New Molecular Targets for Antidepressant Drugs

Major depressive disorder (MDD) is a common and severe mental disorder that is usually recurrent and has a high risk of suicide. This disorder manifests not only with psychological symptoms but also multiple changes throughout the body, including increased risks of obesity, diabetes, and cardiovascular disease. Peripheral markers of oxidative stress and inflammation are elevated. MDD is therefore best described as a multisystem whole-body disease. Pharmacological treatment with antidepressants usually requires several weeks before the desired effects manifest. Previous theories of depression, such as the monoamine or neurogenesis hypotheses, do not explain these characteristics well. In recent years, new mechanisms of action have been discovered for long-standing antidepressants that also shed new light on depression, including the sphingolipid system and the receptor for brain-derived neurotrophic factor (BDNF).

Phenomenological description of PTSD through a case

Post-traumatic stress disorder (PTSD) is a severe mental disorder described only by operational criteria, without a proper dialectic essential analysis. In this study, we present a typical PTSD case with psychotic features, describing his living world through the domains of Heideggerian ontological-existential constituents –spatiality, temporality, corporeity and interpersonality (being-with-others). A phenomenological reduction and diagnostic elaboration was then performed. An essence of pervasive fear, that locks all intentionality and taints the entire being-in-the-world is described as the main characteristic of PTSD. The differential diagnosis is then discussed through a temporal perspective, showing essential differences among Bipolar Disorder, Schizophrenia and Persistent Delusional Disorder. We stand for a return to phenomenology, and its use to diagnosis and disorder description as a way to improve diagnostic validity and reliability.

Occupational Therapy in the Process of Recovering from Severe Mental Disorder

Background Severe mental disorder (SMD) produces a significant functional limitation that affects the performance of daily activities. This limitation is where the occupational therapist intervenes by seeking greater autonomy of these patients through specific activities. This study aims to identify the main limitations of people with SMD and see whether an occupational intervention has any effect in helping to overcome or ameliorate these limitations.Method An experimental study consisting of 103 subjects was carried out, where an evaluation was given before and after the intervention. The tool used is called the WHODAS questionnaire included in the DSM 5.Results Within the programming of activities, those with a higher attendance rating during cognitive stimulation, cooking workshop, therapeutic walks, relaxation, and creative activities were mainly men. The results showed that both patients and professionals indicated that Understanding and Communicating, Participation in Society, and Activities of Daily Living were the main perceived limitations. Upon discharge, both patients and professionals saw positive outcomes. Conclusion The intervention programs carried out by Occupational Therapy, along with the other aspects of the treatment that the patients with SMI have received, have played a part in improving the performance and occupational interests of the patients.

Mental disorder and PTSD in Syria during wartime: a nationwide crisis

AimsSyria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees.MethodThis is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors.ResultOur study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores.ConclusionThe conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.

Community Based Pasung Release on Schizophrenia

Schizophrenia is a severe mental disorder, persistent, chronic, easy to relapse. Schizophrenics at risk of becoming victims of pasung. Confinement is any form of limitation of movement of people with mental illness by families and/or communities. The government has launched the program to end pasung, but the incidence of pasung in the community is still quite high. Liberation of community-based pasung includes prevention of pasung, handling of pasung and rehabilitation of post-pasung. The method of community-based pasung release at the rehabilitation stage that is widely used is Assertive Community Treatment (ACT) and has been proven to reduce recurrence and hospitalization rates in schizophrenics so as to reduce the incidence of pasung and prevent re-pasung.