[Prevalence of Mental Disorders in Multimodal Therapy of Chronic Back Pain.]

[Prevalence of mental disorders in multimodal therapy of chronic back pain.]

Filed under: Depression Treatment

Orthopade. 2012 Nov 14;
Artner J, Lattig F, Cakir B, Gündel H, Reichel , Spiekermann JA

Because of its biopsychosocial factors chronic back pain is often resistant to unimodal therapy regimes. Multimodal pain programs are a promising therapy option in the management of chronic pain as they focus on functional restoration. The aim of the study was to evaluate the prevalence of psychopathology in patients with chronic back pain. The study included127 patients suffering from chronic back pain in multimodal inpatient pain therapy who were assessed by a psychologist. A retrospective analysis was performed focusing on the psychological diagnoses. Further factors investigated were age, gender, numeric rating scale (NRS) pain intensity at the beginning and end of the program, hospital anxiety and depression scale (HADS), further psychological treatment recommendations and migration background. Fisher’s exact test was performed to calculate the significance in the different subgroups. The results showed that there was a high prevalence of depression, anxiety disorders and adjustment disorders in patients with chronic back pain. In this cohort the prevalence of depression and anxiety disorders was significantly higher than the estimated prevalence of the normal German population.
HubMed – depression

The role of steroids in the development of post-partum mental disorders.

Filed under: Depression Treatment

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012 Nov 12;
Paskova A, Jirak R, Mikesova M, Adamcova K, Fartakova Z, Horakova V, Koucky M, Hill M, Hruskovicova H, Starka L, Duskova M, Parizek A

BACKGROUND: Unfavorable post-partum changes to mental well-being affect more than half of all women, and are a risk to the health of both mother and baby. Their effects place strains on health and social systems. Currently, no generally accepted theory exists of the causes and mechanisms of post-partum mental disorders. METHODS: Literature search up to 2012, using PubMed and search words: neuroactive steroids, post-partum mental disorders, depression, corticotropin-releasing hormone and estrogens. RESULTS: There are several theories for post-partum depression. One is that autoimmune diseases are involved. Others revolve around genes responsible or that lead to increased disposition to the disorder. It is likely however that the process is associated with the separation of the placenta and the fetal zone of fetal adrenal gland, the main sources of corticotropin-releasing hormone and sexual and neuroactive steroids during pregnancy, and the ability of the receptor system to adapt to these changes. The central nervous system is able to produce neurosteroids, but the drop in levels of peripheral steroids likely leads to a sudden deficit in neuroinhibitory steroids modulating ionotropic receptors in the brain. CONCLUSIONS: Post-partum depression is a multifactorial disease with unknown etiology. It is probably associated with sudden changes in the production of hormones influencing the nervous system, and on the other hand the ability of the receptor system to adapt to these changes. When the relative changes in concentrations of hormones, rather than their absolute levels, is likely more important.
HubMed – depression

Multi-locus genome-wide association analysis supports the role of glutamatergic synaptic transmission in the etiology of major depressive disorder.

Filed under: Depression Treatment

Transl Psychiatry. 2012; 2: e184
Lee PH, Perlis RH, Jung JY, Byrne EM, Rueckert E, Siburian R, Haddad S, Mayerfeld CE, Heath AC, Pergadia ML, Madden PA, Boomsma DI, Penninx BW, Sklar P, Martin NG, Wray NR, Purcell SM, Smoller JW

Major depressive disorder (MDD) is a common psychiatric illness characterized by low mood and loss of interest in pleasurable activities. Despite years of effort, recent genome-wide association studies (GWAS) have identified few susceptibility variants or genes that are robustly associated with MDD. Standard single-SNP (single nucleotide polymorphism)-based GWAS analysis typically has limited power to deal with the extensive heterogeneity and substantial polygenic contribution of individually weak genetic effects underlying the pathogenesis of MDD. Here, we report an alternative, gene-set-based association analysis of MDD in an effort to identify groups of biologically related genetic variants that are involved in the same molecular function or cellular processes and exhibit a significant level of aggregated association with MDD. In particular, we used a text-mining-based data analysis to prioritize candidate gene sets implicated in MDD and conducted a multi-locus association analysis to look for enriched signals of nominally associated MDD susceptibility loci within each of the gene sets. Our primary analysis is based on the meta-analysis of three large MDD GWAS data sets (total N=4346 cases and 4430 controls). After correction for multiple testing, we found that genes involved in glutamatergic synaptic neurotransmission were significantly associated with MDD (set-based association P=6.9 × 10(-4)). This result is consistent with previous studies that support a role of the glutamatergic system in synaptic plasticity and MDD and support the potential utility of targeting glutamatergic neurotransmission in the treatment of MDD.
HubMed – depression

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