Neurocognitive Impairments and Depression and Their Relationship to Hepatitis C Virus Infection

The hepatitis C virus is a blood-borne virus with a direct cytopathic action. Chronic hepatitis C is a prevalent and costly disease. Studies have shown that it is a significant overlap between hepatitis C virus and mental disorders and that a substantial number of patients infected are suffering from mood disturbances and neurocognitive impairment. Recently, the neurocognitive impairments (attention, memory, and executive function alterations) were recognized as being independent of liver fibrosis and representing the direct effect of hepatitis C virus on neurons. However, until now impairments in neurocognition are not associated with viral replication or overall viral burden. Moreover, interferon alpha is still used to treat patients with hepatitis C. According to various researchers, 30–70% will develop significant psychiatric symptoms, leading to a premature discontinuation of therapy or noncompliance and worsening of quality of life. Several potential mechanisms may be implicated in the onset of a depressive episode following interferon alpha, the most important being the activation of immune-inflammatory pathways. This chapter will present the complex and striking relationships between hepatitis C virus infection and central nervous system symptoms. A variety of approaches, which integrate the extensive research data (including molecular, brain imaging, and neuropsychological findings), will be discussed

Psychiatric Comorbidities in Irritable Bowel Syndrome (IBS)

FA lot of research has pointed out that irritable bowel syndrome (IBS) is a multifactorial illness involving visceral hypersensitivity, alteration of communication between the enteric nervous system (ENS) and central nervous system (CNS), increased intestinal permeability, minimal intestinal inflammation, and altered intestinal microflora. Psychological, social, and genetic factors appear to be important in the development of IBS symptomatology through several mechanisms. This chapter addresses the relationships between irritable bowel syndrome (IBS) and psychiatric comorbidities. The aim of this chapter is to provide an overview of explanatory hypothesis and to describe a variety of approaches which integrate the vast research data about IBS and psychiatric comorbidities, including genetic, brain imaging, and neuropsychological findings. The section of this chapter which overlooks the psychotropic treatment reviews the comparative efficacy of various drugs

The Many Faces of Negative Symptoms in Schizophrenia

Negative symptoms are relatively frequent across schizophrenia spectrum disorders diagnostic categories and they represent deficits in different domains such as emotional, volitional and experiential. Even though negative symptoms have long been recognized as a core feature of schizophrenia, their definition has been changing over time. Different conceptualization classified this category of symptoms as primary or secondary, persistent or transient. At the current moment there are five agreed upon domains of the concept of negative symptoms, which are separated into two dimensions—experience (anhedonia, avolition, asociality) and expression (blunted affect, alogia). Multiple mechanistic pathways have been proposed and investigated for each dimension and for each domain. The current chapter attempts to address recent advances in the literature regarding the concepts, definitions and classifications of negative symptoms and their etiological model

The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations

Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Although generally considered a functional disorder, there is now substantial evidence that IBS is associated with a poor quality of life and significant negative impact on work and social domains. Neuroimaging studies documented changes in the prefrontal cortex, ventro-lateral and posterior parietal cortex and thalami, and implicate alteration of brain circuits involved in attention, emotion and pain modulation. Emerging data reveals the interaction between psychiatric disorders including generalized anxiety disorder, panic disorder, major depressive disorder, bipolar disorder, and schizophrenia and IBS, which suggests that this association should not be ignored when developing strategies for screening and treatment. Psychological, social and genetic factors appear to be important in the development of IBS symptomatology through several mechanisms: alteration of HPA axis modulation, enhanced perception of visceral stimuli or psychological vulnerability. Elucidating the molecular mechanisms of IBS with or without psychiatric comorbidities is crucial for elucidating the pathophysiology and for the identification of new therapeutical targets in IBS

Coping Strategies and Irritable Bowel Syndrome: A Systematic Review.

Background and Aims: Irritable bowel syndrome (IBS) is associated with a high prevalence of psychiatric comorbidities. While psychosocial determinants were intently studied, coping strategies with stress used by IBS patients were never comprehensively reviewed. Therefore, this systematic review aimed to summarize the coping strategies used by IBS patients and to identify which tools are frequently used to measure coping strategies. Methods: According to PRISMA guidelines, we searched for articles indexed in PubMed, EBSCOhost, EMBASE and Cochrane Library. The search terms included: (coping OR coping strategies OR coping mechanism) AND (irritable bowel syndrome OR IBS). The initial search identified 756 articles. After applying all filters (human filters, excluding conference abstracts and conference papers), 96 studies remained. Finally, a total of 21 articles were included in this systematic review. Results: Twenty-one articles using fifteen coping instruments and six measures of quality of life were found. One was interventional, one longitudinal, and the rest were cross-sectional studies. One study was qualitative, while the rest used quantitative measures. Emotion-focused coping was associated with worse psychological outcomes, while the effect of problem-focused coping was not regularly associated with better psychological outcomes. Catastrophizing was negatively associated with health-related quality of life. Psychological distress (anxiety, depression) was significantly related to the impairment of health-related quality of life. Conclusion: Patients with IBS cope in different ways when confronted with health and daily-life stressors. The maladaptive strategy of coping is associated with poor health-related quality of life and psychiatric comorbidities but methodological problems limit conclusions regarding the strength and nature of this association. Future research needs to focus on which strategies are most effective at reducing psychological distress in IBS patients

Anxiety and Depression in Metabolic-Dysfunction-Associated Fatty Liver Disease and Cardiovascular Risk

(1) Background: The relationship between anxiety and depression in metabolic-dysfunction-associated fatty liver disease (MAFLD) and cardiovascular (CV) risk remains uncertain. Therefore, we aimed to assess whether anxiety and depression are associated with increased CV risk in MAFLD. (2) Methods: We conducted a cross-sectional observational study involving 77 subjects (39 MAFLD patients, 38 controls), between January and September 2020. Hepatic steatosis was assessed using a combination of hepatic ultrasonography and SteatoTestTM. CV parameters were evaluated using echocardiography and Doppler ultrasound. Self-reported questionnaires pertaining to symptoms of anxiety and depression were used. Anxiety was evaluated using Lehrer Woolfolk Anxiety Symptom Questionnaire (LWASQ), further divided into somatic, behavioral, and cognitive factors, as well as a global score, and depression using Beck Depression Inventory (BDI). (3) Results: MAFLD patients presented significantly higher BDI scores (p-value 0.009) and LWASQ global scores (p-value 0.045) than controls. LWASQ somatic factor was significantly associated with global longitudinal strain (GLS) in linear analysis (−0.0404, p-value = 0.002), while it lost significance following multivariate analysis (−0.0166, p-value = 0.124). Although group (MAFLD vs. controls) predicted BDI, LWASQ global score, and LWASQ somatic factor in linear regression, they lost significance in multivariate analysis. Moreover, the relationship between interventricular septal wall thickness (IVSWT) and BDI, LWASQ global score, and LWASQ somatic factor was significant in linear analysis, but statistical significance disappeared after multivariate analysis. (4) Conclusions: Although MAFLD patients presented increased anxiety and depression risk in univariate analysis, this association lost significance in multivariate analysis. A significant association between GLS levels and LWASQ somatic factor, in addition to IVSWT in anxiety and depression in univariate analysis, was observed, but was lost after multivariate analysis