Brain biopsy in the diagnosis of Creutzfeldt-Jakob disease with a history of prodromal psychiatric symptoms and catatonic behavior

Creutzfeldt-Jakob disease (CJD) is a neurodegenerative disorder belonging to the group of transmissible spongiform encephalopathies. The transition of physiological, soluble, neuroprotective prion protein PrPc into its insoluble, misfolded isoform PrPSc remains its central pathogenic event. The progressive accumulation of isoform PrPSc within the brain tissue results in spongiform degeneration and a plethora of clinical symptoms. Typically, CJD manifests as progressive dementia with myoclonus, visual or cerebellar dysfunction, pyramidal/extrapyramidal signs or akinetic mutism. However, a growing number of studies indicate that CJD may present with prodromal psychiatric manifestations including anhedonia, anxiety, irritability, depression, insomnia, psychosis and catatonic behavior. We present a case of CJD with a history of prodromal psychiatric symptoms and catatonic behavior diagnosed by brain biopsy

DYADIC ADJUSTMENT AMONG HEALTHY SPOUSES OF BIPOLAR I AND II DISORDER PATIENTS

Background: The aim of the study was to investigate the total dyadic adjustment (including satisfaction, cohesion, consensus and affectional expression) among spouses of bipolar patients with I and II subtypes. Subjects and methods: 82 subjects (46 women/ 36men) were enrolled in the study - 50 spouses of bipolar I (BD I) patients and 32 spouses of bipolar II (BD II) patients. We used an interview, the Dyadic Adjustment Scale (DAS), and a questionnaire including questions concerning basic socio-demographic data, the duration of marriage, as well as information about the patient\u27s illness. Results: The results indicate that BD I is likely to be more disruptive for life-partners and is associated with a lower dyadic adjustment (assessed by the healthy spouse) than BD type II (p≤0.05). There are differences in DAS scales when specific episodes are compared with each other as well (p≤0.01). Also patients\u27 illicit substance use and co-morbidity were significant factors (p≤0.01). Conclusions: We would like to emphasize that bipolar disorder affects marriage (even the healthy spouse) and that its different subtypes (especially type I) as well as additional factors may be associated with significant deterioration of a relationship

Subtypes of interictal depressive disorders according to ICD-10 in patients with epilepsy

Background and purpose The purpose of the study was to evaluate the frequency of interictal depressive symptoms and different subtypes of depressive disorders according to 10th revision of the International Classification of Diseases (ICD-10) criteria in patients with epilepsy and its association with the type of epilepsy. Material and methods 289 outpatients with epilepsy (169 females, 120 males) aged 18–82 years completed Beck Depression Inventory (BDI). Subjects who scored >11 in BDI were further evaluated by the psychiatrist according to the ICD-10 diagnostic criteria. Results 41.9% (121) of the 289 participants scored >11 in BDI. 104 (85.9%) patients who scored >11 in BDI had comorbid mental disorders according to ICD-10 criteria. The most common were organic mood disorders (F06.3 – 31.4%), depressive episode (F32 – 22.3%) and dysthymia (F34.1 – 9.1%) There were no differences in the prevalence of depression and subtypes of depression in patients with certain epilepsy types. Depression was diagnosed before entering the study in only one third of patients with final diagnosis of depression. Conclusions Our results confirm the prevailing view that interictal depression is common in epilepsy patients. Depression remains underrecognized and undertreated in patients with epilepsy

Subtypes of interictal depressive disorders according to ICD-10 in patients with epilepsy

Background and purpose: The purpose of the study was to evaluate the frequency of interictal depressive symptoms and different subtypes of depressive disorders according to 10th revision of the International Classification of Diseases (ICD-10) criteria in patients with epilepsy and its association with the type of epilepsy. Material and methods: 289 outpatients with epilepsy (169 females, 120 males) aged 18-82 years completed Beck Depression Inventory (BDI). Subjects who scored >11 in BDI were further evaluated by the psychiatrist according to the ICD-10 diagnostic criteria. Results: 41.9% (121) of the 289 participants scored >11 in BDI. 104 (85.9%) patients who scored >11 in BDI had comorbid mental disorders according to ICD-10 criteria. The most common were organic mood disorders (F06.3 – 31.4%), depressive episode (F32 – 22.3%) and dysthymia (F34.1 – 9.1%) There were no differences in the prevalence of depression and subtypes of depression in patients with certain epilepsy types. Depression was diagnosed before entering the study in only one third of patients with final diagnosis of depression. Conclusions: Our results confirm the prevailing view that interictal depression is common in epilepsy patients. Depression remains underrecognized and undertreated in patients with epileps