The current study investigate the disease activity and effectiveness of treatment in patients with RA on biological disease modifying antirheumatic drugs (bDMARDs) in combination with a conventional synthetic DMARD (csDMARD) and determine whether or not the benefits of different therapies were sustained over a follow up period of 1 year. 124 patients were selected with a mean age 55.26 ± 13, 18SD years, meeting the 1987 ACR and /or ACR/ EULAR (2010) classification criteria for Rheumatoid arthritis (RA). Patients were arranged according to treatment regimens: Tocilizumab (TCL) – 30 patients, Certolizumab (CZP) – 16, Golimumab (GOL) – 22, Etanercept (ETN) 20, Adalimumab (ADA) 20, Rituximab (RTX) – 16. Disease activities was the primary concern. Independent joint assessor evaluated 28 joints on baseline, 6th and 12th month’s thereafter. C-reactive protein (CRP) was used to measure the inflammatory process. DAS28-CRP, clinical disease activity index (CDAI) and simplified disease activity index (SDAI) were calculated. On baseline all of the patients’ groups had severe disease activity (mean DAS28-CRP > 5.2, mean CDAI > 22, mean SDAI > 26. It was noted that, during the 6th month follow-up period all of the treatment groups significantly decreased DAS28-CRP, CDAI, SDAI and reach moderate disease activity. After 6th and 12th months of treatment all of the groups on bDMARDs had significantly lower disease activity. The GOL group reach remission only according to DAS28-CRP: 2.49 ± 0.76, and low disease activity as measured by CDAI: 6.78 ± 4.51 and SDAI 7.80 ± 5.67. The other 5 groups after 12 months reach the level of low disease activity according to the three activity parameters: DAS28-CRP (TCL 3.07 ± 0.73, CZP 3.06 ± 0.65, ETN 2.85 ± 0.55, ADA 3.15 ± 0.82, RTX 2.90 ± 0.70), CDAI (TCL 9.80 ± 4.91, CZP – 9.33 ± 4.22, ETN 7.97 ± 3.80, ADA 10.00 ± 5.25, RTX 7.48 ± 2.99) and SDAI (TCL 10.45 ± 5.14, CZP 9.94 ± 4.43, ETN 9.03 ± 4.25, ADA 10.50 ± 5.61, RTX 8.08 ± 3.24). The therapy with different bDMARDs added to a csDMARD led to very similar results – a minimal disease activity and a state of remission in the GOL treatment group only as per DAS28-CRP

Using a computational model of embodied consciousness to study psychopathology

We used a generative model of consciousness, called the Projective Consciousness Model (PCM) from Rudrauf et al. (2017), to simulate behavioral characteristics (related to joint attention and approach/avoidance) of two psychopathological conditions: Autism Spectrum Disorder (ASD) and Social Anxiety Disorder (SAD). We had two complementary aims with this study in silico, based on the manipulation of model’s parameters (affecting prior beliefs and perspective taking) and the resulting free energy dynamics. First, we aimed at testing the capacity of the PCM to mathematically implement valid clinical phenomenology. Second, we aimed at exploring whether hidden mechanisms, hypothesized by the current literature to underpin ASD and SAD, could lead to artificial behavior similar to that observed in humans. Our results confirm in simulations the mathematical prediction on the relations between the different parameters. Thus, behaviors reminding of ASD and SAD phenotypes were observed, which encourages future work on the application of the PCM’s potential for unifying and relating psychological mechanisms, and contribute to psychological research

Stage-specific interventions for emotion dysregulation disorders in adolescents

Since most of the early signs of psychological distress are nonspecific and often under the threshold of a diagnosable disorder, especially in early adolescence, a dimensional and transdiagnostic approach is needed to guide early interventions. In this review, we focus on the transdiagnostic mechanism of emotion dysregulation hypothesised to underlie a group of psychopathologies that we named “emotion dysregulation disorders”. Some promising interventions useful at different stages of the evolution of such disorders (from subclinical to clinical ones) are briefly presented. Among them, we propose cognitive-behavioural therapies, mindfulness-based interventions, and mentalisation-based treatment. The mindfulness-based interventions are an essential part of our ongoing study on the effects of an 8-week regular practice of mindfulness on non-clinical adolescents between 13 and 15 years old. We finally conclude with a proposition for a potential clinical staging model for emotion dysregulation disorders