17 research outputs found
Depressioon ja sotsiaalne toimimine
Depressiooniga seostub halvem sotsiaalne toimimine. Probleemiks võib olla nii objektiivne igapäevarollidega hakkamasaamine kui ka vähene subjektiivne rahulolu. Töös on analüüsitud Eesti rahvastiku andmete alusel depressioonisümptomite seoseid objektiivse majandusliku toimimise, lähisuhete ja rahuloluga ning selgitatud soolisi erinevusi depressiooni ja toimimise seostes. Töö andmestik on pärit Eesti terviseuuringust 1996–1997. Selgus, et Eestis seostub depressiivsus pigem väiksema jooksva sissetuleku kui vähemapüsivara omamisega. Tugevad seosed ilmnesid depressiivsusel väheste lähisuhete ja mitut eluvaldkonda hõlmava kehva rahuloluga. Mõningaid soolisi erinevusi ilmnes depressiivsuse seostes suhetega
Une kvaliteet ja sagedasemad unehäired arstiteaduskonna üliõpilastel
Töö kajastab üht osa unehäirete epidemioloogilisest uuringust, kus on püütud välja selgitada olulisemate unehäirete esinemissagedus Eesti noorte inimeste seas. 413 uuritust hindas oma une kvaliteeti heaks või pigem heaks 69,2% (286); rahuldavaks 23,7% (98) ning pigem halvaks või halvaks 7,0% (29). Uuritute halba unekvaliteeti iseloomustasid peamiselt uinumisraskused, sagedased öised ärkamised ja päevane unisus, mis on insomnia sagedasemad tunnused
Bupropioonravi depressiooni korral: mono- ja kombinatsioonteraapia
Bupropioon on ainus dopamiini ning noradrenaliini tagasihaarde inhibiitor, mis on näidustatud depressiivse häire ja aastaajast sõltuva meeleoluhäire raviks, olles kliiniliste uuringute põhjal niisama tõhus kui teised antidepressandid. Kakskümmend aastat kliinilist praktikat kinnitab bupropiooni ohutust ning efektiivsust, seega on ta kasutatav esimese valiku preparaadina. Üha enam tõendeid räägib ka bupropiooni kasutamise poolt juhtudel, kui depressiivne sümptomaatika serotoniini tagasihaarde inhibiitorite abil ei taandu või taandub vaid osaliselt. Mitmed uuringud kinnitavad bupropiooni eeliseid serotoninergiliste antidepressantide ees melanhoolsete sümptomite ravis. Ülevaates on keskendutud bupropioonravi eelistele depressiivsete patsientide ravis, et optimeerida selle kasutamist arstlikus praktikas.
Eesti Arst 2010; 89(2):113−11
Depressiooni ja ärevuse esinemine Eesti inimestel: depressiivse häire hetkelevimus, depressiivsuse ja ärevuse levimuse muutus kümne aasta jooksul
Eesti Arst 2008; 88(Lisa2):80−8
Bupropiooni augmentatsiooni toime estsitalopraamravi suhtes resistentsetel depressiivsetel patsientidel
Üha enam on andmeid, et bupropioon on üks efektiivsemaid valikuid augmentatsiooniks neil depressiivsetel patsientidel, kes serotoniini tagasihaarde inhibiitoritele reageerivad osaliselt või mitteküllaldaselt. Käesolevas uuringus jälgiti bupropiooni augmentatsiooni efektiivsust ja talutavust estsitalopraamravile mittereageerinud patsientidel. Seisundi kliinilist raskusastet ja paranemist hinnati kahenädalase intervalliga, kasutades selleks erinevaid skaalasid. Patsiendid hindasid sümptomeid ja võimalikke kõrvaltoimeid enesehinnangulistel skaaladel. Sarnaselt eelnevate uuringutega leiti, et bupropiooni augmentatsioon oli üldiselt hästi talutav ja aitas edukalt saada ravivastust enamikul serotoniini tagasihaarde inhibiitori monoteraapia suhtes resistentsetel patsientidel. Melanhoolset tüüpi depressioon oli seotud ebapiisava või osalise ravivastusega estsitalopraamile. Tulemused toetasid seisukohta, et bupropioon on esmavaliku antidepressant melanhoolse depressiooni ravis.
Eesti Arst 2009; 88(2):82−9
Polymorphisms in wolframin (WFS1) gene are possibly related to increased risk for mood disorders
Wolfram syndrome gene (WFS1) has been suggested to have a role in the susceptibility for mood disorders. A 26-fold increased risk for psychiatric disorders in WFS1 mutation carriers has been sug- gested. In this study we tested the hypothesis that the WFS1 gene is related to the risk for mood disorders. We analysed 28 single-nucleotide polymorphisms (SNPs) of the WFS1 gene in 224 unrelated patients with major depressive disorder and bipolar disorder and in 160 healthy control subjects. Patients were further stratified according to their comorbidity with anxiety disorders. We applied arrayed primer extension (APEX)-based genotyping technology followed by association and haplotype analysis. Five SNPs in the WFS1 gene were associated with major depressive disorder, and three SNPs with bipolar disorder. Haplotype analysis revealed a common GTA haplotype, formed by SNPs 684C/ G, 1185C/T and 1832G/A, conferring risk for affective disorders. Specifically, for major depression the GTA haplotype has an OR of 1.59 (p=0.01) and for bipolar disorder an OR of 1.89 (p=0.03). These results support the hypothesis that the WFS1 gene is involved in the genetic predisposition for mood disorders
Kui suured on kulutused peaajuhaigustele Eestis?
Uurimuse eesmärgiks on anda ülevaade peaajuhaigustega seotud kulutustest Eestis. Uurimus tehti Euroopas varem kasutatud metoodikaga. Peaajuhaigusega isikuid oli 2004. a Eestis 370 000. Kulutused kõikidele uuringusse kaasatud peaajuhaigustele (12 peaajuhaigust või haigusrühma) olid kokku 264 miljonit eurot. Hinnanguliselt kulub peaajuhaigustele 2% SKTst ehk 194 eurot iga Eesti inimese kohta aastas. Peaajuhaigustega seotud kulutused põhjustavad märkimisväärset koormust Eesti ühiskonnale, kusjuures uurimuses esitatud kulutused on tõenäoliselt alahinnatud
kvaliteetsete uuringute puudumise tõttu. Et analüüsida, kuidas kliinilise töö tõhustamine end ära tasub, ja leida tõhusamaid võimalusi peaajuhaiguste käsitluseks, on vajalikud Eestis tehtud ja vastavaid olusid arvestavad prospektiivsed kulu-uuringud.
Eesti Arst 2008; 87(5):347−35
Polymorphisms in the interleukin-10 gene cluster are possibly involved in the increased risk for major depressive disorder
<p>Abstract</p> <p>Background</p> <p>Innate immune inflammatory response is suggested to have a role in the pathogenesis of major depressive disorder (MDD). Interleukin (IL)-10 family cytokines IL-10, IL-19, IL-20, and IL-24 are all implicated in the inflammatory processes and polymorphisms in respective genes have been associated with various immunopathological conditions. This study was carried out to investigate whether single-nucleotide polymorphisms (SNPs) in these genes are also associated with MDD.</p> <p>Methods</p> <p>Case-control association study was performed with seven SNPs from the <it>IL10 </it>gene cluster. 153 patients with MDD and 277 healthy control individuals were recruited.</p> <p>Results</p> <p>None of the selected SNPs were individually associated with MDD. The linkage disequilibrium (LD) analysis indicated the existence of two recombination sites in the <it>IL10 </it>gene cluster, thus confirming the formerly established LD pattern of this genomic region. This also created two haplotype blocks, both consisting of three SNPs. Additionally, the haplotype analysis detected a significantly higher frequency of block 2 (<it>IL20 </it>and <it>IL24 </it>genes) haplotype TGC in the patients group compared to healthy control individuals (P = 0.0097).</p> <p>Conclusion</p> <p>Our study established increased risk for MDD related to the <it>IL20 </it>and <it>IL24 </it>haplotype and suggests that cytokines may contribute to the pathogenesis of MDD. Since none of the block 2 SNPs were individually associated with MDD, it is possible that other polymorphisms linked to them contribute to the disease susceptibility. Future studies are needed to confirm the results and to find the possible functional explanation.</p
sleep quality and more common sleep- related problems in medical students. Sleep Med.
Abstract Background and purpose: The aim of this paper is to conduct a survey based on a questionnaire that would characterize nighttime and daytime habits in medical students; to estimate how subjective sleep quality is associated with nighttime and daytime habits and sleep problems in students; to estimate how academic progress and workload is associated with subjective sleep quality, nighttime and daytime habits and sleep problems in students; and to estimate the prevalence of self-reported sleep problems in Estonian medical students. Patients and methods: The study group included 413 medical students of the University of Tartu, aged 19-33 years. The self-reported Sleep and Daytime Habits Questionnaire (S&DHQ) covered demographic characteristics (4 questions) and sleep and daytime habits (24 questions). Of the latter, 18 multiple-choice questions provided answers expressed as discontinuous variables on a nominal scale, 4 questions provided answers expressed as continuous variables on an interval scale, and 2 questions provided answers expressed as quality characterization on a five-point scale. The supplement includes information about lifestyle and academic progress on a four-point scale. Results: The S & DHQ could be used to study sleep problems in young medical students. The subjective sleep quality of students was as follows: excellent-29%; good-40%; satisfactory-24%; poor 6%; very poor-1%. Sleep quality is associated with academic progress (RZ 0.174; P!0.001), leisure activity (RZ0.210; P!0.001), and living conditions (RZ0.195; P!0.001). Sleep quality is not associated with students' daily (RZ0.021; PO0.05) or nightly workload (RZ0.0664; PO0.05). Daytime sleepiness poses a significant problem for students and is associated both with sleep disorders and work while studying. Conclusions: The study demonstrates that complaints about sleep problems are common in young medical students.
Soluble interleukin-2 receptor and tumor necrosis factor levels in depressed patients in Estonia
Several studies have reported immune system alterations in depressed patients. Furthermore, correlations between some interleukins and specific depressive symptoms have been found, but results are ambiguous. It might be caused by heterogeneous patient population and concomitant administration of antidepressants. The aim of our study was to look at differences in the levels of soluble interleukin-2 receptor (sIL-2R) and tumor necrosis factor-α (TNFα) between currently depressed patients with first or recurrent episode of depression, patients in full remission and healthy controls. Secondly, we looked for correlations between sIL-2R and TNFα and different depressive symptoms. A total of 75 medication-free currently depressed patients (76% of females), 17 patients in the full remission phase of major depression (58.8% of females), and 55 healthy controls (58.2% of females) participated in this study. The results showed that the level of sIL-2R was significantly lower in depressed patients in remission phase compared to the healthy controls and subjects with recurrent depression. Drug-naï ve patients with major depressive disorder with recurrent episode had higher levels of sIL-2R than previously treated or patients with the first episode. TNFα levels were higher in drug-naï ve patients with major depressive disorder with recurrent episode compared with previously treated patients. Further analysis of patients revealed that sIL-2R was positively correlated with decreased activity and agitation. TNFα was associated with decreased activity and suicidality