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Depressive symptoms, age at diagnosis and a clinically defined metabolic syndrome as independent correlates of glycemic control in patients with type 2 diabetes mellitus

Author(s): Elias Andreoulakis,Thomas Hyphantis,Apostolos Iacovides,Dimitrios Kandylis,John G. Yovos,Ioannis Nimatoudis / Language(s): English Issue: 6/2015

Objective: The findings concerning the association of metabolic syndrome (MetS) and depression with glycemic control are controversial. Recently, age at type 2 diabetes mellitus (T2DM) diagnosis has attracted particular attention but the relevant findings are limited. This study aimed to further assess the association between age at T2DM diagnosis, depressive symptoms and MetS with glycemic control in T2DM patients. Methods: In 116 T2DM patients we assessed disease-related and MetS-related variables as well as depressive symptom severity (Center for Epidemiological Studies-Depression scale - CES-D). Glycemic control, as assessed by glycated hemoglobin (HBA1c) levels, was the dependent variable. Results: Suboptimal HBA1c levels, i.e. 7% (53 mmol/mol) or higher, were found in 35.3% of the patients. Elevated CES-D scores indicative of clinically relevant depressive symptoms (CES-D≥16) or possible major depression (CES-D>23) where found in 31.9% and 11.2% of the patients, respectively. Younger age at T2DM diagnosis (p=0.004), greater treatment intensity (p=0.009), higher levels of depressive symptoms (p=0.011) and the presence of a clinically defined MetS (p=0.012) were the variables independently associated with glycemic control in multiple regression analysis after adjusting for sex, education, marital status, family history of diabetes and disease duration. Conclusion: In T2DM patients, the linear association found between depressive symptom severity and glycemic control points to the need of depressive symptoms being timely addressed. Younger age at T2DM onset may also be an important correlate of suboptimal glycemic control, independent of disease duration. Finally, classification of MetS in T2DM by clinical severity might help delineate its impact on glycemic control.

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The special subtypes of déjà vu (part 3)

Author(s): Vernon M. Neppe / Language(s): English Issue: 6/2015

Subjective psi experience (SPE) is a non-prejudicial term allowing non-prejudicial analysis. The qualitative nosological subtype of SPE déjà vu involves distinct qualities: This grows, is intense, often frequent, and specifically involves time distortions past and future with predictive elements and a specific knowing.

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Understanding déjà vu: explanations, mechanisms and the ‘normal’ kind of déjà vu (Part 2)

Author(s): Vernon M. Neppe / Language(s): English Issue: 6/2015

The 72 different proposed explanations for déjà vu are examined. Broadly 50 were hypothesized before 1979 and another 22 were brought forward thereafter. These show the many explanations for the concept, but they do not illustrate the scientific mechanisms with which to approach déjà vu. These explanations may ultimately express themselves phenomenologically in a limited number of ways and these explanations may commonly overlap.

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Human errors may explain a false epide prescription pain medication overdose deaths

Author(s): Alen J Salerian / Language(s): English Issue: 1/2016

This study reviews the validity of a public perception promoted by Centers Control that prescription pain medications have contributed to an epidem deaths and illicit use of heroin. No scientific evidence has been found to su causative link between prescription pain medications and an epidemic of deaths and illicit use of heroin. The study results suggest highly complex m medical and psychosocial influences to be predominant in the increasing overdose deaths.

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The new focus on theistic psychotherapy

Author(s): Leon James / Language(s): English Issue: 2/2016

The historical intellectual spectrum of psychology and clinical psychiatry is rooted in naturalism or materialism, which requires that mental and emotional disorders be attributed to natural causes in a way similar to what has been done in medicine for the physical body. In the past decade there has been an intensified resurgence of the attempt to expand the intellectual base of psychology and psychopathology beyond what has been allowed so far by psychology’s adoption of strict empiricism and the scientific method1,2 has decried the endorsement of materialism in psychology and psychiatry, which has resulted in the inability to consider the legitimacy of purely mental issues such as psychic forces that influence consciousness, or the patient’s relationship to God. These psychic forces are defined as having an independent existence, apart from the physical world and its material forces. These mental activities are called “spiritual” or “transcendent”, besides others.

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Obesity and mental illness: a bidirectional pathogenesis!

Author(s): Adel Zaraa / Language(s): English Issue: 2/2016

The surgeon general of the USA released in 2010 “A vision for a healthy and fit nation” and reported that the prevalence of obesity changed relatively little during the 1960s and 1970s, but it increased sharply over the ensuing decades-from 13.4% in 1980 to 34.3% in 2008 among adults and from 5% to 17% among children during the same period. The prevalence of extreme obesity also increased during 1976-1980 and 2007-2008, and approximately 6% of U.S. adults now have a BMI of 40 kg/m2 or higher. Obesity poses a major public health challenge. Each year, obesity contributes to an estimated 112,000 preventable deaths.

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TSH screening practice in psychiatric inpatient unit at hmc, in Qatar-a quality improvement project

Author(s): Adel Zaraa,Alaa M. Taha,Mahmoud Aborabeh,Mahmoud Midany / Language(s): English Issue: 5/2016

The relationship between TSH and psychiatric illness is a well known although understudied field in Psychiatry. In a study done in India by Radhakrishnan et al., abnormal thyroid hormonal status was found in 29% of patients with schizophrenia 23.2 % in patients with mood disorders had abnormal TSH.1 Meanwhile a study in Poland showed that the prevalence of thyroid dysfunction was higher in mood disorders. Hu LY et al., explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders and they found that patients with hyperthyroidism were more likely to develop bipolar disorder.These studies demonstrate the importance of thyroid function in the development of various disorders.

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Vitamin B12 screening at the psychiatric inpatient unit at HMC, Qatar quality improvement project

Author(s): Adel Zaraa,F. Kamal Lolwa,Mahmoud Aborabeh,Mahmoud Midany / Language(s): English Issue: 5/2016

Background and purpose Vitamin B12 has been the subject of numerous studies since the discovery of vitamin B compounds in 1974. It is essential for optimal neurological functioning and its deficiency results in neurological and psychiatric diseases, ranging from mild presentations of numbness and tingling to severe mood and cognitive impairment. This is demonstrated in Penninx et al., a prospective cohort study with a sample of 700 disabled, non-demented community-dwelling women with low B12 levels had a twofold risk of severe depression. The findings are consistent with the results of The Rotterdam study, a population-based study that reported that elderly persons with a deficiency in vitamin B12 levels are more likely to have depression. Similarly, a link between depression and low B12 has been reported in Jae-Min Kim et al., indicating that it may be a risk factor for late onset depression.

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Screening pattern of valproate level on admission to psychiatric unit in patients receiving the medication: quality improvement project

Author(s): Adel Zaraa,Mahmoud Aborabeh,Mahmoud Midany / Language(s): English Issue: 5/2016

The estimated lifetime prevalence of bipolar I and II disorders in general population is 3.7%- 3.9 % in recent epidemiological studies. Based on APA guidelines for management of bipolar disorder, the first-line pharmacological treatment for more severe manic or mixed episodes is the initiation of lithium plus an antipsychotic or valproate plus an antipsychotic. For less ill patients, monotherapy with lithium, valproate, or an antipsychotic such as olanzapine may be sufficient and the initial treatment for patients who experience rapid cycling should include lithium or valproate.

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Folate screening pattern at the psychiatric inpatient unit at hmc, qatar-quality improvement project

Author(s): Adel Zaraa,Lolwa F. Kamal,Mahmoud Aborabeh,Mahmoud Midany / Language(s): English Issue: 5/2016

Current studies have emphasized the importance of Folate and Its crucial role in basic metabolic processes including methylation, synthesis of DNA and complex cellular interactions, where its deficiency may lead to impaired monoamine metabolism, contributing to a myriad of neuropsychiatric disorders. These have been explored in different studies by Bottiglieri T et al., in patients with depression and dementia. Accumulating evidence shows a link between low folate levels and depression. A study in Finland of middle-aged men found that individuals with low dietary folate intake were more prone to present with depressive symptoms, and in another study with members from the US population detected low folate levels in its depressed subjects. In another study, the Sacramento Area Latino Study on Aging (SALSA), Marisa et al., found an association between low folate and depression in their subjects.

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Is ketamine infusion a safe, effective treatment alternative to combat depression?

Author(s): Scott W Stern / Language(s): English Issue: 3/2015

At low, sustained dosage, Ketamine Infusion is said to be more effective for those who have been unsuccessful with more conventional anti-depressant medications. http://www.ketamineinfusioncenters. com/treating-depression “In New York City, Dr. Glen Brooks has been working with Ketamine Infusion Depression Treatment for many years and founded NY Ketamine Infusions. According to Brooks, “Ketamine has a well established history as a general anesthetic agent. Recent advances have proven Ketamine to have additional benefits as a treatment for chronic pain and depression. Sub anesthetic doses are often effective when other treatments have been less successful.”

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Depression may be a complication of various brain disorders: neuroimaging evidence

Author(s): Alen J Salerian / Language(s): English Issue: 4/2015

Depression is a complex multifactorial psychiatric disorder affecting a large number of people. The heightened risk of suicide and economic burden make depression a major health concern.1 Compelling data suggest that higher mental functions, executive function, awareness, planning, strategic thinking, initiative and processing sensory input are the domain of prefrontal cortex function and in particular Bradman areas 8,9,10,42 and 46.2 It is noteworthy that the core depression symptoms of diminished joy, energy, self-confidence, problem-solving ability and ability to make strategic plans are also manifestations of diminished prefrontal cortex function.

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Working with a suicidal client

Author(s): Irene Christofidou / Language(s): English Issue: 5/2015

Suicide is a topic that even at the sounding of it alarms everyone. It takes the lives of more than 30,000 Americans each year. Researchers are trying to identify all the risk factors which will help prevent suicide and save some people. Conte & Plutchik2 correlated 41 factors with suicide. It is difficult though to prevent it due to the unpredictability of human nature. Nevertheless below are some of the most common factors in order to determine whether a client is suicidal. Age is a major risk factor. White males above 65years old are at risk. Then 15years old up to 24years old is another risk age, especially when there are prior attempts and if the child is a college student, where the pressure of academic demands, social interaction problems and career choices elevate the risk of committing suicide.3 In children, 10 to 14years old suicide is rare but if it happens, is due to the loss of a parent, abuse or psychopathology.3 Although, age is an important factor, gender also provides information. Males usually do a complete suicide, whereas females have more attempted suicides.

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Dysfunctional metacogntive beliefs in body dysmorphic disorder

Author(s): Zahra Zeinodini,Sahar Sedighi,Mandana Baghertork Rahimi,Simasadat Noorbakhsh,Sepideh Rajezi Esfahani / Language(s): English Issue: 5/2015

The present study aims to examine the correlation of body dysmorphic disorder, with metacognitive subscales, metaworry and thought-fusion. The study was conducted in a correlation framework. Sample included 155 high school students in Isfahan, Iran in 2013-2014, through convenience sampling. To gather data about BDD, Yale-Brown Obsessive Compulsive Scale Modified for BDD was applied. Then, Meta Cognitive Questionnaire, Metaworry Questionnaire, and Thought-Fusion Inventory were used to assess metacognitive subscales, metaworry and thought-fusion. Data obtained from this study were analyzed using Pearson correlation and multiple regressions in SPSS 18. Result indicated YBOCS-BDD scores had a significant correlation with scores from MCQ (P<0.05), MWG (P<0.05), and TFI (P<0.05). Also, multiple regressions were run to predict YBOCS from TFI, MWQ, and MCQ-30. These variables significantly predicted YBOCS F (3,151) =32.393, R2=0.57. Findings indicated that body dysmorphic disorder was significantly related to metacognitive subscales, metaworry, and thought fusion in high school students in Isfahan.

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The diagnostic work-up of eating disorders

Author(s): Magnus Sjogren / Language(s): English Issue: 5/2015

Background: The mortality of Anorexia Nervosa (AN) is the highest among all psychiatric disorders, and Eating Disorders (ED) overall pose serious health threats to a significant proportion of the population. In spite of an increasing recognition of the clinical impact of ED, often, the general readiness and knowledge of the diagnostic work-up among Physicians is insufficient. Material and method: A literature search of recent national and international scientific publications on the diagnostic work-up of ED was done in November 2015. PUBMED was the major source of information, but also known publications were utilized to collate the relevant information. Result: The result is presented as essential components in the diagnostic work-up, where potential relevant clinical findings such as e.g. eating behaviours, co-morbidities, laboratory findings, medical risk and risk of suicidality, are all necessary to enable an accurate diagnosis as part of a multilayered clinical problem description, in the diagnosis of ED. Discussion: Early and accurate diagnosis of ED will enable prompt initiation of relevant treatment. This is most optimally served by a multilayered clinical problem description, where the clinical diagnosis is one part, together with several other clinical aspects, of the diagnosis of ED.

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OCCUPATIONAL THERAPIST PRACTITIONERS’ PERCEPTIONS OF CONTINUING EDUCATION FOR NEUROREHABILITATION: A QUALITATIVE STUDY

Author(s): Terrell Kane,Blair Carsone / Language(s): English Issue: 1/2024

Occupational therapists are required to obtain CE units to ensure professional competency. This study examined occupational therapy practitioners to understand: What are OTPs’ perceived challenges and CE needs when working with populations with neurological impairments? And how can CE courses be tailored towards addressing these challenges and gaps in knowledge effectively? There were 14 responses and 6 themes identified. Participants indicated if they had access to supportive resources as well as their preferred mode of delivery for CE. The findings of this study can be used to identify the preferences, specific clinical skillsets currently used, and gaps in supportive resources.

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COMPREHENSIVE EDUCATIONAL-REHABILITATION APPROACH IN A PERSON POST-STROKE: A CASE STUDY

Author(s): Alma Glinac / Language(s): English Issue: 1/2024

A stroke occurs due to a disruption in brain circulation, leading to partial or complete loss of motor, sensory, perceptual, or cognitive abilities. This can result in disability and reduced rehabilitation potential. Therefore, the approach to working with individuals who have experienced a stroke is crucial, adapting to their individual needs in a holistic manner. In this context, the aim of this study was to present a comprehensive rehabilitation approach for an 88-year-old patient following a stroke through the implementation of educationalrehabilitation treatment, achieving gradual improvements in the recovery process. Tests such as the Mini-Mental State Examination, Motor Evaluation Scale for Upper Extremity in Stroke patients, The Barthel Index for Activities of Daily Living, Aphasic Depression Rating Scale, and The Modified Rankin Scale were applied to assess the set goal. The educationalrehabilitation treatment was conducted daily for 45 minutes, for two months within clinical rehabilitation and nine months in home conditions. The treatment was based on the principles of brain neuroplasticity and motor learning, involving cognitive training, motor training, adaptive skills training, relaxation, education and counseling, motivational training, and the promotion of metacognitive abilities. The research data underwent analysis through descriptive statistics, and the findings were visually illustrated in graphical representations. Based on the obtained results, it can be concluded that there is noticeable functional progress in the patient across all evaluated areas.

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INTERDISCIPLINARY APPROACH TO PSYCHOTHERAPY THROUGH NEUROSCIENCE

Author(s): Meliha Bijedić,Zlatko Ercegović / Language(s): English Issue: 1/2024

This paper analyses the connection between psychotherapy and neuroscience, exploring existing literature and research findings on this topic. It focuses on the fundamental principles of researching psychotherapy within the framework of neuroscience, investigating the mental correlates of psychotherapy. Psychotherapy provides deep insight into patients' unconscious processes and the necessity of reconstructing latent memories within the therapeutic environment. The relationship between therapist and patient creates a new affective configuration that enables the reinterpretation of implicit memories, with neuronal changes reflecting psychic transformations. By integrating with neuroscientific research, it provides the opportunity to analyse the impact of other scientific disciplines on psychotherapeutic practice and ensures the integration of complex psychotherapeutic concepts with perspectives from other scientific fields. This interdisciplinary approach enriches the discipline of psychotherapy, successfully incorporating new insights from various areas of science. The connection of different scientific disciplines reflects the improvement of understanding complex dynamics of the mind and encourages further research and application in the field of psychotherapy and neuroscience.

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THE USE OF ROBOTIC REHABILITATION IN THE TREATMENT OF MOTOR IMPAIRMENTS IN CHILDREN WITH CEREBRAL PALSY – A SYSTEMATIC REVIEW AND META-ANALYSIS

Author(s): Denis Arsovski,Aleksandra Karovska Ristovska,Goran Ajdinski,Olivera RASHIKJ-CANEVSKA / Language(s): English Issue: 2/2024

Cerebral palsy is a neurological disorder affecting motor function in children with cerebral palsy and requires new rehabilitation perspective beyond traditional pediatric treatments. Robotic-assisted gait training and other assistive devices as methods of robotic rehabilitation became popular as a way to improve motor function in pediatric patients with cerebral palsy. This meta-analysis evaluated the effectiveness of robotic rehabilitation on motor impairments in children with cerebral palsy, focusing on functional outcomes like gait, balance and gross motor skills. PubMed, Embase, Cochrane Library, Scopus and Web of Science databases were searched and research papers were included up to 2024. Studies with robotic interventions for children with cerebral palsy were included using the PICOS criteria. The primary outcome was to evaluate the improvement in motor function by measuring gross motor skills and gait parameters. Data analysis used effect size calculation, I² statistic for heterogeneity, Egger test and funnel plot analysis for publication bias, as well as meta regression analysis. This review included 56 research papers. Robotic-assisted rehabilitation showed improvements in motor skills, walking speed, balance and functional mobility with robotic-assisted gait training being the most effective. Moderate heterogeneity was I²=52% and no publication bias was found through this review. Robotic rehabilitation with focus on robotic-assisted gait training is showing improvements in motor function for children with cerebral palsy and has many advantages over traditional rehabilitation methods by allowing controlled repetitive training. Future research should focus on continuous outcomes and optimization protocols to assure that robotic-assisted rehabilitation is relevant to the field of pediatric neurorehabilitation.

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Opraštanje kao kognitivna, emocionalna, motivacijska i ponašajna promjena – procesni i višedimenzijski psihološki konstrukt

Author(s): Tanja Radionov / Language(s): Croatian Issue: 2/2024

In interpersonal relationships, people sometimes hurt one another, which often causes reactions of avoidance or revenge but also opens the possibility of forgiveness. Forgiveness plays a vital role in people's lives; it affects the overall health and quality of interpersonal relationships. The aim of the paper is a general presentation of insights in the field of the psychology of forgiveness. Forgiveness is defined as a cognitive, emotional, motivational, and behavioural change from negative to positive and as a processual and multidimensional psychological construct. There are several leading theories of forgiveness and measuring instruments for forgiveness. Research has established a positive connection between forgiveness and physical and mental health. Long-term individual processual intervention models focused on forgiveness are very effective and have found clinical application in psychoeducation and counselling. In conclusion, it is important to encourage positive social interactions and effective strategies in relationships, such as forgiveness.

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