Depression Treatment: Diagnosis, Assessment and Management of Delusional Jealousy in Parkinson’s Disease With and Without Dementia.
Diagnosis, assessment and management of delusional jealousy in Parkinson’s disease with and without dementia.
Filed under: Depression Treatment
Neurol Sci. 2012 Dec 30;
Perugi G, Poletti M, Logi C, Berti C, Romano A, Del Dotto P, Lucetti C, Ceravolo R, Dell’osso L, Bonuccelli U
Patients with Parkinson’s disease (PD) may present delusional jealousy (DJ). In a previous cross-sectional prevalence study we identified 15 cognitively preserved and five demented PD patients with DJ. The current study aimed at evaluating their clinical (motor and non-motor) characteristics and the pharmacological treatments associated with DJ, and its subsequent pharmacological management. Patients were assessed by neurologists and psychiatrists using the Hoehn and Yahr scale, the Unified Parkinson’s Disease Rating Scale, the Brief Psychiatric Rating Scale, the Beck Depression Inventory, the Hamilton Anxiety Scale and the Neuropsychiatric Inventory. Efficacy of DJ management was evaluated in follow-up visits. All patients were in therapy with dopamine agonists. A subgroup of five cognitively preserved patients developed DJ after a short period of treatment of therapy with dopamine agonists, while other patients developed DJ after a longer period of dopaminergic treatment. Psychiatric comorbidities were common in cognitively preserved and in demented patients. The pharmacological management included the interruption of dopamine agonists in two patients and the reduction of dopamine agonist dose plus the use of antipsychotics in other patients. These clinical data suggest that the management of medicated PD patients should include investigation for the presence of DJ and the evaluation of clinical characteristics potentially relevant to the prevention or the early recognition of delusions.
HubMed – depression
Coloanal anastomosis or abdominoperineal resection for very low rectal cancer: what will benefit, the surgeon’s pride or the patient’s quality of life?
Filed under: Depression Treatment
Int J Colorectal Dis. 2012 Dec 30;
Digennaro R, Tondo M, Cuccia F, Giannini I, Pezzolla F, Rinaldi M, Scala D, Romano G, Altomare DF
PURPOSES: Sphincter-saving operation with coloanal anastomosis (CAA) has become an established option for very low rectal cancer, but few studies have compared its functional results and quality of life (QoL) with abdominoperineal resection (APR) showing controversial results. PATIENTS AND METHODS: Patients treated for low rectal cancer with APR or CAA, disease-free after a median follow-up period of 26.5 (8-84) and 52.5 (12-156) months, respectively, were retrospectively reviewed. General and disease-specific changes in QoL and severity of disease were evaluated by Karnofsky scale, EORTC-C30, EORTC-CR38, SF-36, PGWBI, FIQL, PAC-QoL, ICIQ-SF, Stoma-QoL, AMS, Wexner’s score and obstructed defecation syndrome (ODS) score. RESULTS: Twenty-six APR patients and 34 CAA patients entered the study. Karnofsky score did not show significant differences. The median Stoma-QoL was 58.2 (45-76.6), indicating a good stoma function in 95 % of patients. EORTC-C30, CR38, PGWBI and SF-36 questionnaires did not show significant differences between the two groups except for sexual function (better after CAA, p?=?0.01). Eleven patients after APR and eight after CAA had urinary incontinence, and its severity did not differ significantly. Eighteen of 21 CAA patients complained of faecal incontinence [AMS, 80 (15-120); Wexner, 13 (2-19)] with an impact on their QoL [FIQL: lifestyle, 1.75 (0-4); coping/behaviour, 1.3 (0-3.5); depression, 2.1 (0-5.2); embarrassment, 2 (0-4.6)] and 11 complained of obstructed defecation [7.5 (3-16)] with significant consequences on QoL [PAC-QoL, 30.4 (19.2-80.3)]. CONCLUSIONS: QoL in patients with permanent stoma and in those after CAA did not differ significantly. APR patients had worse sexual function, while most CAA patients had faecal incontinence and sometime obstructed defecation, with important impact on their QoL.
HubMed – depression
Health-Related Fitness, Body Mass Index, and Risk of Depression among Adolescents.
Filed under: Depression Treatment
Med Sci Sports Exerc. 2012 Dec 27;
Rieck T, Jackson A, Martin S, Petrie T, Greenleaf C
The Centers for Disease Control and Prevention indicates that depression is a serious issue for teenagers with 10 to 15% reporting some symptoms and 15% having considered attempting suicide in 2009. PURPOSE: To determine the relations between cardiorespiratory fitness and body mass index (BMI) and depressive symptoms among young adolescents. METHODS: The sample included 531 females and 455 males in grades 6 to 8. The FITNESSGRAM® physical fitness test battery was administered to the participants as part of required school activities. Two results from the test battery, cardiorespiratory fitness and BMI, were used to classify the students in meeting or not meeting healthy fitness zones (HFZ) established for each test. The Center for Epidemiological Studies-Depression Scale (CES-DC) was administered in the schools to assess behavioral and cognitive aspects of depression. Participants were classified as elevated depression (CES-DC ? 16, n = 295) or normal (< 16, n = 691). RESULTS: Logistic regression was used to assess the relations of Health Fitness Zone status for cardiorespiratory fitness and BMI with depression while controlling for age, ethnicity, gender, economic status (school lunch support), and the other fitness factor (cardiorespiratory fitness or BMI). Children classified as not in the Health Fitness Zone for cardiorespiratory fitness had significantly higher odds of elevated depression (OR = 1.71 (95% CI = 1.03 - 2.84). BMI was not significantly related to depression. CONCLUSION: These findings indicate that a healthy level of cardiorespiratory fitness was associated with a lower level of depression as measured by the CES-DC. Due to the cross sectional nature of this study, no cause and effect relations can be assumed. HubMed – depression
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