Clinical Neuroscience

Modern health worries in patients with affective disorders. A pilot study

FREYLER Anett1, SIMOR Péter2, SZEMERSZKY Renáta3, SZABOLCS Zsuzsanna1, KÖTELES Ferenc3

SEPTEMBER 30, 2019

Clinical Neuroscience - 2019;72(09-10)

DOI: https://doi.org/10.18071/isz.72.0337

Background - Modern health worries (MHWs) are asso­ciated with various indicators of negative affect, conspiracy theories, and paranormal beliefs in healthy individuals. Purpose - The current pilot study aimed to assess MHWs and indicators of negative affect in patients with affective disorders (N = 66), as well as the possible associations between MHWs and paranoid and schizophrenic tendencies. Results - Compared to somatic patients, psychiatric patients showed higher levels of MHWs, somatosensory amplification, health anxiety, and somatic symptoms. Medium level associations between MHWs and paranoid (r = 0.35, p < 0.01) and schizophrenic (r = 0.37, p < 0.01) tendencies were also revealed. Somatosensory amplification (β = 0.452, p < 0.001) and paranoia (β = 0.281, p < 0.01) significantly contributed to MHWs in multiple linear regression analysis (R2 = 0.323, p < 0.001). Discussion - High (i.e. pathological) levels of negative affect can impact a number of related characteristics. Non-pathological paranoid tendencies might contribute to MHWs. The identification of paranoid tendencies seems to be relevant for the treatment of psychiatric patients exhibiting MHWs. Conclusion - Patients with affective disorders are characterized by higher levels of modern health worries, health anxiety, and somatosensory amplification. Modern health worries are associated with paranoid tendencies.

AFFILIATIONS

  1. Doctoral School of Psychology, Eötvös Loránd University; Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Budapest
  2. Institute of Psychology, Eötvös Loránd University, Budapest
  3. Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Budapest

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

Coexistence of cervical vertebral scalloping, pedicle deficiencies and dural ectasia in type I neurofibromatosis

YALDIZ Mahizer

Neurofibromatosis type 1 (NF-1; also known as Von Recklinghausen’s disease) is a common autosomal dominant disease that occurs in the general population at the rate of 1 in 3000. Many NF-1 patients present with spinal malformations. A 54-year-old female patient was admitted to the Outpatient Clinic of Dermatology with gradually increasing swelling and spots on the body that had been present for a long period of time. Cervical vertebral scalloping, pedicle deficiencies and dural ectasia (DE) were also detected. She was diagnosed with NF-1. NF-1 is routinely seen in dermatology practice. Coexistence of NF-1 with vertebral scalloping, pedicle deficiencies and DE rarely occurs. Our case is the second reported instance in the literature of NF-1 with a spinal anomaly in the cervical region, and the first reported instance of the coexistence of NF-1 with cervical vertebral scalloping, pedicle deficiencies and DE.

Clinical Neuroscience

Acute bilateral drop foot as a complication of prolonged squatting due to haemorrhoid

KOKSAL Ayhan, DOGAN Burcu Vasfiye

Drop foot is defined as difficulty of dorsiflexion of the foot and ankle due to weak anterior tibial, extensor hallucis longus and extensor digitorum longus muscles. Cauda equina syndrome, local peroneal nerve damage due to trauma, nerve entrapment, compartment syndrome and tumors are common etiologies. A 32-year-old male patient was applied with difficulty in dorsiflexion of both of his toes, feet and ankles after he had squatted in toilette for 6-7 hours (because of his haemorrhoid) after intense alcohol intake 2 weeks before. Acute, partial, demyelinating lesion in head of fibula segment of peroneal nerves was diagnosed by electromyography. This case was reported since prolonged squatting is an extremely rare cause of acute bilateral peroneal neuropathy. This type of neuropathy is mostly demyelination and has good prognosis with physical therapy and mechanical devices, but surgical intervention may be required due to axonal damage. People such as workers and farmers working in the squatting position for long hours should be advised to change their position as soon as the compression symptoms (numbness, tingling) appear.

Clinical Neuroscience

[Newer studies on the strong link between sleep and epilepsy: Epilepsy as an epileptic transformation of sleep plastic functions]

HALÁSZ Péter

[Aims - Overview of the new data about the strong link of sleep and epilepsy and conjoining cognitive impairment. Methods - Search for relevant references and summary of our own research activity on the topic. Results - Strong interrealtionship exists between epilepsy and plastic brain functions (memory processing and synaptic homeostasis) and the working modes of NREM sleep. In the most frequent childhood and adult epilepsy networks responsible for plastic functions can be derailed to an epileptic level of excitability, and suffer a transitory or permanent epileptic transformation. Exampling on the three big epilepsies: absence epilepsy; medial temporal lobe epilepsy; and childhood idiopathic focal age dependent epilepsy spectrum we demonstrate the most important features of this epileptic transformation. The association of cognitive impairment to certain sleep dependent epilepsies gains explanation by the epilepsy caused interference with slow wave decline (ICFE) and memory consolidation (MTLE) during NREM sleep. This paper serves also to introduce the concept of sleep dependent system epilepsies. Conclusions - We provide evidences about shared mechanisms among sleep related epilepsies being the derailment of sleep plastic funcions toward exaggerated excitability determined by the inherent possibilities of the signal transduction properties. ]

Clinical Neuroscience

[The role of epigenetic regulations in early childhood diseases]

TORY Vera

[With the acceptance of “The developmental origins of health and disease” concept in the 1990s, it became clear that epigenetic inheritance, which do not involve changes in the DNA sequence has important role in the pathogenesis of diseases. Epigenetic regulation serves the adaptation to the changing environment and maintains the reproductive fitness even on the drawback of increased risk of diseases in later life. The role of epigenetic mechanisms in chronic non-communicable diseases has been well established. Recent studies have revealed that epigenetic changes have also causal role in certain pediatric diseases. The review evaluates the recent epigenetic findings in the pathomechanism of common pediatric diseases. The wide range and long-lasting duration of epigenetic regulations give importance to the subject. Methods are already available to evaluate a part of the epigenetic changes in the clinical practice, presently aiming primarily the estimation of the disease risk or definition of diagnosis. Furthermore, there are already available limited means to influence the epigenetic regulation. ]

Clinical Neuroscience

[The role of Hungarian-rooted scholars in the development of Otoneurology ]

TAMÁS T. László, GARAI Tibor, TOMPOS Tamás, MAIHOUB Stefani, SZIRMAI Ágnes

[Despite of the symptoms of vertigo have been known since thousands of years, it was evident by the research of the pioneer scientists of the 19th century (Flourens, Ménière, Breuer and others) that dizziness can also be attributed to inner ear disfunctions. The discovery of the vestibulo-ocular reflex was an important milestone (Endre Hőgyes, 1884). The vestibulo-ocular reflex stabilizes images on the retina by rotating the eyes at the same speed but in the opposite direction of head motion. The milestone discovery of Hőgyes by stimulating individual labyrinth receptors and recording the activity of eye muscles were verified by János Szentágothai in 1950. Low-frequency lesions of the angular vestibulo-ocular reflex can be investigated by caloric test (Robert Bárány,1906), high-frequency lesions by head impulse test (Gabor Michael Halmagyi and Ian Stewart Curthoys, 1988).]

All articles in the issue

Related contents

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Attachment as a predictor of risk for eating disorders on a representative hungarian adult sample]

SZALAI Dömötör Tamás, CZEGLÉDI Edit

[Background and purpose – Many studies confirm the relationship between attachment disturbances and (the severity of) eating disorders, however among them only one Hungarian study can be found. The exact predisposing traits of attachment and the strength of relationship is still uncleared. Our aim was to explore these aspects. Methods – Study was based on a cross-sectional nationally representative survey, called „Hungarostudy 2013” (N=2000, 46.9% males, mean age 46.9 years, SD=18.24 years). Measures: Sociodemographic and self-reported anthropometric data (weight and height), short Hungarian version of Relationship Scale Questionnaire, SCOFF questionnaire and short Hungarian version of Beck Depression Inventory. Results – The frequency of risk for eating disorders (anorexia or bulimia nervosa) was 3.9% (N=76) among the respondents (N=1860). Attachment anxiety was significantly higher in the risk for eating disorders group (t(1888)=-3.939, p<0.001), and significantly predicted the risk for eating disorders after adjusting for the potential background variables (OR=1.09, p=0.040). Detachment was not a significant predictor of risk for eating disorders (OR=0.98, p=0.515). Younger age (OR=0.97, p<0.001), higher level of depression (OR=1.09, p<0.001) and higher body mass index (OR=1.08, p<0.001) were also significant cross-sectional predictors of risk for eating disorders. The explained variance of the model was 10.7%. Conclusion – The study supported, that higher attachment anxiety is associated with the increased risk of eating disorders, with a possible therapeutic relevance. Assessment of attachment’s further aspects and creating multivariable models are required for more thorough understanding and optimising of intervention points.]

Lege Artis Medicinae

[Interrelations between antidepressants and diabetes]

HARGITTAY Csenge, GONDA Xénia, MÁRKUS Bernadett, VÖRÖS Krisztián, TABÁK Gy. Ádám, KALABAY László, RIHMER Zoltán, TORZSA Péter

[Diabetes and depression are frequent comorbidities. They are a heavy burden by themselves, however, as comorbidities increase additionally the number of diabetes-related complications, morbidity, and mortality. In the background of interrelations, there are both well-known and hypothetical mechanisms. The aim of the present review is to outline these interrelations between antidepressants and diabetes and to discuss the effect of medications on carbohydrate metabolism respectively. Anti­depressant treatment on the one hand may improve mood, cognitive function and medication adherence leading to an improved glucose metabolism, on the other hand through their metabolic side effects, they may worsen carbohydrate metabolism. Concerning metabolic side effects, selec­tive serotonin reuptake inhibitors are the sa­fest, while tricyclic antidepressants and mo­noamine oxidase inhibitors should be administered under close monitoring. Se­rotonin and noradrenaline reuptake inhibitors may deteriorate gly­cae­mic control via increased noradre­nergic activation. Novel antidepressants, how­ever, have a neutral or positive impact on gly­caemic measures. Screening for and temporally adjusted treatment of depres­sion may decrease the risk of comorbidities ge­nerated complications. While caring for diabetic patients with depression, one should consider metabolic side effects of antidepressants and close monitoring of carbohydrate metabolism.]

Clinical Neuroscience

[Vertigo - comorbidity with psychiatric disorders]

FAZEKAS András

[Vertigo is one of the most common symptom and complaint in the clinical practice. The differential diagnosis can only be attained by a careful interdisciplinary way of thinking and activity, given the fact that the vestibular, neurological and psychiatric disorders - considered as pathogenic factors - are being present simultaneously in triggering the symptoms, and there can be overlaps between the certain pathological processes. The author deals with the co-morbidity of the vertigo and the psychiatric symptoms - anxiety, panic-disorder -, pointing out the common neurobiological and neurophysiological factors in the background of the symptoms, emphasizing the importance of the SSRI-s in the restoration of the serotonerg dysfunction.]

Clinical Neuroscience

[Ketamine administration in case of severe, therapy resistant depressed patient, case report]

MORVAI Szabolcs, NAGY Attila István, BÁLINT-SZÖLLŐSI Adrienn, MÓRÉ E Csaba, BERECZ Roland, FRECSKA Ede

[Objective - In our case report we present the treatment of a female patient suffering from therapy resistant depression. This procedure is not in practice in Hungary at present, the aim of our work to reproduce the findigs of international studies in domestic circumstances. Matter - Major depression is a common, chronic and severe mental disorder, with 16.2% lifetime prevalence. Many international randomized, placebo controlled trials found administration of ketamine infusion effective in depressed patients. Methods - Since ketamine is an anesthetic agent, its administration was performed in the post-operative monitoring room of our hospital operating-room, supervised by an anesthesiologist. According to formerly published data, a dose of 0.5 mg/kg of body weight was administered intravenously in 40 minutes by perfusor. The drug was administered in a same manner fifteen days later. Subject - The patient was admitted to our inpatient ward with severe depression. During two months of combined antidepressant therapy her condition has not improved significantly. Approval for off label drug indication was granted with urgency by the National Institute of Quality and Organizational Development in Healthcare and Medicines. Results - During the two treatments the Hamilton Depression Rating Scale 21 items rating scale score was reduced to 8 from the baseline 28, the Hamilton Anxiety Rating Scale score was reduced to 6 from 25, Beck Depression Inventory was reduced to 9 from 20. Upon administration of the drug no severe adverse event was detected, the mild dissociative state related to ketamine was ceased in a short period of time. Discussion - With administration of 0.5 mg/kg ketamine the authors managed to achieve rapid improvement in a therapy resistant depressed patient, without permanent side effects. Our future plan is to repeat the use of the drug within a double-blind, placebo controlled trial in order to prove its efficacy in hospital settings. ]