Depression and anxiety in epilepsy: the association with demographic and seizure-related variables

<p>Abstract</p> <p>Background</p> <p>Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. Accordingly, the present study was designed to investigate the association of interictal mood disorders with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy.</p> <p>Methods</p> <p>We investigated 201 patients with epilepsy (51.2% males, mean age 33.2 ± 10.0 years, range 16–60) with a mean disease duration of 13.9 ± 9.5 years. Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of mood disorders with various variables was investigated with simple and multiple linear regression analyses.</p> <p>Results</p> <p>High seizure frequency and symptomatic focal epilepsy (SFE) were independent determinants of depression, together accounting for 12.4% of the variation of the BDI-21. The STAI-S index was significantly associated with the type of epilepsy syndrome (SFE). Finally, high seizure frequency, SFE and female gender were independent determinants of trait anxiety accounting for 14.7% of the variation of the STAI-T.</p> <p>Conclusion</p> <p>Our results confirm the prevailing view that depression and anxiety are common psychological disorders in epileptics. It is additionally concluded that female gender, high seizure frequency and a symptomatic epilepsy syndrome are independent risk factors for the development of anxiety and/or depression.</p

Factors associated with caregiver psychological distress in chronic schizophrenia

Caregivers of patients with schizophrenia experience increased levels of psychological distress. This study investigated the impact of caring for patients with chronic schizophrenia on the mental health status of the caregivers and described the relationship between various socio-demographic and clinical characteristics and caregiving psychological distress. The study was carried out at the Psychiatric Hospital of Athens. The Symptom Check List Revised (SCL-90-R) was administered to 87 caregivers of chronic schizophrenia patients and 90 healthy controls. The Positive and Negative Syndrome Scale (PANSS) was administered to schizophrenia patients in order to assess illness severity. The group of caregivers scored higher on the majority of symptom dimensions of the SCL-90-R than the control group. Clinical features of schizophrenia, i.e. duration of illness and PANSS positive and negative symptoms significantly predicted caregiving psychological distress. Caregivers’ and patients’ socio-demographic characteristics were not associated with caregivers’ distress, with the exception of caregivers’ sex: female caregivers experienced significantly higher levels of psychological distress than males. The study suggests that clinical features of schizophrenia influence distress levels in caregivers of patients with chronic schizophrenia. The stronger predictors of distress appear to be female caregiver’s gender, duration of illness as well as positive and negative symptomatology

Elevated Muscle-Specific miRNAs in Serum of Myotonic Dystrophy Patients Relate to Muscle Disease Progress

The discovery of reliable and sensitive blood biomarkers is useful for the diagnosis, monitoring and potential future therapy of diseases. Recently, microRNAs (miRNAs) have been identified in blood circulation and might have the potential to be used as biomarkers for several diseases and clinical conditions. Myotonic Dystrophy type 1 (DM1) is the most common form of adult-onset muscular dystrophy primarily characterized by muscle myotonia, weakness and atrophy. Previous studies have shown an association between miRNAs and DM1 in muscle tissue and, recently, in plasma. The aim of this study was to detect and assess muscle-specific miRNAs as potential biomarkers of DM1 muscle wasting, an important parameter in the disease’s natural history. Disease stable or progressive DM1 patients with muscle weakness and wasting were recruited and enrolled in the study. RNA isolated from participants’ serum was used to assess miRNA levels. Results suggest that the levels of muscle-specific miRNAs are correlated with the progression of muscle wasting and weakness observed in the DM1 patients. Specifically, miR-1, miR-133a, miR133b and miR-206 serum levels were found elevated in DM1 patients with progressive muscle wasting compared to disease stable DM1 patients. Based on these results, we propose that muscle-specific miRNAs might be useful molecular biomarkers for monitoring the progress of muscle atrophy in DM1 patients

Elevated Muscle-Specific miRNAs in Serum of Myotonic Dystrophy Patients Relate to Muscle Disease Progress

<div><p>The discovery of reliable and sensitive blood biomarkers is useful for the diagnosis, monitoring and potential future therapy of diseases. Recently, microRNAs (miRNAs) have been identified in blood circulation and might have the potential to be used as biomarkers for several diseases and clinical conditions. Myotonic Dystrophy type 1 (DM1) is the most common form of adult-onset muscular dystrophy primarily characterized by muscle myotonia, weakness and atrophy. Previous studies have shown an association between miRNAs and DM1 in muscle tissue and, recently, in plasma. The aim of this study was to detect and assess muscle-specific miRNAs as potential biomarkers of DM1 muscle wasting, an important parameter in the disease’s natural history. Disease stable or progressive DM1 patients with muscle weakness and wasting were recruited and enrolled in the study. RNA isolated from participants’ serum was used to assess miRNA levels. Results suggest that the levels of muscle-specific miRNAs are correlated with the progression of muscle wasting and weakness observed in the DM1 patients. Specifically, miR-1, miR-133a, miR133b and miR-206 serum levels were found elevated in DM1 patients with progressive muscle wasting compared to disease stable DM1 patients. Based on these results, we propose that muscle-specific miRNAs might be useful molecular biomarkers for monitoring the progress of muscle atrophy in DM1 patients.</p></div

Muscle-specific miRNAs levels are elevated in the serum of DM1 patients.

<p>Serum samples from twenty three DM1 patients and twenty three healthy participants were analysed for the presence of muscle-specific miRNAs. miR-1 (<b>A</b>), miR-133a (<b>B</b>), miR-133b (<b>C</b>) and miR-206 (<b>D</b>) were significantly elevated in the serum of DM1 patients compared to the serum of healthy participants (p<0.005). Distribution charts of miR-1 (<b>E</b>), miR-133a (<b>F</b>), miR-133b (<b>G</b>) and miR-206 (<b>H</b>) levels in DM1 patients and healthy participants show the elevated levels of the muscle-specific miRNAs in the serum of DM1 patients compared to healthy participants. Horizontal lines inside the boxes mark the medians. Mean expression values are marked with rhombus. *** p < 0.0001.</p

The serum levels of muscle-specific miRNAs are correlated with the progression of muscle wasting of DM1 patients.

<p>The DM1 patients were classified as progressive and non-progressive based on the progression of the muscle wasting that the patients faced at the time of blood sample collection. miR-1 (<b>A</b>), miR-133a (<b>B</b>), miR-133b (<b>C</b>) and miR-206 (<b>D</b>) serum levels were significantly higher in the progressive DM1 patients compared to the non-progressive DM1 patients (p<0.005). Distribution charts of miR-1 (<b>E</b>), miR-133a (<b>F</b>), miR-133b (<b>G</b>) and miR-206 (<b>H</b>) levels in progressive and non-progressive DM1 patients show the elevated levels of the muscle-specific miRNAs in the serum of progressive DM1 patients compared to non-progressive DM1 patients. Horizontal lines inside the boxes mark the medians. Mean expression values are marked with rhombus. *** p < 0.0001, ** p < 0.005.</p

Muscle-specific miRNAs are specific for muscle wasting progress independent of the severity of the patient.

<p>DM1 patients were divided into moderate and not-moderate DM1 patients. For each of the sub-group the patients were also divided into progressive and non-progressive DM1 patients. Statistical analysis showed that in both groups, moderate DM1 patients (<b>A</b>) and not-moderate DM1 patients (<b>B</b>), the levels of the four muscle-specific miRNAs are increased in progressive DM1 patients compared to non-progressive DM1 patients. ** p < 0.005, * p < 0.05.</p