Both atomoxetine and methylphenidate reduced the symptoms of ADHD and anxiety. Atomoxetine was more effective in anxiety symptom reduction from the fourth week of treatment.
Major depressive disorder (MDD) is characterized by dysphoric mood, which may be accompanied by suicidal ideation. It is supposed that MDD is associated with dysfunction of the autonomic nervous system, but studies in pediatric patients are rare. Therefore, we aimed to study the relationship between MDD and autonomic regulation in adolescence using the electrodermal activity as an index of sympathetic cholinergic control. We examined 25 adolescents suffering from MDD without comorbidities and prior to pharmacotherapy (13 girls, mean age 14.6 ± 0.4 year) and 25 age/gender-matched healthy control subjects. The electrodermal activity was continuously recorded during 5 min of supine rest. The value of this activity in μS was averaged for each minute of the recording. We found that in depressed patients, electrodermal activity was significantly lower each minute of the recording compared to that in the control group. The study demonstrates electrodermal hypoactivity in adolescent patients with MDD, which points to dysfunctional regulation of the sympathetic part of the autonomic nervous system. This finding could represent a potential pathomechanism leading to higher risk of negative health outcomes in pediatric depressed patients. Further research is needed to elucidate the incompletely understood interaction between MDD and autonomic regulatory outputs at young age.
Introduction: Go/NoGo continuous performance task (CPT) is a neuropsychological test designed for measurement of attention and impulsivity and very often associated with attention deficit hyperactivity disorder (ADHD). The aim of this study was to provide current view of test with its application in future psychophysiological research and clinical practise. Methods: The studies regarding CPT were collected using scientific databases (PUBMed, Medline, SCOPUS). The heart rate variability (HRV) as an index of parasympathetic activity and electrodermal activity (EDA) as a noninvasive index of sympathetic arousal were applied in ADHD and depression during Go/NoGo CPT. Conclusion: In psychophysiological research, the altered HRV and EDA could represent a noninvasive biomarkers for internalizing/externalizing psychopathology. It seems that Go/NoGo CPT could be used as an important diagnostic tool in mental disorders, however future research is needed.
Attention-Deficit/Hyperactivity Disorder (ADHD) is connected with high level of psychiatric comorbidity in paediatric population. Depressive disorder is common comorbid disorder co-existing with ADHD. Atomoxetine is worldwide approved for treatment of ADHD in paediatric population; in addition atomoxetine is effective and safe in treatment of some comorbid disorders in ADHD. Pharmacotherapy of depression is limited and residual symptoms are common. Fluoxetine is currently considered to be the gold standard of treatment of depression, but effectiveness of acute phase of treatment is not sufficient. Atomoxetine as a selective noradrenaline reuptake inhibitor or olanzapine as a multi receptors antagonist drug in combination with fluoxetine could be perspective augmented treatment strategy of depression just for their antidepressant effect. The aim of our following study is to evaluate and compare effectiveness and safety of monotherapy and combined/augmented therapy in acute phase of depression treatment in adolescence, as well as introduce complex modern research methodology of effectiveness and safety of treatment.
A b s t r a c t Despite of the fact, that comorbidity of depression and anxiety is a frequent condition in clinical practice, current psychiatric classification systems (according to WHO-ICD 10 and according to APA-DSM IV-TR) are not taking this reality into account sufficiently. The concept of anxious depression is very important for clinical practice. Recommended guidelines and algorithms of treatment based on evidence based medicine (EBM), established mainly on randomized controlled trials are designed separately for depression and separately for anxious disorders. This presents very often a significant complication in clinical practice. The aim of this article was to bring the concept of anxious depression to closer attention with highlighting of possible therapeutic approaches.
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