{"title":"Stress and neuroinflammation.","authors":"Angela J Grippo, Melissa-Ann L Scotti","doi":"10.1159/000343965","DOIUrl":"https://doi.org/10.1159/000343965","url":null,"abstract":"<p><p>It has been well established that there is bidirectional communication between the immune and central nervous systems. One context in which this interaction has been extensively studied is that of the stress response. Stress, whether physical or psychological, induces alterations in immune function. Often exposure to a stressor results in pro-inflammatory responses in the brain and periphery. These responses are mediated by a variety of inflammatory molecules including neuropeptides, cytokines, and stress hormones among others. Here, we will discuss several of the more comprehensively studied of these inflammatory mediators and their role(s) in stress-induced neurogenic inflammation. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"20-32"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virus infection as a cause of inflammation in psychiatric disorders.","authors":"Karl Bechter","doi":"10.1159/000343967","DOIUrl":"https://doi.org/10.1159/000343967","url":null,"abstract":"<p><p>Many neurotropic viruses exist and may cause classical inflammation but also low-level neuroinflammation. However, viruses may be dormant within the CNS and become active later. The role of neurotropic virus infections in the causation of psychiatric disorders may be underestimated, because the diagnostic approach to the CNS is difficult and to dormant infections in general, but especially within the CNS. Evidence is increasing that infections increase the risk of psychiatric disorders, not only prenatal infections but also infections during the lifetime. The question how low level neuroinflammation may be involved in severe psychiatric disorders like affective and schizophrenic spectrum disorders is intriguing but remains to be studied. Experimental data clearly show that low-level neuroinflammation can be induced by viruses, but the definitions of inflammation and low level neuroinflammation appear to be blurred and apparently the previous classical definition of inflammation has to be widened. Virus infection itself or virus-related products or virus-induced autoimmunity may play a role in disease pathogenesis. More sensitive diagnostic approaches from neuroimaging and CSF investigations may hold the key to a better understanding and definition of CNS viral infections as an etiopathogenetic subgroup of severe psychiatric disorders. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"49-60"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anxiety and cardiovascular disease.","authors":"Simon J C Davies, Christer Allgulander","doi":"10.1159/000351945","DOIUrl":"https://doi.org/10.1159/000351945","url":null,"abstract":"<p><p>This chapter examines the association of anxiety disorders and anxiety symptoms with cardiovascular disease, focussing on hypertension (an independent risk factor for myocardial infarction and stroke) and coronary heart disease. In both cases, epidemiological data linking the cardiovascular disorder with specific anxiety disorders and anxiety symptoms are examined first, and evidence relating to putative mechanisms that may underlie these associations is explored. For hypertension, an association with panic attacks and panic disorder has been reported most consistently, but the literature relating to other forms of anxiety is inconsistent, especially as some studies have reported an association of anxiety with low blood pressure. Recent work which has attempted to elucidate this confusing situation is presented. Mechanisms which may be responsible for the link between hypertension and panic include autonomic nervous system dysfunction (which may be under serotonergic control), respiratory mechanisms, cytokines, platelet dysfunction and behavioural factors. While an association of depression with coronary heart disease has been studied extensively, the association with anxiety disorders has been slower to emerge. Studies contributing to this evidence base are examined, and as for hypertension putative mechanisms are discussed. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"29 ","pages":"85-97"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000351945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Essential fatty acids as potential anti-inflammatory agents in the treatment of affective disorders.","authors":"Cai Song","doi":"10.1159/000343970","DOIUrl":"https://doi.org/10.1159/000343970","url":null,"abstract":"<p><p>In the last two decades, many studies have demonstrated that increased inflammatory responses occur in patients with affective disorders, which could contribute to the dysfunction of neuroendocrine and neurotransmission in these diseases. The evidence consequently suggests that drugs or natural products with anti-inflammatory properties should be developed to treat the illness. Among several candidates that modulate the neuro-immune network, omega-(n)-3 essential unsaturated fatty acids have emerged as effective treatments for affective disorders. Because these fatty acids can influence membrane structure, reduce inflammation and regulate protein and gene expressions, their effects seem promising. In this chapter, the newest findings that support the inflammatory theory of affective disorders have been first selected and reviewed. Secondly, the role of n-3 fatty acids in the immune system and brain has been introduced and then the possible mechanisms by which n-3 fatty acids attenuated symptoms of depression are discussed by the insight of the results from the animal studies. Finally, the clinical effects of n-3 fatty acids on major, bipolar and postpartum depression are summarized. Furthermore, the chapter points out the limitations and future research in this area. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"75-89"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343970","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The question of pro-inflammatory immune activity in schizophrenia and the potential importance of anti-inflammatory drugs.","authors":"Volker Arolt, Oliver Ambrée","doi":"10.1159/000343972","DOIUrl":"https://doi.org/10.1159/000343972","url":null,"abstract":"<p><p>Throughout the last 20 years, numerous studies have indicated pro-inflammatory activity in patients with an acute schizophrenic episode. In this report, the most relevant findings concerning the cytokine systems in schizophrenia are demonstrated, together with recent studies on gene expression. Findings in humans are supplemented by observations from rodent models of schizophrenia. Furthermore, the current state of both neuroleptic and anti-inflammatory compounds on the immune system is reported, together with clinical data on the effects of anti-inflammatory medications on the course of the acute illness in patients with schizophrenia. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"100-16"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inflammation in suicidality: implications for novel treatment options.","authors":"Shorena Janelidze, Lena Brundin","doi":"10.1159/000346085","DOIUrl":"https://doi.org/10.1159/000346085","url":null,"abstract":"<p><p>Suicide is an increasing health problem worldwide and the most severe complication of multiple psychiatric disorders. It is also prevalent in several somatic conditions. In recent years, significant advances have been made in understanding the neurobiology of suicidal behaviors. Several lines of evidence have emerged suggesting that inflammation may contribute to the pathophysiology of suicide. Basic and clinical data indicate that the effects of inflammation on mood and behavior are likely to be mediated by the kynurenine pathway metabolites and glutamatergic neurotransmission. At the same time, the triggers of inflammatory changes observed in suicidal patients are largely unknown but may include stress, infectious agents and autoimmune diseases. As available treatment options against suicidality are only moderately effective, targeting the inflammatory system may provide novel therapeutic opportunities. For this goal to be achieved, however, we need to gain better insight into the origin, mechanisms and outcomes of inflammation in suicidal behavior. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"188-202"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000346085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inflammation, neurotoxins and psychiatric disorders.","authors":"Aye-Mu Myint","doi":"10.1159/000343968","DOIUrl":"https://doi.org/10.1159/000343968","url":null,"abstract":"<p><p>Although immune reactions are necessary to defend against danger signals, the mediator molecules such as cytokines can be detrimental to the organism if the exposure is longer than necessary or in certain abnormal concentrations. The neuroprotection and neurotoxicity induced by the interaction between certain cytokines and the metabolites from tryptophan catabolism, the neuroactive kynurenines, which is partly influenced by corticosteroid action plays an important role in several neurotransmissions such as serotonergic, dopaminergic and glutamatergic transmissions and receptor functions such as N-methyl-D-aspartate receptor or α7-nicotinic-acetylcholine receptor. While the molecules in normal concentrations are essential to the normal glial-neuronal interaction, any changes that induce imbalance in the network between those molecules could disturb the interaction. The role of this network in major psychiatric disorders such as depression, bipolar disorder and schizophrenia and future therapeutic roles are discussed in this manuscript. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"28 ","pages":"61-74"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000343968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Carlo Altamura, Giulia Camuri, Bernardo Dell'Osso
{"title":"Duration of untreated illness and duration of illness in anxiety disorders: assessment and influence on outcome.","authors":"A Carlo Altamura, Giulia Camuri, Bernardo Dell'Osso","doi":"10.1159/000351950","DOIUrl":"https://doi.org/10.1159/000351950","url":null,"abstract":"<p><p>Anxiety disorders are disabling and generally chronic conditions, with a lifetime prevalence of 15-20% in the general population. These disorders are usually associated with early onset and often remain untreated for several years with important consequences on patients' functioning and quality of life. From this perspective, recent literature has considered duration of illness (DI) and duration of untreated illness (DUI), two important variables influencing outcome in many psychiatric conditions including anxiety disorders. The DUI has been defined as the interval between the onset of a specific psychiatric disorder and the subsequent administration of the first adequate pharmacological treatment given at standard dosages and for an adequate period of time in compliant subjects. The DI can be defined as the time elapsing between the onset of a psychiatric disorder and the recovery from the illness. The two variables are likely interrelated, with a longer DUI being a major contributor to a longer DI. A significant body of evidence has shown that prolonged DI and DUI are associated with structural and functional brain abnormalities as well as with poor treatment response, particularly in schizophrenia. More recently, an increasing number of studies have been pointing toward a similar conclusion in affective disorders. As a consequence, the assessment of the latency to treatment (DUI) may represent one of the first steps in order to plan early interventions and reduce the overall DI. The present chapter highlights the role of the DI and latency to treatment in anxiety disorders, focusing on epidemiologic, neuropathological, clinical and prognostic issues. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"29 ","pages":"111-8"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000351950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"On the nature of obsessions and compulsions.","authors":"Sanneke de Haan, Erik Rietveld, Damiaan Denys","doi":"10.1159/000351929","DOIUrl":"https://doi.org/10.1159/000351929","url":null,"abstract":"<p><p>In this chapter, we give an overview of current and historical conceptions of the nature of obsessions and compulsions. We discuss some open questions pertaining to the primacy of the affective, volitional or affective nature of obsessive-compulsive disorder. Furthermore, we add some phenomenological suggestions of our own. In particular, we point to the patients' need for absolute certainty and the lack of trust underlying this need. Building on insights from Wittgenstein, we argue that the kind of certainty the patients strive for is unattainable in principle via the acquisition of factual knowledge. Moreover, we suggest that the patients' attempts to attain certainty are counter-productive as their excessive conscious control in fact undermines the trust they need. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"29 ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000351929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacological treatment of panic disorder.","authors":"Borwin Bandelow, David S Baldwin, Peter Zwanzger","doi":"10.1159/000351953","DOIUrl":"https://doi.org/10.1159/000351953","url":null,"abstract":"<p><p>A comprehensive database has developed and precise recommendations can be provided for treating patients with panic disorder. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are standard treatments for panic disorder. Tricyclic antidepressants are as effective as modern antidepressants, but less well tolerated. For short-term treatment and in non-responsive cases, benzodiazepines such as alprazolam may be used when the patient does not have a history of dependency and tolerance. Combining drug treatment with cognitive behaviour therapy is the most successful treatment strategy for panic disorder. This chapter also includes treatment recommendations for pregnant or lactating women, children, adolescents, elderly patients, and patients who are non-responsive to standard treatments. </p>","PeriodicalId":74212,"journal":{"name":"Modern trends in pharmacopsychiatry","volume":"29 ","pages":"128-43"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000351953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}