Agnieszka Bratek

Sleep and inflammatory markers in different psychiatric disorders

Many psychiatric disorders, like schizophrenia, affective disorders, addictions and different forms of dementia are associated with sleep disturbances. In the etiology and course of those diseases inflammatory processes are regarded to be an increasingly important factor. They are also a frequently discussed element of the pathology of sleep. In this literature review reports on correlations between poor sleep and inflammatory responses in various psychiatric conditions are discussed. The link between schizophrenia, affective disorders and inflammatory cytokines is a complex phenomenon, which has been already confirmed in a number of studies. However, the presence of sleep deficits in those conditions, being a common symptom of depression and psychoses, can be an additional factor having a considerable impact on the immunological processes in mental illnesses. In the analyzed data, a number of studies are presented describing the role of inflammatory markers in sleep disturbances and psychopathological symptoms of affective, psychotic, neurogenerative and other disorders. Also attention is drawn to possible implications for their treatment. Efforts to use, e.g., anti-inflammatory agents in psychiatry in the context of their impact on sleep are reported. The aspect of inflammatory markers in the role of sleep deprivation as the treatment method in major depressive disorder is also discussed. A general conclusion is drawn that the improvement of sleep quality plays a crucial role in the care for psychiatric patients.

Cognitive deficits in adults with obstructive sleep apnea compared to children and adolescents.

Obstructive sleep apnea (OSA) can negatively affect the patient’s physical and psychological functioning, as well as their quality of life. A major consequence of OSA is impaired cognitive functioning. Indeed, several studies have shown that OSA mainly leads to deficits in executive functions, attention, and memory. As OSA can present in all age groups, these associated cognitive deficits have been observed in adults, as well as in children and adolescents. However, these cognitive deficits may have a different clinical picture in young patients compared to adults. In this review, we analyze the most affected cognitive domains in adults and children/adolescents with OSA, as evaluated by neuropsychological and neuroimaging studies. We found that deficits in working memory, attention, or executive functions cognitive domains are found in both adults and children with OSA. However, children with OSA also show changes in behavior and phonological processing necessary for proper development. Moreover, we examine the possible OSA treatments in children and adults that can have a positive influence on cognition, and therefore, improve patients’ general functioning and quality of life.

The symptoms of depression and anxiety in patients with diabetic foot treated with hyperbaric oxygen - preliminary results

Abstract The aim of the study was to assess the level of anxiety and depressiveness in patients who had qualified for hyperbaric oxygen therapy (HBOT) for the treatment of ulcerative lesions in the lower limbs, occurring as a result of diabetic foot syndrome (DFS),. A total of 50 patients with type 2 diabetes and diabetic foot syndrome were enrolled to the study. All patients have received 30 sessions of HBOT. During the therapy blood glucose was measured and photographic documentation was carried out. All patients underwent the following procedures: medical history and socioeconomic interview, psychiatric examination, self-report and objective psychometric tests to measure anxiety and depressiveness. Based on the obtained results, we reported that patients with a greater degree of tissue damage had higher levels of depressive symptoms in the self-report tests as well as in the objective evaluation of the investigator. In terms of location of ulcerative lesions - the level of depressiveness was greater when the affected area included toes, and the level of anxiety was increased when it concerned the heel. Regarding other parameters, statistically significant correlations were not observed.

Peripheral Biomarker Candidates in Schizophrenia

The identification of peripheral biomarkers for schizophrenia is of great clinical importance, with the potential to considerably improve its diagnosis, treatment and prognosis. However, despite intense research efforts and the discovery of several potential candidates for markers, no biomarker assay developed so far possesses sufficient sensitivity and specificity for clinical use. Nevertheless, with the advent of innovative technologies and methods on an analytical and statistical level, including hypothesis-free proteomic and epigenetic procedures and advanced bioinformatics, establishing biomarkers for clinical use may lay within reach. To date, the most promising candidates for biomarkers are linked to neural transmission, neural plasticity (e.g. neurotrophic factors), oxidative stress/free radicals, endocrinology, immunology, signalling pathways, gene expression regulation/activation and lipidomics.

EPA-0968 – Depression, anxiety and intellectual abilities in patients with asthma and chronic obstructive pulmonary disease - preliminary results

In the literature there are examples of comorbidity of respiratory tract diseases (particularly chronic obstructive pulmonary disease and asthma) and mental diseases, especially anxiety, depressive and cognitive disorders. The research project was aimed to confirm a connection between psycho-intellectual functioning and suffering from aforementioned diseases. Participants of the research project were divided into 3 groups. In the asthma group there were 17 people, mean age 51. The COPD group was formed by 22 people, mean age 67. The control group included 18 people, mean age 49. Patients from all groups underwent spirometry, sputum induction and the following tests: Mini-Mental State Examination, Trail Making Test, Beck Depression Inventory – and State-Trait Anxiety Inventory for Adults. In the TMT tests (Part A and B) results were as follows: in control group 31 s and 70 s, in the asthma group 36 s and 96 s and in the COPD group 41 s and 104 s. In the Beck Depression Inventory the lowest mean score was obtained in the control group - 7 points, then in asthma group - 8 points and in COPD group - 12 points. Results for STAI (Part A and B) were distributed as follows: in the asthma group - 35 and 40 points; in the COPD group 39 and 43 points and in the control group 34 and 36 points. Concluding, in the research study the level of anxiety and depression measured by self-assessment questionnaires in the study groups was higher and cognitive functions were worse than in healthy control.

EPA-1511 – Association of early drinking onset with subsequent alcohol abuse

BACKGROUND In the recent years the phenomenon of early alcohol initiation is observed. This problem is often underestimated, in spite of its numerous negative consequences SUBJECTS AND METHODS The research study was based on authors` anonymous questionnaire including questions referring to: age of alcohol initiation, age of the first blackout after drinking alcohol, the place and circumstances of alcohol initiation and the reason of drinking alcohol for the first time. The study group consisted of 125 people, 83 men and 42 women, aged from 22 to 68 participating in treatment programs for alcohol addiction. RESULTS In the study group it occurred before the age of 15 more often than in the control group (49% vs. 42%). The same correlation exists for the alcohol initiation before 12 years of age (13% vs. 8%) and is statistically significant (p<0.05). Whats very alarming drinking alcohol for the first time took place for some of the respondents before the age of 10 and also significantly more often in the study group (6% vs. 2%, p<0.05). CONCLUSIONS The obtained results allow to conclude that in patients addicted to alcohol the initiation took place earlier than in the study group (age 13-15 vs. 16-18). Also, very early alcohol initiation (<12 years) occurred more frequently in the study group (12.8% vs 8.2%). Based on our research, we confirmed that early drinking onset is associated with subsequent alcohol dependence.

P-397 - A case study - biofeedback eeg as a part of therapy of a patient with post-traumatic cerebrasthenia

Introduction EEG Biofeedback is a technique that enables the recognition and modification of the bioelectrical activity of the brain which can be used to improve the patients concentration, control of impulses and reduce disturbance of emotions. Aim of the study The aim of this research is to show the case of the patient with post-traumatic cerebrasthenia who was treated with a combination of both pharmacotherapy (tianeptine) and neurotherapy using mainly EGG BF in the bilateral module training SMR/beta + beta/delta. Material and methods This research is based on a case history of a patient with an implantable cardioverter-difibrillator (ICD) who suffered from blood circulation obstruction caused by catecholaminergic polymorphic ventricular tachycardia. Due to a transient cerebral hypoxia the patient later showed symptoms of posttraumatic cerebrasthenia: problems with concentration, short-term memory and depressive symptoms. Results The therapy resulted in increasing of the SMR and beta potential as well as the stabilization of the cognitive dysfunction and emotional disorders. Conclusions Biofeedback is a useful and effective technique and can be also used in therapy of the patients with posttraumatic cerebrasthenia.