Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 6 Articles
Background: The group-based CBT intervention, the Adolescent Coping with Depression Course (ACDC), has previously\nbeen evaluated within a quasi-experimental design, showing reduction in depressive symptoms compared to a\nbenchmark of similar studies. The aim of our study was to investigate the effectiveness of ACDC within a randomized\ncontrolled (RCT) design.\nMethod: Thirty-five course/control leaders randomly assigned to provide ACDC or usual care (UC) recruited 133\nadolescents allocated to ACDC and 95 to UC. ACDC participants received eight weekly sessions and two followup\nsessions about 3 and 6 weeks after the last session. UC participants received usual care as implemented at the\ndifferent sites. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale\nfor adolescents (CES-D), perfectionism with the revised version of the Dysfunctional Attitude Scale (DAS), and\nrumination with the revised version of the Ruminative Responses Scale (RRS). Attrition was considered missing at\nrandom (MAR) and handled with a full information maximum likelihood (FIML) procedure.\nResults: Intention to treat analysis (ITT), including baseline scores and predictors of missing data as control or\nauxiliary variables, showed a small to medium reduction in depressive symptoms for the ACDC group compared\nto UC (d = -.31). Changes in perfectionism and rumination in favor of the intervention were also significant.\nSensitivity analyses confirmed the findings from the ITT analyses.\nConclusions: The current study supports the effectiveness of this group-based CBT intervention. The intervention can\nhopefully result in clinically significant reductions in symptoms associated with depression among adolescents....
Purpose. Changes in calbindin (CB) expression have been reported in patients with temporal lobe epilepsy (TLE) with controversial\nimplications on hippocampal functions. The aim of this study was to determine the CB immunoreactivity in hippocampal dentate\ngyrus of patients who underwent epilepsy surgery for drug-resistant TLE with and without comorbid depression and/or memory\ndeficits. Methods. Selected hippocampal samples from patients with TLE who underwent epilepsy surgery were included. Clinical\nand complementary assessment: EEG, video-EEG, MRI, psychiatric assessment (structured clinical interview, DSM-IV), and\nmemory assessment (Rey auditory verbal learning test, RAVLT; Rey-Osterrieth complex figure test, RCFT), were determined\nbefore surgery. Hippocampal sections were processed using immunoperoxidase with the anti-calbindin antibody. The\nsemiquantitative analysis of CB immunoreactivity was determined in dentate gyrus by computerized image analysis (ImageJ).\nResults. Hippocampal sections of patients with TLE and HS (n = 24) and postmortem controls (n = 5) were included. A\nsignificant reduction of CB+ cells was found in patients with TLE (p < 0 05, Studentâ??s t-test). Among TLE cases (n = 24),\ndepression (n = 12) and memory deficit (n = 17) were determined. Depression was associated with a higher % of cells with the\nCB dendritic [removed]CB-sprouted cells) (F 1, 20 = 11 81, p = 0 003, hp2 = 0 37), a higher CB+ area (micro m2) (F 1, 20 = 5 33,\np = 0 032, hp2 = 0 21), and a higher optical density (F 1, 20 = 15 09, p = 0 001, hp2 = 0 43) (two-way ANOVA). The GAF scale\n(general assessment of functioning) of DSM-IV inversely correlated with the % of CB-sprouted cells (r = -0 52, p = 0 008) and\nwith the CB+ area (r = -0 46, p = 0 022). Conclusions. In this exploratory study, comorbid depression was associated with a\ndifferential pattern of CB cell loss in dentate gyrus combined with a higher CB sprouting. These changes may indicate granular\ncell dysmaturation associated to the epileptic hyperexcitability phenomena. Further investigations should be carried out to\nconfirm these preliminary findings....
Background: Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes,\nand leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable\nbiopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some\ncharacteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and\nother diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected\nof having PCNSL.\nCase presentation: This report documents a woman who presented with a three-month history of numbness\nand weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed\ndemyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of\nNerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced\nscanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF\nrevealed a high protein level and CSF cytology detected abnormal cells, PCNSL was eventually presumed\naccording to positive CSF cytology and cytological detection of the cerebrospinal fluid flow.\nConclusions: PCNSL is a highly invasive tumour. With the development of technologies such as cerebrospinal\nfluid cytology and flow cytology, CSF analysis has become one of the definite diagnosis methods, and the\ntumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene\nrearrangement testing also provide objective evidence....
Background: Neuropsychiatric symptoms (NPS) are very common in patients with mild cognitive impairment (MCI)\nand Alzheimerâ??s disease (AD) dementia and are associated with various disadvantageous clinical outcomes including a\nnegative impact on quality of life, caregiver burden, and accelerated disease progression. Despite growing evidence of\nthe efficacy of (non)pharmacological interventions to reduce these symptoms, NPS remain underrecognized and\nundertreated in memory clinics. The BEhavioural symptoms in Alzheimerâ??s disease Towards early Identification and\nTreatment (BEAT-IT) study is developed to (1) investigate the neurobiological etiology of NPS in AD and (2) study the\neffectiveness of the Describe, Investigate, Create, Evaluate (DICE) approach to structure and standardize the current care\nof NPS in AD. By means of the DICE method, we aim to improve the quality of life of AD patients with NPS and their\ncaregivers who visit the memory clinic. This paper describes the protocol for the intervention study that incorporates\nthe latter aim.\nMethods: We aim to enroll a total of 150 community-dwelling patients with MCI or AD and their caregivers in two\nwaves. First, we will recruit a control group who will receive care as usual. Next, the second wave of participants will\nundergo the DICE method. This approach consists of the following steps: (1) describe the context in which NPS occur, (2)\ninvestigate the possible causes, (3) create and implement a treatment plan, and (4) evaluate whether these interventions\nare effective. Primary outcomes are the quality of life of patients and their caregivers. Secondary outcomes include NPS\nchange, caregiver burden, caregiversâ?? confidence managing NPS, psychotropic medication use, the experiences\nof patients and caregivers who underwent the DICE method, and the cost-effectiveness of the intervention.\nConclusions: This paper describes the protocol of an intervention study that is part of the BEAT-IT study and\naims to improve current recognition and treatment of NPS in AD by structuring and standardizing the detection\nand treatment of NPS in AD using the DICE approach....
Anxiety in Parkinsonâ??s disease (aPD) is underdiagnosed, undertreated, and understudied. As many as 50% of persons diagnosed\nwith Parkinsonâ??s disease (PD) are reported to suffer from anxiety. Current treatment is largely pharmacologic, which can result\nin a myriad of undesirable and unsafe side effects. The aim of this paper is to examine intervention studies of self-managed\nnonpharmacological strategies for the treatment of anxiety. A comprehensive review was conducted on experimental or quasiexperimental\ntrials that included self-management approaches for the nonpharmacologic treatment of anxiety as a primary or\nsecondary aim or outcome measure. Thirteen studies were identified from four databases. Study quality demonstrated variability\nin design and delivery of self-managed interventions; sample sizes were small; anxiety was most commonly a secondary aim;\nand the use of anxiety measures varied widely. Statistical significance was evident in slightly more than 50% of the anxiety\nintervention studies. A common element in the interventions in all studies was the focused use of breath. Further research is\nneeded to determine the feasibility of using focused breathing, alone, as an intervention for the self-management of anxiety in\nParkinsonâ??s disease....
Background: The main objectives of the mobile Psychiatric Emergency Services (PES) in the Netherlands are to\nassess the presence of a mental disorder, to estimate risk to self or others, and to initiate continuity of care,\nincluding psychiatric hospital admission. The aim of this study was to assess the associations between the level of\nsuicidality and risk of voluntary or involuntary admission in patients with and without a personality disorder who\nwere presented to mobile PES.\nMethods: Observational data were obtained in three areas of the Netherlands from 2007 to 2016. In total, we\nincluded 71,707 contacts of patients aged 18 to 65 years. The outcome variable was voluntary or involuntary\npsychiatric admission. Suicide risk and personality disorder were assessed by PES-clinicians. Multivariable regression\nanalysis was used to explore associations between suicide risk, personality disorder, and voluntary or involuntary\nadmission.\nResults: Independently of the level of suicide risk, suicidal patients diagnosed with personality disorder were less\nlikely to be admitted voluntarily than those without such a diagnosis (admission rate .37 versus .46 respectively).\nHowever, when the level of suicide risk was moderate or high, those with a personality disorder who were\nadmitted involuntarily had the same probability of involuntary admission as those without such a disorder.\nConclusions: While the probability of voluntary admission was lower in those diagnosed with a personality\ndisorder, independent of the level of suicidality, the probability of involuntary admission was only lower in those\nwhose risk of suicide was low. Future longitudinal studies should investigate the associations between (involuntary)\nadmission and course of suicidality in personality disorder....
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