Neurology Psychiatry and Brain Research最新文献

Introduction

Cannabis is one of the commonly used substances among women of childbearing age. The majority of the evidence points to the negative birth outcomes of maternal use of cannabis with some exceptions. This study aims to review the published literature on the effect of prenatal cannabis use in fetal and neonatal development. It also aims to identify neuropsychiatric manifestations among children due to prenatal cannabis use.

Methodology

We performed a systematic review of studies in PubMed/Medline, Google Scholar, and PsycINFO using the keywords: ("Cannabis" or "Marijuana" or "THC" or "Tetrahydrocannabinol" or "Cannabis Sativa") AND Pregnancy. All the case reports, case-series, case-control studies, cross-sectional studies, cohort studies, and Randomized Control Trials (RCTs) published in the English language were systematically reviewed.

Results

A total of 31 studies were included. The bulk of evidence supported significant adverse clinical outcomes among children with prenatal cannabis exposure. The major intrauterine effects included stillbirth and gestational hypertension. Pre-term birth, small for gestational age, low birth weight, and intensive care admission were early neonatal effects whereas lifetime conduct disorder, increased delinquency, depression, including neurobehavioral changes, substance abuse disorder during childhood, etc in offsprings were neuropsychiatric outcomes.

Conclusion

We recommend abstinence of cannabis in pregnant mothers in order to avoid any complication. Also, further studies from low and middle-income countries are warranted.

Transcranial ultrasound (TUS) provides a noninvasive neuromodulation method that has greater spatial precision than existing methods. The present study examined TUS, for the first time, as a potential depression intervention. Twenty-four college students with mild to moderate depression were randomly assigned to an Active TUS Condition or Placebo TUS (no power administered). Participants completed five TUS sessions within seven days. Although depression scores did not change differentially for TUS/Placebo, trait worry decreased in the Active TUS Condition and increased in the Placebo condition. Additionally, those in TUS Active Condition had an increase in global affect over the course of the study, whereas those in the Placebo Condition did not. These results have significant implications for the potential utility of TUS as an intervention for anxiety disorders or worry-related psychopathology, warranting future investigation of the impact of TUS in a larger sample.

Background

Depression is the most common psychiatric disorder in patients with diabetes. We aimed to investigate the prevalence and factors associated with depression in patients with type 2 diabetes and to assess the relationship between depression and attainment of treatment targets.

Methods

In this cross-sectional study, we included patients with type 2 diabetes who were receiving chronic care in the outpatient diabetes unit of the Douala General Hospital, Cameroon. Depression was assessed using the 9-Item-Patient Health Questionnaire (PHQ-9). Logistic regression models were used to identify independent associations.

Results

Of the 177 participants, 52 (29.4 %, 95 % CI: 22.8–36.7) had depression. In bivariate analysis factors associated with depression were; age > 48 years, physical inactivity, major life event, pill burden (≥5 medication types and ≥7 tablets/day), nephropathy and neuropathy. In multivariate analysis neuropathy (aOR: 3.25, 95 % CI: 1.47–7.19; p = 0.004) and major life event (aOR: 8.38, 95 % CI: 2.79–25.15; p < 0.001) were independently associated with depression. Depression was independently associated with HbA1c > 7 % (aOR: 2.50, 95 % CI: 1.23–5.00; p = 0.010).

Conclusion

Depression is common in this group of Cameroonians with type 2 diabetes and is strongly associated with major life event, neuropathy and poor glycaemic control. Our results portray the need to systematically screen and manage depression in patients with type 2 diabetes in this setting.

Objective

Brain ischemia is an arterial vascular disorder, the second cause of death in the world. In this study, the effect of oral consumption of opium on the inflammation status, oxidative stress, infarction volume and neurological function after stroke in male rats were investigated.

Materials and methods

A total of 48 male Wistar rats were randomly assigned into three groups: 1- Sham group: these rats underwent sham surgery. 2- Stroke group: rats of this group underwent 2 h transient focal cerebral ischemia. 3- Opium group: opium administration began eight days before the ischemia, and then rats were underwent 2 h of transient focal cerebral ischemia. After that, the rats were evaluated for neurological impairment 24 h after stroke. The cerebral edema and infarct volume were evaluated by Image j software, and the concentration of total antioxidant capacity (TAC), Malondialdehyde (MDA), TNF-α, and C-reactive protein (CRP) of the brain tissue were measured as an indicator of inflammation and oxidative stress.

Results

TAC concentration in the opium group was significantly higher than of stroke group. Also, the TNF-α, CRP and MDA concentrations in the opium group were significantly lower than stroke group. The degree of cerebral edema and infarct volume in the opium group was significantly lower than stroke group. Moreover, the opium group had better neurological performance than the stroke group.

Conclusion

Based on the results of this study, the use of opium by enhancing the antioxidant capacity and decreasing inflammation after cerebral ischemia can reduce the extent of damage.

Background

Conversion disorder or functional neurological disorder is a psychiatric condition in which the body’s emotional and psychological stressors are converted to physical symptoms that cannot be explained by a neurological or medical condition. Psychogenic pseudoptosis is a rare manifestation of conversion disorder that present a major challenge in terms of diagnosis and treatment.

Case description

A 36-year-old woman presented with acquired left ptosis and longstanding generalized weakness. She denied any toxic substance exposure, insect bites, recent travel or family history of neurological disease. The neurological examination was normal except for an atypical left ptosis with eyebrow droop and inability to walk. However, electrophysiological investigations were normal. The presence of dissociative symptoms and the improvement after starting pharmacotherapy in combination with psychotherapy led to the diagnosis of conversion disorder.

Conclusion

After the exclusion of organic causes, the conversion disorder must be considered in the differential diagnosis of acquired ptosis, especially when accompanied by eyebrows droop sign and a suggestive psychological context.

Background

Novel ketamine-based pharmacotherapies can reduce depressive symptoms among patients with treatment-resistant depression (TRD), but associated short-term symptoms and potential adverse events raise complex benefit-risk questions.

Methods

A web-based discrete-choice experiment was administered to 161 esketamine-treated TRD subjects participating in the SUSTAIN-2 and SUSTAIN-3 clinical-trials; and to 301 online panel participants. Participants evaluated hypothetical depression treatments defined by varying levels of improvement in depression symptoms; time to response; transient post-dose issues (dissociation, dizziness, monitoring requirements, and driving restrictions); and potential long-term risks of ulcerative cystitis and cognitive impairment previously reported from ketamine abuse.

Results

The clinical-trial and panel respondents had similar preferences. On average, the 54 % of clinical-trial and 64 % of panel respondents who accepted benefit-risk tradeoffs placed the highest value on improving depression symptoms (relative importance = 10) and the least importance on avoiding transient post-dose issues (relative importance <3). Clinical-trial respondents were willing to accept risks of permanent cognitive impairment up to 4.7 % [95 % CI: 3.5 % – >5.0 %] or ulcerative cystitis higher than the survey’s maximum 5 % level to improve their depression symptoms from MADRS-40 (severe) equivalent to MADRS-20 (moderate) equivalent; panel respondents accepted somewhat lower risks (P>.05).

Conclusions

Most patients and panelists indicated a willingness to accept significant ulcerative cystitis or cognitive risks to realize improvements in depression, with few differences between samples. Avoiding transient post-dose issues with esketamine was of relatively little concern to most participants.

Background

Obsessive-compulsive symptoms can be seen in patients with schizophrenia. Association of obsessive-compulsive symptoms in schizophrenia can be a co-morbid association or can be induced by the antipsychotic medications too.

Method

We present here a lady with schizophrenia whose repeated washing behavior. The significance of the psychopathology and its implications in management are discussed with review of literature.

Result

The patient was initially thought to be having obsessive-compulsive symptoms, which was later found to be the result of commanding auditory hallucinations.

Conclusion

Obsessive compulsive symptoms in schizophrenia can be secondary to core schizophrenia psychopathology like auditory hallucination.

Background

Depressive patients with atypical symptoms tend to cause greater functional impairment. This study examined the differences of the atypical depressive symptoms between unipolar and bipolar depressive patients (BP I and BP II).

Methods

We studied 466 depressed patients (262 unipolar and 204 bipolar subjects, in which 122 BP I depression, 82 BP II depression) diagnosed with DSM-IV criteria. Atypical depressive symptoms were also evaluated with DSM-IV criteria for atypical features specifier. Binary logistic regression was used to examine the associations of atypical depressive symptoms with depressive disorders after control of confounding variables.

Results

The prevalence with any atypical depressive symptoms in unipolar depressive disorder was 32.8 % (86/262), and in bipolar depression was 44.6 % (91/204), X² = 6.76, P = 0.009. In stepwise binary logistic regression analysis, patients with bipolar depression had more females, more positive psychiatric history, more weight gain or increase in appetite, more interpersonal rejection sensitivity, and more visual values of severest pain.

Limitations

The participants recruited were both inpatients and outpatients in one major hospital which might influence the generality of the study. The cross-sectional research methods can't work out causality.

Conclusions

Bipolar depression and major depressive disorder exhibit subtle differences in presentation, which may help guide the early intervention, initial diagnosis and the choice of therapy.

Background

Panic buying is an emerging phenomenon observed during, but not restricted to, pandemic.

Aim

We aimed to evaluate the nature, extent, and impact of panic buying as reported in the media.

Methods

This study was conducted by collecting the information from the English media reports published till 22nd May 2020. A structured format was developed to collect data. Searching was done by using the keyword “panic buying”. We have excluded the social media posts discussing the panic buying.

Results

The majority of media reporting was from the USA (40.7 %), and about 46 % of reports highlighted the scarce item. Approximately 82 % of the reports presented the causes of panic buying whereas almost 80 % report covered the impact of it. About 25.7 % of reports highlighted the rumor about panic buying and only 9.3 % of reports blamed the government. Only 27.1 % reports described the remedial measures, 30.8 % reports conferred the news on the psychology behind panic buying and 67.3 % news displayed the images of empty shelves.

Conclusion

A high proportion of reports on panic buying have been found from the developed countries discussing the causes & impact of panic buying on the basis of expert opinion.