Neurobiology of Suicidal Behaviour.

Neurobiology of suicidal behaviour.

Filed under: Depression Treatment

Psychiatr Danub. 2012 Oct; 24 Suppl 3: 336-41
Pjevac M, Pregelj P

It is known that suicidal behaviour has multiple causes. If triggers could be mainly attributed to environmental factors, predisposition could be associated with early stressors on one side such as childhood adversities and genetic predisposition. No convincing animal model of suicide has been produced to date. The study of endophenotypes has been proposed as a good strategy to overcome the methodological difficulties. However, research in suicidal behaviours using endophenotypes entrails important methodological problems. Further, serotoninergic system was studied in patients with suicidal behaviour primary due to its involvement of serotonin in impulsive-aggressive behaviour, which has been shown to be a major risk factor in suicidal behaviour. Not only on the level of neurotransmitters but also the regulation of neurotropic factors could be impaired in suicide victims. Multiple lines of evidence including studies of levels of BDNF in blood cells and plasma of suicidal patients, postmortem brain studies in suicidal subjects with or without depression, and genetic association studies linking BDNF to suicide suggest that suicidal behaviour may be associated with a decrease in BDNF functioning. It seems that especially specific gene variants regulating the serotoninergic system and other neuronal systems involved in stress response are associated with suicidal behaviour. Most genetic studies on suicidal behaviour have considered a small set of functional polymorphisms relevant mostly to monoaminergic neurotransmission. However, genes and epigenetic mechanisms involved in regulation of other factors such as BDNF seem to be even more relevant for further research.
HubMed – depression


Psychiatric disorders in neurology.

Filed under: Depression Treatment

Psychiatr Danub. 2012 Oct; 24 Suppl 3: 331-5
Sinanovi? O

Psychiatric disorders (PDs) in neurology are more frequent then it verified in routine exam, not only in the less developed but also in large and very developed neurological departments. Furthermore, psychiatric symptoms (PSs) in neurological disorders (NDs) among primary health care physicians and other specialties are often neglected. Anxiety and depression are most common, but hallucinations, delusions, obsessive-compulsive disorder and delirium or confusional state are also frequent comorbidity in many neurological conditions such as stroke, epilepsy, multiple sclerosis (MS), Parkinson disease (PD). Depression and NDs also have a bidirectional relationship, as not only are patients, for example with stroke at greater risk of developing depression, but patients with depression have a two-fold greater risk of developing a stroke, even after controlling for other risk factors. Dementia or cognitive impairment are part of clinical picture of PD, stroke patients, patients with MS, Huntington disease etc. The prototype of dementia in PD and other NDs is a dysexecutive syndrome with impaired attention, executive functions and secondarily impaired memory. So-called “functional” (or psychogenic or hysterical/conversion) symptoms are relatively infrequent in “neurological” conditions, but very often unrecognized and not properly treated. Treatment of PSs in neurology, basically are not different then treatment of these symptoms in psychiatry and should be include pharmacotherapy and psychiatry. This presentation gives an overview of frequency and type of PSs underlying necessity to recognize these disorders in every day routine exam and properly treatment.
HubMed – depression


Frequency of Bipolar Affective Disorder in Patients with Major Depressive Episode with or without Psychiatric Co-Morbid Disorders.

Filed under: Depression Treatment

Psychiatr Danub. 2012 Oct; 24 Suppl 3: 321-5
Ku?ukali? A, Bravo-Mehmedbaši? A, Kulenovi? AD

Epidemiological studies indicate that only 20% of patients with Bipolar Affective Disorder are diagnosed on time while in 35% of patients diagnosis is 10 years late. Unipolar depression represents the most frequent misdiagnosis.The aim of this study was to determine the frequency of BAD in subjects diagnosed with Major Depressive Episode with or without co-morbid disorders.The study was a part of a large international, multi-center, non-interventional study that was conducted in 14 countries between May and November 2008. Sample in Bosnia and Herzegovina included 200 adult subjects with MDE according to the DSM IV diagnostic criteria who consented to take part in the study, who did not exhibit symptoms of acute somatic condition at the time, and who were capable of filling the HCL-32 checklist.The following assessment instruments were used: CRF (Case Report Form) that includes general psychiatric assessment, GAF (Global Assessment of Functioning) and HCL-32 (Hypomania Symptom Checklist).Bipolar Affective Disorder was diagnosed in 67.84% of the study subjects, and MDE in 32.16%. At least one co-morbid psychiatric disorder was present in 77.78% of subjects with BAD and in 22.22% of subjects with MDE. Anxiety disorders co-morbidity was present in 61.9% of subjects with BAD and in 38.10% of subjects with MDE.Our results confirm previous research about underdiagnosing of BAD. This has unforeseen consequences on the course and prognosis of the disorder significantly affecting quality of life of the patients.
HubMed – depression



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