q1bipolar spectrum features in drug resistant unipolar depression patients : TRES-DEP pilot study

Size: px
Start display at page:

Download "q1bipolar spectrum features in drug resistant unipolar depression patients : TRES-DEP pilot study"

Transcription

1 Research q1biolar sectrum features in drug resistant uniolar deression atients : TRES-DEP ilot study Dominika Dudek, Marcin Siwek, Joanna Borowiecka-Kluza, Tomasz Pawłowski, Andrzej Kiejna, Dorota Łojko, Janusz K. Rybakowski Summary Aim. The aim this ilot study of the all-polish multicenter TRES-DEP (Treatment Resistant Deression) roject was the detection and analysis of biolar sectrum features in drug-resistant (DR) atients with uniolar deression in comarison with atients who resonded to standard antideressant treatment and remitted (non-drug-resistant-non-dr). Method. Fifty DR atients (grou 1) and 50 non-dr atients (grou 2), aged years, fulfilling ICD- 10 / DSM-IV criteria for deressive eisode or recurrent deressive disorder, were included in the study. The resence of biolar sectrum (BS) was detected by the Mood Disorder Questionnaire (MDQ) and the Hyomania Checklist Scale (HCL-32). Results. There were statistically significantly more atients fulfilling BS criteria as assessed with MDQ or HCL-32 in grou 1 than in grou 2 (44% vs 12%, < and 62% vs 34%, < resectively). Significantly more DR atients, comared to non-dr atients, considered their last remission as artial (88% vs 52%, = 0.001). Non-DR atients had a history of fewer deressive eisodes (5.1 ± 3.8 vs 8.5 ± 5.0; = 0.001) and reorted a longer time since the last hositalization (41.9 ± 17.1 vs 14.8 ± 26.5 months, < 0.005). More DR atients fulfilling MDQ BS criteria (MDQ(+)) comared to DR atients without biolar sectrum considered the last remission as artial or reorted lack of remission (100% vs 21%; < 0.05) or reorted treatment nonadherence (41 vs 18%, = 0.055). More MDQ(+) DR atients had occurrences of suicide attemts (41% vs 18%, = 0.055) and a mean number of suicide attemts was higher in this grou (0.86 ± 1.28 vs 0.25 ± 0.59; < 0.05). Conclusion. The results of the study suggest that misdiagnosed and inadequately treated biolarity may be one of the main reasons for non-resonse in the treatment of deression with antideressant drugs. biolar disorder / drug-resistant deression, biolar sectrum / Mood Disorder Questionnaire / Hyomania Check List-32 Dominika Dudek 1, Marcin Siwek 1, Joanna Borowiecka-Kluza 1, Tomasz Pawłowski 2, Andrzej Kiejna 2, Dorota Łojko 3, Janusz K. Rybakowski 3 : 1 Deartment of Adult Psychiatry, Collegium Medicum of Jagiellonian University, Kraków, Poland, 2 Deartment of Psychiatry, Medical University of Wrocław, Poland, 3 Deartment of Adult Psychiatry, Poznań University of Medical Sciences, Poznań, Poland ; Corresondence address : Dominika Dudek, Deartment of Adult Psychiatry, Collegium Medicum of Jagiellonian University, Koernika 21a, Kraków, Poland ; dominika.dudek@oczta.fm This research has not been aided by any grant. INTRODUCTION A growing body of evidence suggests that undiagnosed and therefore inadequately treated biolarity may be one of the most imortant causes of drug resistance in deression diagnosed as uniolar. The results of the Polish multicenter DEP-BI study showed that a significant majority of atients treated for either a deressive eisode or recurrent deressive disorder resent different forms of biolar dis-

2 66 Dominika Dudek et al. order (BD) [1, 2]. Such atients were more often drug resistant. [3]. Other trials have also revealed biolar features in drug-resistant deressive atients [4, 5, 6, 7]. The need for further and more detailed research into this roblem was the basis for the multicenter all-polish Treatment Resistant Deression Project (TRES- DEP). The main aim of TRES-DEP was analysis of the biolar features in a grou of drug resistant atients with uniolar deression in comarison to deressive atients who resonded to standard antideressant treatment and remitted. The demograhic and clinical characteristics of the drug-resistant atient grou was also described. The following aer resents the ilot results of the TRES-DEP roject. MATERIAL AND METHODS Fifty drug-resistant (grou 1) and 50 nondrug-resistant (grou 2, control grou) atients, aged years fulfilling ICD-10 / DSM-IV criteria for deressive eisode or recurrent deressive disorder were included in the study. The main exclusion criteria were: treatment with mood stabilizers, the diagnosis of substance misuse, dementia, and the diagnosis of severe neurological or somatic disease. Patients who scored > 18 oints on the Hamilton Deression Rating Scale were also not included in the study in order avoid the risk of false negative results in biolar detection tools due to severe deressive state. Patients were interviewed using clinical and sociodemograhic questionnaires. The severity of deressive symtoms was measured by the 17-item Hamilton Deression Rating Scale (HDRS-17) [8, 9, 10]. Biolar features were detected using the Mood Disorder Questionnaire (MDQ, by Hirschfeld et al) [11, 12] as well as the Hyomania Check-List (HCL-32, by Angst et al) [13]. Drug-resistance was defined as a lack of significant clinical imrovement after at least two treatment trials with antideressants alied through a suitable eriod of time (min. 4 weeks) and in suitable doses [14, 15]. Grou 2 (gr. 2, N = 50) consisted of atients who did not show drug-resistance in revious deressive eisodes and who achieved symtomatic and clinical remission during the last or current deressive eisode (< 7 oints in HDRS17). Presence of the biolar sectrum detected by MDQ was defined as at least 7 ositive ( yes ) answers in the first art of the MDQ including 13 questions concerning manic / hyomanic symtoms lus the occurrence of at least two of them in the same eriod of the atient s life as well as any moderate or serious roblems which these symtoms cause for the atient [11, 12]. The HCL-32 biolar sectrum criterion used in the study was 14 or more ositive answers ( yes ) [13]. The statistical analysis of the quantitative data was examined with descritive statistics (median, mean, standard deviation) and boxlots. If the normality and equality of variance assumtions were resent (Shairo-Wilk test), a t-test was erformed. If the assumtions were not met, a non-arametric test was used (Mann Whitney U test or Wilcoxon rank-sum test). The chi 2 test was erformed for the analysis of qualitative differences between grous. A value of < 0.05 was considered statistically significant [16, 17, 18]. RESULTS 1. Sociodemograhic characteristics The mean age (± SD) in the drug resistant grou was significantly higher than in control grou. There were no significant differences in the male/female ratio between grou 1 (1/4) and grou 2 (6/19), (Chi 2 test) in addition to there being no other statistically significant differences between the grous according to sociodemograhic arameters /variables such as: marital state, number of children, education level, or occuational status (Tab. 1). 2. Clinical characteristics (disease course, current deression eisode) Taking into account the course of the disease, atients in grou 1 were ill for an average of 10.7 ± 7.7 years, while atients in grou 2 for 8.5 ± 6.7 of years but the difference was statis-

3 q1biolar sectrum features in drug resistant uniolar deression atients TRES-DEP ilot study 67 tically not significant. The age at the onset of the illness in both grous wasn t significantly different. Moreover, in both grous the number of atients with early onset of disease (before 25) was similar (Tab. 2). The average number of revious eisodes of deression was significantly larger in the treatment resistant than in the control grou. There were no statistically significant differences between grous with resect to the number of Table 1. Selected sociodemograhic data in grous 1 and 2 Gr.1 Gr.2 Gr.1 vs Gr.2 Age 49.0± ± Number of children 1.7 ± ± 1.1 Sex Marital status Education level M n = 10 (20%) F n = 40 (80%) Yes n = 37 (74%) No n = 13 (26%) rimary 14% vocational 10% secondary 48% higher 28% M n = 12 (24%) F n = 38 (76%) Yes n = 0 (60%) No n = 20 (40%) rimary 10% vocational 20% secondary 42% higher 28% Working n = 18 (36%) n = 20 (40%) Pension n = 25 (50%) n = 2 0 (40%) hositalized individuals (as reorted during interview) and the average number of hositalizations. However, the time since the last hositalization was significantly longer in the grou of non drug-resistant atients in comarison to the drug-resistant atient grou. Patients from grou 1 more frequently estimated their last remission as incomlete. There were no significant differences between grous in different asects of comliance, i.e. unauthorized discontinuation of treatment or modification of doses. The grous did not differ statistically in the number of suicide attemts or ideations in the history as well as in comorbidity with somatic illness (Tab. 2). Patients from grou 2 more frequently reorted a lack of family history of mental disorders than treatment-resistant atients (grou 1). Family history of deression, schizohrenia, anxiety disorders, suicides, and BD did not differentiate between the grous. BD occurrence in the family was reorted by only one erson in grou 1 and one in grou 2. However, a family burden of alcohol abuse was statistically more frequent in the drug-resistant atient grou than in the control grou (Tab. 2). The duration of the current deressive eisode was statistically longer in the treatment resistant grou (grou 1) than in the grou 2 (Tab. 3). There were no significant differences between grous in frequency of occurrence of suicidal thoughts and suicidal tendencies during the course of the eisodes (Tab. 3). 3. Occurrence of biolar features in studied grous In the drug-resistant atient grou (grou 1), the MDQ biolar sectrum criteria were fulfilled by significantly more individuals than in the non-drug-resistant grou (grou 2). Among the drug-resistant atients, too, more individuals fulfilled the biolar features criteria by the HCL- 32 in comarison to the drug-resistant atients. Similarly, alying the criteria of both tests simultaneously, the number of atients with biolar sectrum features was significantly greater in grou 1 than in grou 2. ( Tab. 4)

4 68 Dominika Dudek et al. Table 2. Selected clinical data regarding the course of the illness in grous 1 an 2 Gr 1 Gr 2 Gr 1 vs Gr 2 Time since the beginning of illness (years) 10.7 ± ± 6.7 Age at onset of illness 38.4 ± ± 10.0 Number of eisodes 8.5 ± ± Number of hositalizations 2.3 ± ± 1.6 Months since the last hositalization 14.8 ± ± Number of suicide attemts 0.52 ± ± 1.0 Chi 2 -test Suicide attemts in the ast n = 14 (28%) n = 13 (26%) Last remission Full 12% (n = 6) Incomlete 88% (n = 44) Full 48% (n = 24) Incomlete 52% (n = 26) Irregularity of treatment n = 14 (28%) n = 12 (24%) Family history of deression n = 18 (36%) n = 12 (24%) Family history of alcoholism n = 12 (24%) n = 4 (8%) Negative family history of mental disorders n = 17 (34%) n = 31 (62%) < Table 3. Selected clinical data regarding the current deression eisode in grous 1 and 2 of the illness in grous 1 an 2 Gr 1 Gr 2 N = 50 Gr 1 vs Gr 2 Duration of eisode (in weeks) 13 ± ± Number of treatments 2.34 ± ± Table 4. Biolar features number of eole fulfilling biolar MDQ or HCL-32 criteria in grous 1 and 2. (MDQ (+)/HCL (+) subgrous of atients, whose results in MDQ and HCL resectively indicated resence of biolar features. MH (+) subgrou of atients, fulfilling both the MDQ and HCL biolar sectrum criteria Presence of suicidal thoughts n = 29 (58%) n = 22 (42%) Presence of suicidal tendencies n = 10 (20%) n = 6 (12%) Gr 1 Gr.2 Gr. 1 vs Gr. 2 MDQ (+) MDQ (-) n = 22 (44%) n = 28 (56%) n = 6 (12%) n = 44 (88%) < HCL (+) HCL (-) n = 31 (62%) n = 19 (38%) n = 17 (34%) n = 33 (66%) MH (+) MH (-) n = 19 (38%) n = 31 (62%) n = 5 (10%) n = 45 (90%) = 0.001

5 q1biolar sectrum features in drug resistant uniolar deression atients TRES-DEP ilot study Biolar features characteristics of answers in MDQ and HCL The next ste was the analysis of answers to the individual questions in the MDQ and HCL questionnaires. In the first 13-question art of the MDQ, drug-resistant atients (gr. 1) answered yes onto following questions (Q) statistically significantly more frequently in comarison to the non drug-resistant grou (gr. 2) : Q1 : you felt so good or so hyer that other eole thought you were not your normal self or you were so hyer that you got into trouble? ( = 0.002, Chi 2 test), Q3 :...you felt much more self-confident than usual? ( = 0.002, Chi 2 test), Q5 :...you were much more talkative or soke much faster than usual? ( = ; Chi 2 test), Q8 :...you had much more energy than usual? ( = ; Chi 2 test), Q9 :...you were much more active or did many more things than usual? ( = 0.001, Chi 2 test), Q11:...you were much more interested in sex than usual? ( = ; Chi 2 test). In the HCL-32, among 32 questions from the mania/hyomania symtoms list, statistically significantly more answered yes in grou 1 in comarison to grou 2 on three questions : Q5 : I am more sociable (make more hone calls, go out more) ( = 0.009, Chi 2 test), Q16 : I am more interested in sex, and/or have increased sexual desire ( = 0.005, Chi 2 test), Q21 : I am more easily distracted ( = 0.020, Chi 2 test). 5. Clinical and demograhic characteristics of atients with drug-resistant deression There were no statistically significant differences regarding age, sex, marital state, number of children, education level, and occuational status between drug-resistant atients fulfilling and not-fulfilling the biolar sectrum criteria by MDQ or HCL-32 (Tab. 5 and 6). Table 5. Biolar features according to MDQ criteria selected sociodemograhic data regarding the course of treatment in the grou of atients with drug-resistant deression (grou 1) MDQ(+) MDQ(-) MDQ(+) vs MDQ(-) Age 49.0 ± ± 7.8 Number of children 1.9 ± ± 1.2 Sex M F n = 6 (27.3%) n = 16 (72.7%) n = 4 (14.3%) n = 24 (85.7%) Marital status n = 16 (72.7%) n = 21 (75.0%) Education level rimary vocational secondary higher n = 5 (22.7%) n = 2 (9.1%) n = 9 (40.9%) n = 6 (27.3%) n = 2 (7.1%) n = 3 (10.7%) n = 15 (53.6%) n = 8 (28.6%) Working n = 9 (40.9%) n = 9 (32.1%) Pension n = 9 (40.9%) n = 16 (57.1%) There were also no statistically significant differences in a range of such factors characterizing course of the illness as: age at the onset of disease, average number of eisodes and hositalizations, average time since the last hositalization (Tab. 7 and 8). Similarly, family history of deression, alcohol abuse, biolar disorder, schizohrenia, anxiety disorders, suicides and coexistence of somatic diseases did not differentiate drug-resistant atients resenting or not resenting biolar sectrum features (Tab. 7 and 8).

6 70 Dominika Dudek et al. Moreover, there were no differences in selected clinical data regarding the current deression eisode i.e.: duration of eisode, number of administrated treatments, resence of suicidal thoughts or tendencies (Tab. 9 and 10). It should be emhasized that drug-resistant atients fulfilling the MDQ biolar features criteria estimated their last remission as incomlete and reorted non-comliance reflected by irregularities in treatment and dosing non-adherence significantly more often than non-biolar sectrum atients. Moreover, in drug-resistant biolar sectrum atients in comarison with atients not fulfilling the MDQ criteria, there was a statistically significant greater number of suicide attemters and a greater average number of suicide attemts (Tab. 7). Table 6. Biolar features according to HCL criteria selected sociodemograhic data regarding the course of treatment in the grou of atients with drug-resistant deression (grou 1). HCL(+) HCL(-) HCL(+) vs HCL(-) Age 48.4 ± ± 5.4 Number of children 1.8 ± ± 1.0 Sex M n = 6 (19.4%) n = 4 (21.1%) F n = 25 (80.6%) n = 15 (78.9%) Marital status n = 23 (74.2%) n = 14 (73.7%) Education level rimary vocational secondary higher n = 5 (16.1%) n = 3 (9.7%) n = 14 (45.2%) n = 9 (29.0%) n = 2 (10.5%) n = 2 (10.5%) n = 10 (52.6%) n = 5 (26.3%) Working n = 12 (38.7%) n = 6 (31.6%) Pension n = 15 (48.4%) n = 10 (52.6%) Table 7. Selected clinical data regarding the course of the illness in drug resistant atients (grou 1) fulfilling (MDQ(+)) or not fulfilling (MDQ(-)) MDQ biolar sectrum criteria MDQ(+) n = 22 MDQ(-) n = 28 MDQ(+) vs MDQ(-) -value Time since the beginning of illness (years) 9.9 ± ± 9.8 Age at onset of illness 39.1 ± ± 7.9 Number of eisodes 8.0 ± ± 4.6 Number of hositalizations 2.0 ± ± 3.1 Months since the last hositalization 13.2 ± ± 31.0 Number of suicide attemts 0.86 ± ± Last remission Full n = 0 (0%) Incomlete n = 22 (100%) Full (n = 6) 21% Incomlete n = 22 (79%) Irregularities of treatment n = 9 (41%) n = (18%) (0.055) Suicide attemts in the ast n = 9 (41%) n = 5 (18%) (0.055) Family history of deression n = 9 (41%) n = 9 (32%) Family history of alcoholism n = 6 (27%) n = 6 (21%) Negative family history of mental disorders n = 9 (41%) n = 13 (46%) 0.021

7 q1biolar sectrum features in drug resistant uniolar deression atients TRES-DEP ilot study 71 Table 8. Selected clinical data regarding the course of the illness in drug resistant atients (grou 1) fulfilling (HCL (+)) or not fulfilling (HCL(-)) HCL-32 biolar sectrum criteria HCL(+) n = 31 HCL(-) n = 19 HCL(+) vs HCL(-) -value Time since the beginning of illness (years) 10.9 ± ± 6.0 Age at onset of illness 37.5 ± ± 6.9 Number of eisodes 6.8 ± ± 5.0 Number of hositalizations 2.2 ± ± 3.4 Months since the last hositalization 15.2 ± ± 34.2 Number of suicide attemts 0.71 ± ± 0.54 Last remission Full n = 2 (6%) Partial n = 29 (94%) Full n = 4 (21%) Partial n = 15 (79%) Test-t Test Chi 2 Irregularities of treatment n = 10 (32%) n = 4 (21%) Suicide attemts in the ast n = 11 (36%) n = 3 (16%) Family history of deression n = 13 (42%) n = 5 (26%) Family history of alcoholism n = 7 (23%) n = 5 (26%) Negative family history of mental disorders n = 12 (39%) n = 10 (53%) Table 9. Selected clinical data regarding the current deression eisode in drug resistant atients (grou 1) fulfilling (MDQ (+)) or not fulfilling MDQ (MDQ(-)) biolar sectrum criteria MDQ(+) MDQ(-) MDQ(+) vs MDQ(-) Duration of eisode (in weeks) 11 ± ± 10.2 Number of treatments 2.18 ± ± 0.7 Presence of suicidal thoughts n = 11 (50%) n = 18 (64.3%) Presence of suicidal tendencies n = 5 (22.7%) n = 5 (17.9%) Table 10. Selected clinical data regarding the current deression eisode in drug resistant atients (grou 1) fulfilling (HCL(+)) or not fulfilling (HCL(-)) HCL-32 biolar sectrum criteria MDQ(+) MDQ(-) MDQ(+) vs MDQ(-) Duration of eisode (in weeks) 11 ± ± 10.2 Number of treatments 2.18 ± ± 0.7 Presence of suicidal thoughts n = 11 (50%) n = 18 (64.3%) Presence of suicidal tendencies n = 5 (22.7%) n = 5 (17.9%)

8 72 Dominika Dudek et al. DISCUSSION The grou of drug-resistant atients, in comarison with non-drug-resistant atients, was characterized by a shorter time since the last hositalization and a larger number of eisodes, as well as a larger number of individuals who subjectively estimated their last remission to be incomlete. These data reflect the unfavourable attern of the course of deressive disorder in the case of drug resistance. In the grou of drug-resistant atients, there were significantly more ersons with a family history of different mental disorders (deression, alcoholism, schizohrenia, biolar disorder, anxiety disorders). However, it should be ointed that in both grous, only 2% of atients reorted cases of biolar disorder in the family. Such an extremely low ercentage suggests the underdiagnosis of BD. Attention should be aid to the statistically more frequent occurrence of alcohol abuse in the families of drug-resistant atients, which may be a confirmation of undiagnosed biolarity. According to Sonne et al [19], alcohol abuse coexists with BD in about 33% of cases and maybe a factor suggesting incidence of biolar sectrum in deressive disorder. It seems that use of the questions included in such tools as the MDQ or the HCL, not only for the examination of the atient, but also during a family interview may imrove the detection of biolarity among atients relatives. In the drug resistant grou, in comarison to the non-drug-resistant grou there were significantly more atients fulfilling MDQ and/ or HCL-32 biolar sectrum criteria. This suggests that a significant ercentage of refractory deression is reresented by misdiagnosed and therefore inadequately treated biolar disorder. Such data are consistent with the results of revious investigations. Sharma at al [6] found the resence of BD (mainly tye II) or features of broadly-defined biolarity resectively in 59% and 80% of atients treated for drug-resistant deression. In another study, characterized by long-term follow-u (1-7 years), it was observed that a significant art of drug-resistant deression is associated with BD. The diagnosis was changed from uniolar affective disorder to biolar disorder in 5 of 21 atients [7]. The results of the all-polish, multicenter DEP-BI roject showed that about 60% of the outatients treated by sychiatrists for recurrent deression or deressive eisode reresent different forms of BD [1, 3]. Moreover, in a grou of atients who fulfilled biolarity criteria there were more cases of drugresistance [3]. The differences between drug-resistant and non drug-resistant atients in frequency of answer to secific questions in the MDQ and HCL questionnaires shown in this ilot study also suggest that, in case of adding of a larger number of atients to the trial, it may be ossible to choose such secific questions from the questionnaires used, which would be used during interviewing atients to increase the robability of recognition of biolar features among drug-resistant atients. The varying, in terms of occurrence or lack of it, features of biolarity in the grou of drug-resistant atients, characterized by answers to questions from the MDQ and HCL questionnaires, may enable the searation of factors which, during the interview, may contribute to an imrovement in diagnostic vigilance in the future. Drug-resistant atients fulfilling the MDQ biolar sectrum criteria, comared to the drug-resistant atients without biolar sectrum, considered the last remission as artial or reorted lack of remission, reorted treatment nonadherence, had more frequent occurrences of suicide attemts as well as a greater number of suicide attemts. These results suggest that resence of biolar sectrum may significantly and negatively affect the course and rognosis in drug-resistant deression. References 1. Rybakowski JK, Suwalska A, Lojko D, Rymaszewska J, Kiejna A. Biolar mood disorders among Polish sychiatric outatients treated for major deression. J Affect. Disord. 2005; 84(2-3): Kiejna A, Rymaszewska J, Hadrys T, Suwalska A, Lojko D, Rybakowski JK. Biolar or uniolar? the question for clinicians and researchers. J. Affect. Disord. 2006; 93(1 3): Rybakowski JK, Suwalska A, Lojko D, Rymaszewska J, Kiejna A. Tyes of deression more frequent in biolar

9 q1biolar sectrum features in drug resistant uniolar deression atients TRES-DEP ilot study 73 than in uniolar affective illness: results of the Polish DEP- BI study. Psychoathology. 2007; 40(3): Ghaemi SR, Rosenquist KJ, Ko JY, Baldassano CF, Kontos NJ, Baldessarini RJ. Antideressant treatment in biolar versus uniolar deression. Am. J. Psychiatry 2004; 161, Hantouche E, Angst J. Rate and risk factors of hyomania in recurrent and treatment resistant deression. 3rd International Congress on Brain and Behaviour, , Theassaloniki, Greece. Annals Gen. Psychiatry 2007,7, Sul.1, S Sharma V, Khan M, Smith A. A closer look at treatment resistant deression: is it due to a biolar diathesis? J. Affect. Disord. 2005; 84: Inoue T, Nakagawa S, Kitaichi Y, Izumi T, Tanaka T, Masui T, Kusumi I, Denda K, Koyama T, Long-term outcome of antideressant-refractory deression: The relevance of unrecognized biolarity. Journal of affective disorders.2006 Oct; 95(1-3): Hamilton M. A rating scale for deression. Journal of Neurology Neurosurgery and Psychiatry 1960; 23: Hamilton M. Develoment of a rating scale for rimary deressive illness. Br J Soc Clin Psychol. 1967; 6: Pużyński S, Wciórka J. Narzędzia oceny stanu sychicznego. W: Bilikiewicz A, Pużyński S, Rybakowski J, Wciórka J eds. Psychiatria vol 1. Podstawy sychiatrii. Wrocław: Urban & Partner; Hirschfeld RM, Williams JB, Sitzer RL, Calabrese JR, Flynn L, Keck PE, Lewis L, McElroy SL, Post RM, Raort DJ, Russell JM, Sachs GS, Zajecka J. Develoment and Validation of a Screening Instrument for Biolar Sectrum Disorder: The Mood Disorder Questionnaire Am J Psychiatry 157: , November Hirschfeld RM, Biolar sectrum disorder: imroving its recognition and diagnosis. J.Clin. Psychiatry: 2001; 62 Sul 14: J. Angst, R. Adolfsson, F. Benazzi, A. Gamma, E. Hantouche, T. Meyer, P. Skear, E. Vieta, J. Scott The HCL- 32: Towards a self-assessment tool for hyomanic symtoms in outatients. Journal of Affective Disorders, 2005; 88(2): Kennedy SH, Lam RW, Nutt DJ, Thase ME. Treatmentresistant deression. In: Kennedy SH, Lam RW, Nutt DJ, Thase ME eds. Treating deression effectively. Nowy Jork- Londyn: Martin Dunitz; 2004; Souery D, Amsterdam J, de Montigny C, Lecrubier Y, Montgomery S, Li O, Racagni G, Zohar J, Mendlewicz J. Treatment resistant deression: methodological overview and oerational criteria. Eur Neurosychoharmacol. 1999; 9: Ferguson GA, Takane Y. Analiza statystyczna w sychologii i edagogice. Warszawa: PWN; Armitage P. Metody statystyczne w badaniach medycznych. Warszawa: PZWL; Brzeziński J. Metodologia badań sychologicznych. Warszawa: PWN; Sonne SC, Brady KT. Substance abuse and biolar comorbidity. Psychiatr Clin North Am. 1999; 22(3):

10

Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age Years): A Population Based Case-Control Study

Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age Years): A Population Based Case-Control Study Send Orders for Rerints to rerints@benthamscience.net Current Alzheimer Research, 2014, 11, 681-693 681 Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age 65-84 Years): A

More information

Functioning and depression in patients under cognitivebehavioral

Functioning and depression in patients under cognitivebehavioral Basic Science Functioning and deression in atients under cognitivebehavioral Jasna Petković 1, Emir Tuković 2 1 University Clinical Center, Psychiatric Clinic Tuzla, Bosnia and Herzegovina 2 Deartment

More information

Khalida Ismail, 1 Andy Sloggett, 2 and Bianca De Stavola 3

Khalida Ismail, 1 Andy Sloggett, 2 and Bianca De Stavola 3 American Journal of Eidemiology Coyright 2000 by The Johns Hokins University School of Hygiene and Public Health All rights reserved Vol. 52, No. 7 Printed in U.S.A. Common Mental Disorders and Cigarette

More information

Evaluation of the Coping Strategies Used by Knee Osteoarthritis Patients for Pain and Their Effect on the Disease-Specific Quality of Life

Evaluation of the Coping Strategies Used by Knee Osteoarthritis Patients for Pain and Their Effect on the Disease-Specific Quality of Life January Aril 2016 Volume 9 Issue 1 Page 80 Original Article Evaluation of the Coing Strategies Used by Knee Osteoarthritis Patients for Pain and Their Effect on the DiseaseSecific Quality of Life Semra

More information

Features of bipolarity among unipolars

Features of bipolarity among unipolars Features of bipolarity among unipolars Joanna Rymaszewska, Andrzej Kiejna, Tomasz Hadryś, Aleksandra Suwalska, Dorota Łojko, Janusz K. Rybakowski Summary Aim, material and method: The aim of the study

More information

Acne Itch: Do Acne Patients Suffer From Itching?

Acne Itch: Do Acne Patients Suffer From Itching? Acta Derm Venereol 2008; 88: 38 42 CLINICAL REPORT Acne Itch: Do Acne Patients Suffer From Itching? Adam Reich, Katarzyna Trybucka, Anna Tracinska, Dominik Samotij, Blazej Jasiuk, Marek Srama and Jacek

More information

Outcomes following first-episode psychosis Why we should intervene early in all ages, not only in youth

Outcomes following first-episode psychosis Why we should intervene early in all ages, not only in youth 673454ANP0010.1177/0004867416673454ANZJP ArticlesLain et al. research-article2016 Research Outcomes following first-eisode sychosis Why we should intervene early in all ages, not only in youth Australian

More information

Chapter 13 Mental Health

Chapter 13 Mental Health Chater 13 Mental Health 564 Health of Boston 2016-2017 565 13 Mental Health Mental Health Mental wellness is a fundamental comonent of overall health. The World Health Organization (WHO) defines mental

More information

Introducing Two-Way and Three-Way Interactions into the Cox Proportional Hazards Model Using SAS

Introducing Two-Way and Three-Way Interactions into the Cox Proportional Hazards Model Using SAS Paer SD-39 Introducing Two-Way and Three-Way Interactions into the Cox Proortional Hazards Model Using SAS Seungyoung Hwang, Johns Hokins University Bloomberg School of Public Health ABSTRACT The Cox roortional

More information

COPD is a common disease. Over the prolonged, Pneumonic vs Nonpneumonic Acute Exacerbations of COPD*

COPD is a common disease. Over the prolonged, Pneumonic vs Nonpneumonic Acute Exacerbations of COPD* vs Acute Exacerbations of COPD* David Lieberman, MD; Devora Lieberman, MD; Yevgenia Gelfer, MD; Raiesa Varshavsky, MD; Bella Dvoskin, MD, PhD; Maija Leinonen, PhD; and Maureen G. Friedman, PhD Study objective:

More information

Annie Quick and Saamah Abdallah, New Economics Foundation

Annie Quick and Saamah Abdallah, New Economics Foundation Inequalities in wellbeing Annie Quick and Saamah Abdallah, New Economics Foundation Abstract: This aer exlores the nature and drivers of inequality in wellbeing across Euroe. We used the first six rounds

More information

Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan

Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan Int. J. Environ. Res. Public Health 2011, 8, 3922-3937; doi:10.3390/ijerh8103922 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdi.com/journal/ijerh Article

More information

Assessment of Health Professionals Views and Beliefs about Mental Illnesses: A Survey from Turkey

Assessment of Health Professionals Views and Beliefs about Mental Illnesses: A Survey from Turkey International Journal of Humanities and Social Science Invention ISSN (Online): 2319 7722, ISSN (Print): 2319 7714 Volume 5 Issue 5 May. 2016 PP.55-62 Assessment of Health Professionals Views and Beliefs

More information

COGNITIVE DYSFUNCTION, DISSOCIATION AND QUALITY OF LIFE IN BIPOLAR AFFECTIVE DISORDERS IN REMISSION

COGNITIVE DYSFUNCTION, DISSOCIATION AND QUALITY OF LIFE IN BIPOLAR AFFECTIVE DISORDERS IN REMISSION sychiatria Danubina, 2010; Vol. 22, No. 4, 528 534 Medicinska naklada - Zagreb, Croatia Original aer COGNITIVE DYFUNCTION, DIOCIATION AND QUALITY OF LIFE IN BIOLAR AFFECTIVE DIORDER IN REMIION Klara Latalova

More information

Haematological abnormalities and quality of life in patients with chronic hepatitis C who meet major depression disorder during antiviral therapy

Haematological abnormalities and quality of life in patients with chronic hepatitis C who meet major depression disorder during antiviral therapy Articolo originale Original article Haematological abnormalities and quality of life in atients with chronic heatitis C who meet major deression disorder during antiviral theray Alterazioni ematologiche

More information

Anxiety disorders are more common than any other

Anxiety disorders are more common than any other Article Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prosective Study Steven E. Bruce, Ph.D. Kimberly A.

More information

Restorative proctocolectomy with ileal pouch anal anastomosis

Restorative proctocolectomy with ileal pouch anal anastomosis ORIGINAL ARTICLE Biosychosocial Determinants of Health-Related Quality of Life After Ileal Pouch Anal Anastomosis for Ulcerative Colitis* Winfried Häuser, MD,* Nadine Dietz, Ulf Steder-Neukamm, Karl-Heinz

More information

The nosology for eating disorders has undergone extensive

The nosology for eating disorders has undergone extensive Article An Emirical Study of the Classification of Eating Disorders Cynthia M. Bulik, Ph.D. Patrick F. Sullivan, M.D., F.R.A.N.Z.C.P. Kenneth S. Kendler, M.D. EMPIRICAL CLASSIFICATION OF EATING DISORDERS

More information

Attitudes and beliefs about mental illness among relatives of patients with schizophrenia

Attitudes and beliefs about mental illness among relatives of patients with schizophrenia Attitudes and beliefs about mental illness among relatives of atients with schizohrenia Ajak Manguak Agau a and Anne Bodilsen b a National Institute of Health Sciences, Jonglei b Aarhus University Hosital,

More information

Polymorbidity in diabetes in older people: consequences for care and vocational training

Polymorbidity in diabetes in older people: consequences for care and vocational training 763 ORIGINAL ARTICLE Polymorbidity in diabetes in older eole: consequences for care and vocational training B van Bussel, E Pijers, I Ferreira, P Castermans, A Nieuwenhuijzen Kruseman... See end of article

More information

Journal of the American College of Cardiology Vol. 38, No. 1, by the American College of Cardiology ISSN /01/$20.

Journal of the American College of Cardiology Vol. 38, No. 1, by the American College of Cardiology ISSN /01/$20. Journal of the American College of Cardiology Vol. 38, No. 1, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(01)01308-0 Acute

More information

Randomized controlled trials: who fails run-in?

Randomized controlled trials: who fails run-in? Rees et al. Trials (2016) 17:374 DOI 10.1186/s13063-016-1451-9 RESEARCH Oen Access Randomized controlled trials: who fails run-in? Judy R. Rees 1, Leila A. Mott 1, Elizabeth L. Barry 1, John A. Baron 1,2,

More information

Exploratory Study of the Clinical Characteristics of Adolescent Girls with a History of Physical or Sexual Abuse Consulting in a Mood Disorder Clinic

Exploratory Study of the Clinical Characteristics of Adolescent Girls with a History of Physical or Sexual Abuse Consulting in a Mood Disorder Clinic / DE L ACADÉMIE CANADIENNE DE PSYCHIATRIE DE L ENFANT ET DE L ADOLESCENT Brief Communication Exloratory Study of the Clinical Characteristics of Adolescent Girls with a History of Physical or Sexual Abuse

More information

carinzz prophylactic regimens

carinzz prophylactic regimens Genitourin Med 1997;73:139-143 Continuing medical education HIV Eidemiology Unit, Chelsea and Westminster Hosital, 369 Fulham Road, London SW10 9TH, UK P J Easterbrook Acceted for ublication 8 October

More information

Internet-based relapse prevention for anorexia nervosa: nine- month follow-up

Internet-based relapse prevention for anorexia nervosa: nine- month follow-up Fichter et al. Journal of Eating Disorders 2013, 1:23 RESEARCH ARTICLE Oen Access Internet-based relase revention for anorexia nervosa: nine- month follow-u Manfred Maximilian Fichter 1,2*, Norbert Quadflieg

More information

Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: Risk factors and impact on outcomes

Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: Risk factors and impact on outcomes Piskin et al. BMC Infectious Diseases 2012, 12:268 RESEARCH ARTICLE Oen Access Inadequate treatment of ventilator-associated and hosital-acquired neumonia: Risk factors and imact on outcomes Nihal Piskin

More information

Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India, 2

Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India, 2 Vol 9, Issue 1, 2016 ISSN - 0974-2441 Research Article IMPACT OF CONTINUOUS PATIENT COUNSELLING ON KNOWLEDGE, ATTITUDE, AND PRACTICES AND MEDICATION ADHERENCE OF DIABETIC PATIENTS ATTENDING OUTPATIENT

More information

University of Groningen. Depression vulnerability: is it really what you think? van Rijsbergen, Gerard

University of Groningen. Depression vulnerability: is it really what you think? van Rijsbergen, Gerard University of Groningen Deression vulnerability: is it really what you think? van Rijsbergen, Gerard IMPORTANT NOTE: You are advised to consult the ublisher's version (ublisher's PDF if you wish to cite

More information

Treating Patients with HIV and Hepatitis B and C Infections: Croatian Dental Students Knowledge, Attitudes, and Risk Perceptions

Treating Patients with HIV and Hepatitis B and C Infections: Croatian Dental Students Knowledge, Attitudes, and Risk Perceptions Treating Patients with HIV and Heatitis B and C Infections: Croatian Dental Students Knowledge, Attitudes, and Risk Percetions Vlaho Brailo, D.M.D., Ph.D.; Ivica Pelivan, D.M.D., Ph.D.; Josi Škaričić;

More information

Recurrence of Angina After Coronary Artery Bypass Surgery: Predictors and Prognosis (CASS Registry)

Recurrence of Angina After Coronary Artery Bypass Surgery: Predictors and Prognosis (CASS Registry) JACC Vol. 26, No. 4 895 Recurrence of Angina After Coronary Artery Byass Surgery: Predictors and Prognosis (CASS Registry) AIRLIE A. C. CAMERON, MD, FACC, KATHRYN B. DAVIS, PHD, FACC,* WILLIAM J. ROGERS,

More information

Numune Education and Research Hospital, Department Of Gastroenterology,

Numune Education and Research Hospital, Department Of Gastroenterology, Clinical Theray Resonse and Outcome of Overla Syndromes: Autoimmune Heatitis and Primary Biliary Cirrhosis Comared to Autoimmune Heatitis and Autoimmune Cholangitis Ersan Ozaslan 1, Cumali Efe 1, Sabiye

More information

Decision Analysis Rates, Proportions, and Odds Decision Table Statistics Receiver Operating Characteristic (ROC) Analysis

Decision Analysis Rates, Proportions, and Odds Decision Table Statistics Receiver Operating Characteristic (ROC) Analysis Decision Analysis Rates, Proortions, and Odds Decision Table Statistics Receiver Oerating Characteristic (ROC) Analysis Paul Paul Barrett Barrett email: email:.barrett@liv.ac.uk htt://www.liv.ac.uk/~barrett/aulhome.htm

More information

Constipation in adults with neurofibromatosis type 1

Constipation in adults with neurofibromatosis type 1 Ejerskov et al. Orhanet Journal of Rare Diseases (2017) 12:139 DOI 10.1186/s13023-017-0691-4 RESEARCH Oen Access Constiation in adults with neurofibromatosis tye 1 Cecilie Ejerskov 1,2,3*, Klaus Krogh

More information

Comparative study of anxiety and depression following maxillofacial and orthopedic injuries. Study from a Nigerian University Teaching Hospital

Comparative study of anxiety and depression following maxillofacial and orthopedic injuries. Study from a Nigerian University Teaching Hospital Received: 16 June 2017 Revised: 12 Setember 2017 Acceted: 14 Setember 2017 DOI: 10.1002/cre2.90 ORIGINAL ARTICLE Comarative study of anxiety and deression following maxillofacial and orthoedic injuries.

More information

Prefrontal cortex fmri signal changes are correlated with working memory load

Prefrontal cortex fmri signal changes are correlated with working memory load Cognitive Neuroscience and Neurosychology NeuroReort 8, 545 549 (997) WE investigated whether a nonsatial working memory (WM) task would activate dorsolateral refrontal cortex (DLPFC) and whether activation

More information

An assessment of diabetes-dependent quality of life (ADDQoL) in women and men in Poland with type 1 and type 2 diabetes

An assessment of diabetes-dependent quality of life (ADDQoL) in women and men in Poland with type 1 and type 2 diabetes ORIGINAL ARTICLE www.aaem.l An assessment of diabetes-deendent quality of life (ADDQoL) in women and men in Poland with tye 1 and tye 2 diabetes Ewelina Bąk 1,A-F, Zofia Nowak-Kausta 2,D, Dorota Dobrzyń-Matusiak

More information

Risk factors for post-colectomy adhesive small bowel obstruction

Risk factors for post-colectomy adhesive small bowel obstruction Original article Acta Medica Academica 2016;45(2):121-127 DOI: 10.5644/ama2006-124.167 Risk factors for ost-colectomy adhesive small bowel obstruction Edin Husarić 1, Šefik Hasukić 1, Nešad Hotić 1, Amir

More information

RISK FACTORS FOR NOCTURIA IN TAIWANESE WOMEN AGED YEARS

RISK FACTORS FOR NOCTURIA IN TAIWANESE WOMEN AGED YEARS ORIGINAL ARTICLE RISK FACTORS FOR NOCTURIA IN TAIWANESE WOMEN AGED 20 59 YEARS Ching-Hung Hsieh*, Hsing-Yu Chen 1, Chun-Sen Hsu, Shao-Tung Chang 2, Chien-Dai Chiang 3 Deartment of Obstetrics and Gynecology,

More information

Interactions between Symptoms and Motor and Visceral Sensory Responses of Irritable Bowel Syndrome Patients to Spasmolytics (Antispasmodics)

Interactions between Symptoms and Motor and Visceral Sensory Responses of Irritable Bowel Syndrome Patients to Spasmolytics (Antispasmodics) Interactions between Symtoms and Motor and Visceral Sensory Resonses of Irritable Bowel Syndrome Patients to Sasmolytics (Antisasmodics) Igor L.Khalif 1, Eamonn M.M.Quigley 2, P.A.Makarchuk 1, O.V.Golovenko

More information

Cheng-Fang Yen Yu-Min Chen Jen-Wen Cheng Tai-Ling Liu Tzu-Yu Huang Peng-Wei Wang Pinchen Yang Wen-Jiun Chou

Cheng-Fang Yen Yu-Min Chen Jen-Wen Cheng Tai-Ling Liu Tzu-Yu Huang Peng-Wei Wang Pinchen Yang Wen-Jiun Chou Child Psychiatry Hum Dev (2014) 45:338 347 DOI 10.1007/s10578-013-0403-9 ORIGINAL ARTICLE Effects of Cognitive-Behavioral Theray on Imroving Anxiety Symtoms, Behavioral Problems and Parenting Stress in

More information

Sensitivity and applicability of the Brazilian version of the Brief Assessment of Cognition in Schizophrenia (BACS)

Sensitivity and applicability of the Brazilian version of the Brief Assessment of Cognition in Schizophrenia (BACS) Dementia & Neurosychologia 2007;3:260-265 Sensitivity and alicability of the Brazilian version of the Brief Assessment of Cognition in Schizohrenia (BACS) João Vinícius Salgado 1,2, Carolina F. Richards

More information

PHYSICAL ACTIVITY ASSOCIATED TO LOWER PREVALENCE OF DEMENTIA IN ELDERLY SUBJECTS

PHYSICAL ACTIVITY ASSOCIATED TO LOWER PREVALENCE OF DEMENTIA IN ELDERLY SUBJECTS PHYSICAL ACTIVITY ASSOCIATED TO LOWER PREVALENCE OF DEMENTIA IN ELDERLY SUBJECTS Ricardo Barcelos-Ferreira, Marcos Antônio Loes, Cássio Machado de Camos Bottino. BACKGROUND Longitudinal studies have found

More information

Automatic System for Retinal Disease Screening

Automatic System for Retinal Disease Screening Automatic System for Retinal Disease Screening Arathy.T College Of Engineering Karunagaally Abstract This work investigates discrimination caabilities in the texture of fundus images to differentiate between

More information

Getting to Goal: Managed Care Strategies for Children, Adolescents, and Adults With ADHD

Getting to Goal: Managed Care Strategies for Children, Adolescents, and Adults With ADHD n osttest n Getting to Goal: Managed Care Strategies for Children, Adolescents, and Adults With ADHD Instructions There are no fees for articiating in and receiving CME credit for this activity. During

More information

Cardiology & Vascular Research

Cardiology & Vascular Research Research Article Cardiology & Vascular Research ISSN 2639-8486 Correlation of Limb Bioimedance to Echocardiograhic Indicators of Congestion in Patients with NYHA Class II/III Heart Failure Accardi AJ *,

More information

Depression in Diabetes Self-Rating Scale: a screening tool

Depression in Diabetes Self-Rating Scale: a screening tool Andrzej Kokoszka ORIGINAL II Department of Psychiatry, Medical University of Warsaw, Poland Depression in Diabetes Self-Rating Scale: a screening tool Abstract Background. Early diagnosis and treatment

More information

Original Article. Kee Hyun Cho, MD and Soo Jung Kang, MD. Introduction. Korean Circulation Journal

Original Article. Kee Hyun Cho, MD and Soo Jung Kang, MD. Introduction. Korean Circulation Journal Original Article htt://dx.doi.org/10.4070/kcj.2014.44.5.328 Print ISSN 1738-5520 On-line ISSN 1738-5555 Korean Circulation Journal Clinically Useful Predictors of Resistance to Intravenous Immunoglobulin

More information

Six-Month Outcome in Patients With Myocardial Infarction Initially Admitted to Tertiary and Nontertiary Hospitals

Six-Month Outcome in Patients With Myocardial Infarction Initially Admitted to Tertiary and Nontertiary Hospitals JACC Vol. 30, No. 5 November 1, 1997:1187 92 1187 Six-Month Outcome in Patients With Myocardial Infarction Initially Admitted to Tertiary and Nontertiary Hositals JAUME MARRUGAT, MD, GINÉS SANZ, MD,* RAFEL

More information

Syncope in Children and Adolescents

Syncope in Children and Adolescents Aril 1997:1039 45 1039 Syncoe in Children and Adolescents DAVID J. DRISCOLL, MD, FACC, STEVEN J. JACOBSEN, MD, PHD, CO-BURN J. PORTER, MD, FACC, PETER C. WOLLAN, PHD Rochester, Minnesota Objectives. The

More information

Journal of the American College of Cardiology Vol. 35, No. 4, by the American College of Cardiology ISSN /00/$20.

Journal of the American College of Cardiology Vol. 35, No. 4, by the American College of Cardiology ISSN /00/$20. Journal of the American College of Cardiology Vol. 35, No. 4, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(99)00641-5 Utilization

More information

Original paper Videosurgery. Łukasz Kaska, Monika Proczko, Jarek Kobiela, Tomasz Jerzy Stefaniak, Zbigniew Śledziński

Original paper Videosurgery. Łukasz Kaska, Monika Proczko, Jarek Kobiela, Tomasz Jerzy Stefaniak, Zbigniew Śledziński Original aer Videosurgery Dynamics of tye 2 diabetes mellitus laboratory remission after Roux-en-Y gastric byass in atients with body mass index lower than 35 kg/m 2 and higher than 35 kg/m 2 in a 3-year

More information

Magnitude and determinants of Diabetes mellitus (DM) and diabetic nephropathy (DN) in patients attending Al-Leith General Hospital

Magnitude and determinants of Diabetes mellitus (DM) and diabetic nephropathy (DN) in patients attending Al-Leith General Hospital Indian Journal of Basic and Alied Medical Research; March 2018: Vol.-7, Issue- 2, P. 486-494 Original article: Magnitude and determinants of Diabetes mellitus (DM) and diabetic nehroathy (DN) in atients

More information

Quality of Life and Symptom Control in Patients with Cancer

Quality of Life and Symptom Control in Patients with Cancer International Journal of Caring Sciences Setember-December 2017 Volume 10 Issue 3 Page 1685 Original Article Quality of Life and Symtom Control in Patients with Cancer Sera Unsar, PhD Professor, Trakya

More information

Gender Differences and Predictors of Work Hours in a Sample of Ontario Dentists. Cite this as: J Can Dent Assoc 2016;82:g26

Gender Differences and Predictors of Work Hours in a Sample of Ontario Dentists. Cite this as: J Can Dent Assoc 2016;82:g26 Gender Differences and Predictors of Work Hours in a Samle of Ontario Dentists Julia C. McKay, DDS, PhD; Atyub Ahmad, BSc(Hon), MMI, DDS; Jodi L. Shaw, DMD, MSc, FRCD(C); Faahim Rashid, DDS, MSc, FRCD(C);

More information

Asthma Prescribing Practices of Government and Private Doctors in Malaysia - A Nationwide Questionnaire Survey

Asthma Prescribing Practices of Government and Private Doctors in Malaysia - A Nationwide Questionnaire Survey ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (2005) 23: 7-17 Asthma Prescribing Practices of and Doctors in Malaysia - A Nationwide Questionnaire Survey Li-Cher Loh and Pei-Se Wong SUMMARY A self-answered,

More information

Amino acids in retinitis pigmentosa

Amino acids in retinitis pigmentosa British Journal of Ohthalmology, 1981, 65, 626-630 Amino acids in retinitis igmentosa STEVE A. ARSHINOFF,' J. CLEMENT McCULLOCH,' WILLIAM MACRAE,2 ARTHUR N. STEIN,3 AND ERROL B. MARLISS3 From the Deartments

More information

Chapter 2. Horm Behav Jul;60(2):

Chapter 2. Horm Behav Jul;60(2): Chater The newborn rat s stress system readily habituates to reeated and rolonged maternal searation, while continuing to resond to stressors in context deendent fashion. Nikolaos P. Daskalakis 1, Sanne

More information

Does Job Strain Increase the Risk for Coronary Heart Disease or Death in Men and Women?

Does Job Strain Increase the Risk for Coronary Heart Disease or Death in Men and Women? American Journal of Eidemiology Coyright 2004 by the Johns Hokins Bloomberg School of Public Health All rights reserved Vol. 159, No. 10 Printed in U.S.A. DOI: 10.1093/aje/kwh127 Does Job Strain Increase

More information

Possible Association of the Ubiquitin-Specific Peptidase 46 Gene (USP46) with Affective Temperamental Traits in Healthy Korean Volunteers

Possible Association of the Ubiquitin-Specific Peptidase 46 Gene (USP46) with Affective Temperamental Traits in Healthy Korean Volunteers ORIGINAL ARTICLE htts://doi.org/10.30773/i.2018.10.02 Print ISSN 1738-3684 / On-line ISSN 1976-3026 OPEN ACCESS Possible Association of the Ubiquitin-Secific Petidase 46 Gene (USP46) with Affective Temeramental

More information

THE EFFECT OF PATIENTS HABITS OF INTERNET USE FOR HEALTH CONSULTATIONS ON THE PHYSICIAN-PATIENT RELATIONSHIP

THE EFFECT OF PATIENTS HABITS OF INTERNET USE FOR HEALTH CONSULTATIONS ON THE PHYSICIAN-PATIENT RELATIONSHIP THE EFFECT OF PATIENTS HABITS OF INTERNET USE FOR HEALTH CONSULTATIONS ON THE PHYSICIAN-PATIENT RELATIONSHIP Halil Erdem Özel, Selahattin Genç, Fatih Özdoğan, Adin Selçuk Derince Eğitim ve Araştırma Hastanesi,

More information

Protocol: Influence of Budesonide and Budesonide/ Formoterol on Asthma Control in Smoking Asthmatic Adults

Protocol: Influence of Budesonide and Budesonide/ Formoterol on Asthma Control in Smoking Asthmatic Adults The Oen Resiratory Medicine Journal, 2010, 4, 51-57 51 Protocol: Influence of and / Formoterol on Asthma Control in Smoking Asthmatic Adults Oen Access Louis-Philie Boulet *,1, Francine Deschesnes 1, Simone

More information

Association of anxiety with body mass index (BMI) and waist to hip ratio (WHR) in medical students

Association of anxiety with body mass index (BMI) and waist to hip ratio (WHR) in medical students Original Research Association of anxiety with body mass index (BMI) and waist to hi ratio (WHR) in medical students Rajeshree S. Meshram, Yogita D. Sulaxane, Snehal S. Kulkarni, Ashok H. Kale Deartment

More information

Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands Send Orders of Rerints at rerints@benthamscience.org 6 The Oen Nursing Journal, 2013, 7, 6-13 Oen Access Informal Caregivers of Peole with Dementia: Problems, Needs and Suort in the Initial Stage and in

More information

Can the anxiety domain of EQ-5D and mental health items from SF-36 help predict outcomes after surgery for lumbar degenerative disorders?

Can the anxiety domain of EQ-5D and mental health items from SF-36 help predict outcomes after surgery for lumbar degenerative disorders? clinical article J Neurosurg Sine 25:352 356, 2016 Can the anxiety of EQ-5D and mental health items from SF-36 hel redict outcomes after surgery for lumbar degenerative disorders? Leah Y. Carreon, MD,

More information

Fibromyalgia in patients with rheumatoid arthritis. A 10-year follow-up study, results from the Oslo Rheumatoid Arthritis Register

Fibromyalgia in patients with rheumatoid arthritis. A 10-year follow-up study, results from the Oslo Rheumatoid Arthritis Register Fibromyalgia in atients with rheumatoid arthritis. A 10-year follow-u study, results from the Oslo Rheumatoid Arthritis Register S.A. Provan, C. Austad, V. Halsaa, H.B. Hammer, T.K. Kvien, T. Uhlig Deartment

More information

Induced Mild Hypothermia for Ischemic Stroke Patients

Induced Mild Hypothermia for Ischemic Stroke Patients Med. J. Cairo Univ., Vol. 82, No. 2, December: 179-186, 2014 www.medicaljournalofcairouniversity.net Induced Mild Hyothermia for Ischemic Stroke Patients AHMED E.S. ELNAHRAWY, M.Sc.; MERVAT M. KHALEF,

More information

Analysis of 14,843 Neonatal Congenital Heart Surgical Procedures in the European Association for Cardiothoracic Surgery Congenital Database.

Analysis of 14,843 Neonatal Congenital Heart Surgical Procedures in the European Association for Cardiothoracic Surgery Congenital Database. Analysis of 14,843 Neonatal Congenital Heart Surgical Procedures in the Euroean Association for Cardiothoracic Surgery Congenital Database Andrzej Kansy, MD, PhD, Zdzislaw Tobota, MD, Przemyslaw Maruszewski,

More information

Relation of Arterial Structure and Function to Left Ventricular Geometric Patterns in Hypertensive Adults

Relation of Arterial Structure and Function to Left Ventricular Geometric Patterns in Hypertensive Adults JACC Vol. 28, No. 3 Setember 1996:751 6 751 Relation of Arterial Structure and Function to Left Ventricular Geometric Patterns in Hyertensive Adults MARY J. ROMAN, MD, FACC, THOMAS G. PICKERING, MD, PHD,

More information

Depression, metabolic control, and antidepressant medication in young patients with type 1 diabetes

Depression, metabolic control, and antidepressant medication in young patients with type 1 diabetes Pediatric Diabetes 2015: 16: 58 66 doi: 10.1111/edi.12130 All rights reserved 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Pediatric Diabetes Original Article Deression, metabolic control,

More information

Marriage Satisfaction of Parents of Children with Autism.

Marriage Satisfaction of Parents of Children with Autism. Dr Tomasz Gosztyła Faculty of Pedagogy, Deartment of Psychology University of Rzeszów Marriage Satisfaction of Parents of Children with Autism. Introductory Exloration of the Problem among Polish Married

More information

Executive Dysfunction in Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) Original Article

Executive Dysfunction in Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) Original Article Original Article Executive Dysfunction in Children and adolescents with Attention Deficit Hyeractivity Disorder (ADHD) 1, 2, 3 Mehdi Tehrani-Doost, MD Reza Rad Goodarzi, MD 2 Mitra Seasi, MS 1 Javad Alaghband-Rad,

More information

Research Article ABSTRACT. Amanda Myhren-Bennett College of Nursing, University of South Carolina, Columbia, SC 29208, USA

Research Article ABSTRACT. Amanda Myhren-Bennett College of Nursing, University of South Carolina, Columbia, SC 29208, USA Quality in Primary Care (2017) 25 (3): 176-186 2017 Insight Medical Publishing Grou Research Article Research Article Adherence to Standards of Practice Treating Diabetes between Physicians and Nurse Practitioners:

More information

Article 4 Comparison of Amplitude of Accommodation in Different Vertical Viewing Angles

Article 4 Comparison of Amplitude of Accommodation in Different Vertical Viewing Angles Article 4 Comarison of Amlitude of Accommodation in Different Vertical Viewing Angles Chiranjib Majumder, M. Otom, Twintech International University College of Technology, Kuala Lumur, Malaysia Lee Shin

More information

Prognostic Value of Exercise Thallium-201 Imaging Performed Within 2 Years of Coronary Artery Bypass Graft Surgery

Prognostic Value of Exercise Thallium-201 Imaging Performed Within 2 Years of Coronary Artery Bypass Graft Surgery 848 JACC Vol. 31, No. 4 BYPASS SURGERY Prognostic of Exercise Thallium-201 Imaging Performed Within 2 Years of Coronary Artery Byass Graft Surgery TODD D. MILLER, MD, FACC, TIMOTHY F. CHRISTIAN, MD, FACC,

More information

Min Kyung Hyun. 1. Introduction. 2. Methods

Min Kyung Hyun. 1. Introduction. 2. Methods Evidence-Based Comlementary and Alternative Medicine Volume 2016, Article ID 2625079, 5 ages htt://dx.doi.org/10.1155/2016/2625079 Research Article The Needs and Priorities for Government Grants for Traditional

More information

Patients and doctors attitudes towards bipolar disorder do we share our beliefs?

Patients and doctors attitudes towards bipolar disorder do we share our beliefs? Patients and doctors attitudes towards bipolar do we share our beliefs? Grzegorz Mączka, Marcin Siwek, Michał Skalski, Bartosz Grabski, Dominika Dudek Summary Aim. The aim of the presented study was an

More information

Motor Resonance Mechanisms during Action Imitation in Depression

Motor Resonance Mechanisms during Action Imitation in Depression Motor Resonance Mechanisms during Action Imitation in Deression Djamila Bennabi, Nicolas Carvalho, Ambra Bisio, Emmanuel Haffen, Thierry Pozzo ABSTRACT Objectives Major deressive disorder has been associated

More information

December 2014 MRC2.CORP.D.00011

December 2014 MRC2.CORP.D.00011 This program is paid for by Otsuka America Pharmaceutical, Inc. and Lundbeck, LLC. The speaker is a paid contractor of Otsuka America Pharmaceutical, Inc. advice or professional diagnosis. Users seeking

More information

Author's personal copy

Author's personal copy Vision Research 48 (2008) 1837 1851 Contents lists available at ScienceDirect Vision Research journal homeage: www.elsevier.com/locate/visres Bias and sensitivity in two-interval forced choice rocedures:

More information

Sexual dysfunction in women with rheumatoid arthritis

Sexual dysfunction in women with rheumatoid arthritis ORIGINAL ARTICLE Sexual dysfunction in women with rheumatoid arthritis Huriye Aras 1, Bekir Aras 2, Afita Icagasioglu 3, Yasemin Yumusakhuylu 3, Eray Kemahli 4, Sema Haliloglu 3, Fusun Moral Oguz 3 1 Deartment

More information

Haloperidol Use in Acute Traumatic Brain Injury: A Safety Analysis

Haloperidol Use in Acute Traumatic Brain Injury: A Safety Analysis Research Article imedpub Journals htt://www.imedub.com Journal of Intensive and Critical Care ISSN 2471-8505 DOI: 10.21767/2471-8505.100023 Haloeridol Use in Acute Traumatic Brain Injury: A Safety Analysis

More information

Differences in the local and national prevalences of chronic kidney disease based on annual health check program data

Differences in the local and national prevalences of chronic kidney disease based on annual health check program data Clin Ex Nehrol (202) 6:749 754 DOI 0.007/s057-02-0628-0 ORIGINAL ARTICLE Differences in the local and national revalences of chronic kidney disease based on annual health check rogram data Minako Wakasugi

More information

King s Research Portal

King s Research Portal King s Research Portal Document Version Peer reviewed version Link to ublication record in King's Research Portal Citation for ublished version (APA): Murrells, T., Ball, J., Maben, J., Lee, G., Cookson,

More information

Anchor Selection Strategies for DIF Analysis: Review, Assessment, and New Approaches

Anchor Selection Strategies for DIF Analysis: Review, Assessment, and New Approaches Anchor Selection Strategies for DIF Analysis: Review, Assessment, and New Aroaches Julia Kof LMU München Achim Zeileis Universität Innsbruck Carolin Strobl UZH Zürich Abstract Differential item functioning

More information

Relating mean blood glucose and glucose variability to the risk of multiple episodes of hypoglycaemia in type 1 diabetes

Relating mean blood glucose and glucose variability to the risk of multiple episodes of hypoglycaemia in type 1 diabetes Diabetologia (2007) 50:2553 2561 DOI 10.1007/s00125-007-0820-z ARTICLE Relating mean blood glucose and glucose variability to the risk of multile eisodes of hyoglycaemia in tye 1 diabetes E. S. Kilatrick

More information

Developmental enamel defects and their impact on child oral health-related quality of life

Developmental enamel defects and their impact on child oral health-related quality of life Paediatric Dentistry Pediatric Dentistry Develomental enamel defects and their imact on child oral health-related quality of life Fabiana Vargas-Ferreira (a) Thiago Machado Ardenghi (b) (a) Deartment of

More information

Pulmonary Pharmacology & Therapeutics

Pulmonary Pharmacology & Therapeutics Pulmonary Pharmacology & Theraeutics 24 (2011) 633e637 Contents lists available at SciVerse ScienceDirect Pulmonary Pharmacology & Theraeutics journal homeage: www.elsevier.com/locate/yut The efficacy

More information

Journal of Affective Disorders

Journal of Affective Disorders Journal of Affective Disorders 136 (2012) 370 376 Contents lists available at SciVerse ScienceDirect Journal of Affective Disorders journal homeage: www.elsevier.com/locate/jad Research reort COMT Met

More information

Dental X-rays and Risk of Meningioma: Anatomy of a Case-Control Study

Dental X-rays and Risk of Meningioma: Anatomy of a Case-Control Study research-article2013 JDRXXX10.1177/0022034513484338 PERSPECTIVE D. Dirksen*, C. Runte, L. Berghoff, P. Scheutzel, and L. Figgener Deartment of Prosthetic Dentistry and Biomaterials, University of Muenster,

More information

Title. CitationJournal of Affective Disorders, 95(1-3): Issue Date Doc URL. Type. File Information

Title. CitationJournal of Affective Disorders, 95(1-3): Issue Date Doc URL. Type. File Information Title Long-term outcome of antidepressant-refractory depre Inoue, Takeshi; Nakagawa, Shin; Kitaichi, Yuji; Izum Author(s) Denda, Kenzo; Koyama, Tsukasa CitationJournal of Affective Disorders, 95(1-3):

More information

Comparison of Water Seal and Suction After Pulmonary Lobectomy: A Prospective, Randomized Trial

Comparison of Water Seal and Suction After Pulmonary Lobectomy: A Prospective, Randomized Trial GENERAL THORACIC Comarison of Water Seal and Suction After Pulmonary Lobectomy: A Prosective, Randomized Trial Alessandro Brunelli, MD, Marco Monteverde, MD, Alessandro Borri, MD, Michele Salati, MD, Rita

More information

Migraine headache is one of the most debilitating RECONSTRUCTIVE

Migraine headache is one of the most debilitating RECONSTRUCTIVE RECONSTRUCTIVE Positive Botulinum Toxin Tye A Resonse Is a Prognosticator for Migraine Surgery Success Michelle Lee, M.D. Mikhal A. Monson, B.S. Mengyuan T. Liu, B.S. Deborah Reed, M.D. Bahman Guyuron,

More information

The Egyptian Journal of Hospital Medicine (January 2019) Vol. 74 (2), Page

The Egyptian Journal of Hospital Medicine (January 2019) Vol. 74 (2), Page The Egytian Journal of Hosital Medicine (January 2019) Vol. 74 (2), Page 310-317 Assessment of serum vitamin D level before and after narrowband theray in vitiligo Hassan Abou Khodair, Ahmed Wahhed-Allah

More information

Do People s First Names Match Their Faces?

Do People s First Names Match Their Faces? First names and faces 1 Journal of Articles in Suort of the Null Hyothesis Vol. 12, No. 1 Coyright 2015 by Reysen Grou. 1539-8714 www.jasnh.com Do Peole s First Names Match Their Faces? Robin S. S. Kramer

More information

Cardiology & Vascular Research

Cardiology & Vascular Research Research Article Cardiology & Vascular Research Benefit of -VASc Score in Predicting Imlantable Cardioverter Defibrillator Shocks Seyda GUNAY 1, Sabri SEYIS 2* and Özge KURMUŞ 3 1 Deartment of Cardiology,

More information

Effect of valproate and pregabalin on human anxiety-like behaviour in a randomised controlled trial

Effect of valproate and pregabalin on human anxiety-like behaviour in a randomised controlled trial Bach et al. Translational Psychiatry (2018) 8:157 DOI 10.1038/s41398-018-0206-7 Translational Psychiatry ARTICLE Effect of valroate and regabalin on human anxiety-like behaviour in a randomised controlled

More information

Risk of suicide in high-risk pregnancy: an exploratory study

Risk of suicide in high-risk pregnancy: an exploratory study ORIGINAL ARTICLE Risk of suicide in high-risk regnancy: an exloratory study Gláucia Rosana Guerra Benute 1, Roseli Mieko Yamamoto Nomura 2, Vanessa Marques Ferreira Jorge 3, Daniele Nonnenmacher 4, Renério

More information

Clinical Outcome of Primary Gastric Lymphoma Treated with Chemotherapy Alone or Surgery Followed by Chemotherapy

Clinical Outcome of Primary Gastric Lymphoma Treated with Chemotherapy Alone or Surgery Followed by Chemotherapy ORIGINAL ARTICLE Clinical Outcome of Primary Gastric Lymhoma Treated with Chemotheray Alone or Surgery Followed by Chemotheray Ming-Chih Chang, 1,2 * Ming-Jer Huang, 1 Ying-Wen Su, 1 Yi-Fang Chang, 1 Johnson

More information

Key words: Diabetes Mellitus, HbA1c, Insulin, Sulfonylureas, Metformin. DOI: /jyp

Key words: Diabetes Mellitus, HbA1c, Insulin, Sulfonylureas, Metformin. DOI: /jyp J Young Pharm, 2018; 10(4) : 471-475 A multifaceted eer reviewed journal in the field of Pharmacy www.jyoungharm.org www.hcog.net Original Article Comarison of Insulin, Sulfonylurea and Sulfonylureas-Metformin

More information

A. Rosas-Cabral, et al.: RDW and mortality in patients with ACS. Contents available at PubMed Gac Med Mex. 2016;152:61-7

A. Rosas-Cabral, et al.: RDW and mortality in patients with ACS. Contents available at PubMed Gac Med Mex. 2016;152:61-7 A. Rosas-Cabral, et al.: RDW and mortality in atients with ACS Contents available at PubMed www.anmm.org.mx PERMANYER Gac Med Mex. 2016;152:61-7 www.ermanyer.com GACETA MÉDICA DE MÉXICO ORIGINAL ARTICLE

More information