Topical issues of interaction of psychotropic drugs

2021 ◽  
pp. 27-38
Author(s):  
Artur Udalisovich Karimov ◽  
Maxim Leonidovich Maximov ◽  
Dmitry Germanovich Semenikhin ◽  
Linar Arturovich Karimov
Keyword(s):  
Mental Disorders ◽  
Psychotropic Drugs ◽  
Review Article ◽  
Internal Organs ◽  
Pharmacodynamic Interactions ◽  
Number Of Patients ◽  
The Central Nervous System ◽  
Practical Information ◽  
Somatic Diseases ◽  
Qualitative Changes

In mental patients with concomitant somatic pathology, psychotropic drugs are prescribed in combination with other drugs used in the treatment of various somatic diseases. As well as a large number of patients with somatic diseases, they receive therapy aimed at correcting mental disorders. At the same time, it is important to take into account the possibility of cross-influence of such pharmacotherapy on the functions of the central nervous system and internal organs, as well as the peculiarities of drug interactions between drugs. According to the mechanism of development, there are pharmaceutical, pharmacokinetic and pharmacodynamic interactions of drugs. The result of the interaction of drugs is more often a change in the intensity of the effect of drugs, less often there are qualitative changes in their action. The review article provides up-to-date practical information on the interaction of drugs for the treatment of mental disorders with drugs of other groups.

scholarly journals Non-Oncological Neuroradiological Manifestations in NF1 and Their Clinical Implications

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1831
Author(s):  
Camilla Russo ◽  
Carmela Russo ◽  
Daniele Cascone ◽  
Federica Mazio ◽  
Claudia Santoro ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Structural Organization ◽  
Neurofibromatosis Type ◽  
Review Article ◽  
Tumor Suppressor Protein ◽  
Clinical Implications ◽  
Nf1 Gene ◽  
The Central Nervous System

Neurofibromatosis type 1 (NF1), the most frequent phakomatosis and one of the most common inherited tumor predisposition syndromes, is characterized by several manifestations that pervasively involve central and peripheral nervous system structures. The disorder is due to mutations in the NF1 gene, which encodes for the ubiquitous tumor suppressor protein neurofibromin; neurofibromin is highly expressed in neural crest derived tissues, where it plays a crucial role in regulating cell proliferation, differentiation, and structural organization. This review article aims to provide an overview on NF1 non-neoplastic manifestations of neuroradiological interest, involving both the central nervous system and spine. We also briefly review the most recent MRI functional findings in NF1.

scholarly journals Cognitive Behavioral Therapy of Patients with Somatic Symptoms—Diagnostic and Therapeutic Difficulties

2021 ◽  
Vol 10 (14) ◽  
pp. 3159
Author(s):  
Agata Orzechowska ◽  
Paulina Maruszewska ◽  
Piotr Gałecki
Keyword(s):  
Mental Health Problems ◽  
Mental Disease ◽  
Behavioral Therapy ◽  
Physical Symptoms ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Diagnostic Dilemma ◽  
Number Of Patients ◽  
Psychological Element ◽  
Somatic Diseases

In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the “owner” of the sick organ but is considered and treated as a “whole”. The interpenetration of somatic manifestations with mental health problems forces patients who experience subjective suffering, including mental suffering, from current symptoms to visit specialists from different fields of medicine, and their treatment does not bring about any improvement. Cognitive behavioral psychotherapy (CBT) is one form of therapy that attempts to respond to the needs of an increasing—in recent years—number of patients who demonstrate somatic disorders of a multifaceted nature. The co-occurrence of physical and mental disorders repeatedly makes it impossible to determine which symptoms were the cause and which were the effect; hence, it is difficult to establish clear boundaries between the categories of these disorders and diseases. The therapist, to whom the patient with somatic diseases is eventually referred, may be faced with a diagnostic dilemma, the solution of which will give direction to further psychotherapeutic work. The common feature of this group of patients is a strong focus on physical ailments, while omitting or almost completely ignoring the psychological factors involved. The purpose of this paper is to present the causally diverse circumstances in which a patient with physical symptoms needs diagnosis and therapeutic support from the perspective of a cognitive behavioral approach.

scholarly journals Enriching CBT by Neuroscience: Novel Avenues to Achieve Personalized Treatments

2020 ◽  
Author(s):  
Kristoffer N T Månsson ◽  
Ulrike Lueken ◽  
Andreas Frick
Keyword(s):  
Mental Disorders ◽  
Common Mental Disorders ◽  
Behavioral Therapy ◽  
Therapy Outcomes ◽  
Efficient Treatment ◽  
Related Research ◽  
Number Of Patients ◽  
Key Topics ◽  
Selection Of ◽  
The Way

Abstract Although cognitive behavioral therapy (CBT) is an established and efficient treatment for a variety of common mental disorders, a considerable number of patients do not respond to treatment or relapse after successful CBT. Recent findings and approaches from neuroscience could pave the way for clinical developments to enhance the outcome of CBT. Herein, we will present how neuroscience can offer novel perspectives to better understand (a) the biological underpinnings of CBT, (b) how we can enrich CBT with neuroscience-informed techniques (augmentation of CBT), and (c) why some patients may respond better to CBT than others (predictors of therapy outcomes), thus paving the way for more personalized and effective treatments. We will introduce some key topics and describe a selection of findings from CBT-related research using tools from neuroscience, with the hope that this will provide clinicians and clinical researchers with a brief and comprehensible overview of the field.

Mental Disorders and the Use of Psychotropic Drugs in an 85-Year-Old Urban Population

1993 ◽  
Vol 5 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Ingmar Skoog ◽  
Lars Nilsson ◽  
Sten Landahl ◽  
Bertil Steen
Keyword(s):  
Drug Therapy ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Mental Disorder ◽  
Psychotropic Drug ◽  
Psychotropic Drugs ◽  
Urban Population ◽  
Depressive Disorders ◽  
Psychotic Disorders ◽  
Antidepressant Drug

The prevalence of mental disorders was studied in a representative sample of 85-year-old living in Gothenburg, Sweden, (n=494). All subjects were examined by a psychiatrist, whose diagnoses were defined according to the DSM-III-R criteria. In the sample, the prevalence of dementia was 29.8%, and of any other mental disorder was 24.3%. Psychotic disorders were present in 4.7%, depressive disorders in 12.6%, and anxiety disorders in 10.5%. Anxiety disorders were more common in women than in men. Of all subjects, 42.5% used a psychotropic drug (men 30.1%, women 47.6%, p<0.001), 34.2% used anxiolytic-sedatives, 14.0% used antidepressants, and 5.7% used neuroleptics. Women used significantly more anxiolytic-sedatives and antidepressants than did men. Of those with no mental disorders, 29.1% used a psychotropic drug. Although the prescription of psychotropic drugs was high, only one fifth of those with depressive disorders received antidepressant drug therapy and one tenth of those with psychotic disorders received neuroleptics.

scholarly journals The Impact of Debt Burden on the Number of Suicides in the Russian Regions

2021 ◽  
Vol 17 (4) ◽  
pp. 97-117
Author(s):  
Svetlana Doroshenko ◽  
◽  
Olga Sanaeva ◽  
◽  
Keyword(s):  
Mental Disorders ◽  
Unemployment Rate ◽  
Rural Areas ◽  
Negative Impact ◽  
Generalized Method Of Moments ◽  
Russian Regions ◽  
Debt Burden ◽  
Suicide Rates ◽  
Number Of Patients ◽  
The Impact

Population size is one of the most important parameters of national social and economic systems. This parameter is controlled by a variety of factors (components) that form ambiguous and complex feedback circuits. The most important issue is the study of the behavioral reactions of the population, which form certain parameters of the dynamics of the population. The authors consider only one behavioral reaction that seems to them to be important – the propensity for suicide, which ultimately leads to the formation of the suicide dynamics and which entails serious socio-economic and demographic losses. We put an emphasis on assessing the impact of financial parameters, namely households’ debt burden, on the suicide rates in the Russian regions. An econometric assessment of the influence of individual debt on the number of suicides among other socio-economic factors (unemployment rate, logarithm of GRP per capita, divorce rate, number of patients with mental disorders, average actual working week, number of alcoholics) was carried out for the regions among rural, urban populations and total. We use panel data for 80 Russian regions covering the period from 2005 to 2018. We apply the generalized method of moments (GMM) using Stata 14 statistical package. The empirical analysis demonstrates negative impact of the amount of individual debt on the number of suicides in the regions of Russia, which contradicts the results of similar studies conducted for developed economies. At the same time, some results obtained earlier in domestic and foreign studies have been confirmed, including an existence of a parabolic (U-shaped) dependence between the length of working hours and the suicide rates in the regions of the Russian Federation. In addition, there is a direct connection between an increase in the committed suicides and an increase in divorce rates and the number of patients with mental disorders. Moreover, we find out that the rise in unemployment rate and alcohol consumption leads to an increase in the number of committed suicides. This effect is especially perceptible among the people living in rural areas

Psychiatric Consultations with Depressed Medical Inpatients: A Randomized Controlled Cost-Effectiveness Study

1989 ◽  
Vol 18 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Michiel W. Hengeveld ◽  
Frans A. J. M. Ancion ◽  
Harry G. M. Rooijmans
Keyword(s):  
Cost Effectiveness ◽  
Mental Disorders ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Effectiveness Study ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Consult Group ◽  
Medical Inpatients ◽  
Cost Effectiveness Study

Nonspecific, supportive psychiatric consultations were performed with a random sample of thirty-three general medical inpatients scoring thirteen or more on the Beck Depression Inventory. The control group consisted of thirty-five patients, matched for sex, marital status, somatic history, and seriousness of illness. The number of patients receiving no analgesic and/or psychotropic medication in the consult group (39%) was significantly greater than that in the control group (17%). When compared with their mean BDI score on admission, the BDI score just before discharge had decreased significantly in the consult group (from 20 to 13), but not in the control group (from 19 to 16). Probably because the patient sample was too heterogeneous, with too low a prevalence of mental disorders (45%), a significant reduction in other medical care expenditures and in length of hospital stay could not be demonstrated.

Сellular and Molecular Mechanisms of Proinflammatory Monocytes Participation in the Pathogenesis of Mental Disorders. Part 3

Psychiatry ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 125-134
Author(s):  
E. F. Vasilyeva ◽  
O. S. Brusov
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mental Disorders ◽  
Molecular Mechanisms ◽  
Microglial Cells ◽  
Inflammatory Reactions ◽  
Mental Diseases ◽  
The Central Nervous System ◽  
The Brain

Background: at present, the important role of the monocyte-macrophage link of immunity in the pathogenesis of mental diseases has been determined. In the first and second parts of our review, the cellular and molecular mechanisms of activation of monocytes/macrophages, which secreting proinflammatory CD16 receptors, cytokines, chemokines and receptors to them, in the development of systemic immune inflammation in the pathogenesis of somatic diseases and mental disorders, including schizophrenia, bipolar affective disorder (BAD) and depression were analyzed. The association of high levels of proinflammatory activity of monocytes/macrophages in patients with mental disorders with somatic comorbidity, including immune system diseases, is shown. It is known that proinflammatory monocytes of peripheral blood, as a result of violation of the integrity of the hematoencephalic barrier can migrate to the central nervous system and activate the resident brain cells — microglia, causing its activation. Activation of microglia can lead to the development of neuroinammation and neurodegenerative processes in the brain and, as a result, to cognitive disorders. The aim of review: to analyze the results of the main scientific studies concerning the role of cellular and molecular mechanisms of peripheral blood monocytes interaction with microglial cells and platelets in the development of neuroinflammation in the pathogenesis of mental disorders, including Alzheimer’s disease (AD). Material and methods: keywords “mental disorders, AD, proinflammatory monocytes, microglia, neuroinflammation, cytokines, chemokines, cell adhesion molecules, platelets, microvesicles” were used to search for articles of domestic and foreign authors published over the past 30 years in the databases PubMed, eLibrary, Science Direct and EMBASE. Conclusion: this review analyzes the results of studies which show that monocytes/macrophages and microglia have similar gene expression profiles in schizophrenia, BAD, depression, and AD and also perform similar functions: phagocytosis and inflammatory responses. Monocytes recruited to the central nervous system stimulate the increased production of proinflammatory cytokines IL-1, IL-6, tumor necrosis factor alpha (TNF-α), chemokines, for example, MCP-1 (Monocyte chemotactic protein-1) by microglial cells. This promotes the recruitment of microglial cells to the sites of neuronal damage, and also enhances the formation of the brain protein beta-amyloid (Aβ). The results of modern studies are presented, indicating that platelets are involved in systemic inflammatory reactions, where they interact with monocytes to form monocyte-platelet aggregates (MTA), which induce the activation of monocytes with a pro inflammatory phenotype. In the last decade, it has been established that activated platelets and other cells of the immune system, including monocytes, detached microvesicles (MV) from the membrane. It has been shown that MV are involved as messengers in the transport of biologically active lipids, cytokines, complement, and other molecules that can cause exacerbation of systemic inflammatory reactions. The presented review allows us to expand our knowledge about the cellular and molecular aspects of the interaction of monocytes/macrophages with microglial cells and platelets in the development of neuroinflammation and cognitive decline in the pathogenesis of mental diseases and in AD, and also helps in the search for specific biomarkers of the clinical severity of mental disorder in patients and the prospects for their response to treatment.

Prevalence of psychiatric disorders among patients with Multiple Sclerosis: a cross-sectional study.

2020 ◽  
Author(s):  
Michał Błachut ◽  
Anna Rebeka Szczegielniak ◽  
Krzysztof Świerzy ◽  
Magdalena Zając- Tarska ◽  
Katarzyna Kubicka-Bączyk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Underlying Disease ◽  
Psychiatric Evaluation ◽  
Cross Sectional ◽  
Mini International Neuropsychiatric Interview ◽  
Sociodemographic Data ◽  
Number Of Patients

Abstract Background: Multiple Sclerosis is one of the leading autoimmune disorders causing disability among young adults. Various types of mood, affect, and behaviour disorders along with cognitive impairment can be manifested in a course of MS, with affective and anxiety disorders being the most prevalent. Mental health challenges, in addition to the neurological burden of MS, significantly affect quality of life and the course of the underlying disease. Objective: The aim of this work was to determine the prevalence of mental disorders in a sample of MS patients during outpatient treatment in Zabrze, Poland, with a focus on those with mood and anxiety disorders, and to compare the results obtained in these groups with clinical and sociodemographic data. Method: The study was conducted between 2017 and 2018 on 103 MS patients of the Neurological Outpatient Clinic of the Medical University of Silesia Hospital No.1 in Zabrze, Poland. During the study, sociodemographic data were collected, as well as the type and course of the underlying disease, comorbidities, and medicines used. The MINI-international neuropsychiatric interview and a psychiatric examination were utilized to assess the occurrence of mental disorders. Result: 68% of all patients received a psychiatric diagnosis at some point in their life with only 4% having been hospitalized before; 49.5% met the diagnostic criteria for various psychiatric disorders. Measured by the MINI International Neuropsychiatric Interview, 33% of patients reported a past episode of major depression while 8.7% met the criteria for a current episode. The same number of patients admitted ongoing treatment due to recurrent depressive disorder. In regards to anxiety disorders, the most common was generalized anxiety disorder (10.7%), followed by agoraphobia (8.7%), panic disorder (7.8%), and social phobia (4.9%). Most of the patients (94.2%) at the time of the psychiatric evaluation presented a low level of suicide risk, while 1.9% of the patients presented a medium risk, and 3.9% - a high risk. Conclusion(s): The study confirmed a significantly higher prevalence of mental disorders among MS patients; thus, the psychiatric state of patients in this group should be investigated systematically, simultaneously with the assessment of their neurological state. Trial registration: N/A Key words: Multiple Sclerosis, psychiatric disorders, comorbidity, psychiatric care, clinical characteristics.

Somatic diseases and suicidal behaviour

2021 ◽  
pp. 321-332
Author(s):  
Elsebeth Stenager ◽  
Egon Stenager ◽  
Annette Erlangsen
Keyword(s):  
Mental Disorders ◽  
Suicidal Behaviour ◽  
Children And Youth ◽  
Medical Settings ◽  
Physical Conditions ◽  
Pain Syndromes ◽  
The Us ◽  
Somatic Disorders ◽  
Somatic Diseases ◽  
Different Parts

The association between somatic disorders and suicidal behaviour has been examined in many studies. Despite large variation in quality and study design, recent studies have improved our knowledge substantially, not only regarding the extent of risk but also factors influencing the risk. Most studies have been conducted in European countries, the US, Australia, Japan, and South Korea. A series of studies have examined suicide risk in relation to somatic disorders of older persons, while others addressed somatic disorders and attempted suicide in children and youth. Physical conditions may play an important role in medical settings, regardless of whether mental disorders are present or not, though especially when mental disorders are present. This chapter presents a review of present knowledge on suicide and suicidal behaviour in selected somatic disorders and pain syndromes, with a focus on studies from different parts of the world.

Old Age Mental Disorders in Newcastle-upon-Tyne

1965 ◽  
Vol 111 (479) ◽  
pp. 939-946 ◽  
Author(s):  
R. F. Garside ◽  
D. W. K. Kay ◽  
Martin Roth
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Social Isolation ◽  
Physical Disability ◽  
Normal Subjects ◽  
Functional Disorder ◽  
Income Status ◽  
Number Of Patients ◽  
Missing Items ◽  
Newcastle Upon Tyne

An earlier paper (Kay, Beamish and Roth, 1964b) described 26 features that differentiated significantly between mentally normal and functionally ill subjects over the age of 65, or between normals and those with organic mental illness. These features were found to fall into four main groups concerned with (i) physical disability, (ii) social isolation, (iii) personality deviation, (iv) social and income status. Many of the features appeared clearly to be inter related, but to an unknown degree, and this complicated the interpretation of the results. In the hope of shedding some light on this problem, a factorial analysis of 34 features, including most of the 26 previously described, was carried out. Because of missing items, the number of patients was reduced by 27 to 267, consisting of 152 mentally normal subjects, 88 subjects with functional illness, and 27 with organic mental illness. This report is complementary to the two previous articles (Kay, Beamish and Roth, 1964a, 1964b), in which the method of selecting the subjects and the definitions of organic and functional disorder are fully described.

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