Phaeochromocytoma Masquerading as Anxiety and Depression.

Phaeochromocytoma masquerading as anxiety and depression.

Am J Case Rep. 2013; 14: 161-163
Zardawi IM

Patient: Female, 36 Final Diagnosis: Pheochromocytoma Symptoms: Anxiety • depression Medication: – Clinical Procedure: – Specialty: Oncology • endocrinology.Unusual clinical course, Mistake in diagnosis.Pheochromocytoma is a rare catecholamine-producing neuroendocrine tumour with protean clinical manifestations, which can mimic a variety of conditions, often resulting in erroneous and delayed diagnosis.A case of undiagnosed pheochromocytoma in a 36 year old female with a 15 year history of anxiety and depression is described. The patient collapsed while on the phone to the next of kin and stopped breathing. She was initially revived but suffered a cardiac arrest and died. At autopsy an undiagnosed adrenal pheochromocytoma was found.When considering a diagnosis of anxiety and depression, medical causes of the symptoms must be excluded. Common conditions, such as thyroid disorders, stimulant abuse, asthma, cardiac arrhythmias, alcohol withdrawal and rarely pheochromocytoma, causing a similar spectrum of symptoms should be excluded by history and clinical examination. HubMed – depression


Pain, psychological symptoms and prescription drug misuse in HIV: A literature review.

J Pain Manag. 2012 4; 5(2): 111-118
Tsao JC, Plankey MW, Young MA

Pain is a common problem among persons living with HIV. In this population, pain often co-occurs with psychological symptoms, as well as illicit drug abuse. Recently, the misuse of prescription drugs, including the misuse of opioid medications for pain relief, has emerged as a significant public health problem. The purpose of this article is to review the literature on the associations among pain, illicit drug use, and symptoms of depression and anxiety in the misuse of prescription medications in HIV disease.Although relatively little attention has centered on the management of pain, psychological symptoms and other distressing, yet treatable symptoms in HIV, the fact that drug abuse behaviors now constitute a primary risk factor for HIV infection requires a shift in focus for clinicians and researchers alike. There is currently little agreement regarding the medical provision of opioids to persons with a history of illicit drug use. Thus, additional research is required to ensure adequate treatment of pain and psychological symptoms in persons living with HIV while minimizing the risk of prescription drug misuse. HubMed – depression


Emotional Reasoning Processes and Dysphoric Mood: Cross-Sectional and Prospective Relationships.

PLoS One. 2013; 8(6): e67359
Berle D, Moulds ML

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world [1]. Emotional reasoning appears to characterise anxiety disorders. We aimed to determine whether elevated levels of emotional reasoning also characterise dysphoria. In Study 1, low dysphoric (BDI-II?4; n?=?28) and high dysphoric (BDI-II ?14; n?=?42) university students were administered an emotional reasoning task relevant for dysphoria. In Study 2, a larger university sample were administered the same task, with additional self-referent ratings, and were followed up 8 weeks later. In Study 1, both the low and high dysphoric participants demonstrated emotional reasoning and there were no significant differences in scores on the emotional reasoning task between the low and high dysphoric groups. In Study 2, self-referent emotional reasoning interpretations showed small-sized positive correlations with depression symptoms. Emotional reasoning tendencies were stable across an 8-week interval although not predictive of subsequent depressive symptoms. Further, anxiety symptoms were independently associated with emotional reasoning and emotional reasoning was not associated with anxiety sensitivity, alexithymia, or deductive reasoning tendencies. The implications of these findings are discussed, including the possibility that while all individuals may engage in emotional reasoning, self-referent emotional reasoning may be associated with increased levels of depressive symptoms. HubMed – depression


Inflammation’s Association with Metabolic Profiles before and after a Twelve-Week Clinical Trial in Drug-Naïve Patients with Bipolar II Disorder.

PLoS One. 2013; 8(6): e66847
Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Wang YS, Wang LJ, Lee IH, Wang TY, Yeh TL, Yang YK, Hong JS, Lu RB

Inflammation is thought to be involved in the pathophysiology of bipolar disorder (BP) and metabolic syndrome. Prior studies evaluated the association between metabolic profiles and cytokines only during certain mood states instead of their changes during treatment. We enrolled drug-naïve patients with BP-II and investigated the correlation between changes in mood symptoms and metabolic indices with changes in plasma cytokine levels after 12 weeks of pharmacological treatment. Drug-naïve patients (n?=?117) diagnosed with BP-II according to DSM-IV criteria were recruited. Metabolic profiles (cholesterol, triglyceride, HbA1C, fasting serum glucose, body mass index (BMI) and plasma cytokines (TNF-?, CRP, IL-6, and TGF-?) were measured at baseline and 2, 8, and 12 weeks post-treatment. To adjust within-subject dependence over repeated assessments, multiple linear regressions with generalized estimating equation methods were used. Seventy-six (65.0%) patients completed the intervention. Changes in plasma CRP were significantly associated with changes in BMI (P?=?1.7E-7) and triglyceride (P?=?0.005) levels. Changes in plasma TGF-?1 were significantly associated with changes in BMI (P?=?8.2E-6), cholesterol (P?=?0.004), and triglyceride (P?=?0.006) levels. However, changes in plasma TNF-? and IL-6 were not associated with changes in any of the metabolic indices. Changes in Hamilton Depression Rating Scale scores were significantly associated with changes in IL-6 (P?=?0.003) levels; changes in Young Mania Rating Scale scores were significantly associated with changes in CRP (P?=?0.006) and TNF-? (P?=?0.039) levels. Plasma CRP and TGF-?1 levels were positively correlated with several metabolic indices in BP-II after 12 weeks of pharmacological intervention. We also hypothesize that clinical symptoms are correlated with certain cytokines. These new findings might be important evidence that inflammation is the pathophysiology of clinical symptoms and metabolic disturbance in NCT01188148. HubMed – depression