IntroductionFunctional recovery is the contemporary treatment goal in Major Depressive Disorder (MDD). Although consistency among physician and patient expectations may influence the therapeutic result (Demyttenaere K et al, 2011), patients’ perceptions are not always fully captured. Vortioxetine,a multimodal antidepressant, has shown encouraging data in achieving functional recovery, improving both mood and cognitive symptoms (Mahableshwarkar AR et al, 2015).ObjectivesThe aim of the study was to assess the effectiveness of vortioxetine on mood symptoms, cognitive symptoms and functionality, assessed by patient-rated tools, in MDD outpatients in Greece.MethodsIn this non-interventional study, vortioxetine was administered as flexible dosing (5-20 mg/d). Mood symptoms, cognitive symptoms and functioning were assessed by the patient-rated scales PHQ-9, PDQ-D and SDS respectively, at baseline, 1 and 3 months. Repeated measures analysis of variance and t-test were used for the statistical analyses.Results336 patients participated in the study. PHQ-9 score ±SD decreased from 16.1±5.3, to 10.0±5.7 and 4.6±4.5, PDQ-D score ±SD decreased from 37.3±16.6 to 23.1±14.8 and 12.0±10.6, SDS Score ±SD decreased from 18.7±5.3 to 12.9±5.9 and to 7.8±6.5, at baseline, 1 and 3 months, respectively. The 3 SDS subscales: work/school life improved from 5.8±2.4 to 4.2±2.2 and 2.6±2.2, social life improved from 6.6±2.0 to 4.5±2.2 and 2.7±2.3 and family life improved from 6.3±2.0 to 4.3±2.1 and 2.6±2.3 -baseline, 1 and 3 months, respectively (p<0.001 for all paired comparisons).ConclusionsMDD patients in Greece treated with vortioxetine significantly improved on mood symptoms, cognitive symptoms and functioning, enriching the already published efficacy data which is mostly based on clinician-rated scales.Conflict of interestA. Galanopoulos and E. Papalexi are full-time employees in Lundbeck Hellas.
Internet addiction is a matter of great interest for researchers, taking into consideration Internet's rapid spread and its ever growing use in children, adolescents and adults. It has been associated with multiple psychological symptoms and social difficulties, therefore raising even greater concerns for its adverse consequences. The present study that consists part of a broader research, aims to investigate the association between excessive Internet use and personality traits in an adult population. Specifically, the research examined the relation between dysfunctional internet behaviour and personality traits as neuroticism and extraversion, the two personality dimensions that have arisen as the most important ones in all relevant research. Our main hypotheses are that dysfunctional internet behaviour would be positively associated with neuroticism but negatively linked to extraversion. The 1211 participants aged over 18 years, completed the IAT (Internet Addiction Test) by Kimberly Young and the Eysenck Personality Questionnaire (EPQ) and some other questionnaires detecting psychopathology. Additionally, part of the administered questionnaires concerned socio-demographic characteristics of the participant subjects: specifically sex, age, marital status, education (educational years), place of residence -urban, semi-urban and rural-, whether they suffer from somatic or mental health disorder and if they take medication for any of the above categories. All the questionnaires have been electronically completed by each participant. Results showed that 7.7% showed dysfunctional internet behaviour that concerns both medium and severe degree of dependence by the use of Internet, as measured by the use of IAT. The univariate logistic regression analysis revealed that the individuals exhibiting symptoms of dysfunctional internet behaviour were more likely to suffer from a chronic mental health disorder, to use psychotropic medication and to score higher on neuroticism. In contrast, they were less likely to have children and be extraverted. Multiple logistic regression analysis confirmed that neuroticism and extraversion were independently associated with dysfunctional internet behaviour. Individuals with high scores on neuroticism were more likely to meet the criteria for dysfunctional internet behaviour, while high scores on extraversion were associated with a lower probability of dysfunctional internet behaviour. Identification of personality traits that could be connected to some sort of "addictive personality" -particularly neuroticism and Introversion- might help researchers to identify and prevent internet addiction on the early stages and possibly could have a positive contribution to the therapeutic treatment of this addiction disorder.
New concept: It is well known that schizophrenia has wide heterogenity of its long-term course and outcome. In 2004 ''The Remission in Schizophrenia Working Group'' (Andreasen, Carpenter, Kane et al) developed an operational criteria system for the measurement of remission. In their consensus remission was defined by using an absolute threshold of severity of the diagnostic symptoms of schizophrenia rather than improvement from the baseline. Remission is a low-mild symptom intensity level, where the symptoms do not influence behavior. To measure remission they used a complex psychopathological scale, PANSS. Old study: At the beginning of the 1970s we started a study, in which we investigated 185 patients. They were diagnosed according to Leonhard's classification of functional psychoses schizophrenia and cycloid psychoses (schizoaffective psychoses). We reinvestigated them 30 years later, using numerous psychopathological tests, including PANSS. For measuring the level of functioning, we estimated GAF also. The level of functioning was considered ''good'' when the GAF was higher than 60%. According to that 49% of schizophrenic patients had good prognosis, while this rate of schizoaffective patients was 95%. Results: We applied the remission conception to our patients and found that only 19% of the schizophrenic patients were in remission, in contrast with schizoaffective patients, where this rate was 90%. Conclusion: This result confirmed that function and social adaptation did not move in parallel with the severity of psychopathological symptoms, and that this remission concept is a stringent standard.
New concept: It is well known that schizophrenia has wide heterogenity of its long-term course and outcome. In 2004 ''The Remission in Schizophrenia Working Group'' (Andreasen, Carpenter, Kane et al) developed an operational criteria system for the measurement of remission. In their consensus remission was defined by using an absolute threshold of severity of the diagnostic symptoms of schizophrenia rather than improvement from the baseline. Remission is a low-mild symptom intensity level, where the symptoms do not influence behavior. To measure remission they used a complex psychopathological scale, PANSS. Old study: At the beginning of the 1970s we started a study, in which we investigated 185 patients. They were diagnosed according to Leonhard's classification of functional psychoses schizophrenia and cycloid psychoses (schizoaffective psychoses). We reinvestigated them 30 years later, using numerous psychopathological tests, including PANSS. For measuring the level of functioning, we estimated GAF also. The level of functioning was considered ''good'' when the GAF was higher than 60%. According to that 49% of schizophrenic patients had good prognosis, while this rate of schizoaffective patients was 95%. Results: We applied the remission conception to our patients and found that only 19% of the schizophrenic patients were in remission, in contrast with schizoaffective patients, where this rate was 90%. Conclusion: This result confirmed that function and social adaptation did not move in parallel with the severity of psychopathological symptoms, and that this remission concept is a stringent standard.
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