Affective Disorders In Patients Research Articles

Clinical and dynamic features of bipolar affective disorder in patients with chronic coronary artery disease

Introduction. Currently, the study of comorbidity, which is characteristic of the clinical picture of modern patients, is relevant. This also applies to psychiatric disorders in cardiovascular diseases, which are common, affect social functioning and determine the clinical and biological characteristics of patients and prognosis. Bipolar disorder and coronary heart disease are one example of such a comorbidity. Recent evidence suggests that up to 40% of patients with bipolar disorder die from cardiovascular disease.Aim: To study the frequency of bipolar disorders and their clinical and dynamic features in patients with chronic coronary artery disease with the assessment of seven-year survival rates.Material and Methods. Patients with confirmed chronic coronary artery disease, aged 35–70 years, living in Tomsk and the Tomsk Region: the main group (with identified mood disorders, diagnosed by a psychiatrist, n = 262) and the comparison group (without mood or other mental disorders, n = 291). The Hamilton Depression Scale for Seasonal Affective Disorders was used to assess depressive symptoms. The survival tables and Kaplan – Meier methods were used to assess survival, survival curves were compared using the Mantel – Cox logrank test.Results. The frequency of bipolar disorder among hospitalized patients with chronic coronary artery disease was three times higher than that in the population. Depressive symptoms in bipolar disorder did not differ clinically from those in other mood disorders. The prognostic signs indicating the risk of bipolar disorder include: family history with mental disorders, atypical specification of depression, earlier age of onset of depression, high multimorbidity with mental (anxiety disorders, dependence syndrome due to alcohol, nicotine) and physical diseases. According to a retrospective assessment, coronary artery disease in half of the cases developed against the background of bipolar disorder. During the 7-year follow-up period, the number of cases of bipolar disorder doubled compared to the beginning of the study. Patients with bipolar disorder had more frequent acute myocardial infarction and had clinically more significant functional classes of angina pectoris and heart failure.Conclusion. During the 7-year follow-up period, the number of patients with bipolar disorder doubled. Patients with this comorbidity had an unfavorable prognosis in terms of survival (62.5%) compared with individuals without mood disorders.

PSYCHOPATHOLOGY OF EMOTIONAL SPHERE IN PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA AND OBSTRUCTIVE SLEEP APNEA

Obstructive sleep apnea (OSA) is the most common sleep disorder globally. OSA affects 2–6 % of the adult population and 15–26 % of those aged over 70. The main daytime OSA symptoms are daytime sleepiness, decreased mood and concentration. Patients with chronic cerebral ischemia (CCI) often have the same complaints. Although such symptoms characterize emotional and affective disorders, the patients are usually treated by neurologists. The purpose of the study is to identify the characteristics of emotional and affective disorders in patients with chronic cerebral ischemia and obstructive sleep apnea. Materials and Methods. The study involved 45 patients aged 50–78 with CCI, type 1–2. Patients were examined for OSA and underwent cardiorespiratory monitoring. The psychoemotional status of individuals with CCI and OSA was assessed according to HADS, SHAPS, and ESS. Statistical analysis of cardiorespiratory monitoring parameters determined the critical level of average night saturation, at which depressive symptoms are detected. Results. It was found that patients with severe OSA had more severe depressive symptoms and anhedonia, but lower anxiety levels compared with CCI patients without severe OSA. The authors determined critical levels of mean night saturation for development of depression (SpO2avrg<89 %) and clinically significant depression (SpO2avg<87 %). Conclusion. Depression is proved to be the most common emotional disorder in patients with CCI and concomitant OSA. The authors determined critical levels of average night saturation for depressive disorders in patients with CCI type 1–2.

Affective disorders in patients with epilepsy: primary process or consequence of paroxysmal activity?

The high prevalence of primary affective disorders in patients with epilepsy is beyond doubt. However, patients in this group are often identified as suffering from mood disorders that do not fulfil the criteria for primary mood disorders, such as recurrent depressive disorder and bipolar affective disorder. The aim of this paper is to analyze the classification and clinical picture of affective disorders in patients with epilepsy and differential diagnostic approaches to identify primary affective disorders and secondary affective disorders in epilepsy. A set of diagnostic signs for the differential assessment of affective disorders in patients with epilepsy is presented. Research of affective pathology in patients with epilepsy and the development of strategies for its successful treatment are still needed.

System of psychotherapy for patients with schizotypal disorder

Background. A review of the specialized literature gives an idea of the dissociation between the significant prevalence of polymorphic forms of schizotypal disorder and the lack of scientific development of psychotherapy methods for these conditions. Purpose. To develop and test the effectiveness of the system of psychotherapy of affective disorders in patients with schizotypal disorder. Materials and Methods. According to the results of preliminary clinical anamnestic, clinical, psychopathological and psychodiagnostic studies of a contingent of 100 patients with schizotypal disorder with affective disorders of various spectrums, a system of psychotherapy for the phenomena under study was developed. To evaluate the effectiveness of the developed therapeutic measures, we used SF-36 questionnaire for determining quality of life indicators. Results. The developed system of psychotherapy is implemented in two consecutive stages: the first one is aimed at affective manifestations directly, and the second one is aimed at the second stage is aimed at developing patients’ skills of perception of subjective signs of deterioration of the underlying disease. According to the results of the analysis, it was found that patients who received psychotherapeutic treatment within the developed system had significantly (p≤0.001) higher quality of life scores 3 months after the treatment treatment compared to patients who did not receive such support: the total score was 63.83±0.35 and 60.98±0.39 points, respectively. Significant differences were found between the study groups in such components of quality of life as «Life activity», «Social activity», «Social functioning» and «Mental health». Conclusions. A two-stage system of psychotherapy of affective disorders has been developed in patients with schizotypal disorder, based on the principles of personalized medicine, the first stage of which is aimed at the direct reduction of affective disorders, the second – on the acquisition of new skills of self-analysis and detection of indirect signs of deterioration of their condition, which, in combination with adequate psychopharmacologic support allowed to improve their quality of life.

Study of the association of polymorphisms of the folate cycle enzyme gene with the degree of cognitive and affective disorders in patients in the post-covid period

Recently, molecular genetic studies have become widespread, and demonstrated the importance of DNA and histone methylation processes in the epigenetic regulation of gene expression. The aim of this study was to detect the association of polymorphisms of the folate cycle enzyme gene methylenetetrahydrofolate reductase (MTHGFR) with the degree of cognitive and affective disorders and the serum level of homocysteine and folic acid in 41 post-covid patients. Hematological and laboratory indices, serum concentration of C-reactive protein, D-dimer, homocysteine and folic acid were determined. MTHGFR polymorphisms for C677T and A1298C mutations were determined by polymerase chain reaction in real time. According to the MTHGFR C677T genotype variant, the examined patients were divided into 3 groups: 1) 21 persons (male/female 10/11) with homozygous CC genotype; 2) 17 ones (male/female 12/5) with heterozygous CT genotype; 3) 3 persons with a recessive homozygous TT genotype (all men). Six months after the end of the acute phase of the coronavirus disease, patients were surveyed using questionnaires to assess the psycho-emotional state: cognitive function, anxiety and depression. No significant difference was found in the average scores of cognitive function, anxiety and depression in patients of group 1 and 2. Individuals of the group 1 C677C, who had an additional recessive homozygous C1298C mutation (group 1a, n=6), were characterized by an elevated level of homocysteine, which showed a high negative correlation with serum folate (r= -0.95). A small group of individuals with the recessive homozygous T677T genotype (group 3, all men) was distinguished by an older age, the presence of cardiovascular diseases, type 2 diabetes (2 cases out of 3), more severe manifestations of COVID-19, which forces us to pay attention to potentially increased risk of complications in such patients and requires further investigation. Correlation relationships between assessments of cognitive function, anxiety, depression and serum levels of homocysteine and folate in patients with different genotypes of MTHGFR C677T were recorded. Therefore, the use of a molecular genetic approach made it possible to pay attention to the possible predisposition to hyperhomocysteinemia in individuals who have a folic acid deficiency, and different combination of alleles of the MTHGFR gene C677T and A1298C.

Gender specifics of affective disorders in patients with coronary heart diseas (according to screening and psychometric tests)

Aim. To study gender characteristics of affective disorders (prevalence and severity of anxiety and depression) and quality of life in patients with coronary heart disease (CHD) according to screening and psychometric tests.Materials and methods. Five hundred seventy six patients with a verified diagnosis of CHD were tested using the Screening Questionnaire for Affective Spectrum Disorders (SQASD): 385 (67.8 %) men and 191 (33.2 %) women. From the total screening group using, 383 patients were examined with the Beck Depression Inventory (BDI), while examination with the hospital anxiety and depression scale (HADS) included 351 patients with CHD. The quality of life index was determined in 242 patients with CHD using the Modified Seattle Angina Questionnaire (SAQ).Results. In the general group of patients with CHD examined by SQASD, anxiety and depressive disorders (ADD) were diagnosed in 81 %, the absence of ADD – in 19 %, p < 0.0001. In the group of patients examined using SQASD and the BDI scale, the presence of ADD was noted in 78.9 %, the absence – in 21.1 %, p < 0.0001. Screening of patients examined with the BDI scale revealed higher incidence of ADD in women: 95 % vs. 71.5 %, p < 0.0001. The overall score on the HADS anxiety scale in the men’s group was 7.9 ± 4.7, in the women’s group – 10.28 ± 3.9, p < 0.0001, while according the HADS depression scale – 6.32 ± 3.92 and 7.7 ± 4.18, respectively, p < 0.004. The level of depression by BDI scale in the men’s group was 14.07 ± 9.82, in the women’s group – 17.75 ± 8.42, p < 0.0004. Absence of symptoms of depression according the BDI scale was observed more often in the group of men compared with the group of women: 36.9 % and 19.2 %, p < 0.0005. The frequency of severe anxiety (45.8 % and 28.7 %, p < 0.002) and depression (26.2 % and 11.5 %, p < 0.0004) according the HADS was higher in the group of women compared to the group of men. The value of the IUCN quality of life index was higher in the group of men (25.4 ± 7.1 and 22.4 ± 4.8, p < 0.001).Conclusion. In this study, screening of CHD patients using SQASD and psychometric tests (BDI and HADS) has revealed higher incidence of ADD and psychosocial risk factors (anxiety and depression) in the group of women compared with the group of men. The results of screening are generally consistent with the survey data of psychometric tests and QOL indicators.

Transcranial magnetic stimulation and SSRIs in the complex treatment of Parkinson’s disease patients with depressive disorders

Affective disorders in patients with Parkinson's disease (PD) are significantly more common than in the general population in people of the same age. It is known that the ef ficacy of antidepressants in PD patients is lower than in patients with a depressive disorder not associated with PD. Therefore, such patients may take high doses of antidepressants, which is accompanied by side effects manifestations and a decrease in quality of life. Transcranial magnetic stimulation (TMS) is a safe treatment for depressive disorder that has been successfully used in PD patients. The article presents a comparison of the effectiveness of complex therapy with TMS and SSRIs with SSRI monotherapy for the treatment of depressive disorder in PD patient.

Psychosocial and environmental factors influencing affective disorders in patients with alcohol use disorders

Psychosocial and environmental factors influencing affective disorders in patients with alcohol use disorders

Contribution of the μ-opioid receptor system to affective disorders in temporal lobe epilepsy: A bidirectional relationship?

Affective disorders are frequent comorbidities of temporal lobe epilepsy (TLE). The endogenous opioid system has been implicated in both epilepsy and affective disorders, and may play a significant role in their bidirectional relationship. In this cross-sectional study, we investigated the association between μ-opioid receptor binding and affective disorders in patients with TLE. Nine patients with TLE and depression/anxiety underwent 11 C-carfentanil positron emission tomography (CFN PET) and neuropsychiatric assessment, including the Hospital Anxiety and Depression Scale and the Positive and Negative Affect Schedule. The normalized CFN PET scans were compared with those of 26 age-matched healthy controls. Correlation analyses with affective symptoms were performed by region of interest-based analysis focusing on the limbic circuit and orbitofrontal cortex. We observed widely reduced CFN binding potential (BP) in bilateral frontal lobes and striata in patients with TLE compared to healthy controls. In the TLE group, more severe anxiety and negative affect were associated with decreased CFN BP in the posterior cingulate gyrus. In patients with TLE, interictally reduced binding in the opioid system was associated with higher levels of anxiety and negative affect. We speculate that seizure-related agonist-driven desensitization and downregulation of opioid receptors could be a potential underlying pathomechanism.

Depression and Anxiety Symptoms Are Associated with Mean Platelet Volume in Autoimmune Disorders.

Platelets are increasingly considered a bridge between mental and immunological disorders. However, data relating to platelet parameters in patients with autoimmune disorders are limited. The aim of the present study was to investigate, for the first time, the association of platelet parameters with the symptoms of affective disorders in patients with autoimmune conditions. In this cross-sectional study, we measured the complete blood count (CBC), the Generalized Anxiety Disorder Scale for anxiety (GAD-7), and the Beck Depression Inventory for depression (BDI) in 121 patients with autoimmune disorders. Mean platelet volume (MPV) was positively correlated with both anxiety and depression. Platelet distribution width (PDW) was negatively correlated with anxiety and depression. Before adjustment for covariates, logistic regression analysis revealed a significant association of MPV with depression and anxiety. After adjustment for covariates, only depression was associated with MPV. The area under the ROC curve of MPV for GAD-7 determined anxiety and BDI determined depression was 0.63. Our study showed that among the CBC hematological parameters, the MPV might be a useful biomarker of depression and anxiety in patients with autoimmune disorders. Further investigations of platelet parameters in controlled prospective studies are warranted to confirm our preliminary results.

Cognitive dysfunction, pain and affective disorders in patients with Chiari malformation type 1 in the context of reciprocal relationships

BACKGROUND. Chiari malformation type 1 (CM1) is a multicomponent pathology. The CM1 symptom complex has a variable structure within the limits of cerebrospinal fluid, cerebellar, brainstem and spinal disorders. A new component is cognitive dysfunction. Various hypotheses of its formation are discussed. Along with the independent role of CM1 in the development of cognitive dysfunction, great importance is attached to pain and affective disorders.
 AIM. To identify the features of cognitive status in patients with CM1 and to assess the relationship with pain and affective disorders.
 MATERIAL AND METHODS. The study included 110 adult patients with CM1 aged 25.616.9 years. The control group consisted of 50 people aged 26.365.0 years. The assessment of neuroimaging parameters was carried out on an MR tomograph with an induction of a magnetic field of 1.5 T. MMSE, MoCA, and the Trail Making Test were used to assess cognitive status. The pain syndrome was assessed using the SF-MPQ-2-RU questionnaire and the visual analogue scale, assessment of affective disorders HADS and DASS-21.
 RESULTS. Patients with CM1 had significantly lower cognitive indicators. Deficits are found in the domains of executive functioning, visual-spatial skills, attention, delayed recall and speech. The association of cognitive decline and pathognomonic headache for CM1 may indicate the presence of common pathogenic mechanisms. The decisive importance probably belongs to cerebellar dysregulation dysfunction of the universal process of cerebellar transformation. It is assumed that emotional disorders collectively affect the structure of cognitive status, not being the main link in pathogenesis.
 CONCLUSIONS. Patients with CM1 show significant cognitive decline. Cerebellar dysregulation may be a common mechanism underlying cognitive dysfunction and pathognomonic for CM1 headache. Emotional disorders collectively affect the structure of cognitive status, not being the main link in pathogenesis.

Vision-Related Quality of Life and Seasonal Affective Disorder in Patients with Glaucoma and Macular Degeneration.

Seasonal affective disorder (SAD) is characterized by depressive episodes related to changes in the seasons. Patients with severe vision loss are at an increased risk of SAD. This study seeks to determine the extent to which patients with moderate vision loss report symptoms of SAD. In this cross-sectional, comparative case series, the Seasonal Pattern Assessment Questionnaire (SPAQ) and the National Eye Institute Visual Function Questionnaire (VFQ-39) were used to screen 111 patients with age-related macular degeneration (AMD) and/or primary open-angle glaucoma (POAG). A multiple regression analysis was performed to create a predictive model for SAD based on the Global Seasonality Score (GSS) using the VFQ-39. Subjects who reported symptoms of SAD (GSS > 8) had lower vision-related quality of life (composite score: 57.2 versus 73.2, p < 0.001). Exploratory factor analysis revealed that the items on the VFQ-39 split into two distinct dimensions that together accounted for 63.2% of the total variance in the GSS. One group of questions addressed vision-related problems; the other group comprised questions related to the quality of life. Whereas this model successfully identified patients with vision loss at risk of SAD, a model restricted to the questions available on the shorter, widely used VFQ-25 instrument did not reliably identify patients at risk of SAD.

Различия модуляции ответов мозга на эмоциональные стимулы у мужчин и женщин при биполярной депрессии

Study Objective: To investigate the prognostic and therapeutically significant characteristics in neurophysiological reactivity of male and female patients with bipolar depression. Study Design: comparative controlled non-randomized clinical experimental study. Materials and Methods. 53 patients (26 men and 27 women) with bipolar depression were examined before the start of their psychopharmacotherapy. They were aged from 21 to 59 years. There were no significant differences between men and women on the Hamilton Depression and Anxiety Scale. The groups of healthy volunteers included 23 men and 29 women of the corresponding age. The participants sorted the photos, 80 of which were images of angry/aggressive people or animals, and 80 had neutral expressions. Simple figures (keys) were displayed 2 seconds before the pictures, their connection with the photographs was not explained. A 128-channel electroencephalogram was recorded and the brain responses elicited by the keys were analyzed. Differences (p &lt; 0.05) between neutral and emotional conditions were defined as emotional modulation (EM). Study Results. EM differences in male and female patients were more pronounced than in the control groups. In women with bipolar depression, EM was consistently located in the posterior areas of the cortex from 100 ms to the end of the analysis period. The EM for the P100 component was missing, and the EM topography for P200 was closer to normal than in men. The EM of components N170 and P380 in patients differed depending on their sex and differed from EM of healthy controls of the same sex. Conclusions. The EM of the brain activity in patients with bipolar depression differs from the EM of healthy people. The differences depend on the gender of the patient and affect several components of the evoked brain activity. This suggests that it is important to take into account the gender of the subjects when studying affective disorders in patients. Keywords: emotional modulation, high-density EEG, bipolar depression, implicit learning, facial expression, anger.

Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

Cognitive and affective disorders in critical SARS-CoV-2 patients and caregivers

We investigated cognitive and affective disorders in patients with SARS-CoV-2 hospitalized in Intensive Care Unit (ICU). Care givers quality of life, psychological distress and satisfaction with the information received by health-care professionals were assessed.

Contribution of AMPA Receptor-Mediated LTD in LA/BLA-CeA Pathway to Comorbid Aversive and Depressive Symptoms in Neuropathic Pain.

Comorbid anxiety and depressive symptoms in chronic pain are a common health problem, but the underlying mechanisms remain unclear. Previously, we have demonstrated that sensitization of the CeA neurons via decreased GABAergic inhibition contributes to anxiety-like behaviors in neuropathic pain rats. In this study, by using male Sprague Dawley rats, we reported that the CeA plays a key role in processing both sensory and negative emotional-affective components of neuropathic pain. Bilateral electrolytic lesions of CeA, but not lateral/basolateral nucleus of the amygdala (LA/BLA), abrogated both pain hypersensitivity and aversive and depressive symptoms of neuropathic rats induced by spinal nerve ligation (SNL). Moreover, SNL rats showed structural and functional neuroplasticity manifested as reduced dendritic spines on the CeA neurons and enhanced LTD at the LA/BLA-CeA synapse. Disruption of GluA2-containing AMPAR trafficking and endocytosis from synapses using synthetic peptides, either pep2-EVKI or Tat-GluA2(3Y), restored the enhanced LTD at the LA/BLA-CeA synapse, and alleviated the mechanical allodynia and comorbid aversive and depressive symptoms in neuropathic rats, indicating that the endocytosis of GluA2-containing AMPARs from synapses is probably involved in the LTD at the LA/BLA-CeA synapse and the comorbid aversive and depressive symptoms in neuropathic pain in SNL-operated rats. These data provide a novel mechanism for elucidating comorbid aversive and depressive symptoms in neuropathic pain and highlight that structural and functional neuroplasticity in the amygdala may be important as a promising therapeutic target for comorbid negative emotional-affective disorders in chronic pain.SIGNIFICANCE STATEMENT Several studies have demonstrated the high comorbidity of negative affective disorders in patients with chronic pain. Understanding the affective aspects related to chronic pain may facilitate the development of novel therapies for more effective management. Here, we unravel that the CeA plays a key role in processing both sensory and negative emotional-affective components of neuropathic pain, and LTD at the amygdaloid LA/BLA-CeA synapse mediated by GluA2-containing AMPAR endocytosis underlies the comorbid aversive and depressive symptoms in neuropathic pain. This study provides a novel mechanism for elucidating comorbid aversive and depressive symptoms in neuropathic pain and highlights that structural and functional neuroplasticity in the amygdala may be important as a promising therapeutic target for comorbid negative emotional-affective disorders in chronic pain.

From accurate diagnosis to targeted therapy: depression in general medical practice

Objective: to analyze the diagnostic significance of clinical and phenomenological characteristics of affective disorders in patients with chronic somatic pathology.Patients and methods. The analysis included the results of a clinical evaluation of 131 patients with chronic somatic pathology, including 96 patients suffering from cardiovascular diseases and 35 patients with cerebral small vessel disease. Clinical assessment included Primary care evaluation of mental disorders (PRIME-MD) and Hamilton Depression Rating Scale.Results and discussion. Despite the significant frequency and transparent clinical symptoms, general practitioners diagnosed mental disorders in only 30% of patients with depression. We observed a higher prevalence of somatic rather than psychological complaints during the clinical survey. According to the screening using PRIME-MD, 74% of patients were diagnosed with mood disorders, anxiety, and somatoform disorders. We also noted their significant comorbidity with a predominance of a depression and anxiety combination (p &lt; 0.001). Hypertensive patients had the highest depression prevalence (87%) and severity. Moderate depression was the most frequent diagnosis in the study participants, corresponding to major depressive disorder (61.5%).Conclusion. In general, the symptoms of anhedonia, depression, and anxiety were most pronounced in patients with affective disorders. The high prevalence of somatic symptoms complicates depression evaluation. It is possible to highlight depression and anhedonia as significant symptoms for the detection of depression in patients with somatic disorders.

High Prevalence of Post-stroke Anxiety in Elderly Patients Following COVID-19 Outbreak.

Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak.Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic.Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021–5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074–1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215–1.490, P < 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89.Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.

Quality of life, disability level and nutritional status among Multiple sclerosis patients

Background: The most severe form of nervous dysfunction among young individuals is Multiple sclerosis (MS). Symptoms usually appear at (15–40) years of age.MS is identified as an affective disorder in patients for a long time, characterized by current nervous system (NS) injury structure and rising accumulative damage.Recent years have seen a rise in the number of MS. This affects more than two million individuals every year in the world. Methods: Ethical approval for this study was granted by the Ethics Committee for the Medical Research/University of Mosul. This was a retrospective and a hospital-based study performed. In the latter, MS patients' medical records fulfilling the McDonald diagnostic criteria were analyzed, and both demographics and clinical characteristics were reviewed. We did exclude patients with neuromyelitis optica and isolated transverse myelitis. A retrospective study design was applied in Ibn-Sina Teaching Hospital, City of Mosul, Iraq. Results:This section summarizes the main findings of this research. Identified 500 patients who fulfilled our criteria for having MS. The crude estimated Prevalence of MS in the Mosul population was thus 50/100,000. The research population's demographic and clinical characteristics were identified and found a positive first or second-degree family history of MS at least 11.4% of Mosul patients. Conclusion:Based on the assumptions and previous studies that patients with multiple sclerosis in Mosul suffer from milder disease severity than those in western countries, it was surprising that half of the patients suffer from gait disability.

Динаміка поширеності афективних розладів у пацієнтів з деменцією під час пандемії COVID-19

This text is the thesis of the III scientific-practical conference with international participation "Psychosomatic medicine: science and practice". The following is devoted to the dynamics of prevalence of affective disorders in patients with dementia during the COVID-19 pandemic.