Marlena Zajączkowska

Impact of oxidative/nitrosative stress and inflammation on cognitive functions in patients with recurrent depressive disorders.

Data show that up to 38.2% of the European population have a mental disorder and that recurrent depressive disorder (rDD) is among the most commonly diagnosed disabling diseases. Over the last few years, neurocognitive impairments in rDD have become a new research front focusing on the role of cognitive decline during the course of rDD and in relation to its clinical presentation and prognosis. Both immune-inflammatory and oxidative and nitrosative stress (O&NS) processes potentially play a role in development of cognitive dysfunction in rDD. New evidence shows that chronic inflammatory and O&NS reactions occur in the brains of patients with neurodegenerative disorders and those with rDD. This narrative review presents the current state of knowledge on the possible impact of selected inflammatory and O&NS enzymes on cognitive functioning in patients with rDD. We focus on manganese superoxide dismutase (MnSOD), inducible nitric oxide synthase (iNOS), and myeloperoxidase (MPO).

Depression and ways of coping with stress: A preliminary study

Background Coping with stress is defined as all activities undertaken by a human in a stressful situation. The effect of stress on depression, its role in triggering the subsequent phases of the disease, and the factors that mediate the stress-depression relationship become more and more often subjects of research in psychiatry and psychology. Factors important for the formation of depressive symptoms and disease progression are significantly associated with coping strategies used in the face of stress. The main aim of the study was to evaluate the most popular strategies of coping with stress in people with depression in comparison to healthy subjects. Material/Methods Initial research was carried on 80 patients aged from 20 to 66 years with a diagnosis of depression. The control group consisted of 30 healthy subjects aged 22 to 57 years. Analysis of the most popular strategies of coping with stress was performed with the Multiphasic Inventory for Measuring Coping (COPE) by Carver, Scheier, and Weintraub. Results In contrast with healthy people, patients with depression in stressful situations more often use strategies based on avoidance and denial and have more difficulties in finding positive aspects of stressful events. Conclusions Depression may be an important factor in the negative assessment of one’s own ability to cope with difficult situations and can aggravate a tendency to perceive stressful events as overwhelming.

ASMT gene expression correlates with cognitive impairment in patients with recurrent depressive disorder.

Background Recurrent depressive disorder is a multifactorial disease; one of the typical features is cognitive impairment. The purpose of this study was analysis of ASMT gene expression both on mRNA and protein levels in patients with recurrent depressive disorder (rDD) and assessment of the relationship between plasma level of ASMT protein, gene expression on mRNA level, and cognitive performance. Material/Methods The study included 236 subjects: patients with rDD (n=131) and healthy subjects (n=105, CG). Cognitive function assessment was based on: Trail Making Test, The Stroop Test, Verbal Fluency Test (VFT), and Auditory Verbal Learning Test (AVLT). Results Both mRNA and protein expression levels of ASMT gene were significantly higher in healthy subjects when compared to rDD. The average ASMT mRNA expression level measured for the entire group was M=0.21 (SD=0.09), and the protein level was M=12.84 (SD=3.29). In patients with rDD, statistically significant correlations occurred between both mRNA and protein expression levels and part A of the TMT (negative correlation) and verbal fluency test (positive correlation). In the group CG, there was no statistically significant association between the analyzed variables. In the entire group there was a statistically significant correlation between both ASMT mRNA and protein expression levels and all the neuropsychological tests used in the survey. Conclusions 1. Our study confirms previous results showing decreased mRNA and protein expression levels of ASMT gene in depression. 2. Our data suggest a relationship between decreased mRNA and protein expression levels of ASMT gene and cognitive impairment.

Diagnostic Difficulties in Progressive Supranuclear Palsy: A Case Study

Background: Progressive supranuclear palsy (PSP) is a rapidly progressing primary neurodegenerative brain disease that produces an akinetic-rigid form of Parkinsonism characterized by abnormal posture, with early falls, supranuclear gaze palsy, and subcortical dementia. Due to its etiology, it is classified as a “tauopathy”. The location of the pathology accounts for the clinical features. The aim of this study was to present a case report of a patient in whom rapid course of the disease was observed and to demonstrate the diagnostic difficulties of PSP. Case Report: A female patient 54 years of age had initial symptoms of mood and behavioral disorders (apathy, withdrawal, loss of interest, bizarre behavior). Due to these symptoms, frontotemporal dementia was initially suspected. Cognitive dysfunction and subsequent impaired balance and posture (leading to falls) resulted in neurologi cal hospitalization with observation in the direction of spongiform encephalopathy. During psychiatric observation on the basis of significant progression of symptoms and additional tests (e.g., imaging and psycholog ical examination), the patient was diagnosed with progressive supranuclear palsy. Conclusions: The clinical diagnosis can be difficult to make, which results in PSP being under-diagnosed and often misdi agnosed. Therefore, in case of doubt, it is necessary to conduct a detailed diagnosis. Structural neuroimaging studies, although not specific for PSP, may be of some assistance in making the diagnosis.

Difficulties in identifying emotional states in patients treated for depressive disorders compared to patients with selected somatic diseases

Summary Background: Dysfunction in cognitive and affective domains limiting access to mental states in the self and impairing identification of emotions is defined as alexithymia. It leads to the inability to realize and recognize feelings, to use language to describe them, and to differentiate between emotions and bodily symptoms. Alexithymia is considered to be a stable personality feature, which along with other personality factors predispose to numerous mental and somatic disorders. Material/Methods: Our test group included 30 patients diagnosed with the following mood disorders: depressive episode and recurrent depressive disorder. The first comparison group consisted of 30 patients treated for coronary heart disease, heart failure, and heart rhythm disorders, some of them with coexisting hypertension and history of myocardial infarction. The second comparison group was composed of 22 outpatients diagnosed with hepatitis C. The Bermond Vorst Alexithymia Questionnaire-(BVAQ) was used in the study. Results: Statistically significant differences were found in most of the dimensions, thus resulting in overall differences in level of alexithymia between groups. There was no difference between groups only in poverty of imagination and concrete thinking. Respondent age and duration of illness coexisted with higher levels of alexithymia (total score) and selected alexithymic dimensions mainly in the group of patients with hepatitis, and also for the entire population. Conclusions: Respondents with a diagnosis of mood disorders are characterized by greater deficits in identify ing and naming their own emotional states as compared to patients with a diagnosis of cardiac disease or viral hepatitis.