Virginija Adomaitienė

Impact of depression on multiple sclerosis patients

IntroductionAlthough depression is the most frequent psychiatric disorder presenting in multiple sclerosis (MS) patients, few studies have examined the impact of depression on patients’ views about their MS treatment.Aim of the studyassess patients’ views of the impact of MS on their daily lives and current needs in MS management, and the relationship between these perceptions and the presence or absence of depression.Materials and methodsIn all, 270 adult patients with MS took part in this study. Depression was assessed according to ICD-10 criteria. The impact of MS on patients’ social, work, domestic activities and family life, as well as patients’ views on how their MS treatment could be made more effective, were assessed by original questionnaire.ResultsDepression was present in 20.7% of patients, with a similar prevalence between the sexes. Patients who indicated that MS interfered with their family life were at significantly increased risk of depression (<0.001). Patients who identified the need to pay more attention to MS, and to include more medications in reimbursement lists, as factors that would improve the management of MS, were more likely to be diagnosed with depression.ConclusionsThe negative impact of MS on family life is an important factor contributing to the risk of depression. Patients identified the amount of attention paid to MS, and the inclusion of more medications in reimbursement lists, as important in improving the management of MS.

The relationships between depression and life activities and well-being of multiple sclerosis patients

Multiple sclerosis (MS) is one of the most disabling neurodegenerative disorders. Depression is the most frequent psychiatric disorder accompanying MS. Although much attention is given to correlations between depression and MS clinical factors, analysis of correlations between depression and life activities (social, household, professional activities and family life) and the well-being of MS patients’ is insufficient. However, improvement of these functions could positively influence the outcomes of MS treatment. The aim of this study was to evaluate relationships between depression, life activities of MS patients, and their proposals how to improve the well-being. Materials and methods. The study lasted three years with 270 adult MS patients involved in it. ICD-10 criteria were used to diagnose depression. Original questionnaire was used to measure life activities and the well-being of the patients. Results. Prevalence of depression was 20.7% with no difference regarding the gender. Almost 84% of depressed respondents indicated, that MS disturbs their family life, 71.4% recommended to assign more attention to MS in general and 64.3% — to include more medications into reimbursement list. Conclusions. MS patients diagnosed with depression significantly more often than non-depressed indicate that MS disturbs their family life; recommend to assign more attention to MS in general and to include more medications into reimbursement list.

Compulsive Shopping: Little Known Disorder Close to Us

Kompulsyvus potraukis pirkti – retai diagnozuojamas Lietuvoje sutrikimas. Vis dėlto JAV mokslininkai teigia, kad 3-8 proc. jų populiacijos sis sutrikimas yra diagnozuojamas. Dėl vis dar nenusistovėjusio sio sutrikimo priskyrimo obsesiniams – kompulsiniams, potraukių ar impulsų kontrolės sutrikimams Lietuvoje nėra issamesnių tyrimų, susijusių su sio sutrikimo sociodemografinėmis charakteristikomis. Taciau mūsų atliktas bandomasis tyrimas parodė, kad „patologinio apsipirkinėjimo“ epizodai nėra jau tokie mums nesuprantami ir svetimi. Mūsų istirti 18 – 27 m. amžiaus studentai nurodė, kad beveik trecdaliui is jų bent kartą gyvenime yra pasireiskusi nenumaldoma pagunda ką nors pirkti, susijusi su palengvėjimo jausmu po apsipirkimo ir patvirtinimo, kad įsigyti daiktai/daiktas yra visiskai nereikalingi. Kompulsyvus potraukis pirkti paminėtas jau daugiau nei pries 100 metų, taciau issamesni jo tyrimai pasaulyje trunka tik kelis desimtmecius. Lietuvoje sis sutrikimas retai diagnozuojamas, todėl duomenų apie jo pasireiskimo ypatumus stokojama. Mūsų tyrimo tikslas - įvertinti oniomanijos epizodo paplitimo sociodegrafines charakteristikas ir jų sąsajas su gyvenimo kokybe tarp Kauno kolegijos studentų. Tyrimui buvo taikomas anoniminis sociodemografinis anketavimo metodas (lytis, amžius, gyvenamoji vieta, seimyninė padėtis, pajamos, oniomanijos pasireiskimo dažnis per gyvenimą, ar oniomanijos epizodas trukdė gyvenimo kokybei). Tyrime dalyvavo 148 respondentai (59,5 proc. moterų, tiriamųjų amžiaus vidurkis – 22,7 m., vyrų ir moterų grupės pagal amžiaus vidurkį buvo vienalytės). Nustatyta, kad daugiau nei trecdaliui respondentų bent vieną kartą gyvenime yra pasireiskes kompulsyvaus potraukio pirkti epizodas. Nei vienas respondentas nenurodė, kad oniomanijos epizodas jam pasireiskia siuo metu. Isvados: oniomanijos epizodo pasireiskimas buvo susijes su moteriska lytimi, jaunesniu amžiumi, vienisumu, gyvenimu mieste ir didesnėmis pajamomis. Jis reiksmingai dažniau trukdė vyresnių, turincių seimą, mieste gyvenancių ir didesnes pajamas gaunancių vyrų gyvenimo kokybe. doi:10.5200/sm-hs.2012.025

Clinical Case Report of Oniomania

Kompulsyvus potraukis pirkti (oniomanija) – tai elgesio sutrikimas, pasireiskiantis kaip nenumaldomas poreikis pirkti dažniausiai visiskai nereikalingus daiktus ir sukeliantis asmenybei ir visuomenei (arba jos daliai – bendruomenei, seimai) nepageidaujamas pasekmes. Jis lydimas prodrominio įtampos periodo, nesugebėjimo atsispirti pagundai pirkti būsenos bei palengvėjimo atlikus veiksmą epizodo. Manoma, kad JAV sis sutrikimas pasireiskia 5 proc. visuomenės narių, is kurių 80 proc. yra moterys. Neretai sis sutrikimas lydimas komorbidinių nuotaikos, nerimo, psichikos ir elgesio sutrikimų vartojant psichoaktyviąsias medžiagas bei valgymo sutrikimų. Sio sutrikimo klasifikacija vis dar nėra nusistovėjusi - skirtingos psichiatrų tradicijos skirtingai interpretuoja oniomanijos prigimtį. Vieni ją sieja su obsesiniais – kompulsiniais, kiti – su impulsų kontrolės ar potraukių sutrikimais. Lietuviskoje tradicijoje tai galėtų būti klasifikuojama kaip F63.8 arba F63.9 (kiti arba nepatikslinti įprocių ir potraukių sutrikimai). Mes aprasome 41 m. moters, 32 dienas gydytos Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų (LSMUL KK) Psichiatrijos klinikoje diagnostikos problemas, gydymo eigą ir rezultatus. doi:10.5200/sm-hs.2012.033

Relationship Between Suicidal Behavior and Cognitive Disorders in the Elderly

Darbo tikslas – įvertinti senyvo amžiaus žmonių suicidinio elgesio sąsajas su kognityvinių funkcijų sutrikimais. Tiriamieji ir tyrimo metodai. Analizuoti 184 pacientų, kuriems buvo tirtos kognityvinės funkcijos, duomenys. Tarpusavyje lyginti pacientai, turintys ir neturintys suicidinių mincių. Rezultatai ir isvados. Senyvo amžiaus pacientas, turintis suicidinių mincių ir kognityvinių funkcijų sutrikimų, dažniausiai gyvena mieste, yra vidurinio issilavinimo, greta psichikos sutrikimo serga somatine liga. Taip pat sie pacientai suicidines mintis issako ir bando žudytis per pirmuosius metus po psichikos sutrikimo nustatymo. Senyvo amžiaus, turinciam suicidinių mincių, pacientui dažniausi sutrikimai tokiose kognityvinių funkcijų srityse kaip operacinė atmintis, dėmesys, orientacija, vizualiniai-erdviniai bei kalbiniai gebėjimai. doi:10.5200/sm-hs.2012.068

Comparison of Memory Disorders in Amnestic Mild Cognitive Impairment and Alzheimer‘S Disease

According to the literature, long-term memory disorders appear earliest as mild cognitive impairment progresses to Alzheimer’s disease. Other types of memory impairment are discussed sparcely in literature, most studies include general tests of memory performance. Objective: Compare memory disorders in amnestic mild cognitive impairment and Alzheimer’s disease. Subjects: 75 patients were tested twice in the period of one year, 44 of those with amnestic mild cognitive impairment and 12 with Alzheimer’s disease. Method: Memory disorders were tested using 10 Word Test, Backwards Digit Span, Associative Memory Test, and Rey- Osterrieth Complex Figure Test. Results: Estimate means of associative and visual memory corresponds the norm; disorders appear in domains of short-term memory, working memory, long-term memory, and maximal retrieval in amnestic mild cognitive impairment. All memory domains are below norm in Alzheimer’s disease. Statistically significant mean differences (p < 0,05) were obtained in such domains as short-term memory, maximal retrieval, associative and working memory when comparing the groups of amnestic mild cognitive impairment and Alzheimer’s disease. The level of disturbance is significantly lower in all memory domains in single-domain amnestic mild cognitive impairment than those of Alzheimer’s disease. In multiple-domain amnestic mild cognitive impairment, significantly lower memory disturbances appear only in maximal retrieval (p = 0,026) and working memory (p = 0,001) domains. Conclusions: Disorders in all memory domains – i.e., short-term, working, associative, long-term, visual memory, and maximal retrieval – are characteristic to Alzheimer’s disease. Disorders of short-term, working, long-term memory, and maximal retrieval are characteristic to amnestic mild cognitive impairment. Disorders of memory in multiple-domain amnestic mild cognitive impairment display similar pattern to those in Alzheimer’s disease. It can be assumed that single-domain amnestic mild cognitive impairment progresses to multiple-domain amnestic mild cognitive impairment, as mild cognitive impairment progresses to Alzheimer’s disease. Article in Lithuanian doi:10.5200/sm-hs.2012.114

Diagnostic challenge in neuropsychiatry: two case reports

BackgroundTemporal lobe epilepsy straddles the borderland between psychiatry and neurology. Since this condition may involve gross disorders of thought, emotion, and sensory disturbances in the absence of tonic clonic seizures, psychiatrists may often fail to recognize the epileptic origin of the disorder. Our objective was to portray two case reports to increase recognition of common psychiatric symptoms and syndromes manifested in epilepsy.MethodDescriptive analysis of two females, suffering from derealization — depersonalization syndrome, hallucinations, and delusions.ResultsBoth patients were being treated for decades for depression and schizophrenia; however no positive treatment results resulted. A cooperative team of psychiatrists and neurologists of the Kaunas Medical Academy revealed epileptic roots of these cases, which resulted in treatment changes from antipsychotics to mood stabilizers. This new treatment showed long-acting positive outpatient outcomes.ConclusionContemporary medical science could show improved outcomes not only by fragmenting into smaller specialized pieces, but also associating into bigger units, especially in the case of psychiatry. However, more exhaustive research should be provided to confirm such necessity.