Late-life depression : issues for the general practitioner

Late-life depression (LLD) is both a prevalent and life-threatening disorder, affecting up to 13.3% of the elderly population. LLD can be difficult to identify because patients mainly consult their general practitioner (GP) for somatic complaints. Moreover, patients may be hesitant to express the problem to their GP. Increased vigilance on the part of the GP can only benefit older people with depression. To recognize the risk of LLD, screening tools are provided in addition to treatment options for LLD. This review aims to provide the GP with guidance in recognizing and treating LLD. It tries to connect mainstream etiologies of LLD (e.g., vascular, inflammation, hypothalamo-pituitary-adrenal axis) with risk factors and current therapies. Therefore, we provide a basis to the GP for decision-making when choosing an appropriate therapy for LLD

Ouderdomsdepressie : symptomen, risicofactoren en behandeling

Ouderdomsdepressie is een veelvoorkomende psychische stoornis bij ouderen, met een geschatte prevalentie van 13,3%. De aandoening gaat gepaard met een verhoogde morbiditeit en mortaliteit en genereert hoge kosten voor de samenleving. Zo liggen de kosten voor de behandeling van een oudere persoon met depressie 1,86 keer hoger dan de behandeling van een oudere persoon zonder depressie. De gevolgen van onbehandelde ouderdomsdepressie zijn een slechte levenskwaliteit, verergering van chronische ziekten en zelfdoding. Vanwege de atypische presentatie wordt de diagnose vaak over het hoofd gezien. Het vroegtijdig herkennen van een ouderdomsdepressie kan levensreddend zijn. Een behandelde ouderdomsdepressie kent een goede prognose: tot 70% van de oudere patiënten met een depressie behandeld met antidepressiva herstelt van een episode van depressie. Het doel van deze review is om een uitgebreide en praktische leidraad te bieden met betrekking tot de belangrijkste risicofactoren en de diagnostische en therapeutische aanpak van ouderdomsdepressie

Dementia : diagnosis, behaviour management, ethical issues

In this scientific advisory report on public health policy, the Superior Health Council of Belgium provides recommendations on the diagnosis of dementia, behaviour management and the ethical issues raised. This report aims at providing professionals with specific recommendations on the diagnosis of dementia, behaviour management and the ethical issues raised

Distinct effects of T-705 (favipiravir) and ribavirin on influenza virus replication and viral RNA synthesis

T-705 (favipiravir) is a new antiviral agent in advanced clinical development for influenza therapy. It is supposed to act as an alternative substrate for the viral polymerase, causing inhibition of viral RNA synthesis or virus mutagenesis. These mechanisms were also proposed for ribavirin, an established and broad antiviral drug that shares structural similarity with T-705. We here performed a comparative analysis of the effects of T-705 and ribavirin on influenza virus and host cell functions. Influenza virus-infected cell cultures were exposed to T-705 or ribavirin during single or serial virus passaging. The effects on viral RNA synthesis and infectious virus yield were determined and mutations appearing in the viral genome were detected by whole-genome virus sequencing. Besides, the cellular nucleotide pools were quantified as well as direct inhibition of the viral polymerase enzyme. We demonstrate that the anti-influenza effect of ribavirin is based on IMP dehydrogenase inhibition, which results in fast and profound GTP depletion and an imbalance in the nucleotide pools. In contrast, T-705 acts as a potent and GTP-competitive inhibitor of the viral polymerase. In infected cells, viral RNA synthesis is completely inhibited by T-705 or ribavirin at ≥50 μM, whereas exposure to lower drug concentrations induces formation of non-infectious particles and accumulation of random point mutations in the viral genome. This mutagenic effect is two-fold higher for T-705 than for ribavirin. Hence, T-705 and ribavirin both act as purine pseudobases, but profoundly differ with regard to the mechanism behind their antiviral and mutagenic effects on influenza virus.status: publishe

Clinical validation of the Psychotic Depression Assessment Scale (PDAS) against independent global severity ratings in older adults

Stress-related psychiatric disorders across the life spa