Hepatitis C pretreatment profile and gender differences : cognition and disease severity effects

Copyright © 2019 Barreira, Marinho, Bicho, Flores, Fialho and Ouakinin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Background: The hepatitis C virus (HCV) is known to infect the brain, however, the findings based on associated neuropsychiatric syndrome are controversial and the association itself remains unclear. Gender research in HCV infection is limited, failing to integrate the role of gender differences in neurocognitive syndrome. The aim of this study was to characterize psychological and neurocognitive profiles in HCV-infected patients before treatment and to explore gender differences in those profiles, as well as the impact of disease severity. Methods: A total of 86 patients diagnosed with chronic hepatitis C were included. Depression and anxiety were assessed using Hamilton anxiety scale (HAM-A), Hamilton depression scale (HAM-D), Beck Depression Inventory (BDI). For cognition, a neuropsychological battery to measure attention, concentration and memory was used, and executive function components validated for the Portuguese population was also used before starting treatment. To identify the disease severity, platelet ratio index, and FibroScan® were used. Results: A statistically significant gender effect was found on HAM-A (B = 0.64, CI: 0.17–1.11) and HAM-D (B = 0.62, CI: 0.14–1.09), with women scoring higher compared to men. Regarding neuropsychological scores, significant differences between gender were identified in executive functions measured by Trail Making Test (TMT B) (B = 0.48, CI: 0.02–0.97), TMT B-A (B = 0.26, CI: −39.2 to −3.7) and in digit span total (B = −0.52, CI: −1.0 to −0.04), with women performing worse than men. Controlling for years of substance dependence, TMT-B and TMT B-A showed significant gender differences. Regarding the presence or absence of substance dependence, only HAM-A and HAM-D remained significant. For categorical variables, Digit Span Total was also influenced by gender, with women being more likely to be impaired: odds ratio (OR) = 7.07, CI: 2.04–24.45), and a trend was observed for Digit Span Backward (OR = 3.57, CI: 1.31–9.75). No significant differences were found between disease severity and neurocognitive performance. Conclusion: Data suggest that gender has an influence on depression, anxiety and cognitive functions with women showing greater impairment compared with men. This effect seems to be influenced by substance dependence.info:eu-repo/semantics/publishedVersio

Meaning-centered group psychotherapy in Portuguese cancer patients: A pilot exploratory trial

Spiritual well-being and a sense of meaning are important influences for quality of life (QoL) in patients with advanced cancer (Field and Cassel, 1997; Sinclair et al., 2006). The importance of the existential care lead to the emergence of meaning-focused interventions (Breitbart, 2002; Chochinov et al., 2005; Puchalski, 2013) in advanced cancer patients or terminally ill (Yalom and Greaves, 1977; Spiegel et al., 1981; Edelman et al., 1999; Edmonds et al., 1999; Classen et al., 2001; Kissane et al., 2003, 2007; Lee et al., 2006; Breitbart et al., 2010; Chochinov et al., 2011). In response to this need, Breitbart and his investigation group developed meaning-centered psychotherapy (MCP) to help patients with advanced cancer sustain or enhance a sense of meaning and purpose in their lives, even as they approach the end of life (Breitbart, 2000, 2002; Greenstein and Breitbart, 2000; Breitbart et al., 2010, 2015; Van der Spek et al., 2013; Applebaum et al., 2015). MCP was first developed in a group format (meaning-centered group psychotherapy — MCGP), which is a manualized eight-week intervention (each session: 1.5 h) that utilizes a combination of didactics, experiential exercises and discussion (Breitbart, 2002). The first randomized control trial (RCT) showed benefits in enhancing spiritual well-being and a sense of meaning (Breitbart et al., 2010). Further studies suggested that more severe forms of despair respond better to existential interventions (Breitbart et al., 2015).P30 CA008748info:eu-repo/semantics/publishedVersio

Maturação Orbitofrontal, Marcadores Somáticos e Vulnerabilidade Precoce:: para uma Hipótese Compreensiva de “Miopia Emocional” na Toxicodependência

The “emotional myopia” hypothesis is a theoretical reflection to increase the understanding of the psychologicalvulnerability showed by many drug addicts Instead of an incorporation, a cooperation is proposed of levels of knowledge onthe determinants of the neurodevelopment, psychoanalytical and attachment perspectives and psychobiological models of drugaddictions. Environmental inputs that change brain morphology are highlighted, not only early trauma or care deprivationbut also others derived from the long-term use of drugs as the core of vulnerability. We propose that Damasio’s hypothesisof somatic markers forms part of this theoretical formulation. The low quality of early social interactions may support anincreasing emotional disengagement, a poor maturation of the social brain, an increase of alexithymic patterns and noveltyseekingbehaviours, all potential triggers for searching for pleasure in drugs.O modelo de “miopia emocional” constitui uma hipótese teórica de compreensão da vulnerabilidade psicológica identificada em muitos toxicodependentes. Trata-se de uma tentativa de estabelecer de uma forma cooperativa, mas não incorporativa, associações entre níveis de conhecimento em torno dos determinantes relacionais do neurodesenvolvimento, perspectivas psicanalíticas e da vinculação e modelos psicobiológicos explicativos das toxicodependências. Nela saliento as influências ambientais sobre as mudanças na morfologia cerebral, não apenas o trauma precoce ou a privação de cuidados e suporte afectivo mas também aquelas que derivam de consumos continuados de certas substâncias, e hipotetizo que num largo espectro de situações clínicas as primeiras poderão auxiliar as segundas. Proponho que a hipótese dos marcadores-somáticos proposta por Damásio participe numa concepção desenvolvimentista do consumo de substâncias. A qualidade das interacções precoces pode fundamentar um desligamento afectivo do indivíduo em desenvolvimento, participando na fraca maturação do cérebro social, no desenvolvimento de um padrão alexitímico e numa procura urgente de sensações, todos eles potenciais factores precipitantes para o recurso ao prazer imediato do consumo

Depressive Symptoms and Neurocognitive Performance Among HIV-Infected Women

The aims of this article were to explore the relationship between depressive symptoms and neuropsychological performance in a sample of HIV-infected women, and to examine the contribution of demographic, HIV-related variables, and depressive symptoms to neurocognitive performance. In this cross-sectional study, a sample of 103 HIV-infected women, recruited from February to December 2010, were assessed for depressive symptoms (with the Beck Depression Inventory) and neurocognitive performance (with the HIV Dementia Scale). Severe depressive symptoms were reported by 31.1% of the women. Findings indicated that severe levels of depressive symptoms were significantly associated with reduced cognitive functioning in HIV-infected women, particularly in domains of attention, psychomotor speed, and construction. Older age and low education level were significantly associated with neurocognitive impairment in univariate analyses. In the multivariate model, only depressive symptoms were significantly related to neurocognitive impairment. Compared to participants with none/minimal depressive symptoms, those with moderate and severe depressive symptoms had odds ratios for neurocognitive impairment of 5.03 (95% CI, 1.33-18.99) and 3.22 (95% CI, 1.15-9.06), respectively. These findings support continued investigation of the presence of neurocognitive impairment, particularly among women, and may help mental health providers with early detection, planning, and implementation of more effective interventions.The current study was supported by Abbott Laboratories, Portugal

Emotional dysregulation features and problem gambling in university students : a pilot study

© 2020 Taylor & Francis Group, LLCUndergraduate students typically cope with various changes in their lives and experience many stressors associated with academic issues. Distress can make them more vulnerable to particular behavioral patterns in order to cope with negative affect. The association of problematic gambling with particular emotion regulation characteristics—some of which are developmentally dependent—becomes a recent focus of research with clinical and preventive implications. We carried out a pilot study enrolling voluntarily young adults of a public university in the Lisbon area, and 117 Portuguese-speaking individuals were interviewed. Participants, mainly female (M = 20.6; SD = 3.9), were investigated taking into consideration their gambling practices, characteristics of impulsivity and alexithymia, along with the symptoms of depression and anxiety. Portuguese versions of the South Oaks Gambling Scale (SOGS) and Short-Version of Impulsive Behavior Scale (S-UPPSP) were prepared (i.e., translation and back-translation of the original versions were performed). The prevalence of gambling problems in this sample is modest, although they were associated with negative urgency and sensation-seeking, as well as with depression symptoms. Multiple correspondence analysis, a particular multivariate model associating gambling problems with socio-demographic and psychological variables, allowed identifying different profiles of individuals. Trace and state emotional dysregulation features are selectively associated with distinctive gambling patterns, according to some previous findings in studies with other groups. Results may address new findings in terms of morbidity, risk factors and the design of future preventive strategies among such individuals.info:eu-repo/semantics/publishedVersio