Showing papers by "Adam Wichniak published in 2022"
TL;DR: The determination of salivary MELA concentration using LC-MS/MS allows for the determination of the DLMO, and the method may be applied in clinical practice for the diagnosis and monitoring of circadian rhythm disorders.
Abstract: ABSTRACT Melatonin (MELA) is a nocturnal hormone involved in the regulation of the circadian rhythm. MELA can be detected in plasma and saliva, and its salivary concentration strongly correlates with its plasma concentration. Dim light melatonin onset (DLMO) is considered to be the most accurate objective marker for assessing the circadian phase. The purpose of the study was to establish a method for the determination of MELA in plasma and saliva based on the liquid chromatography with tandem mass spectrometry (LC-MS/MS) and compare DLMO using both plasma and saliva matrices. The validation of the LC-MS/MS methods was performed in accordance with the European Medicines Agency (EMA) guideline. The study was conducted on a group of 21 volunteers, male and females, aged 26–54 years. Plasma and saliva were collected at five time points: between 20:00 and 00:00 hours. The MELA concentration was determined by the LC-MS/MS. The DLMO was considered as the point in time when MELA concentration exceeds 20 pg/mL in plasma and 7 pg/mL in saliva. The correlation coefficient between the plasma and salivary MELA concentration was r = 0.764 (p < .001). The ratio of the plasma/saliva MELA concentrations was 2.87. The mean time of the DLMO in the plasma was 21:30 ± 0:45 hours, and in the saliva was as follows: 21:34 ± 1:00 hours. The correlation between the DLMO, calculated based on the plasma and saliva MELA profiles, was r = 0.679 (p < .05). The determination of salivary MELA concentration using LC-MS/MS allows for the determination of the DLMO. Our method may be applied in clinical practice for the diagnosis and monitoring of circadian rhythm disorders. Abbreviations: CE: Collision Energy; CID: Collision-Induced Dissociation; DL: Desolvation Module; DLMO: Dim Light Melatonin Onset; EFSA: European Food Safety Authority; EMA: European Medicines Agency; ESI: electrospray ionization; HB: heat block; HPLC: high performance liquid chromatography; IS: internal standard; K3EDTA: ethylenediaminetetraacetic acid tripotassium salt; LC-MS/MS: liquid chromatography with tandem mass spectrometry; LLE: liquid–liquid extraction; LLOQ: lower limit of quantification; MELA: melatonin; MELA-D4: melatonin-d4; MRM: multiple reaction monitoring; Q1: quadrupole 1; Q3: quadrupole 3; RE: relative error; RIA: radioimmunoassay; RSD: relative standard deviation; SD: standard deviation; ULOQ: upper limit of quantification
3 citations
TL;DR: In this article , a literature search and expert opinion emerged during a virtual meeting of European psychiatrists that was convened to discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression.
Abstract: Abstract Objective: To discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression. Methods: Our review was based on a literature search and expert opinion that emerged during a virtual meeting of European psychiatrists that was convened to discuss this topic. Results: Current evidence demonstrates that depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions. A wide variety of pharmacological and non-pharmacological treatments and work-based interventions are effective in reducing depression-related sick leave duration and/or facilitating return to work. Recent real-world evidence showed that patients treated with antidepressant monotherapy appear to recover their working life faster than those receiving combination therapy. Although depression-related sick leave duration was found to correlate with severity of depressive symptoms, it cannot be used alone as a viable marker for disease severity. Conclusions: Given its multifactorial nature, depression-related sick leave duration is not on its own a viable outcome measure of depression severity but could be used as a secondary outcome alongside more formal severity measures and may also represent a useful measure of functionality in depression. Key points Depression in the working population and depression-related sick leave have a profound economic impact on society Depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions A wide variety of pharmacological and non-pharmacological treatments and work-based interventions have been shown to be effective in reducing depression-related sick leave duration and/or facilitating return to work In terms of pharmacological intervention, recent real-world evidence has shown that patients treated with antidepressant monotherapy are able to recover their working life faster than those treated with combination therapy Although depression-related sick leave duration has been shown to correlate with severity of depressive symptoms, it is not a viable outcome measure of depression severity on its own, but could be used as secondary outcome alongside more formal clinician- and patient-rated severity measures Depression-related sick leave duration may, however, represent a viable outcome for measuring functionality in depression
2 citations
TL;DR: The aim of this paper is to present the problem of excessive daytime sleepiness in the course of seasonal affective disorder and to propose modafinil therapy, an agent used in adults to treat excessive sleepiness associated with narcolepsy.
Abstract: Excessive daytime sleepiness or an increased need for sleep are an increasingly common reason of medical appointments. For years, the literature on sleep disorders has reported a complex two-way relationship between excessive sleepiness and mental disorders – especially mood disorders, which include winter depression in seasonal affective disorder. Assessment and effective treatment of excessive sleepiness in patients with seasonal affective disorder is an important component of the therapy. Hypersomnia is often a residual symptom of affective disorders, compromising the quality of life and daily functioning. Modafinil is an agent used in adults to treat excessive sleepiness associated with narcolepsy, with or without cataplexy. In addition to the registered indications, previous studies have shown efficacy and good tolerance of modafinil as augmentation treatment of depressive episodes in patients with residual symptoms in the form of fatigue and excessive daytime sleepiness, who received drugs from the group of serotonin reuptake inhibitors. The aim of this paper is to present the problem of excessive daytime sleepiness in the course of seasonal affective disorder and to propose modafinil therapy.
TL;DR: In this paper , stosowanie arypiprazolu w postaci iniekcji o długim działaniu zmniejsza ryzyko hospitalizacji o 44%.
Abstract: Kane i wsp. udowodnili, że stosowanie arypiprazolu w postaci iniekcji o długim działaniu zmniejsza ryzyko hospitalizacji o 44%. W grupie pacjentów leczonych iniekcjami o długim działaniu co najmniej jedna hospitalizacja w okresie obserwacji wystąpiła u 22% osób, w grupie otrzymującej leczenie standardowe – u 36% osób. Oznacza to, że w grupie 7 pacjentów ochroniła ona przed hospitalizacją o jedną osobę niż leczenie standardowe.
TL;DR: In this paper , the authors present the position statement of the working group of the Section of Biological Psychiatry of the Polish Psychiatric Association concerning the proper patients selection and safety of use of repetitive transcranial magnetic stimulation (rTMS) in the therapy of psychiatric conditions.
Abstract: Transcranial magnetic stimulation (TMS) is a method of noninvasive brain stimulation developed since the 1980s. Repetitive transcranial magnetic stimulation (rTMS) is one of the methods of noninvasive brain stimulation, which is increasingly used to treat psychiatric disorders. Recent years witnessed a dynamic growth in the number of sites offering therapy with rTMS and of the interest of patients in this method in Poland. This article presents the position statement of the working group of the Section of Biological Psychiatry of the Polish Psychiatric Association concerning the proper patients selection and safety of use of rTMS in the therapy of psychiatric conditions. Before starting to use rTMS, the involved personnel should undergo a period of training in one of the centers with relevant experience. Equipment dedicated to perform rTMS should be appropriately certified. The main therapeutic indication is depression, including drug-resistant patients. rTMS may also be used in obsessive-compulsive disorder, negative symptoms and auditory hallucinations in schizophrenia, nicotine addiction, cognitive and behavioral disturbances in Alzheimer's disease, and post-traumatic stress disorder. The strength of magnetic stimuli and the overall dosing of stimulation must be based on the recommendations of the International Federation of Clinical Neurophysiology. The main contraindications are the metal elements in the body, especially medical electronic devices near the stimulating coil, epilepsy, hearing loss, structural changes in the brain, which may be associated with epileptogenic foci, pharmacotherapy, which lowers the seizure threshold, and pregnancy. The main side effects are induction of epileptic seizure, syncope, pain and discomfort during stimulation, as well as induction of manic or hypomanic episodes. The respective management is described in the article.
TL;DR: In this paper , the authors found that insufficient sleep increases sensitivity to chronic stress and may be a precursor to the deterioration of mental health and the development of burnout in nurses and midwives.
Abstract: Purpose Insufficient sleep increases sensitivity to chronic stress and may be a precursor to the deterioration of mental health and the development of burnout. The aim of our study was to verify whether symptoms of insomnia mediate the relationship of occupational stress with mental health among nurses who work shifts. Materials and Methods The analyses included 117 female nurses and midwives who work shifts. They filled in the 16-item Effort-Reward Imbalance Questionnaire (ERIQ) assessing occupational stress, the Insomnia Severity Index (ISI), the Patient Health Questionnaire (PHQ-9, the question about sleep was excluded from the analyses), the Generalized Anxiety Disorder Assessment (GAD-7), and the 16-item Oldenburg Burnout Inventory (OLBI) consisting of two scales – Disengagement and Exhaustion (OLBI-D and OLBI-E). Results Insomnia partially mediated the association of the effort-reward imbalance ratio with depression, anxiety and the exhaustion dimension of burnout. We found no association of insomnia symptoms with the depersonalization dimension of burnout, but the effort-reward imbalance ratio was associated with the depersonalization scale. Conclusion The results showed that occupational stress has varying degrees of influence on mental health, partly depending on the severity of insomnia symptoms among nurses and midwives who work shifts.
TL;DR: In this article , the authors present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy.
Abstract: Early onset of schizophrenia (before the age of 18 years) is associated with a higher risk of delayed or missed diagnosis, more severe course of the disease, and an increased susceptibility to adverse reactions to antipsychotic drugs. The objective of this paper is to present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy. The formal criteria that must be met to diagnose schizophrenia are the same for children and adults. Early-onset schizophrenia must be thoroughly differentiated from uni - or bipolar affective disorder, autism-spectrum disorders (ASDs) and anxiety disorder. Diagnostic assessment for psychotic disorders is also necessary in the case of abnormal, destructive or aggressive behaviour, or self-harm. The mainstay of schizophrenia treatment is pharmacological therapy, which is used in the treatment of acute episodes and in maintenance treatment - prevention of relapses. However, the use of pharmacological interventions in children and adolescents only to reduce the risk of psychosis development is not justified. Antipsychotic agents significantly differ by their tolerance profile and clinical efficacy. Second-generation antipsychotic agents approved for the treatment of early-onset schizophrenia - aripiprazole, lurasidone and paliperidone - enable its effective and safe treatment. The necessary complement to pharmacological therapy is non-pharmacological interventions that should be adapted to the patient's age, cognitive abilities, disease stage and the needs of the whole family.
01 Aug 2022
TL;DR: The psychofarmakologia kliniczna as discussed by the authors is a premiera na rynku wydawniczym, to prawie 900 stron rzetelnej, ciekawej wiedzy przekazanej w swoich dziedzinach.
Abstract: Oddajemy w ręce czytelników wyjątkową książkę pt. „Psychofarmakologia kliniczna”. Autorzy omówili w niej zastosowanie środków farmakologicznych w leczeniu zaburzeń psychicznych. Publikacja została przygotowana przez wybitnych polskich specjalistów – psychiatrów, farmakologów i neurobiologów. Jest to ważna premiera na rynku wydawniczym. „Psychofarmakologia kliniczna” to prawie 900 stron rzetelnej, ciekawej wiedzy przekazanej przez uznane autorytety w swoich dziedzinach. Książka jest skierowana do lekarzy specjalistów – psychiatrów, neurologów, seksuologów, neurobiologów, farmakologów, a także osób przygotowujących się do egzaminu specjalizacyjnego w wybranych gałęziach medycyny. Zainteresuje również psychoterapeutów pracujących w zespołach interdyscyplinarnych.