Hamilton Scale Research Articles

Comparison of withdrawal symptom intensity between hypnosis and nicotine-replacement-therapies: A pilot study

ABSTRACT Smoking cessation is a global public health issue. Nicotine dependence is a dynamic process that is not limited to physical dependence. Hypnosis can be helpful in the global management of smoking cessation. We explored this effect by comparing the effects of hypnosis and nicotine-replacement therapies (NRT) on tobacco withdrawal. Thirty participants were included in this comparative-randomized pilot study in parallel controlled groups after ethical validation. Participants were recruited by a general practitioner and had standardized consultations with addiction and hypnosis specialists and adapted treatment. The evolution of withdrawal symptoms was compared using the Cigarette Withdrawal Scale-21 for one month after smoking cessation in an adult tobacco-addict population wishing to stop smoking and receiving either NRT or hypnosis, both supported by motivational interviews. Craving intensity (French version of the Tobacco Craving Questionnaire), nicotine dependence (Fagerström), tobacco consumption, anxiety (Hamilton scale), and depression (Montgomery-Asberg scale) were also evaluated. Hypnosis appeared to have an influence on reducing the number of smoked cigarettes, whereas NRT appeared to influence markers of both physical and psychic dependence. A complementarity of hypnosis and NRT may be a viable therapeutic alternative to reduce the intensity of withdrawal symptoms after voluntary smoking cessation. A study on a larger population with a longer follow-up is needed to assess the advantages of each method to quit smoking.

COVID-19: Psychological Impact after Intensive Care Unit Hospitalisation

Background: Psychological consequences after a COVID-19 infection are more or less serious according to patients. Many risk factors exist and psychological support may be necessary to a better health care. Objective: Identify prevalence and risk factors of anxiety, depression, stress disorders and quality of life alteration after a COVID-19 infection. Methods: All patients hospitalized in the post-intensive unit care department after a COVID-19 infection were included, and we collected data’s concerning socio-demographic parameters, psychiatric disorders and clinical signs. Anxiety and depression were assessed using the Hamilton scales and post-traumatic stress according to the DSM-5 recommendations. The Hospital anxiety and depression scale (HADS) was equally used to evaluate anxio-depressive symptoms probability. Quality of life was evaluated by the SF-36 questionnaire. IBM statistics SPSS 20 was used for statistical analysis. Results: Our study included 41 patients, with a mean age of 55 ± 18 (17 - 85) years, and a sex ratio F/M of 0.95. A minor to severe anxiety was found in 26.8% of patients and a depression in 31.7% of patients. The HADS showed a confirmed anxiety and depression in 24.4% of patients, with a previous intubation related to symptoms (p = 0.007). An acute stress was identified in 34.1% of patients with a higher prevalence in women (p = 0.052). A poor general health was related to older ages (p = 0.049), to hypertension (p = 0.01) and to female gender (p = 0.043). Conclusion: Prevalence of anxiety and depression after a COVID 19 infection is near on for three patients. Risk factors were older age, female gender, hypertension and a previous intubation. These psychological disorders lead to quality-of-life alteration needing a screening and a structured follow-up with a psychological support.

Analysis of psychic imbalance, caused by screening of a video of surgical extraction of a lower third molar in a sample of mental patients as compared to the general population.

BackgroundThe goal of this study is to validate the psychometric properties of the Hamilton Rating Scales for anxiety and depression. These two scales will be used to analyze anxiety and depression, seven days before, after and seven days after screening of a video showing ex-traction of a lower third molar in four different strata of the sample: mixed disorder, anxiety dis-order, adaptive disorder, and no mental disorder. Material and MethodsA prospective study was performed of 240 Caucasian subjects ages 18-70 in a psychiatry outpatient clinic in Malaga. The study was ap-proved by the Research Ethics Committee of the University of Seville. Following interviews with a psychiatrist and completion of the Hamilton scales, the participants were divided into four levels, with 60 participants per group. The influence of sex and place of residence were analysed. ResultsThe scales showed good psychometric properties. At the three video screenings, the means were higher for women, persons from rural environments and persons with mixed disorder in the first instance and then anxiety disorder. ConclusionsPatients with mixed disorder experience a higher level of anxiety and depression than do patients free of mental pathologies. Key words:Anxiety disorder, adaptive disorder, dental anxiety, mixed anxiety-depressive disorder, surgical extraction.

Free Papers Compiled

BACKGROUNDStudies conducted in various parts of world as well as in India have revealed that Subclinical Hypothyroidism (SCH) is one of the risk factors for Depression. Several studies have found depression symptoms as a prevalent finding in patients with SCH. SCH has been found to have a negative effect in treatment of depression as well.AIMTo study the prevalence of SCH in patients with diagnosis of depressive episode, attending tertiary medical careMETHODSCross sectional Study conducted on 78 patients (selected by consecutive sampling) with a diagnosis of Depressive episode visited Govt Hospital for Mental Care, Visakhapatnam from March 2021 to September 2021. Hamilton Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS) were applied and blood levels of TSH, T4 and T3 were evaluated.RESULTSIn our study 6.78% of study population were found to have SCH with mildly elevated TSH level and T3, T4 level WNL. HAMD and MADRS Scale scores revealed mild to moderate depression in 73.8% of patients.CONCLUSIONSimilar to studies conducted elsewhere, our study also revealed SCH to be an important associated finding in patients with depression. Treating subclinical hypothyroidism may be a game changer in treating depressive episodes in such patients.

Clinical study to compare effect of Haridradi lepa and Shringatadi tailam along with Shwadanshtradi churna in Keshashatan (hair fall)

Background: Hair loss affects people of all gender, ages, and ethnicities, and it has both physical and psychological consequences. In today’s world, chemical hair treatments such as bleaching, straightening, relaxing, or permanent waving are very popular. Aims and Objectives: The purpose of this study was to evaluate the effect of Haridradi lepa and Shringatadi tailam along with Shwadanshtradi churna on hair loss and to research the literature on hair loss. Materials and Methods: A total of 90 patients with hair fall diagnosed clinically were enrolled and divided into two groups randomly. The duration of the trial was 2 months. There were 45 patients in each group. Cases were diagnosed using clinical signs of hair loss as described in classics. For male pattern baldness, the modified Norwood–Hamilton scale was used. For female hair loss, the Ludwig scale was used. Results and Conclusion: The percentage relief of the Sammuchya lakshnas (overall symptoms) was maximal 35.6% with P-value 0.0156 for the Study Group A patients and 44.6% with P-value 0.0136 for Study Group B patients, according to the research. The statistical study revealed that both groups improved significantly.

To Determine the Effectiveness of Artificial Intelligence in Neurorehabilitation and in Poststroke Psychological Impact – A Pilot Study

Background: Patients with CVA have multiple complications, one among them is psychological problem. Various studies showed incidence of anxiety (20–25%) and 1 in 3 stroke survivors have depression. In traditional rehabilitation approach, patitent needs attendant who should be supporting full time. Due to changing time and busy schedule of atttendants ensuring the effective rehabilitation is challenging. Thereby active participation in rehabilitation is impaired. Effective rehabilitation can be assisted through emerging technologies like Artificial Intelligence (AI) and AI enabled devices. Literature review showed that AI is applied in various branches of medical science. Aim and Objectives: To assess the effectiveness of AI enabled devices in rehabilitation of patients with CVA and in post stroke psychological impact. Materials and Methods: This study is undertaken with sample population categorized into two groups by using, one of the AI enabled devices like Alexa[© Amazon] that has inbuilt capability for routine activity remainders, graded exercise, speech and music therapy for rehabilitation along with routine physical therapy and at the end psychological impact of CVA is assessed using Hamilton scale for anxiety and depression. Results: Depression is more prevalent than anxiety in the study group. Anxiety score remained same in both the groups before and after study. Depression score changes noted in both groups before and after the study. Conclusion: From the study it is found that AI assisted rehab program is more effective in reducing the psychological stress.

Treatment of patients with chronic cerebral ischemia: experience of using the combined neuroprotective drug Picamilon Ginkgo

To compare the clinical efficacy and safety of Picamilon Ginkgo and ginkgo biloba in patients with cognitive impairment in vascular diseases of the brain (chronic cerebral ischemia). An open multicenter randomized comparative study involved 278 patients over 45 years of age with a diagnosis of chronic cerebral ischemia and cognitive impairment. 139 of them received Picamilon Ginkgo and 139 received monotherapy with ginkgo biloba extract for 90 days. Dynamics were compared on the MoCA, MMSE, Hamilton scale for assessing depression and the quality of life of EQ-5D, and the subjective effectiveness of therapy by patients and doctors was evaluated. Combination therapy resulted in significantly greater regression of cognitive impairment compared to monotherapy. At the end of the study, the differences between the groups were significant both on the MMSE scale (p=0.007) and on the MoCA scale (p=00003). At the same time, significant differences between the groups in the magnitude of cognitive improvement on the MoCA scale were noted already from the 30th day of treatment. Combination therapy also contributed to a more significant improvement in the patient's quality of life: dynamics on the EQ-5D scale significantly (p<0.05) differed in the groups, also starting from the 30th day of therapy. There were no significant differences in the dynamics of the Hamilton scale for assessing depression between the compared groups. Both Picamilon Ginkgo and monotherapy with ginkgo biloba extract were safe and were not accompanied by significant adverse events. The combination of standardized ginkgo biloba extract with Picamilon has an advantage over monotherapy with ginkgo biloba extract in patients with chronic cerebral ischemia, as it contributes to a more significant regression of cognitive impairment and improvement of quality of life.

Regenerative Biotechnologies in Plastic Surgery: A Multicentric, Retrospective, Case-Series Study on the Use of Micro-Needling with Low-Level Light/Laser Therapy as a Hair Growth Boost in Patients Affected by Androgenetic Alopecia

A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.

Evaluation of Platelet Glutamate Dehydrogenase Activity in Late-Life Depressions

The aim of the study is to evaluate the activity of platelet glutamate dehydrogenase (GDH) in late-life depression compared to the healthy control group and to reveal possible correlations with clinical data. Patients and methods: 42 elderly patients (60–86 years old) with depressive episodes of different nosological categories according to ICD-10 were examined: a single depressive episode (F32.0, F32.1), a depressive episode in recurrent depressive disorder (RDD — F33.0, F33.1) and a depressive episode in bipolar affective disorder (BD — F31.3). The activity of GDH and the severity of depression (using the Hamilton depressive scale, HAMD-17, and the Hamilton scale for assessing anxiety, HARS) were evaluated twice: before the starting the course of antidepressant therapy (day 0) and on the 28th day of the treatment course. Results: patients showed a significant decrease in the activity of GDH compared to the control group (p &lt; 0.0008). Before the treatment, GDH activity was significantly reduced compared to the control in both RDD and BD (p &lt; 0.002 and p &lt; 0.004), whereas after the treatment, the decreased GDH activity was observed only in patients with BD (p &lt; 0.002). When compared with the control group, male patients showed a significant decrease in GDH activity both before and after the treatment course (p &lt; 0.017 and p &lt; 0.027), whereas women patients showed the decrease only before the treatment (p &lt; 0.014). Conclusion: the decreased platelet GDH activity in elderly depressions may indicate an impairment of glutamate metabolism. Gender differences were revealed in the reversal of GDH activity level after the therapy: in men, the level of GDH activity did not recover to control values after the treatment course. An elevation in the level of GDH to control values over a 28-day course of therapy occurred only in patients with RDD, but not in patients with BD.

MEDICAL AND PSYCHOLOGICAL SUPPORT OF WOMEN WITH THE THREAT OF PRETERM BIRTH IN THE LAST TRIMESTER OF PREGNANCY AND AFTER DELIVERY

Introduction. Throughout life, everyone faces a variety of emotionally complex situations. Pregnancy is one of such situations for a woman. It’s a very strong level of experience and a specific set of sensations in life, the study of which has recently received close attention. Circumstances that have developed in Ukraine in connection with environmental disadvantages mainly determine the low health index of pregnant women, and create preconditions for the increasing frequency of premature pregnancies in future generations. This problem is of great medical and social importance. More than a third of babies born prematurely lag behind in physical and psychomotor development. Considering the above mentioned, it can be argued that the creation of a system of medical and psychological support for pregnant women with a risk of preterm birth in the last trimester of pregnancy is relevant, necessary and timely.&#x0D; The purpose of the study is to develop a set of measures for medical and psychological support of women at risk of preterm birth in the last trimester of pregnancy and after childbirth based on a systematic approach to the study of individual psychological, pathopsychological and psychosocial characteristics.&#x0D; Material and methods. During 2016-2019 the study was conducted based on Storozhynets Central District Hospital in the Chernivtsi region. 150 pregnant women in the third trimester of pregnancy (23-37 weeks) and their husbands were examined. The main group (MG) included 120 women with the risk of premature birth in the last trimester of pregnancy. The comparison group (CP) included 30 women with a physiological course of pregnancy.&#x0D; The main therapeutic group (MTG) consisted of 42 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive (MTG1) and destructive (MTG2) types of interaction in the triad "mother-child-father", who agreed to participate in medical and psychological care. The correctional group (CG) included 12 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive and destructive types of interaction in the triad "mother-child-father", who refused to participate in the proposed measures.&#x0D; Results. Analysis of the evaluation of the developed system of medical and psychological support of the family during pregnancy showed the following (p &lt;0.001): a) improvement of psycho-emotional state, well-being and overcoming emotional stress demonstrated by MTG1 women (up to 43.7 ± 0.8 and 42.5 ± 1.5, respectively, and after 20.8 ± 1.5 and 22.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 11.4 ± 1.2 and HARS 12.5 ± 1.2 after HDRS 4.2 ± 0.4 and HARS 5.7 ± 0.4) and female MTG2 indicators of RA and PA on the Spielberger-Khanin scale (up to 51.7 ± 0.8 and 50.7 ± 1.5, respectively, and after 21.4 ± 1.8 and 23.1 ± 1.5, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 16.3 ± 1.2 and HARS 18.3 ± 1.2 after HDRS 7.6 ± 0.7 and HARS 6.9 ± 0.6). Among CG women indicators RA and PA on the Spielberger-Khanin scale (up to 47.7 ± 0.8 and 46.6 ± 1.5, respectively; after 45.8 ± 1.5 and 42.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (before HDRS 13.8 ± 1.2 and HARS 15.4 ± 1.2; after HDRS 12.2 ± 0.4 and HARS 14.7 ± 0.4) were higher. b) there was an increased level of social support on the last two scales - "support of colleagues" and "support of public organizations" among MTG1 and MTG2 women (up to 25.3%, after 55.2% / up to 14.8%, after 45, 2%, respectively) compared with CG women (up to 18.5%, after 24.5%). c) there was a complete reduction of the deformation of marital relations in the majority of MTG1 (83.3%) and MTG2 (75%) women in contrast to the examined CG.&#x0D; Conclusions. The implementation of the system of medical and psychological support for women with a risk of preterm birth in the last trimester of pregnancy and after childbirth allowed to optimize the choice of adequate behavioral strategies in a family, improve emotional state and well-being, optimize women's attitudes to pregnancy and harmonize family interaction (72.5%) ˂0.001), to harmonize the relationship in the triad "mother - child - father" in the postpartum period (66.4%) (p˂0.001).

The concentration of MMP-9 and the effects of intravenous anaesthetics on the efficacy of electroconvulsive therapy in patients with drug-resistant depression

Abstract Introduction: This study attempts to assess the concentration of intracellular matrix metalloproteinase (MMP-9) before and after the treatment of depressive episodes with ECT therapy and also to correlate the concentration of this enzyme with the use of commonly used general anaesthetics. Materials and methods: The study group comprised of 37 patients hospitalized in the Department of Adult Psychiatry in Poznan, with a diagnosis of episodes of drug-resistant depression during the course of bipolar and unipolar affective disorders, and who were being treated using electroconvulsive therapy. For the purpose of inducing anaesthesia during the procedure propofol was used in 10 cases, thiopental in 9 cases. Propofol was alternated with ketamine in a further 10 cases and thiopental was alternated with ketamine in another 9 cases. In order to assess the intensity of depression symptoms, the 17 point Hamilton depression scale was used, immediately before commencing ECT therapy, and one day after its completion. The serum concentration of MMP-9 was determined before and after the series of ECT treatments. In order to assess the serum concentration of MMP-9, an ELISA immunoenzymatic method was applied. Results: In this study, a significant reduction of MMP-9 concentration was noted after therapy, relative to the starting concentration, in the serum of patients suffering from depressive episodes resulting from either unipolar or bipolar affective disorders. These results correlated with improved psychiatric state, as assessed by the Hamilton scale. A significantly lower MMP-9 concentration was noted in the serum of patients given alternating thiopental and ketamine anaesthesia. Conclusions: This study suggests the importance of the enzyme as a biological marker for the effective treatment of depression. Furthermore, the choice of general anaesthetic applied during ECT also plays a role.

Obsessive–compulsive symptoms in anxiety and depressive disorders: Influence of recent and/or traumatic life events

IntroductionA high prevalence of obsessive–compulsive symptoms (OCSs) in anxiety-depressive disorders ranging from 30 to 67% has been described. ObjectiveThis study aims to assess the presence and persistence of OCSs in an outpatient sample of subjects with anxiety and depressive disorders, as well as its relationship with recent life events (RLEs) and/or traumatic experiences (TEs). MethodWe conducted a prospective, observational, analytical study of 200 subjects with DSM-5 diagnoses of anxiety and/or depression. Participants were included by consecutive sampling and were evaluated at baseline and after 6–12 months (mean 8.5 months) of follow-up. The severity of the symptoms was assessed through the Hamilton Anxiety Scale (HARS) and Hamilton Scale for the evaluation of depression (HRSD-17), and comorbidity was assessed through the International Neuropsychiatric Interview (MINI). The Revised Inventory of Obsessions and Compulsions (OCI-R), the Recent Vital Changes Questionnaire (CVSV), and the Diagnostic Scale for Post-Traumatic Stress (PDS) were also administered. Results54% of the sample presented OCSs, and 30.5% presented one or more TEs throughout life. At the baseline visit, the presence of OCSs was associated with the severity of depressive symptoms (p=0.028), the presence of TEs (p<0.01), symptoms of post-traumatic stress disorder (p<0.01) and the number of RLEs (p<0.01). Response rate at follow-up was 38%, and persistence of OCSs was found in 60.5% of patients, independent of depressive or anxious symptoms, but was associated with the number of RLEs (p<0.01). ConclusionThe presence of OCSs in patients with anxiety and depressive disorders is frequent and persistent. Anxious-depressive patients with a history of TEs and RLEs had higher OCS levels. These findings highlight the importance of early detection and the use of therapeutic strategies focused on resilience to stress and trauma.

Assessment of quality of life of patients with colon cancer depending on the type of perioperative anesthetia

The purpose of the study. Assess the quality of life of patients with colon cancer in the perioperative period, depending on the chosen method of anesthesia.&#x0D; Materials and methods. In the period from January to August 2020, an analysis of the results of anesthesia in 32 patients with colon cancer was performed on the basis of the Department of Anesthesiology and Intensive Care of KNP «ZPC» ZOR. Two groups of patients were formed in a randomized manner. The difference between the groups was the difference in drug combinations and dosages of anesthesia. Subjective pain assessment studies in patients were performed using a visual analog scale (VAS) questionnaire. The EQ 5D scale (5-point pain scale) was used to assess quality of life. The Hamilton scale was used to assess the patient's psycho-emotional state. Student's mean T test was used to compare pain levels before and after surgery, and p &lt; 0,05 was considered statistically significant.&#x0D; Results. There was a statistically significant difference between cortisol levels after surgery in patients of groups I and II (p = 0,0001). When comparing insulin and blood glucose, it was found that the results of biochemical parameters are lower in group II patients, indicating a lower level of pain or its absence in the first 6 hours after surgery (p = 0,0001). Patients in groups I and II had an increase in the VAS scale, but in patients who used only general anesthesia, the rates were twice as high as in the group of patients who used a combination of epidural anesthesia (p = 0,0001).&#x0D; Evaluating the results of the questionnaire on the EQ 5D scale, a similar picture was established as when evaluating on the VAS scale where in the second group of patients statistically significantly lower pain rates than in the first group (p = 0,0001). The level of anxiety in patients who underwent epidural anesthesia decreased slightly in the postoperative period compared with baseline (p = 0,005).&#x0D; Conclusions. The quality of life of patients in the second group is higher than in patients of group I according to the questionnaire scale EQ 5D (p = 0,0001). The level of anxiety in patients of group I is higher in the first 6 hours after surgery than in patients of group II where epidural anesthesia is used (p = 0,0001).

Possibilities of daytime anxolytics in the correction of residual neurological manifestations of COVID-19

Introduction. In addition to acute manifestations, coronavirus infection is characterized by long-lasting symptoms: asthenia, somatic vegetative manifestations, sleep disorders and psychoemotional background, the question of therapeutic correction of which is especially relevant.The aim of the studywas to study the mental, somatoform and cognitive aspects of anxiety disorders after coronavirus infection during treatment with tofizopam (Grandaxin®) at 150 mg / day.Materials and methods. The study involved patients who had a new coronavirus infection, who 4 weeks after the end of treatment for the underlying disease had complaints that suggest the presence of an anxiety disorder. The Hamilton scale was used to assess the level of anxiety. The patients were examined before the start of treatment, after 2, 4 and 6 weeks of therapy.Results. Prior to the start of therapy, all patients had an overall high level of anxiety: the average HAM-A score was 31.72 ± 2.24 points. At the end of Grandaxin® therapy, all patients showed a decrease in the level of anxiety: the average score for HAM-A was 12.68 ± 2.04 points (p &lt; 0.001). At the end of the course of therapy, patients noted an increase in mental performance, improved memory and attention, that is, a decrease in the severity of cognitive disorders associated with anxiety was&gt; distinct – the average score on the “cognitive disorders” subscale decreased three times – from 1.6 ± 0.12 to 0.5 ± 0.09 (p˂0.001).Conclusions.Disorders of the psychoemotional background (more often in the form of increased personal anxiety), sleep disorders, autonomic disorders, asthenic syndrome significantly affect the quality of life of patients who have suffered a new coronavirus infection. A comprehensive approach is needed in the clinical diagnosis of the long-term consequences of a new coronavirus infection and their subsequent correction with drug therapy.

Visual analysis of literature knowledge structure and acupoint matching rules of acupuncture for depression

To analyze the literature knowledge structure and acupoint matching rules of acupuncture for depression. The articles regarding acupuncture for depression published from January 1 of 1984 to October 19 of 2020 were searched in CNKI database. CiteSpace5.7.R2 software was used to import the literature data, and the keyword cluster analysis, emergence analysis and time-zone analysis of articles and acupoints were conducted, and the map of scientific knowledge was draw. A total of 3524 articles were included to the knowledge structure analysis, while 601 articles into the acupoint matching rules analysis. There were 13 keyword clusters of acupuncture for depression, with "post-stroke depression" and "electroacupuncture treatment" as high-frequency keywords, and "electroacupuncture treatment" and "Hamilton depression scale" had high centrality, and "electroacupuncture treatment" had the highest emergence intensity. The keywords such as "electroacupuncture treatment" and "Hamilton depression scale", etc. appeared the earliest, followed by "post-stroke depression", "fluoxetine" and "auricular point therapy", etc. According to traditional Chinese medicine theory, acupoint keywords were divided into four clusters: ①core acupoint, ②replenishing-spleen and dispelling phlegm, dispersing-liver and relieving depression, reinforcing qi and nourishing blood, ③back-shu points, five-zhi points, ④inducing-resuscitation and opening-closes. The main knowledge structure of acupuncture for depression includes five parts: treatment method, depression type, TCM-related diseases, literature type and curative effect index. Clinical acupoint matching should adhere to the principle of "focusing the disease before syndrome" and "combination of disease and syndrome", and treatment should be modified for the syndromes of phlegm stagnation blocking, liver-stagnation and qi-stagnation, and deficiency of both qi and blood.

POSSIBILITIES OF THERAPY OF PAIN SYNDROME IN ENDOMETRIOSIS

Therapeutic tactics of endometriosis are aimed primarily at overcoming the pain syndrome, the absence of recurrence of the underlying disease, maintaining fertility and improving the psycho-emotional state of women. The objective to develop, pathogenetically substantiate treatment and rehabilitation measures taking into account pathogenetic preconditions in women with endometriosis in combination with pain. Materials and methods 85 patients with genital endometriosis with severe pelvic pain (VAS 7-10 points) (n = 44) - group I and moderate (VAS 4-6 points) (n = 41) - group II. The mean age of women in clinical trials I and II of the study was 37.71 ± 0.93 and 41.05 ± 1.08 (M ± m) years, respectively. The choice of treatment tactics was determined on the basis of immunohistochemical markers: estrogen receptors (ER), progesterone (PGR), proliferation index (Ki-67), vasculoendothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) in eutopic acid., psychoemotional characteristics and intensity of pelvic pain. Rеsultes of treatment in the examined patients a significant (p &lt;0.05) reduction of pelvic pain was determined, both in the short and long term. After 6 months, the level of personal anxiety decreased - by - 38.62%, after 12 months. – at - 48.15% (p &lt;0.05). The rate of decrease in the level of depressive disorders on the Hamilton scale of all studied women was: - 32.2% after 6 months and -42.15% after 12 months (p &lt;0.05). Conclusion our approach to treating endometriosis helped to overcome pain in 83.53% of women, improve psycho-emotional and general condition, normalize sleep - was determined in 88.3% of women, reduce reactive anxiety and depressive disorders in 84.7% of patients, indicates the effectiveness proposed therapy.

Ефективність препарату Адаптол у комплексному лікуванні хворих із синдромом тиреотоксикозу

Мета дослідження — вивчення ефективності Адаптолу у лікуванні хворих на дифузний токсичний зоб (ДТЗ) різного ступеня тяжкості з відхиленнями в емоційній сфері без виражених психоорганічних порушень, а також впливу препарату на ефективність основної тиреостатичної терапії, що дає змогу розширити спектр показань для застосування препарату в практиці лікарів-ендокринологів. Матеріали та методи. Під спостереженням перебувало 25 хворих із тиреотоксикозом у стані медикаментозної субкомпенсації (17 — із явним, що розвинувся внаслідок ДТЗ, і 8 — із субклінічним), які отримували в комплексному лікуванні препарат Адаптол протягом двох місяців (група I). Ще 20 хворих з аналогічною патологією сформували контрольну групу (група II). Хворі контрольної групи статистично вірогідно не відрізнялися за віком, статтю, тривалістю та тяжкістю ДТЗ від осіб основної групи. Результати. Проведений аналіз отриманих даних свідчить про те, що в першій (основній) групі хворих на ДТЗ (з додатковим призначенням препарату Адаптол) відзначається більш суттєвий ефект від лікування порівняно з хворими контрольної групи. Додаткове призначення препарату Адаптол сприяло зменшенню добової дози тиреостатичних препаратів у хворих на ДТЗ, що зменшує ризик виникнення ускладнень терапії. Якщо середня добова доза препаратів тіамазолу/карбімазолу на початку лікування в обстежених групах хворих не відрізнялася, то через 2 місяці лікування середня доза тиреостатичних препаратів у першій групі становила 24,3 ± 2,1 мг, у групі контролю — 31,8 ± 2,4 мг (р &lt; 0,05). У процесі терапії Адаптолом відзначалося зниження (р &lt; 0,05) вмісту малонового діальдегіду, а також підвищення активності ферментів антиоксидантного захисту: супероксиддисмутази (р &lt; 0,05) і глутатіонпероксидази (р &lt; 0,05). Висновки. Через 2 місяці терапії Адаптолом, згідно із шкалою Гамільтона, серед хворих основної групи були відсутні тривожні стани (5,6 ± 1,2 бала; р &lt; 0,05), тоді як у контрольній групі відзначалася наявність симптомів тривоги (14,8 ± 2,7 бала; р &lt; 0,05). Адаптол чинить позитивний терапевтичний вплив як щодо оксидантної, так і щодо антиоксидантної системи, що проявляється гальмуванням перекисного окислення ліпідів і активацією компенсаторних процесів. З огляду на проведене дослідження застосування Адаптолу має посісти належне місце в схемах лікування ДТЗ та розширити його можливості у разі як легкого, так і тривалого перебігу захворювання.

Практичне значення діагностики депресії у пацієнтів із цукровим діабетом 2-го типу

Актуальність. Цукровий діабет (ЦД) і депресія сьогодні є поширеними та соціально значущими захворюваннями. Незважаючи на величезну кількість робіт і досліджень, присвячених вивченню причин цих станів, сучасний погляд на етіологію як ЦД, так і депресії залишає безліч нез’ясованих питань. Мета. Продемонструвати практичне застосування шкал діагностики депресії у пацієнтів із ЦД 2-го типу. Матеріали та методи. У дослідження було рандомізовано 190 пацієнтів. Для діагностики депресії використовувалися адаптовані шкали PHQ-9, PAID, WHO, MINI-6, шкала Гамільтона; опрацьовано дані з амбулаторних карт пацієнта за останні 15 років; проведено збір анамнезу, загальний огляд, вимірювання рівня глікованого гемоглобіну та ліпідограми, а також обов’язкову консультацію психіатра, ендокринолога, подолога. Згідно з аналізом зібраних даних і отриманих результатів, пацієнтам призначалися за необхідності седативні препарати, антидепресанти, анксіолітики та психотерапія. Результати. Із загальної кількості пацієнтів (n = 230) після скринінгу було рандомізовано 190 осіб. Стан депресії, виявлений під час інтерв’ю, розцінювався як поточний (протягом двох тижнів) діагноз великого депресивного розладу (Major Depressive Disorder) за Міжнародною класифікацією хвороб 10-го перегляду. Якщо в амбулаторній картці пацієнта епізоди депресії були зафіксовані та задокументовані, то встановлювався діагноз «рекурентна депресія». Обов’язковою також була інформація про стан тривоги та суїцидальні наміри (чи їх спроба в минулому). Після отриманих результатів психіатром приймалося рішення про необхідність прийому седативних препаратів, антидепресантів, анксіолітиків і проведення психотерапії. Висновки. Синергічний ефект тривоги та депресії на стан ЦД підвищує ризик розвитку мікро- та макросудинних ускладнень, спричинює гіперглікемію у пацієнтів та зумовлює пошук нових методів вирішення цієї проблеми.

The Relationship Between Alexithymia and Risk for Postpartum Depression

Coronavirus disease 2019 (COVID-19) is classified as a stressful life experience. The aim of this study was to assess the levels of alexithymia and risk for postpartum depression in women during the COVID-19 pandemic and state-of-emergency lockdown in Serbia. This cross-sectional study included 108 adult (age ≥18 years) postpartum women with children age 12 months or younger. We used the following questionnaires: Edinburgh Post-natal Depression Scale (EPDS), Toronto alexithymia scale (TAS), Hamilton scale for the assessment of anxiety (HAM-A) and depression (HAM-D), and an additional questionnaire constructed for this study. We found that 14.8% of participants had a score of 10 or higher on EPDS, 23.15% had alexithymia, and 31.32% had borderline alexithymia. There was a significant positive correlation of alexithymia with risk for postpartum depression, high-intensity anxiety, and depression in postpartum women with a score of 10 or higher on HAM-D and 18 or higher on HAM-A. Higher rates on TAS were noticed in mothers who were older, single, and dissatisfied with emotional status, with lower educational level, unemployment, and lack of family support. Multiple linear regression analysis including all factors that correlate with higher TAS scores showed that higher scores on HAM-D (beta = 0.75, P &lt; .01) and higher scores on EPDS (beta = 0.69; P &lt; .01) were independent predictors of higher EPDS scores (adjusted R 2 = 0.52, P &lt; .01 for overall model). Alexithymia could develop in response to pandemics, and pandemics and the measures taken to combat a pandemic could be considered as risk factors for postpartum depression. [ Psychiatr Ann . 2021;51(9):431–436.]

Abnormal expression profile of plasma-derived exosomal microRNAs in patients with treatment-resistant depression

Whether microRNAs (miRNAs) from plasma exosomes might be dysregulated in patients with depression, especially treatment-resistant depression (TRD), remains unclear, based on study of which novel biomarkers and therapeutic targets could be discovered. To this end, a small sample study was performed by isolation of plasma exosomes from patients with TRD diagnosed by Hamilton scale. In this study, 4 peripheral plasma samples from patients with TRD and 4 healthy controls were collected for extraction of plasma exosomes. Exosomal miRNAs were analyzed by miRNA sequencing, followed by image collection, expression difference analysis, target gene GO enrichment analysis, and KEGG pathway enrichment analysis. Compared with the healthy controls, 2 miRNAs in the plasma exosomes of patients with TRD showed significant differences in expression, among which has-miR-335-5p were significantly upregulated and has-miR-1292-3p were significantly downregulated. Go and KEGG analysis showed that dysregulated miRNAs affect postsynaptic density and axonogenesis as well as the signaling pathway of axon formation and cell growths. The identification of these miRNAs and their target genes may provide novel biomarkers for improving diagnosis accuracy and treatment effectiveness of TRD.