American Journal of Psychiatry and Neuroscience, 2017
Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems... more Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems to be the main cause for disability by the World Health Organization report from 2017. The aetiology of depression seems to be heterogenous and remains uncertain. Aims: In this context, no matter the depression form, the chronic neuro-inflammation and depression are linked by a bidirectional connection and this is important because in order to try to identify o biomarker for depression screening you need to research at the foundation of the disease. Method: The data analysed are from a prospective study with N=100 patients who presented for laboratory routine evaluations between 1st February-30th June 2016 in the outpatient clinic of the National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). We used the recommended cut-off of ≥ 8 points for the HADS depression subscale. Laboratory data included all inflammation standard markers and serum high-sensitivity C-reactive protein (hs-CRP) determination for all the patients. The study was approved by the I.O.S.U.D. U.M.F. Craiova ethical committee. A written informed consent was obtained from all participants. Statistical Package for Social Sciences version 22 was used to analyse the data. Results and discussions: In the study, we noticed a 63.4% of female, with a mean age of 71.6 (±7.51) years, from the urban area 92.7%. Moreover, 98.8% of people presented comorbidities. After controlling for somatic comorbidities, logistic regression model revealed that elevated levels of hs-CRP increased the likelihood of being diagnosed with depressive symptoms in elderly patients (β = .174; SE of β = .059; p = 0.003; 95% CI = 1.061-1.337). We found a relationship between higher levels of hs-CRP and increased risk for depression in older adults. That may be important as hs-CRP represents a vulnerability marker for cardiovascular diseases too. Using this marker may help to identify people at risk for both cardiovascular illnesses and depression. Conclusions: The relationship between the 3 above variables is a complex one, since depression represents a risk factor for cardiovascular diseases and vice versa and hs-CRP seems to be a marker for both conditions. However, the cross-sectional nature of our study doesn’t allow us to clarify this relationship.
Abstract:
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. ... more Abstract: Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
Abstract:
The prevalence of depression increases with the age, elderly depressed patient requirin... more Abstract: The prevalence of depression increases with the age, elderly depressed patient requiring an increased attention, probably due to changes associated with aging, life events (death of family members, reduction of social interactions, retirement and lack of activities etc.), somatic illnesses, medications used to treat somatic illnesses and so on. The aim of this study was to illustrate, in terms of depression and anxiety, the situation of elderly depressed patients that are addressing to a geriatric institution for a medical examination due to various conditions specific to age. For that we performed an analysis of a group of 90 patients, aged between 41 and 96 years old, who addressed to the National Institute of Geriatrics and Gerontology Ana Aslan, for various diseased related to the age. Depression and anxiety were evaluated based on HADS scale (Hospital Evaluation of Depression and Anxiety Scale). Performing the HADS-D scale to this group of elderly patients has identified the presence of depression in 40% of patients. Anxiety was much more present compared with depression, 69% of patients addressing to the geriatrician experienced different degrees of this disease. The data obtained confirm the higher prevalence of depression in women compared to men, in a ratio of 2:1. Key words: elderly, depression, anxiety, diagnosis, HADS
abstract
Neuro-inflammation represents the immunerelated processes in the central nervous system ... more abstract Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), acute, appearing after psychological stress, trauma, infections or neurological pathologies, and chronic, associated with neurodegenerative disease and possible cognitive degradation. The inflammatory process is also directly linked with CNS and cardiovascular disease, being predicted by the levels of high sensitivity C protein. Cellular biological and biochemical mechanisms of inflammatory processes are very complex, our paper aimed to gather the latest and the most relevant proofs that link the psychiatric, and especially affective disorders, stress and neuro- inflammation.
CONCLUSIONS: Although we expected a better remission rate for the first episode of depression com... more CONCLUSIONS: Although we expected a better remission rate for the first episode of depression compared with the MDE reccurent episodes, that was not confirmed. For the patients with more than one MDE, waiting for a longer period in order to obtain symptomatic remission might be advisible.
CONCLUSION: Patients with unipolar depression showe statistically significant more more often tha... more CONCLUSION: Patients with unipolar depression showe statistically significant more more often than the patient with bipolar depression, the folowing symptoms: anhedonia, decreased energy, loss of confidence and self-esteem, feelings of guilt, changes in psychomotor activity,appetite change and thought of death or suicide. Consistent with the existing body of literature, we found some clinical differences between unipolar and bipolar depressive patients clinical symptoms but not substantial ones.
Depressive disorder represents the leading cause of disability worldwide. An increasing body of e... more Depressive disorder represents the leading cause of disability worldwide. An increasing body of evidence suggests that patients presenting psychological distress and depression show alterations in immunological markers. The aim of our study was to observe the correlation of fibrinogen as a potential biological marker for psychological distress and depression. Data analyzed in this paper refers to patients (N=100) included in a prospective study conducted between 01 February-30 June 2016, males and females, age>18 years, recruited from the patients whom presented for diverse para-clinical evaluations in the outpatient clinic National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Socio-demographic information collected included: gender, age, marital status, environmental origin, level of education, socioeconomic status. For all the participants of the study fibrinogen was measured using a turbidimetry method. Psychological distress and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). From the total number of patients 64% were female, with a mean age of 67 years, from the urban area (92%), retired (80%).We found a mean value of fibrinogen of 301.16 mg/dL (SD ± 63.20). At HADS-global the patients presented a mean value of 15.9 (SD ± 7.31), while at the HADS-D the mean value was 6.41 (SD ± 3.60). Low statistically significant positive correlations between fibrinogen and HADS-global ( r (98)= .30, p= 0.0023) and s HADS-D (r (98)=.36, p=0.0003) were found. Our studys results were consistent with the data literature reported from previous studies showing a significant positive correlation between psychological distress, depression and fibrinogen. Also, we found higher levels of plasma fibrinogen when we compared patients presenting psychological distress with those without psychological distress, even though the effect size was rather small.
The central nervous system has a bidirectional communication with the immune system by many mecha... more The central nervous system has a bidirectional communication with the immune system by many mechanisms that could link depression with an increase of the inflammation markers like C reactive protein (CRP), interleukin (IL)-1, IL-6 and tumor necrosis factor alpha (TNF-α) (2-6). Some studies even proved that on type 1 diabetic women but the literature data is not consistent on this subject (20-22). Therefore, the main objective of this research is to find out if the most common inflammation biological markers (like CRP, fibrinogen and others) are some statistically significant markers for the major depressive episode (MDE) and if theirs values correlates with MDE severity measured with HADS scales. In this research included 100 people from general population that came for routine blood tests on INGG ambulatory and agreed to sign the inform consent and to complete the HADS questionnaire after a psychiatric evaluation. The results of the Shapiro-Wilk and Anderson-Darling tests for all the parameters evaluated in this research, showed that the most variables do not have a Gauss distribution. Therefore, we used non-parametric tests for statistical analysis purposes (Mann-Whitney test instead of t student and “rho” Spearman quotient instead of the “r” correlation Pearson quotient). We have found a direct correlation, significantly statistic, between CPR and HADS score. Regarding CRP, the value of “rho” correlation quotient was 0.2278 corresponding for p=0.0227 (p<0.05). Regarding the validity of the biological marker which best predicts the anxiety, on the 3rd position is CRP with a Mann-Whitney value of 0.0265. For the validity of the correlation between depression symptoms and inflammatory biomarkers like CRP the Mann-Whitney value is 0.014. The main limitation of this research is the relative small sample, the fact that this population came for routine blood tests and more important the high age average of the participants.
CONCLUSIONS: In rating the severity and improuvement of the dissease, the clinicians and the pati... more CONCLUSIONS: In rating the severity and improuvement of the dissease, the clinicians and the patients have different perspectivesbased on the different training and subjective impression. The patients are more likely to rate higher the improvements as response to treatment while the clinicians rate the response as they have been trained (more than 50% reduction of the symptoms) but they tend to rate higher the severity of the depression.
This naturalistic study was made with the help of 300 romanian psychiatrists that screened 5661 p... more This naturalistic study was made with the help of 300 romanian psychiatrists that screened 5661 patient by using the ICD 10 criteria for MDD. Most of the patient with MDD were at a recurrent depressive episode (67.3% - 3745 patients). From the patients with unipolar depression 46.8% had a cardiovascular comorbidity. In the group with bipolar depression the percentage of cardiovascular comorbidity was lower, at 33.9%. The patients with unipolar depression had asociated a cardiovascular dissease more often thean the other group: OR=1.379, CI=1.209-1.572, p=0.001.
American Journal of Psychiatry and Neuroscience, 2017
Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems... more Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems to be the main cause for disability by the World Health Organization report from 2017. The aetiology of depression seems to be heterogenous and remains uncertain. Aims: In this context, no matter the depression form, the chronic neuro-inflammation and depression are linked by a bidirectional connection and this is important because in order to try to identify o biomarker for depression screening you need to research at the foundation of the disease. Method: The data analysed are from a prospective study with N=100 patients who presented for laboratory routine evaluations between 1st February-30th June 2016 in the outpatient clinic of the National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). We used the recommended cut-off of ≥ 8 points for the HADS depression subscale. Laboratory data included all inflammation standard markers and serum high-sensitivity C-reactive protein (hs-CRP) determination for all the patients. The study was approved by the I.O.S.U.D. U.M.F. Craiova ethical committee. A written informed consent was obtained from all participants. Statistical Package for Social Sciences version 22 was used to analyse the data. Results and discussions: In the study, we noticed a 63.4% of female, with a mean age of 71.6 (±7.51) years, from the urban area 92.7%. Moreover, 98.8% of people presented comorbidities. After controlling for somatic comorbidities, logistic regression model revealed that elevated levels of hs-CRP increased the likelihood of being diagnosed with depressive symptoms in elderly patients (β = .174; SE of β = .059; p = 0.003; 95% CI = 1.061-1.337). We found a relationship between higher levels of hs-CRP and increased risk for depression in older adults. That may be important as hs-CRP represents a vulnerability marker for cardiovascular diseases too. Using this marker may help to identify people at risk for both cardiovascular illnesses and depression. Conclusions: The relationship between the 3 above variables is a complex one, since depression represents a risk factor for cardiovascular diseases and vice versa and hs-CRP seems to be a marker for both conditions. However, the cross-sectional nature of our study doesn’t allow us to clarify this relationship.
Abstract:
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. ... more Abstract: Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
Abstract:
The prevalence of depression increases with the age, elderly depressed patient requirin... more Abstract: The prevalence of depression increases with the age, elderly depressed patient requiring an increased attention, probably due to changes associated with aging, life events (death of family members, reduction of social interactions, retirement and lack of activities etc.), somatic illnesses, medications used to treat somatic illnesses and so on. The aim of this study was to illustrate, in terms of depression and anxiety, the situation of elderly depressed patients that are addressing to a geriatric institution for a medical examination due to various conditions specific to age. For that we performed an analysis of a group of 90 patients, aged between 41 and 96 years old, who addressed to the National Institute of Geriatrics and Gerontology Ana Aslan, for various diseased related to the age. Depression and anxiety were evaluated based on HADS scale (Hospital Evaluation of Depression and Anxiety Scale). Performing the HADS-D scale to this group of elderly patients has identified the presence of depression in 40% of patients. Anxiety was much more present compared with depression, 69% of patients addressing to the geriatrician experienced different degrees of this disease. The data obtained confirm the higher prevalence of depression in women compared to men, in a ratio of 2:1. Key words: elderly, depression, anxiety, diagnosis, HADS
abstract
Neuro-inflammation represents the immunerelated processes in the central nervous system ... more abstract Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), acute, appearing after psychological stress, trauma, infections or neurological pathologies, and chronic, associated with neurodegenerative disease and possible cognitive degradation. The inflammatory process is also directly linked with CNS and cardiovascular disease, being predicted by the levels of high sensitivity C protein. Cellular biological and biochemical mechanisms of inflammatory processes are very complex, our paper aimed to gather the latest and the most relevant proofs that link the psychiatric, and especially affective disorders, stress and neuro- inflammation.
CONCLUSIONS: Although we expected a better remission rate for the first episode of depression com... more CONCLUSIONS: Although we expected a better remission rate for the first episode of depression compared with the MDE reccurent episodes, that was not confirmed. For the patients with more than one MDE, waiting for a longer period in order to obtain symptomatic remission might be advisible.
CONCLUSION: Patients with unipolar depression showe statistically significant more more often tha... more CONCLUSION: Patients with unipolar depression showe statistically significant more more often than the patient with bipolar depression, the folowing symptoms: anhedonia, decreased energy, loss of confidence and self-esteem, feelings of guilt, changes in psychomotor activity,appetite change and thought of death or suicide. Consistent with the existing body of literature, we found some clinical differences between unipolar and bipolar depressive patients clinical symptoms but not substantial ones.
Depressive disorder represents the leading cause of disability worldwide. An increasing body of e... more Depressive disorder represents the leading cause of disability worldwide. An increasing body of evidence suggests that patients presenting psychological distress and depression show alterations in immunological markers. The aim of our study was to observe the correlation of fibrinogen as a potential biological marker for psychological distress and depression. Data analyzed in this paper refers to patients (N=100) included in a prospective study conducted between 01 February-30 June 2016, males and females, age>18 years, recruited from the patients whom presented for diverse para-clinical evaluations in the outpatient clinic National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Socio-demographic information collected included: gender, age, marital status, environmental origin, level of education, socioeconomic status. For all the participants of the study fibrinogen was measured using a turbidimetry method. Psychological distress and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). From the total number of patients 64% were female, with a mean age of 67 years, from the urban area (92%), retired (80%).We found a mean value of fibrinogen of 301.16 mg/dL (SD ± 63.20). At HADS-global the patients presented a mean value of 15.9 (SD ± 7.31), while at the HADS-D the mean value was 6.41 (SD ± 3.60). Low statistically significant positive correlations between fibrinogen and HADS-global ( r (98)= .30, p= 0.0023) and s HADS-D (r (98)=.36, p=0.0003) were found. Our studys results were consistent with the data literature reported from previous studies showing a significant positive correlation between psychological distress, depression and fibrinogen. Also, we found higher levels of plasma fibrinogen when we compared patients presenting psychological distress with those without psychological distress, even though the effect size was rather small.
The central nervous system has a bidirectional communication with the immune system by many mecha... more The central nervous system has a bidirectional communication with the immune system by many mechanisms that could link depression with an increase of the inflammation markers like C reactive protein (CRP), interleukin (IL)-1, IL-6 and tumor necrosis factor alpha (TNF-α) (2-6). Some studies even proved that on type 1 diabetic women but the literature data is not consistent on this subject (20-22). Therefore, the main objective of this research is to find out if the most common inflammation biological markers (like CRP, fibrinogen and others) are some statistically significant markers for the major depressive episode (MDE) and if theirs values correlates with MDE severity measured with HADS scales. In this research included 100 people from general population that came for routine blood tests on INGG ambulatory and agreed to sign the inform consent and to complete the HADS questionnaire after a psychiatric evaluation. The results of the Shapiro-Wilk and Anderson-Darling tests for all the parameters evaluated in this research, showed that the most variables do not have a Gauss distribution. Therefore, we used non-parametric tests for statistical analysis purposes (Mann-Whitney test instead of t student and “rho” Spearman quotient instead of the “r” correlation Pearson quotient). We have found a direct correlation, significantly statistic, between CPR and HADS score. Regarding CRP, the value of “rho” correlation quotient was 0.2278 corresponding for p=0.0227 (p<0.05). Regarding the validity of the biological marker which best predicts the anxiety, on the 3rd position is CRP with a Mann-Whitney value of 0.0265. For the validity of the correlation between depression symptoms and inflammatory biomarkers like CRP the Mann-Whitney value is 0.014. The main limitation of this research is the relative small sample, the fact that this population came for routine blood tests and more important the high age average of the participants.
CONCLUSIONS: In rating the severity and improuvement of the dissease, the clinicians and the pati... more CONCLUSIONS: In rating the severity and improuvement of the dissease, the clinicians and the patients have different perspectivesbased on the different training and subjective impression. The patients are more likely to rate higher the improvements as response to treatment while the clinicians rate the response as they have been trained (more than 50% reduction of the symptoms) but they tend to rate higher the severity of the depression.
This naturalistic study was made with the help of 300 romanian psychiatrists that screened 5661 p... more This naturalistic study was made with the help of 300 romanian psychiatrists that screened 5661 patient by using the ICD 10 criteria for MDD. Most of the patient with MDD were at a recurrent depressive episode (67.3% - 3745 patients). From the patients with unipolar depression 46.8% had a cardiovascular comorbidity. In the group with bipolar depression the percentage of cardiovascular comorbidity was lower, at 33.9%. The patients with unipolar depression had asociated a cardiovascular dissease more often thean the other group: OR=1.379, CI=1.209-1.572, p=0.001.
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Aims: In this context, no matter the depression form, the chronic neuro-inflammation and depression are linked by a bidirectional connection and this is important because in order to try to identify o biomarker for depression screening you need to research at the foundation of the disease.
Method: The data analysed are from a prospective study with N=100 patients who presented for laboratory routine evaluations between 1st February-30th June 2016 in the outpatient clinic of the National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). We used the recommended cut-off of ≥ 8 points for the HADS depression subscale. Laboratory data included all inflammation standard markers and serum high-sensitivity C-reactive protein (hs-CRP) determination for all the patients. The study was approved by the I.O.S.U.D. U.M.F. Craiova ethical committee. A written informed consent was obtained from all participants. Statistical Package for Social Sciences version 22 was used to analyse the data.
Results and discussions: In the study, we noticed a 63.4% of female, with a mean age of 71.6 (±7.51) years, from the urban area 92.7%. Moreover, 98.8% of people presented comorbidities. After controlling for somatic comorbidities, logistic regression model revealed that elevated levels of hs-CRP increased the likelihood of being diagnosed with depressive symptoms in elderly patients (β = .174; SE of β = .059; p = 0.003; 95% CI = 1.061-1.337). We found a relationship between higher levels of hs-CRP and increased risk for depression in older adults. That may be important as hs-CRP represents a vulnerability marker for cardiovascular diseases too. Using this marker may help to identify people at risk for both cardiovascular illnesses and depression.
Conclusions: The relationship between the 3 above variables is a complex one, since depression represents a risk factor for cardiovascular diseases and vice versa and hs-CRP seems to be a marker for both conditions. However, the cross-sectional nature of our study doesn’t allow us to clarify this relationship.
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we
used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
The prevalence of depression increases with the age, elderly depressed patient requiring an increased attention, probably due to changes associated with aging, life events (death of family members, reduction of social interactions, retirement and lack of activities etc.), somatic illnesses, medications used to treat somatic illnesses and so on. The aim of this study was to illustrate, in terms of depression and anxiety, the situation of elderly depressed patients that are addressing to a geriatric institution for a medical
examination due to various conditions specific to age. For that we performed an analysis of a group of 90 patients, aged between 41 and 96 years old, who addressed to the National Institute of Geriatrics and Gerontology Ana Aslan, for various diseased related to the age. Depression and anxiety were evaluated based on HADS scale (Hospital Evaluation of Depression and Anxiety Scale). Performing the HADS-D scale to this group of elderly patients has identified the presence of depression in 40% of patients. Anxiety was much more present compared with depression, 69% of patients addressing to the geriatrician experienced different degrees of this disease. The data obtained confirm the higher prevalence of depression in women compared to men, in a ratio of 2:1. Key words: elderly, depression, anxiety, diagnosis, HADS
Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), acute, appearing after psychological stress, trauma, infections or neurological pathologies, and chronic, associated with neurodegenerative disease and possible cognitive degradation. The inflammatory process is also directly linked with
CNS and cardiovascular disease, being predicted by the levels of high sensitivity C protein. Cellular biological and biochemical mechanisms of inflammatory processes are very complex, our paper aimed to gather the latest and the most relevant proofs that link the psychiatric, and especially affective disorders, stress and neuro- inflammation.
in this paper refers to patients (N=100) included in a prospective study conducted between 01 February-30 June 2016, males and females, age>18 years, recruited from the patients whom presented for diverse para-clinical evaluations in the outpatient clinic National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Socio-demographic
information collected included: gender, age, marital status, environmental origin, level of education, socioeconomic status. For all the participants of the study fibrinogen was measured using a turbidimetry method. Psychological distress and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). From the total number of patients 64%
were female, with a mean age of 67 years, from the urban area (92%), retired (80%).We found a mean value of fibrinogen of 301.16 mg/dL (SD ± 63.20). At HADS-global the patients presented a mean value of 15.9 (SD ± 7.31), while at the HADS-D the mean value was 6.41 (SD ± 3.60). Low statistically significant positive correlations between fibrinogen and HADS-global ( r (98)= .30, p= 0.0023) and s HADS-D (r (98)=.36, p=0.0003) were found. Our studys results were consistent with the data literature reported from previous studies showing a significant positive correlation between psychological distress, depression
and fibrinogen. Also, we found higher levels of plasma fibrinogen when we compared patients presenting psychological distress with those without psychological distress, even though the effect size was rather small.
Aims: In this context, no matter the depression form, the chronic neuro-inflammation and depression are linked by a bidirectional connection and this is important because in order to try to identify o biomarker for depression screening you need to research at the foundation of the disease.
Method: The data analysed are from a prospective study with N=100 patients who presented for laboratory routine evaluations between 1st February-30th June 2016 in the outpatient clinic of the National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). We used the recommended cut-off of ≥ 8 points for the HADS depression subscale. Laboratory data included all inflammation standard markers and serum high-sensitivity C-reactive protein (hs-CRP) determination for all the patients. The study was approved by the I.O.S.U.D. U.M.F. Craiova ethical committee. A written informed consent was obtained from all participants. Statistical Package for Social Sciences version 22 was used to analyse the data.
Results and discussions: In the study, we noticed a 63.4% of female, with a mean age of 71.6 (±7.51) years, from the urban area 92.7%. Moreover, 98.8% of people presented comorbidities. After controlling for somatic comorbidities, logistic regression model revealed that elevated levels of hs-CRP increased the likelihood of being diagnosed with depressive symptoms in elderly patients (β = .174; SE of β = .059; p = 0.003; 95% CI = 1.061-1.337). We found a relationship between higher levels of hs-CRP and increased risk for depression in older adults. That may be important as hs-CRP represents a vulnerability marker for cardiovascular diseases too. Using this marker may help to identify people at risk for both cardiovascular illnesses and depression.
Conclusions: The relationship between the 3 above variables is a complex one, since depression represents a risk factor for cardiovascular diseases and vice versa and hs-CRP seems to be a marker for both conditions. However, the cross-sectional nature of our study doesn’t allow us to clarify this relationship.
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we
used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
The prevalence of depression increases with the age, elderly depressed patient requiring an increased attention, probably due to changes associated with aging, life events (death of family members, reduction of social interactions, retirement and lack of activities etc.), somatic illnesses, medications used to treat somatic illnesses and so on. The aim of this study was to illustrate, in terms of depression and anxiety, the situation of elderly depressed patients that are addressing to a geriatric institution for a medical
examination due to various conditions specific to age. For that we performed an analysis of a group of 90 patients, aged between 41 and 96 years old, who addressed to the National Institute of Geriatrics and Gerontology Ana Aslan, for various diseased related to the age. Depression and anxiety were evaluated based on HADS scale (Hospital Evaluation of Depression and Anxiety Scale). Performing the HADS-D scale to this group of elderly patients has identified the presence of depression in 40% of patients. Anxiety was much more present compared with depression, 69% of patients addressing to the geriatrician experienced different degrees of this disease. The data obtained confirm the higher prevalence of depression in women compared to men, in a ratio of 2:1. Key words: elderly, depression, anxiety, diagnosis, HADS
Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), acute, appearing after psychological stress, trauma, infections or neurological pathologies, and chronic, associated with neurodegenerative disease and possible cognitive degradation. The inflammatory process is also directly linked with
CNS and cardiovascular disease, being predicted by the levels of high sensitivity C protein. Cellular biological and biochemical mechanisms of inflammatory processes are very complex, our paper aimed to gather the latest and the most relevant proofs that link the psychiatric, and especially affective disorders, stress and neuro- inflammation.
in this paper refers to patients (N=100) included in a prospective study conducted between 01 February-30 June 2016, males and females, age>18 years, recruited from the patients whom presented for diverse para-clinical evaluations in the outpatient clinic National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Socio-demographic
information collected included: gender, age, marital status, environmental origin, level of education, socioeconomic status. For all the participants of the study fibrinogen was measured using a turbidimetry method. Psychological distress and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). From the total number of patients 64%
were female, with a mean age of 67 years, from the urban area (92%), retired (80%).We found a mean value of fibrinogen of 301.16 mg/dL (SD ± 63.20). At HADS-global the patients presented a mean value of 15.9 (SD ± 7.31), while at the HADS-D the mean value was 6.41 (SD ± 3.60). Low statistically significant positive correlations between fibrinogen and HADS-global ( r (98)= .30, p= 0.0023) and s HADS-D (r (98)=.36, p=0.0003) were found. Our studys results were consistent with the data literature reported from previous studies showing a significant positive correlation between psychological distress, depression
and fibrinogen. Also, we found higher levels of plasma fibrinogen when we compared patients presenting psychological distress with those without psychological distress, even though the effect size was rather small.