Depression Treatment: Impaired Social Cognition in Multiple Sclerosis.
Impaired social cognition in multiple sclerosis.
Filed under: Depression Treatment
J Neurol Neurosurg Psychiatry. 2013 Jan 11;
Pöttgen J, Dziobek I, Reh S, Heesen C, Gold SM
BACKGROUND: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder of the CNS that is frequently associated with neuropsychiatric symptoms and decreased quality of life. Social support, which has been found to buffer the psychosocial burden of MS, critically depends on intact social cognition. Here we assess social cognition in patients with MS using a naturalistic video based test and explore if potential deficits in theory of mind (ToM) occur independently of known MS associated neuropsychiatric symptoms, such as depression and cognitive impairment. METHODS: 45 outpatients with clinically definite MS and 45 age, sex and education matched healthy control subjects (HCs) underwent standardised testing using the Movie for the Assessment of Social Cognition. MS patients also completed a neuropsychological battery. RESULTS: MS patients showed significantly impaired ToM compared with HCs. Impairments were more pronounced in identification of emotions than in identification of thoughts or intentions. Significantly lower ToM compared with HCs was detected in MS patients during the early disease stages, with limited disability and without substantial neuropsychological deficits. CONCLUSIONS: These results suggest impaired social cognition in MS. Importantly, ToM impairments in this group may not simply be a consequence of the well known neuropsychological deficits. Difficulties with correctly identifying emotions, thoughts and intentions in social situations may result in interpersonal problems and could contribute to the psychosocial burden of MS.
HubMed – depression
Short report: is there anything distinctive about epileptic deja vu?
Filed under: Depression Treatment
J Neurol Neurosurg Psychiatry. 2013 Jan 11;
Warren-Gash C, Zeman A
BACKGROUND: Déjà vu can occur as an aura of temporal lobe epilepsy and in some psychiatric conditions but is also common in the general population. It is unclear whether any clinical features distinguish pathological and physiological forms of déjà vu. METHODS: 50 epileptic patients with ictal déjà vu, 50 non-epileptic patients attending general neurology clinics and 50 medical students at Edinburgh University were recruited. Data were collected on demographic factors, the experience of déjà vu using a questionnaire based on Sno’s Inventory for Déjà Vu Experiences Assessment, symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale as well as seizure characteristics, anti-epileptic medications, handedness, EEG and neuroimaging findings for epileptic patients. RESULTS: 73.5% of neurology patients, 88% of students and (by definition) all epilepsy patients had experienced déjà vu. The experience of déjà vu itself was similar in the three groups. Epileptic déjà vu occurred more frequently and lasted somewhat longer than physiological déjà vu. Epilepsy patients were more likely to report prior fatigue and concentrated activity, associated derealisation, olfactory and gustatory hallucinations, physical symptoms such as headaches, abdominal sensations and fear. After controlling for study group, anxiety and depression scores were not associated with déjà vu frequency. CONCLUSIONS: Déjà vu is common and qualitatively similar whether it occurs as an epileptic aura or normal phenomenon. However ictal déjà vu occurs more frequently and is accompanied by several distinctive features. It is distinguished primarily by ‘the company it keeps’.
HubMed – depression
Do Older Adults Aged 60 to 75 Years Benefit From Diabetes Behavioral Interventions?
Filed under: Depression Treatment
Diabetes Care. 2013 Jan 11;
Beverly EA, Fitzgerald S, Sitnikov L, Ganda OP, Caballero AE, Weinger K
OBJECTIVEIn this secondary analysis, we examined whether older adults with diabetes (aged 60-75 years) could benefit from self-management interventions compared with younger adults. Seventy-one community-dwelling older adults and 151 younger adults were randomized to attend a structured behavioral group, an attention control group, or one-to-one education.RESEARCH DESIGN AND METHODSWe measured A1C, self-care (3-day pedometer readings, blood glucose checks, and frequency of self-care), and psychosocial factors (quality of life, diabetes distress, frustration with self-care, depression, self-efficacy, and coping styles) at baseline and 3, 6, and 12 months postintervention.RESULTSBoth older (age 67 ± 5 years, A1C 8.7 ± 0.8%, duration 20 ± 12 years, 30% type 1 diabetes, 83% white, 41% female) and younger (age 47 ± 9 years, A1C 9.2 ± 1.2%, 18 ± 12 years with diabetes, 59% type 1 diabetes, 82% white, 55% female) adults had improved A1C equally over time. Importantly, older and younger adults in the group conditions improved more and maintained improvements at 12 months (older structured behavioral group change in A1C -0.72 ± 1.4%, older control group -0.65 ± 0.9%, younger behavioral group -0.55 ± 0.1.2%, younger control group -0.43 ± 0.1.7%). Furthermore, frequency of self-care, glucose checks, depressive symptoms, quality of life, distress, frustration with self-care, self-efficacy, and emotional coping improved in older and younger participants at follow-up.CONCLUSIONSThe findings suggest that, compared with younger adults, older adults receive equal glycemic benefit from participating in self-management interventions. Moreover, older adults showed the greatest glycemic improvement in the two group conditions. Clinicians can safely recommend group diabetes interventions to community-dwelling older adults with poor glycemic control.
HubMed – depression
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