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Rojnic Kuzman M, Padberg F, Amann BL, Schouler-Ocak M, Bajic Z, Melartin T, James A, Beezhold J, Artigue Gómez J, Arango C, Jendricko T, Ismayilov J, Flannery W, Chumakov E, Başar K, Vahip S, Dudek D, Samochowiec J, Mihajlovic G, Rota F, Stoppe G, Dom G, Catthoor K, Chkonia E, Heitor Dos Santos MJ, Telles D, Falkai P, Courtet P, Patarák M, Izakova L, Skugarevski O, Barjaktarov S, Babic D, Racetovic G, Fiorillo A, Carpiniello B, Taube M, Melamed Y, Chihai J, Cozman DCM, Mohr P, Szekeres G, Delic M, Mazaliauskienė R, Tomcuk A, Maruta N, Gorwood P. Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries. Eur Psychiatry 2024; 67:e24. [PMID: 38450651 PMCID: PMC10988156 DOI: 10.1192/j.eurpsy.2024.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
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Affiliation(s)
- Martina Rojnic Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Benedikt L. Amann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
- Mental Health Institute Hospital del Mar and Hospital del Mar Research Institute, Barcelona, CIBERSAM, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital Berlin, Berlin, Germany
| | - Zarko Bajic
- Research Unit “Dr. Mirko Grmek”, Psychiatric Clinic “Sveti Ivan”, Zagreb, Croatia
| | - Tarja Melartin
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Julian Beezhold
- Great Yarmouth Acute Service, Northgate Hospital/Norfolk & Suffolk NHS Foundation Trust, Great Yarmouth, UK
| | | | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | | | | | - William Flannery
- Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Egor Chumakov
- Department of Psychiatry and Addiction, Saint-Petersburg State University, Saint-Petersburg, Russia
| | - Koray Başar
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Simavi Vahip
- Affective Disorders Unit, Department of Psychiatry, Ege University Medicine Faculty, Izmir, Turkey
| | - Dominika Dudek
- Psychiatry and Department of Adult Psychiatry, Collegium Medicum Jagiellonian University, Cracow, Poland
| | | | - Goran Mihajlovic
- Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia
| | - Fulvia Rota
- Swiss Society for Psychiatry and Psychotherapy, Switzerland
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Kirsten Catthoor
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Maria João Heitor Dos Santos
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade Católica Portuguesa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Diogo Telles
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post Acute Care, Hôspital Lapeyronie, CHU Montpellier,Montpellier, France
| | - Michal Patarák
- Department of Psychiatry, Slovak Medical University, Bratislava, Slovakia
- Roosevelt Teaching Hospital, Banská Bystrica, Slovakia
| | - Lubomira Izakova
- Department of Psychiatry, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Oleg Skugarevski
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Stojan Barjaktarov
- University Clinic of Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Dragan Babic
- Psychiatry Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Goran Racetovic
- Community Mental Health Center, Health Center Prijedor, Prijedor, Bosnia and Herzegovina
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Bernardo Carpiniello
- University of Cagliari and Psychiatry Unit, Section of Psychiatry, Department of Medical Sciences and Public Health, University Hospital, Cagliari, Italy
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | | | - Jana Chihai
- Department of Mental Health, Medical Psychology and Psychotherapy, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, Kishinev, Moldova
| | | | - Pavel Mohr
- Clinical Department, National Institute of Mental Health, Klecany, Czechia
- Third School of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Ramunė Mazaliauskienė
- Psychiatric Clinic, Lithuanian Health Sciences University Kaunas Hospital, Kaunas, Lithuania
| | | | - Nataliya Maruta
- Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Philip Gorwood
- Université Paris Cité, INSERM UMR1266, Paris, France
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
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2
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Mohr P. Can antipsychotics prevent transition to psychosis in high-risk population? Eur Neuropsychopharmacol 2024; 80:1-2. [PMID: 38101235 DOI: 10.1016/j.euroneuro.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Pavel Mohr
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
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3
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Potočár L, Mladá K, Kučera M, Mohr P, Winkler P, Formánek T. Population mental health, help-seeking and associated barriers following the COVID-19 pandemic: Analysis of repeated nationally representative cross-sectional surveys in Czechia. Psychiatry Res 2024; 331:115641. [PMID: 38042095 DOI: 10.1016/j.psychres.2023.115641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 12/04/2023]
Abstract
This study investigated the Czech adults' mental health following the COVID-19 pandemic and the potential influence of data collection methodology on prevalence estimates. Separately, it investigated changes in help-seeking and associated barriers. Data from representative surveys on Czech adults, conducted in November 2017 (n = 3,306), in May (n = 3,021) and November 2020 (n = 3,000), and in November and December 2022 (n = 7,311), were used. Current mental disorders were assessed by the Mini International Neuropsychiatric Interview, and the treatment gap was established in individuals scoring positively. In help-seeking individuals, encountering barriers was investigated. In 2017 and 2022, 20.02 % and 27.22 % of individuals had at least one mental disorder, respectively. The 2022 panel sampling and online and telephone interviewing estimates (34.29 % and 26.7 %) were substantially higher than those from household sampling and personal interviewing (19.9 %). Prevalence rates based on household sampling and personal interviewing were broadly consistent in 2017 and 2022. The treatment gap was around 80 % from 2017 to 2022. More than 50 % of individuals encountered structural barriers in help-seeking in 2022. This study showed that prevalence rates were still elevated in 2022, but suggests that data collection methodology influenced the estimates. Separately, the treatment gap remained consistently very high, and encountering structural barriers in help-seeking was common.
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Affiliation(s)
- Libor Potočár
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Karolína Mladá
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Matěj Kučera
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic; Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Mohr
- Clinical Center, National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Winkler
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tomáš Formánek
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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4
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Jayatissa H, Avila ML, Rehm KE, Mohr P, Meisel Z, Chen J, Hoffman CR, Liang J, Müller-Gatermann C, Neto D, Ong WJ, Psaltis A, Santiago-Gonzalez D, Tang TL, Ugalde C, Wilson G. Study of the ^{22}Mg Waiting Point Relevant for X-Ray Burst Nucleosynthesis via the ^{22}Mg(α,p)^{25}Al Reaction. Phys Rev Lett 2023; 131:112701. [PMID: 37774292 DOI: 10.1103/physrevlett.131.112701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/21/2023] [Accepted: 08/08/2023] [Indexed: 10/01/2023]
Abstract
The ^{22}Mg(α,p)^{25}Al reaction rate has been identified as a major source of uncertainty for understanding the nucleosynthesis flow in Type-I x-ray bursts. We report a direct measurement of the energy- and angle-integrated cross sections of this reaction in a 3.3-6.9 MeV center-of-mass energy range using the MUlti-Sampling Ionization Chamber (MUSIC). The new ^{22}Mg(α,p)^{25}Al reaction rate is a factor of ∼4 higher than the previous direct measurement of this reaction within temperatures relevant for x-ray bursts, resulting in the ^{22}Mg waiting point of x-ray burst nucleosynthesis flow to be significantly bypassed via the (α,p) reaction.
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Affiliation(s)
- H Jayatissa
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - M L Avila
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - K E Rehm
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - P Mohr
- Institute for Nuclear Research (Atomki), P.O. Box 51, Debrecen H-4001, Hungary
| | - Z Meisel
- Institute of Nuclear and Particle Physics, Ohio University, Athens, Ohio 45701, USA
| | - J Chen
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - C R Hoffman
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - J Liang
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - C Müller-Gatermann
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - D Neto
- Department of Physics, University of Illinois Chicago, 845 W. Taylor St., Chicago, Illinois 60607, USA
| | - W J Ong
- Lawrence Livermore National Laboratory, 7000 East Ave, Livermore, California 94550, USA
| | - A Psaltis
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D-64289, Germany
| | | | - T L Tang
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - C Ugalde
- Department of Physics, University of Illinois Chicago, 845 W. Taylor St., Chicago, Illinois 60607, USA
| | - G Wilson
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803, USA
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5
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Pinchuk I, Leventhal BL, Akiyama T, Berger H, Bobolakis IS, Brendel RW, Catthoor K, Chihai J, Chkonia E, Dom G, Dudek D, James A, Javed A, Kupchik M, Mazaliauskiene R, Mohr P, Lien L, Lakra V, Meyer-Lindenberg A, Seifritz E, Szekeres G, Skokauskas N. The price of peace in our time. World Psychiatry 2023; 22:337-338. [PMID: 37159375 PMCID: PMC10168169 DOI: 10.1002/wps.21109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Irina Pinchuk
- Ukrainian Psychiatric Association, Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | | | - Tsuyoshi Akiyama
- International Committee, Japanese Society of Psychiatry and Neurology; NTT Medical Center Tokyo, Tokyo, Japan
| | | | | | | | | | - Jana Chihai
- Society of Psychiatrists, Narcologists, Psychotherapists and Clinical Psychologists, Republic of Moldova
| | | | - Geert Dom
- European Psychiatric Association, University of Antwerp, Antwerp, Belgium
| | | | | | | | - Marina Kupchik
- Israel Psychiatric Association; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Pavel Mohr
- Czech Psychiatric Association; National Institute of Mental Health, Klecany, Czech Republic; 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Lien
- Norwegian Psychiatric Association, Inland University of Applied Sciences, Elverum, Norway
| | - Vinay Lakra
- Royal Australian and New Zealand College of Psychiatrists
| | | | - Erich Seifritz
- Board Member, Swiss Society of Psychiatry and Psychotherapy
| | | | - Norbert Skokauskas
- WPA Section on Child and Adolescent Psychiatry, Norwegian University of Science and Technology, Trondheim, Norway
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6
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Weichenthal M, Svane IM, Kandolf Sekulovic L, Mangana J, Lugowska I, Mohr P, Espinosa E, Gogas H, Bender M, Ellebæk E, Gavrilova I, Herceg D, Muñoz Couselo E, Schmidt H, Stulhofer Buzina D, Rutkowski P, Ascierto P, Dummer R, Schadendorf D, Bastholt L. 836P Outcome of PD-1 inhibitor therapy of advanced melanoma patients according to demographic factors in a real-world setting across Europe. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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7
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Berking C, Livingstone E, Weichenthal M, Leiter-Stoppke U, Remy J, Eigentler T, Mohr P, Kiecker F, Loquai C, Debus D, Gutzmer R. 828P Effectiveness and safety of dabrafenib and trametinib in patients with BRAFV600 mutated metastatic melanoma in the real-world setting: Final results of the non-interventional COMBI-r study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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8
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Becker J, Ugurel S, Leiter-Stoppke U, Meier F, Gutzmer R, Haferkamp S, Zimmer L, Livingstone E, Eigentler T, Hauschild A, Kiecker F, Hassel J, Mohr P, Fluck M, Thomas I, Garzarolli M, Grimmelmann I, Drexler K, Eckhardt S, Schadendorf D. 787O Adjuvant immunotherapy with nivolumab (NIVO) versus observation in completely resected Merkel cell carcinoma (MCC): Disease-free survival (DFS) results from ADMEC-O, a randomized, open-label phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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9
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Ascierto P, Mohr P, Dronca R, Harris S, Wilson M, Gurm B, Howansky M, Ng WT, Ravimohan S, Vezina H, Pe Benito M, Gurman P. 882TiP Subcutaneous vs intravenous nivolumab in patients with melanoma following complete resection. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Larkin J, Squifflet P, Saad E, Mohr P, Kurt M, Moshyk A, Hamilton M, Kotapati S, Buyse M. 816P Investigating surrogate endpoints (SE) for overall survival (OS) in first-line (1L) advanced melanoma: A pooled-analysis of immune checkpoint inhibitor (ICI) trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Catatonia is a syndrome of primarily psychomotor disturbances associated with typical abnormalities of muscle tone. It is characterized by the co-occurrence of several symptoms of decreased, increased, or abnormal psychomotor activity. Catatonia is a neuropsychiatric syndrome, not an independent nosological entity. Historically associated mainly with schizophrenia (e.g., catatonic subtype), ICD-11, similarly to DSM-5, now recognizes catatonia under a separate classification category, apart from psychotic disorders. In addition to schizophrenia and other primary psychotic disorders, it can occur in the context of other mental disorders, such as mood disorders, or neurodevelopmental disorders, especially autism spectrum disorder. Catatonia can also develop during or immediately after intoxication or withdrawal from psychoactive substances, including phencyclidine, cannabis, hallucinogens such as mescaline or LSD, cocaine and MDMA or related drugs, or during the use of some psychoactive and non-psychoactive medications (e.g. antipsychotic medications, benzodiazepines, steroids, disulfiram, ciprofloxacin). Moreover, catatonia can occur as a direct pathophysiological consequence of various nonpsychiatric medical conditions, e.g., diabetic ketoacidosis, hypercalcemia, hepatic encephalopathy, homocystinuria, neoplasms head trauma, cerebrovascular disease, or encephalitis. Due to the fact that catatonia was mostly associated witch schizophrenia, many cases were not diagnosed and thus did not receive indicated treatment. There are no specific “anti-catatonic” drugs, first-line treatment are benzodiazepines and ECT, in addition to the symptomatic and supportive therapy. The recognition of catatonia as an independent category in ICD-11 can improve medical care for catatonic patients in clinical practice.
Disclosure
No significant relationships.
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Mohr P. Impact of the Pandemic on Psychiatric Research and Publications. Eur Psychiatry 2022. [PMCID: PMC9564849 DOI: 10.1192/j.eurpsy.2022.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In addition to the global negative impact on mental health of general population, as well as psychiatric patients, Covid-19 pandemic affected significantly research. Initially, lockdowns and restrictions of human contacts temporarily disrupted clinical research activities, but the unprecedented health crisis also provided unique opportunity to study epidemiology of mental disorders, direct and indirect effects of the pandemic on psychiatric disorders, underlying pathophysiological mechanisms, or long-term neuropsychiatric consequences. Research has refocused now on better understanding of the causes, presentations, outcome trajectories, and therapy of mental illnesses. New research topics are followed by the surge in publications covering Covid-19 and mental health and/or psychiatric disorders and treatments. The impact of the pandemic on research and publications is also evidenced by the results of a survey among psychiatric researchers.
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Horáková A, Němcová H, Mohr P, Sebela A. Structural, functional, and metabolic signatures of postpartum depression: A systematic review. Front Psychiatry 2022; 13:1044995. [PMID: 36465313 PMCID: PMC9709336 DOI: 10.3389/fpsyt.2022.1044995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Postpartum depression (PPD) is a serious condition with debilitating consequences for the mother, offspring, and the whole family. The scope of negative outcomes of PPD highlights the need to specify effective diagnostics and treatment which might differ from major depressive disorder (MDD). In order to improve our clinical care, we need to better understand the underlying neuropathological mechanisms of PPD. Therefore, we conducted a systematic review of published neuroimaging studies assessing functional, structural, and metabolic correlates of PPD. METHODS Relevant papers were identified using a search code for English-written studies in the PubMed, Scopus, and Web of Science databases published by March 2022. Included were studies with structural magnetic resonance imaging, functional magnetic resonance imaging, both resting-state and task-related, magnetic resonance spectroscopy, or positron emission tomography. The findings were analyzed to assess signatures in PPD-diagnosed women compared to healthy controls. The review protocol was registered in PROSPERO (CRD42022313794). RESULTS The total of 3,368 references were initially identified. After the removal of duplicates and non-applicable papers, the search yielded 74 full-text studies assessed for eligibility. Of them, 26 met the inclusion criteria and their findings were analyzed and synthesized. The results showed consistent functional, structural, and metabolic changes in the default mode network and the salient network in women with PPD. During emotion-related tasks, PPD was associated with changes in the corticolimbic system activity, especially the amygdala. DISCUSSION This review offers a comprehensive summary of neuroimaging signatures in PPD-diagnosed women. It indicates the brain regions and networks which show functional, structural, and metabolic changes. Our findings offer better understanding of the nature of PPD, which clearly copies some features of MDD, while differs in others.
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Affiliation(s)
- Anna Horáková
- Center of Perinatal Mental Health, National Institute of Mental Health, Klecany, Czechia.,Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Hana Němcová
- Center of Perinatal Mental Health, National Institute of Mental Health, Klecany, Czechia.,Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Pavel Mohr
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czechia.,Clinical Center, National Institute of Mental Health, Klecany, Czechia
| | - Antonin Sebela
- Center of Perinatal Mental Health, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czechia
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Rojnic Kuzman M, Slade M, Puschner B, Scanferla E, Bajic Z, Courtet P, Samochowiec J, Arango C, Vahip S, Taube M, Falkai P, Dom G, Izakova L, Carpiniello B, Bellani M, Fiorillo A, Skugarevsky O, Mihaljevic-Peles A, Telles-Correia D, Novais F, Mohr P, Wancata J, Hultén M, Chkonia E, Balazs J, Beezhold J, Lien L, Mihajlovic G, Delic M, Stoppe G, Racetovic G, Babic D, Mazaliauskiene R, Cozman D, Hjerrild S, Chihai J, Flannery W, Melartin T, Maruta N, Soghoyan A, Gorwood P. Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries. Eur Psychiatry 2022; 65:e75. [DOI: 10.1192/j.eurpsy.2022.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe.
Methods
We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style – Staff questionnaire and a set of questions regarding clinicians’ expertise, training, and practice.
Results
SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style.
Conclusions
The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.
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15
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Stege HM, Haist M, Schultheis S, Fleischer MI, Mohr P, Ugurel S, Terheyden P, Thiem A, Kiecker F, Leiter U, Becker JC, Meissner M, Kleeman J, Pföhler C, Hassel J, Grabbe S, Loquai C. Response durability after cessation of immune checkpoint inhibitors in patients with metastatic Merkel cell carcinoma: a retrospective multicenter DeCOG study. Cancer Immunol Immunother 2021; 70:3313-3322. [PMID: 33870464 PMCID: PMC8505278 DOI: 10.1007/s00262-021-02925-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have led to a prolongation of progression-free and overall survival in patients with metastatic Merkel cell carcinoma (MCC). However, immune-mediated adverse events due to ICI therapy are common and often lead to treatment discontinuation. The response duration after cessation of ICI treatment is unknown. Hence, this study aimed to investigate the time to relapse after discontinuation of ICI in MCC patients. METHODS We analyzed 20 patients with metastatic MCC who have been retrospectively enrolled at eleven skin cancer centers in Germany. These patients have received ICI therapy and showed as best overall response (BOR) at least a stable disease (SD) upon ICI therapy. All patients have discontinued ICI therapy for other reasons than disease progression. Data on treatment duration, tumor response, treatment cessation, response durability, and tumor relapse were recorded. RESULTS Overall, 12 of 20 patients (60%) with MCC relapsed after discontinuation of ICI. The median response durability was 10.0 months. Complete response (CR) as BOR to ICI-treatment was observed in six patients, partial response (PR) in eleven, and SD in three patients. Disease progression was less frequent in patients with CR (2/6 patients relapsed) as compared to patients with PR (7/11) and SD (3/3), albeit the effect of initial BOR on the response durability was below statistical significance. The median duration of ICI therapy was 10.0 months. Our results did not show a correlation between treatment duration and the risk of relapse after treatment withdrawal. Major reasons for discontinuation of ICI therapy were CR (20%), adverse events (35%), fatigue (20%), or patient decision (25%). Discontinuation of ICI due to adverse events resulted in progressive disease (PD) in 71% of patients regardless of the initial response. A re-induction of ICI was initiated in 8 patients upon tumor progression. We observed a renewed tumor response in 4 of these 8 patients. Notably, all 4 patients showed an initial BOR of at least PR. CONCLUSION Our results from this contemporary cohort of patients with metastatic MCC indicate that MCC patients are at higher risk of relapse after discontinuation of ICI as compared to melanoma patients. Notably, the risk of disease progression after discontinuation of ICI treatment is lower in patients with initial CR (33%) as compared to patients with initial PR (66%) or SD (100%). Upon tumor progression, re-induction of ICI is a feasible option. Our data suggest that the BOR to initial ICI therapy might be a potential predictive clinical marker for a successful re-induction.
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Affiliation(s)
- H M Stege
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - M Haist
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - S Schultheis
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M I Fleischer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - P Mohr
- Department of Dermatology, Elbe-Kliniken Buxtehude, Buxtehude, Germany
| | - S Ugurel
- Department of Dermatology, University Medical Center Essen, Essen, Germany
| | - P Terheyden
- Department of Dermatology, Allergology and Venerology, University Lübeck, Lübeck, Germany
| | - A Thiem
- Department of Dermatology, University Medical Center Würzburg, Würzburg, Germany
- Department of Dermatology, University Medical Center Rostock, Rostock, Germany
| | - F Kiecker
- Department of Dermatology and Allergology at the Charité, University Medical Center Berlin, Berlin, Germany
| | - U Leiter
- Dermato-Oncology, Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany
| | - J C Becker
- Department of Dermatology, University Medical Center Essen, Essen, Germany
- German Consortium for Translational Oncology (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Meissner
- Department of Dermatology, University Medical Center Frankfurt, Frankfurt, Germany
| | - J Kleeman
- Department of Dermatology, University Medical Center Frankfurt, Frankfurt, Germany
| | - C Pföhler
- Department of Dermatology, University Medical Center Homburg, Homburg, Germany
| | - J Hassel
- Department of Dermatology, University Medical Center Heidelberg, Heidelberg, Germany
| | - S Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - C Loquai
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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16
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Long GV, Arance A, Mortier L, Lorigan P, Blank C, Mohr P, Schachter J, Grob JJ, Lotem M, Middleton MR, Neyns B, Steven N, Ribas A, Walpole E, Carlino MS, Lebbe C, Sznol M, Jensen E, Leiby MA, Ibrahim N, Robert C. Antitumor activity of ipilimumab or BRAF ± MEK inhibition after pembrolizumab treatment in patients with advanced melanoma: analysis from KEYNOTE-006. Ann Oncol 2021; 33:204-215. [PMID: 34710571 DOI: 10.1016/j.annonc.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antitumor activity of ipilimumab or BRAF ± MEK inhibitors (BRAFi ± MEKi) following pembrolizumab administration in melanoma is poorly characterized. PATIENTS AND METHODS In the phase III KEYNOTE-006 study, patients with unresectable stage III/IV melanoma received pembrolizumab (10 mg/kg) once every 2 or 3 weeks (Q3W) or ipilimumab (3 mg/kg) Q3W. The current post hoc analysis evaluates outcomes with ipilimumab or BRAFi ± MEKi as first subsequent systemic therapy after pembrolizumab administration and includes patients who completed or discontinued pembrolizumab after one or more dose. Pembrolizumab arms were pooled. RESULTS At data cut-off (4 December 2017), median follow-up was 46.9 months. Of 555 pembrolizumab-treated patients, first subsequent therapy was ipilimumab for 103 (18.6%) and BRAFi ± MEKi for 59 (10.6%) [33 received BRAFi + MEKi, 26 BRAFi alone; 37 (62.7%) were BRAFi ± MEKi naïve]. In the subsequent ipilimumab group, ORR with previous pembrolizumab was 17.5% [1 complete response (CR); 17 partial response (PR)]; 79.6% had discontinued pembrolizumab due to progressive disease (PD); median overall survival (OS) was 21.5 months. ORR with subsequent ipilimumab was 15.5%; 11/16 responses (8 CRs; 3 PRs) were ongoing. ORR with subsequent ipilimumab was 9.7% for patients with PD as best response to pembrolizumab. Median OS from ipilimumab initiation was 9.8 months. In the subsequent BRAFi ± MEKi group, ORR with previous pembrolizumab was 13.5% (8 PR); 76.3% had discontinued pembrolizumab due to PD; median OS was 17.9 months. ORR with subsequent BRAFi ± MEKi was 30.5%, 7/18 responses (4 CR, 3 PR) were ongoing. Median OS from BRAFi ± MEKi initiation was 12.9 months. ORR for BRAFi ± MEKi-naïve patients who received subsequent BRAFi ± MEKi was 43.2%; 6/16 were ongoing (3 CR, 3 PR). CONCLUSIONS Ipilimumab and BRAFi ± MEKi have antitumor activity as first subsequent therapy after pembrolizumab in patients with advanced melanoma.
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Affiliation(s)
- G V Long
- Melanoma Institute Australia, The University of Sydney, Mater Hospital, Sydney, Australia; Faculty of Medicine & Health, The University of Sydney, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia.
| | - A Arance
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - L Mortier
- Université Lille, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - P Lorigan
- Division of Cancer Sciences, University of Manchester, Manchester; Christie NHS Foundation Trust, Manchester, UK
| | - C Blank
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - P Mohr
- Elbe-Klinikum Buxtehude, Buxtehude, Germany
| | - J Schachter
- Ella Lemelbaum Institute for Immuno-Oncology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - J-J Grob
- Aix Marseille University, Hôpital de la Timone, Marseille, France
| | - M Lotem
- Sharett Institute of Oncology, Hadassah Hebrew Medical Center, Jerusalem, Israel
| | - M R Middleton
- The Churchill Hospital and The University of Oxford, Oxford, UK
| | - B Neyns
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - N Steven
- Queen Elizabeth Hospital, Birmingham, UK
| | - A Ribas
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - E Walpole
- Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Mater Hospital, Sydney, Australia; Westmead and Blacktown Hospitals, Melanoma Institute Australia, Sydney, Australia; University of Sydney, Sydney, Australia
| | - C Lebbe
- Université de Paris, AP-HP Dermatology and CIC, INSERM U976, Saint Louis Hospital, Paris, France
| | - M Sznol
- Yale Cancer Center, New Haven, USA
| | - E Jensen
- Merck & Co., Inc., Kenilworth, USA
| | | | | | - C Robert
- Department of Oncology, Service of Dermatology, Gustave Roussy, Villejuif, France; Paris-Saclay University, Orsay, France
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17
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Grimmelmann I, Haferkamp S, Kähler K, Meier F, Pföhler C, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1079P Comparison of effectiveness and safety of nivolumab monotherapy or in combination therapy with ipilimumab in therapy-naïve and pretreated patients with advanced melanoma within the German noninterventional study NICO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Rojnic Kuzman M, Vahip S, Fiorillo A, Beezhold J, Pinto da Costa M, Skugarevsky O, Dom G, Pajevic I, Peles AM, Mohr P, Kleinberg A, Chkonia E, Balazs J, Flannery W, Mazaliauskiene R, Chihai J, Samochowiec J, Cozman D, Mihajlovic G, Izakova L, Arango C, Goorwod P. Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice. Eur Psychiatry 2021; 64:e41. [PMID: 34103102 PMCID: PMC8314055 DOI: 10.1192/j.eurpsy.2021.2215] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. Methods The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the “EPA Ambassadors”, on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. Results While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. Conclusions Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.
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Affiliation(s)
| | - Simavi Vahip
- Department of Psychiatry, Ege University Medicine Faculty, Affective Disorders Unit, Izmir, Turkey
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Julian Beezhold
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Oleg Skugarevsky
- Psychiatry & Medical Psychology Department, Belarusian Psychiatric Association, Belarusian State Medical University, Minsk, Belarus
| | - Geert Dom
- Belgian Professional Association of Medical Specialists in Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Izet Pajevic
- Department of Psychiatry University Clinical Center Tuzla, School of Medicine University of Tuzla, Bosnia and Herzegovina Psychiatric Association of Bosnia-Herzegovina, Tuzla, Bosnia-Herzegovina
| | - Alma Mihaljevic Peles
- Zagreb School of Medicine, Zagreb University Hospital Centre, Zagreb, Croatia.,Croatian Psychiatric Association, Zagreb, Croatia
| | - Pavel Mohr
- Czech Psychiatric Association, National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anne Kleinberg
- Tallinn Children Hospital Children Mental Health, Tallinn, Estonia
| | - Eka Chkonia
- Estonian Psychiatric Association, Centre Tartu University Psychiatry Clinic, TartuEstonia.,Society of Georgian Psychiatrists, Tbilisi State Medical University, Tbilisi, Georgia
| | - Judit Balazs
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Hungarian Psychiatric Association, Bjørknes University College, Oslo, Norway
| | - William Flannery
- Department of Adult Psychiatry, College of Psychiatrists of Ireland, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ramune Mazaliauskiene
- Lithuanian Psychiatric Association, Lithuanian Health Sciences university, Psychiatric Clinic, Lithuanian Health Sciences university Kaunas hospital, Kaunas, Lithuania
| | - Jana Chihai
- Society of Psychiatrists, Narcologists, Psychotherapists and Clinical Psychologists from Republic of Moldova, Department of Psychiatry, Narcology, Medical Psychology State Medical and Pharmaceutical University "Nicolae Testemitanu" from Republic of Moldova, Kishinev, Moldova
| | - Jerzy Samochowiec
- Polish Psychiatric Association, Department of Psychiatry, Pomeranian Medical University in Szczecin Poland, Szczecin, Poland
| | - Doina Cozman
- Romanian Association of Psychiatry and Psychotherapy, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Goran Mihajlovic
- Department of Psychiatry, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Lubomira Izakova
- Slovak Psychiatric Association, Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Philip Goorwod
- INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Université de Paris, Paris, France.,CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
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19
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Voráčková V, Knytl P, Španiel F, Šustová P, Renka J, Mohr P. Cognitive profiles of healthy siblings of first-episode schizophrenia patients. Early Interv Psychiatry 2021; 15:554-562. [PMID: 32488980 DOI: 10.1111/eip.12982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/11/2020] [Accepted: 04/28/2020] [Indexed: 12/25/2022]
Abstract
AIM Cognitive deficit in psychotic illness is intensively studied, different cognitive subtypes have been suggested. In recent years, there has been an increase in the number of studies in patients with schizophrenia and their relatives searching for endophenotypes of the disease. The aim of our study was to investigate cognitive performance and cognitive subtypes in the siblings of the patients. METHODS Four groups of subjects were included: patients with a first episode of psychotic illness, the siblings of these patients, and two control groups. All the study subjects (N = 84) had a battery of neuropsychological tests that measured basic cognitive domains - memory, executive functions, attention, visual-spatial skills, language skills and psychomotor speed - administered to them. The data were assessed with pairwise t-tests for group comparisons. The siblings were distributed into three groups according to their cognitive performance: non-deficit, partial deficit, and global deficit. Subsequently, the patients were assigned into three groups corresponding to their siblings' performance. RESULTS Our results revealed attenuation of abstract thinking in the siblings compared to the controls. As expected, the patients showed impairment across all cognitive domains. The patients and siblings demonstrated similar profiles in each subtype, in the severity of their impairment, and in their patterns of cognitive performance. CONCLUSIONS Our results suggest that the cognitive profile can be considered as an endophenotype of psychotic disorders.
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Affiliation(s)
- Veronika Voráčková
- Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic.,Diagnostics and Treatment of Mental Disorders, National Institute of Mental Health, Klecany, Czech Republic.,Neuroscience, Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Pavel Knytl
- Diagnostics and Treatment of Mental Disorders, National Institute of Mental Health, Klecany, Czech Republic.,Neuroscience, Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Filip Španiel
- Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic.,Neuroscience, Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Petra Šustová
- Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic
| | - Jiří Renka
- Diagnostics and Treatment of Mental Disorders, National Institute of Mental Health, Klecany, Czech Republic.,Neuroscience, Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Pavel Mohr
- Diagnostics and Treatment of Mental Disorders, National Institute of Mental Health, Klecany, Czech Republic.,Neuroscience, Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
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20
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Mohr P. Experiences and projections for the future of research, training and other academic activities: Will it be the same? Eur Psychiatry 2021. [PMCID: PMC9470935 DOI: 10.1192/j.eurpsy.2021.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The global SARS-CoV-2 pandemic with subsequently imposed restrictions and lockdowns also radically disrupted academic life. Many research projects involving recruitment of human subjects were abruptly put on hold, educational activities have moved into online trainings, scientific meetings have been transformed into virtual events. Social distancing does not restrict only everyday human contact but also limits direct exchange of clinical, educational, and research experiences, professional and academic networking, sharing ideas. Besides all the drawbacks, does the current situation also bring any advantages? Every challenge results in new opportunities. Although the online congresses will most likely never fully replace real-life experience, it was found that many work meetings can be held more efficiently via online communication. Saving time, cutting costs of travel and accommodation, plus other expenses, may help to allocate limited resources where needed. Similarly, while practical medical education and training cannot be substituted for remote broadcasting, many theoretical presentations can. More importantly, epidemic of COVID-19 is a unique opportunity for mental health research, to study individual and population consequences of the virus, its impact on psychiatric patients. It is still early to predict whether and when research, training, meetings, and other academic activities return back to “normal”, but appears that some changes are here to stay.
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21
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Mohr P. Antipsychotics for elderly with psychosis: Deprescribe or continue? Eur Psychiatry 2021. [PMCID: PMC9471925 DOI: 10.1192/j.eurpsy.2021.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Maintenance treatment with antipsychotics remains the key principle in the long-term management of psychotic disorders. For some patients, it means life-long use of medication. Continuous drug administration helps to prevent relapses, maintain remission, and achieve functional recovery. Moreover, epidemiological data suggest that antipsychotic treatment significantly reduces mortality rates of schizophrenia patients. On the other hand, some authors argue that antipsychotic drugs may lose its efficacy over time, their long-term exposure results in more harm than benefit. Especially elderly patients are more sensitive to side effects. Several studies which followed-up patient cohorts over the span of several decades found that there are schizophrenia patients who can achieve good functional outcome and full recovery without antipsychotic treatment. Therefore, it is paramount to identify those individuals, particularly among elderly psychotic patients, who can thrive and benefit from timely antipsychotic discontinuation.DisclosureNo significant relationships.
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22
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Klírová M, Voráčková V, Horáček J, Mohr P, Jonáš J, Dudysová DU, Kostýlková L, Fayette D, Krejčová L, Baumann S, Laskov O, Novák T. Modulating Inhibitory Control Processes Using Individualized High Definition Theta Transcranial Alternating Current Stimulation (HD θ-tACS) of the Anterior Cingulate and Medial Prefrontal Cortex. Front Syst Neurosci 2021; 15:611507. [PMID: 33859554 PMCID: PMC8042221 DOI: 10.3389/fnsys.2021.611507] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/04/2021] [Indexed: 02/02/2023] Open
Abstract
Increased frontal midline theta activity generated by the anterior cingulate cortex (ACC) is induced by conflict processing in the medial frontal cortex (MFC). There is evidence that theta band transcranial alternating current stimulation (θ-tACS) modulates ACC function and alters inhibitory control performance during neuromodulation. Multi-electric (256 electrodes) high definition θ-tACS (HD θ-tACS) using computational modeling based on individual MRI allows precise neuromodulation targeting of the ACC via the medial prefrontal cortex (mPFC), and optimizes the required current density with a minimum impact on the rest of the brain. We therefore tested whether the individualized electrode montage of HD θ-tACS with the current flow targeted to the mPFC-ACC compared with a fixed montage (non-individualized) induces a higher post-modulatory effect on inhibitory control. Twenty healthy subjects were randomly assigned to a sequence of three HD θ-tACS conditions (individualized mPFC-ACC targeting; non-individualized MFC targeting; and a sham) in a double-blind cross-over study. Changes in the Visual Simon Task, Stop Signal Task, CPT III, and Stroop test were assessed before and after each session. Compared with non-individualized θ-tACS, the individualized HD θ-tACS significantly increased the number of interference words and the interference score in the Stroop test. The changes in the non-verbal cognitive tests did not induce a parallel effect. This is the first study to examine the influence of individualized HD θ-tACS targeted to the ACC on inhibitory control performance. The proposed algorithm represents a well-tolerated method that helps to improve the specificity of neuromodulation targeting of the ACC.
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Affiliation(s)
- Monika Klírová
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Veronika Voráčková
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Jiří Horáček
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Pavel Mohr
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Juraj Jonáš
- National Institute of Mental Health, Prague, Czechia
| | - Daniela Urbaczka Dudysová
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Lenka Kostýlková
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Dan Fayette
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | | | | | - Olga Laskov
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Tomáš Novák
- National Institute of Mental Health, Prague, Czechia
- Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
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23
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Tarhini AA, Toor K, Chan K, McDermott DF, Mohr P, Larkin J, Hodi FS, Lee CH, Rizzo JI, Johnson H, Moshyk A, Rao S, Kotapati S, Atkins MB. A matching-adjusted indirect comparison of combination nivolumab plus ipilimumab with BRAF plus MEK inhibitors for the treatment of BRAF-mutant advanced melanoma ☆. ESMO Open 2021; 6:100050. [PMID: 33556898 PMCID: PMC7872980 DOI: 10.1016/j.esmoop.2021.100050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022] Open
Abstract
Background Approved first-line treatments for patients with BRAF V600–mutant advanced melanoma include nivolumab (a programmed cell death protein 1 inhibitor) plus ipilimumab (a cytotoxic T lymphocyte antigen-4 inhibitor; NIVO+IPI) and the BRAF/MEK inhibitors dabrafenib plus trametinib (DAB+TRAM), encorafenib plus binimetinib (ENCO+BINI), and vemurafenib plus cobimetinib (VEM+COBI). Results from prospective randomized clinical trials (RCTs) comparing these treatments have not yet been reported. This analysis evaluated the relative efficacy and safety of NIVO+IPI versus DAB+TRAM, ENCO+BINI, and VEM+COBI in patients with BRAF-mutant advanced melanoma using a matching-adjusted indirect comparison (MAIC). Patients and methods A systematic literature review identified RCTs for DAB+TRAM, ENCO+BINI, and VEM+COBI in patients with BRAF-mutant advanced melanoma. Individual patient-level data for NIVO+IPI were derived from the phase III CheckMate 067 trial (BRAF-mutant cohort) and restricted to match the inclusion/exclusion criteria of the comparator trials. Treatment effects for overall survival (OS) and progression-free survival (PFS) were estimated using Cox proportional hazards and time-varying hazard ratio (HR) models. Safety outcomes (grade 3 or 4 treatment-related adverse events) with NIVO+IPI and the comparators were compared. Results In the Cox proportional hazards analysis, NIVO+IPI showed improved OS compared with DAB+TRAM (HR = 0.53; 95% confidence interval [CI], 0.39-0.73), ENCO+BINI (HR = 0.60; CI, 0.42-0.85), and VEM+COBI (HR = 0.50; CI, 0.36-0.70) for the overall study period. In the time-varying analysis, NIVO+IPI was associated with significant improvements in OS and PFS compared with the BRAF/MEK inhibitors 12 months after treatment initiation. There were no significant differences between NIVO+IPI and BRAF/MEK inhibitor treatment from 0 to 12 months. Safety outcomes favored DAB+TRAM over NIVO+IPI, whereas NIVO+IPI was comparable to VEM+COBI. Conclusion Results of this MAIC demonstrated durable OS and PFS benefits for patients with BRAF-mutant advanced melanoma treated with NIVO+IPI compared with BRAF/MEK inhibitors, with the greatest benefits noted after 12 months. First-line treatments for BRAF V600-mutant melanoma include NIVO+IPI and BRAF/MEK inhibitors. Results from prospective RCTs comparing NIVO+IPI and BRAF/MEK inhibitors have not yet been reported. This MAIC evaluated NIVO+IPI versus BRAF/MEK inhibitors for BRAF-mutant advanced melanoma. OS and PFS benefits were noted with NIVO+IPI versus BRAF/MEK inhibitors beginning at 12 months. These findings may provide information relevant to the selection of treatments for BRAF-mutant advanced melanoma.
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Affiliation(s)
- A A Tarhini
- Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
| | - K Toor
- Evidence Synthesis and Decision Modeling, Precision HEOR, Vancouver, Canada
| | - K Chan
- Evidence Synthesis and Decision Modeling, Precision HEOR, Vancouver, Canada
| | - D F McDermott
- Medical Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA
| | - P Mohr
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - J Larkin
- Medical Oncology, The Royal Marsden Hospital, London, UK
| | - F S Hodi
- Medical Oncology, Dana-Farber/Harvard Cancer Center, Boston, USA
| | - C-H Lee
- US Health Economics and Outcome Research, Metastatic Melanoma, Bristol Myers Squibb, Princeton, USA
| | - J I Rizzo
- Oncology Clinical Development, Bristol Myers Squibb, Princeton, USA
| | - H Johnson
- Worldwide Health Economics and Outcomes Research, Melanoma, Bristol Myers Squibb, Uxbridge, UK
| | - A Moshyk
- Worldwide Health Economics and Outcomes Research, Melanoma, Bristol Myers Squibb, Princeton, USA
| | - S Rao
- US Health Economics and Outcome Research, Metastatic Melanoma, Bristol Myers Squibb, Princeton, USA
| | - S Kotapati
- Worldwide Medical, Melanoma, Bristol Myers Squibb, Princeton, USA
| | - M B Atkins
- Medical Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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24
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Abstract
Dopamine receptor partial agonists (DRPAs; aripiprazole, brexpiprazole, and cariprazine) constitute a novel class of antipsychotics. Although they share a similar mechanism of action, DRPAs differ in their pharmacodynamics, pharmacokinetics, drug interactions, or safety and tolerability. The antipsychotic efficacy of all three drugs was established in several placebo-controlled randomized trials (RCTs) in schizophrenia, both acute phase and relapse prevention. In addition, each of the DRPA agents has been tested in other psychiatric disorders, including bipolar disorder or major depression. However, a few studies have examined their comparative clinical efficacy. There are no head-to-head comparisons between aripiprazole, brexpiprazole, or cariprazine. In two acute schizophrenia RCTs of cariprazine and brexpiprazole, aripiprazole was used as an indirect comparator to control for study sensitivity. To assess potential differences in the efficacy of DRPAs, we reviewed data from controlled trials, systematic reviews, and meta-analyses. Our results showed that the acute antipsychotic effects of DRPAs, as measured by the number needed to treat, are comparable. The three agents were superior to placebo in acute treatment, and cariprazine was found to be effective in the reduction of primary negative symptoms of schizophrenia. In the therapy of bipolar disorder, aripiprazole and cariprazine showed antimanic efficacy, cariprazine was also effective in the management of bipolar depression, and aripiprazole was effective for relapse prevention. The addon administration of aripiprazole or brexpiprazole reduced symptoms of major depression. Aripiprazole can control acute agitation associated with psychosis or bipolar disorder; brexpiprazole showed the potential to manage agitation in dementia patients. Aripiprazole has also established evidence of efficacy in children and adolescents and other conditions: OCD, tic disorders, and autism spectrum disorder. Our review of published data suggests that in terms of clinical efficacy, DRPAs are a heterogeneous group, with each drug possessing its own therapeutic benefits.
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Affiliation(s)
- Pavel Mohr
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Medicine, Charles University, Prague, Czechia
| | - Jirí Masopust
- Psychiatric Clinic of the University Hospital Hradec Kràlové, Charles University, Hradec Kràlové, Czechia
| | - Miloslav Kopeček
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Medicine, Charles University, Prague, Czechia
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25
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Bitter I, Mohr P, Raspopova N, Szulc A, Samochowiec J, Micluia IV, Skugarevsky O, Herold R, Mihaljevic-Peles A, Okribelashvili N, Dragašek J, Adomaitiene V, Rancans E, Chihai J, Maruta N, Marić NP, Milanova V, Tavčar R, Mosolov S. Assessment and Treatment of Negative Symptoms in Schizophrenia-A Regional Perspective. Front Psychiatry 2021; 12:820801. [PMID: 35185643 PMCID: PMC8855151 DOI: 10.3389/fpsyt.2021.820801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Clinicians and researchers consider that there are a variety of symptoms that constitute negative symptoms in schizophrenia, and they may use different definitions for the same symptoms. These differences are also reflected in a variety of negative symptom rating scales. Both research and clinical work are negatively affected by the lack of consensus regarding the symptoms that constitute negative symptoms in schizophrenia. Leading research groups have investigated ways to reduce heterogeneity in the domain of negative symptoms in schizophrenia; however, little attention has been paid to regional differences in the concepts of negative symptoms in schizophrenia. The objective of this review was to collect and summarize information about the assessment and treatment of negative symptoms of schizophrenia in Central and Eastern Europe (CEE). Nineteen experts from 17 countries in CEE participated in this project. The participants collected information about their countries, including the following: (1) the most important publications about negative symptoms in schizophrenia (irrespective of the time of their publication); (2) the most frequently used negative symptom of schizophrenia in clinical practice; (3) definitions of frequently used negative symptoms; and (4) treatment of negative symptoms in schizophrenia. The participating experts/countries most frequently reported the following five negative symptoms: avolition, blunted affect, alogia, asociality, and anhedonia. Several experts also considered other symptoms as belonging to the negative symptom domain, such as a decrease in energy level and changes in personality. The importance of evaluating the long-term course and the relationship between negative symptoms and other symptom domains was also noted. No noticeable differences were reported in the treatment of negative symptoms compared to currently published guidelines and algorithms. The most frequently reported negative symptoms included those defined by the NIMH-MATRICS consensus statement on negative symptoms and recently endorsed in a guidance paper of the European Psychiatric Association. The main differences in the concepts, names, and definitions of primary negative symptoms, especially those related to personality changes, and to the evaluation of the long-term course and relationship between different symptom domains in CEE compared to the current English language literature deserve the attention of psychiatrists and other professionals in this field.
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Affiliation(s)
- Istvan Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Pavel Mohr
- Clinical Center, National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Natalia Raspopova
- Department of Psychiatry, Narcology and Neurology of Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Agata Szulc
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Ioana Valentina Micluia
- Discipline of Psychiatry, Department of Neurosciences, University of Medicine and Pharmacy, Iuliu Haieganu, Cluj-Napoca, Romania
| | - Oleg Skugarevsky
- Department of Psychiatry & Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Alma Mihaljevic-Peles
- Clinical Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nino Okribelashvili
- Department of Psychiatry and Medical Psychology, Tbilisi State University, Tbilisi, Georgia
| | - Jozef Dragašek
- First Department of Psychiatry, University of P. J. Safarik, Medical Faculty and University Hospital of L. Pasteur, Kosice, Slovakia
| | - Virginija Adomaitiene
- Department of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
| | - Jana Chihai
- Medical Psychology and Narcology Department, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Moldova
| | - Natalia Maruta
- Department of Borderline Psychiatry, Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Science of Ukraine, Kharkiv, Ukraine
| | - Nadja P Marić
- Faculty of Medicine University of Belgrade & Institute of Mental Health, Belgrade, Serbia
| | - Vihra Milanova
- Psychiatric Clinic, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Rok Tavčar
- University Psychiatric Clinic Ljubljana and School of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Sergey Mosolov
- Department for Therapy of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia.,Department of Psychiatry, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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26
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Winkler P, Formanek T, Mlada K, Kagstrom A, Mohrova Z, Mohr P, Csemy L. Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys. Epidemiol Psychiatr Sci 2020; 29:e173. [PMID: 32988427 PMCID: PMC7573458 DOI: 10.1017/s2045796020000888] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/09/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
AIMS The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. METHODS We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. RESULTS The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). CONCLUSIONS This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.
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Affiliation(s)
- P. Winkler
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, London SE5 8AF, UK
| | - T. Formanek
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - K. Mlada
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00Pilsen, Czech Republic
| | - A. Kagstrom
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Z. Mohrova
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - P. Mohr
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruska 87, 100 00Prague, Czech Republic
| | - L. Csemy
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
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27
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Haferkamp S, Kähler K, Meier F, Pföhler C, Satzger I, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1104P Nivolumab (NIVO) monotherapy or combination therapy with ipilimumab (NIVO+IPI) in advanced melanoma patients with brain metastases: Real-world evidence from the German non-interventional study NICO. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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28
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Mohr P, Tadmouri A, Suissa J, Alivon M, Meyer N. 1140P A digital companion for patients with BRAF-mutant advanced melanoma treated with targeted therapies: TAVIE skin app. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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29
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Wasserman D, Apter G, Baeken C, Bailey S, Balazs J, Bec C, Bienkowski P, Bobes J, Ortiz MFB, Brunn H, Bôke Ö, Camilleri N, Carpiniello B, Chihai J, Chkonia E, Courtet P, Cozman D, David M, Dom G, Esanu A, Falkai P, Flannery W, Gasparyan K, Gerlinger G, Gorwood P, Gudmundsson O, Hanon C, Heinz A, Dos Santos MJH, Hedlund A, Ismayilov F, Ismayilov N, Isometsä ET, Izakova L, Kleinberg A, Kurimay T, Reitan SK, Lecic-Tosevski D, Lehmets A, Lindberg N, Lundblad KA, Lynch G, Maddock C, Malt UF, Martin L, Martynikhin I, Maruta NO, Matthys F, Mazaliauskiene R, Mihajlovic G, Peles AM, Miklavic V, Mohr P, Ferrandis MM, Musalek M, Neznanov N, Ostorharics-Horvath G, Pajević I, Popova A, Pregelj P, Prinsen E, Rados C, Roig A, Kuzman MR, Samochowiec J, Sartorius N, Savenko Y, Skugarevsky O, Slodecki E, Soghoyan A, Stone DS, Taylor-East R, Terauds E, Tsopelas C, Tudose C, Tyano S, Vallon P, Van der Gaag RJ, Varandas P, Vavrusova L, Voloshyn P, Wancata J, Wise J, Zemishlany Z, Öncü F, Vahip S. Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries. Eur Psychiatry 2020; 63:e82. [PMID: 32829740 PMCID: PMC7576531 DOI: 10.1192/j.eurpsy.2020.79] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
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Affiliation(s)
- D Wasserman
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
| | - G Apter
- French Federation of Psychiatry, Paris, France.,Groupe Hospitalier du Havre, Université de Rouen, Rouen, France
| | - C Baeken
- Flemish Association of Psychiatry, Kortenberg, Belgium.,Department of Psychiatry and Medical Psychiatry, Ghent University, Gent, Belgium
| | - S Bailey
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,University of Central Lancashire, Preston, United Kingdom
| | - J Balazs
- Hungarian Psychiatric Association, Budapest, Hungary.,Department of Developmental and Clinical Child Psychology at the Institute Psychology Eotvos Lorand University, Budapest, Hungary
| | - C Bec
- National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
| | - P Bienkowski
- Polish Psychiatric Association, Warsaw, Poland.,Department of Psychiatry, Warsaw Medical University, Warsaw, Poland
| | - J Bobes
- Spanish Society of Psychiatry, Madrid, Spain.,Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
| | - M F Bravo Ortiz
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - H Brunn
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Danish Psychiatric Association, Copenhagen, Denmark.,Institute of regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ö Bôke
- Psychiatric Association of Turkey, Ankara, Turkey.,Ondokuz Mayıs Üniversitesi, Samsun, Turkey
| | - N Camilleri
- Maltese Association of Psychiatry, Attard, Malta.,University of Malta, Msida, Malta
| | - B Carpiniello
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France.,Italian Psychiatric Association, Roma, Italy.,Department of Public Health, Clinical and Molecular Medicine, Università degli studi di Cagliari, Sardinia, Italy
| | - J Chihai
- Society of Psychiatrists, Narcologists, Psychotherapists, and Clinical Psychologists from the Republic of Moldova, Chișinău, Moldova.,Department of State Medical and Pharmaceutical University "Nicolae Testemitanu", Chișinău, Republic of Moldova
| | - E Chkonia
- Society of Georgian Psychiatrists, Tbilisi, Georgia.,Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - P Courtet
- French Congress of Psychiatry, Paris, France.,University of Montpellier, CHRU Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, Montpellier, France
| | - D Cozman
- Romanian Association of Psychiatry and Psychotherapy, Bucharest, Romania.,Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-NapocaRomania
| | - M David
- French Federation of Psychiatry, Paris, France.,Fondation Bon Sauveur, Bégard, France
| | - G Dom
- Belgium Professional Association of Medical Specialists in Psychiatry, Brussel, Belgium.,Department of Psychiatry, Antwerp University (UA), Antwerpen, Belgium
| | - A Esanu
- Society of Psychiatrists, Narcologists, Psychotherapists, and Clinical Psychologists from the Republic of Moldova, Chișinău, Moldova.,Department of Psychiatry, Narcology and Medical Psychology, State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
| | - P Falkai
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany.,Clinic for Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - W Flannery
- College of Psychiatrists of Ireland, Dublin, Ireland.,Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Gasparyan
- Armenian Psychiatric Association, Yerevan, Armenia.,Medical Psychology Department, Yerevan State Mkhitar Herats Medical University, Yerevan, Armenia
| | - G Gerlinger
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany
| | - P Gorwood
- French Congress of Psychiatry, Paris, France.,Institute of Psychiatry and Neuroscience of Paris (IPNP), University of ParisParis, France
| | - O Gudmundsson
- Icelandic Psychiatric Association, Kopavogur, Iceland.,Psychiatric Department, Landspitali, University Hospital of Iceland, Reykjavík, Iceland
| | - C Hanon
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Regional Resource Center of old age Psychiatry, AP-HP Centre - Université de Paris, Corentin-Celton Hospital, Paris, France
| | - A Heinz
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany.,Clinic for Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - M J Heitor Dos Santos
- Portuguese Society of Psychiatry and Mental Health, Lisbon, Portugal.,Institute of Environmental Health (ISAMB) of the Faculty of Medicine of the University of Lisbon (FMUL), Lisbon, Portugal
| | - A Hedlund
- Swedish Psychiatry Association, Sundsvall, Sweden.,North Stockholm Psychiatry, Stockholm County Medical Area (SLSO), Stockholm, Sweden
| | - F Ismayilov
- Azerbaijan Psychiatric Association, Baku, Azerbaijan.,National Mental Health Centre, Baku, Azerbaijan
| | - N Ismayilov
- Azerbaijan Psychiatric Association, Baku, Azerbaijan.,Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | - E T Isometsä
- Finnish Psychiatric Association, Helsinki, Finland.,Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - L Izakova
- Slovak Psychiatric Association, Bratislava, Slovakia.,Department of Psychiatry, Faculty of Medicine Comenius University and University Hospital, Bratislava, Slovakia
| | - A Kleinberg
- Estonian Psychiatric Association, Tartu, Estonia.,Children Mental Health Centre of Tallinn Children Hospital, Tallinn, Estonia
| | - T Kurimay
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France.,Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary
| | - S Klæbo Reitan
- Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary.,Norwegian Psychiatric Association, Oslo, Norway.,Department of Mental Health, Faculty of Medicine and Health Sciences, Norweigan University of Science and Technology, Trondheim, Norway
| | - D Lecic-Tosevski
- Serbian Psychiatric Association, Belgrade, Serbia.,Psychiatric Association of Eastern Europe and the Balkans, Athens, Greece.,Department of Medical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - A Lehmets
- Estonian Psychiatric Association, Tartu, Estonia.,Psychiatric Centre of the Tallinn West Central Hospital, Tallinn, Estonia
| | - N Lindberg
- Finnish Psychiatric Association, Helsinki, Finland.,Forensic Psychiatry, Helsinki University and Helsinki University Hospital, Helsinski, Finland
| | - K A Lundblad
- Swedish Psychiatry Association, Sundsvall, Sweden.,Adult Psychiatry, Stockholm County Medical Area (SLSO), Stockholm, Sweden
| | - G Lynch
- Royal College of Psychiatrists, London, United Kingdom
| | - C Maddock
- Royal College of Psychiatrists, London, United Kingdom
| | - U F Malt
- Norwegian Psychiatric Association, Oslo, Norway.,Faculty of Medicine, Psychiatry and Psychosomatic Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L Martin
- College of Psychiatrists of Ireland, Dublin, Ireland.,St Loman's Hospital, Mullingar, Ireland
| | - I Martynikhin
- Russian Society of Psychiatrists, Moscow, Russian Federation.,First Pavlov State Medical University of St Petersburg, Saint Petersburg, Russian Federation
| | - N O Maruta
- Association of Neurologists, Psychiatrists and Narcologists of Ukraine, Kharkiv, Ukraine.,Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine State Insitution, Kharkiv, Ukraine
| | - F Matthys
- Flemish Association of Psychiatry, Kortenberg, Belgium.,Department of Psychiatry, Universitair Ziekenhuis, Brussel, Belgium
| | - R Mazaliauskiene
- Lithuanian Psychiatric Association, Vilnius, Lithuania.,Lithuanian University of Health Sciences, Psychiatric Clinic, Kaunas, Lithuania
| | - G Mihajlovic
- Serbian Psychiatric Association, Belgrade, Serbia.,Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia
| | - A Mihaljevic Peles
- Croatian Psychiatric Association, Zagreb, Croatia.,Zagreb School of Medicine and Zagreb University Hospital Centre, Zagreb, Croatia
| | - V Miklavic
- Slovenian Psychiatric Association, Ljubljana, Slovenia.,Ljubljana University Medical Centre, Ljubljana, Slovenia
| | - P Mohr
- Czech Psychiatric Association, Prague, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - M Munarriz Ferrandis
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain
| | - M Musalek
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Institute for Social Aesthetics and Mental Health, Vienna, Austria.,Sigmund Freud University, Vienna, Austria
| | - N Neznanov
- Russian Society of Psychiatrists, Moscow, Russian Federation.,St. Petersburg V.M. Bekhterev Psychoneurological Research Institute, St. Petersburg, Russian Federation
| | | | - I Pajević
- Psychiatric Association of Bosnia-Herzegovina, Tuzla, Bosnia and Herzegovina.,Department of Psychiatry, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - A Popova
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,College Private Psychiatry of Bulgaria, Sofia, Bulgaria.,Nikola Shipkovenski Mental Health Centre, Sofia, Bulgaria
| | - P Pregelj
- Slovenian Psychiatric Association, Ljubljana, Slovenia.,Department of Psychiatry, University of Ljubljana, Ljubljana, Slovenia
| | - E Prinsen
- Netherlands Psychiatric Association, Utrecht, Netherlands
| | - C Rados
- Austrian Society for Psychiatry and Psychotherapy, Vienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Villach State Hospital, Villach, Austria
| | - A Roig
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain.,Mental Health Centre, Horta-Guinardó, Barcelona, Spain
| | - M Rojnic Kuzman
- Croatian Psychiatric Association, Zagreb, Croatia.,Zagreb School of Medicine and Zagreb University Hospital Centre, Zagreb, Croatia
| | - J Samochowiec
- Polish Psychiatric Association, Warsaw, Poland.,European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France.,Department of Psychiatry Pomeranian Medical University, Szczecin, Poland
| | - N Sartorius
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
| | - Y Savenko
- Independent Psychiatric Association of Russia, Moscow, Russian Federation
| | - O Skugarevsky
- Belarusian Psychiatric Association, Minsk, Belarus.,Psychiatry and Medical Psychology Department, Belarusian State Medical University, Minsk, Belarus
| | - E Slodecki
- Royal College of Psychiatrists, London, United Kingdom
| | - A Soghoyan
- Armenian Psychiatric Association, Yerevan, Armenia.,Center of Psychosocial Recovery, Yerevan State Medical University, Yerevan, Armenia
| | - D S Stone
- National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
| | - R Taylor-East
- Maltese Association of Psychiatry, Attard, Malta.,University of Malta, Msida, Malta
| | - E Terauds
- Latvian Psychiatric Association, Riga, Latvia.,Department of Psychiatry and Narcology, Rīga Stradiņš University, Riga, Latvia
| | - C Tsopelas
- Psychiatric Association of Eastern Europe and the Balkans, Athens, Greece.,Department of Psychiatry, Psychiatric Hospital of Athens, Athens, Greece
| | - C Tudose
- Romanian Association of Psychiatry and Psychotherapy, Bucharest, Romania.,Department of Psychiatry "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - S Tyano
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France
| | - P Vallon
- Swiss Society of Psychiatry and Psychotherapy, Bern, Switzerland
| | - R J Van der Gaag
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Psychosomatics and Psychotherapy Stradina Department, University of Riga, Riga, Latvia
| | - P Varandas
- Portuguese Society of Psychiatry and Mental Health, Lisbon, Portugal.,Casa de Saúde da Idanha and San José Psychiatric Clinic Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Belas, Portugal
| | - L Vavrusova
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,Slovak Psychiatric Association, Bratislava, Slovakia
| | - P Voloshyn
- Association of Neurologists, Psychiatrists and Narcologists of Ukraine, Kharkiv, Ukraine.,Department of Neurology and Neurosurgery of Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
| | - J Wancata
- Austrian Society for Psychiatry and Psychotherapy, Vienna, Austria.,Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - J Wise
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.,CNWL NHS Foundation Trust, London, United Kingdom
| | - Z Zemishlany
- Israel Psychiatric Association, Ramat Gan, Israel
| | - F Öncü
- Psychiatric Association of Turkey, Ankara, Turkey.,Forensic Psychiatry Department, Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - S Vahip
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France.,Department of Psychiatry, Ege University School of Medicine, Izmir, Turkey
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Klírová M, Hejzlar M, Kostýlková L, Mohr P, Rokyta R, Novák T. Prolonged Continuous Theta Burst Stimulation of the Motor Cortex Modulates Cortical Excitability But not Pain Perception. Front Syst Neurosci 2020; 14:27. [PMID: 32670027 PMCID: PMC7326109 DOI: 10.3389/fnsys.2020.00027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/28/2020] [Indexed: 11/23/2022] Open
Abstract
Over the past decade, theta-burst stimulation (TBS) has become a focus of interest in neurostimulatory research. Compared to conventional repetitive transcranial magnetic stimulation (rTMS), TBS produces more robust changes in cortical excitability (CE). There is also some evidence of an analgesic effect of the method. Previously published studies have suggested that different TBS parameters elicit opposite effects of TBS on CE. While intermittent TBS (iTBS) facilitates CE, continuous TBS (cTBS) attenuates it. However, prolonged TBS (pTBS) with twice the number of stimuli produces the opposite effect. In a double-blind, placebo-controlled, cross-over study with healthy subjects (n = 24), we investigated the effects of various pTBS (cTBS, iTBS, and placebo TBS) over the right motor cortex on CE and pain perception. Changes in resting motor thresholds (RMTs) and absolute motor-evoked potential (MEP) amplitudes were assessed before and at two time-points (0–5 min; 40–45 min) after pTBS. Tactile and thermal pain thresholds were measured before and 5 min after application. Compared to the placebo, prolonged cTBS (pcTBS) transiently increased MEP amplitudes, while no significant changes were found after prolonged iTBS. However, the facilitation of CE after pcTBS did not induce a parallel analgesic effect. We confirmed that pcTBS with twice the duration converts the conventional inhibitory effect into a facilitatory one. Despite the short-term boost of CE following pcTBS, a corresponding analgesic effect was not demonstrated. Therefore, the results indicate a more complex regulation of pain, which cannot be explained entirely by the modulation of excitability.
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Affiliation(s)
- Monika Klírová
- Clinical Centre, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Martin Hejzlar
- Clinical Centre, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Lenka Kostýlková
- Clinical Centre, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Pavel Mohr
- Clinical Centre, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Richard Rokyta
- Department of Normal, Pathological and Clinical Physiology, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Tomáš Novák
- Clinical Centre, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czechia
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31
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Mohr P, Fülöp Z, Gyürky G, Kiss GG, Szücs T. Successful Prediction of Total α-Induced Reaction Cross Sections at Astrophysically Relevant Sub-Coulomb Energies Using a Novel Approach. Phys Rev Lett 2020; 124:252701. [PMID: 32639776 DOI: 10.1103/physrevlett.124.252701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/19/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
The prediction of stellar (γ,α) reaction rates for heavy nuclei is based on the calculation of (α,γ) cross sections at sub-Coulomb energies. These rates are essential for modeling the nucleosynthesis of so-called p nuclei. The standard calculations in the statistical model show a dramatic sensitivity to the chosen α-nucleus potential. The present study explains the reason for this dramatic sensitivity which results from the tail of the imaginary α-nucleus potential in the underlying optical model calculation of the total reaction cross section. As an alternative to the optical model, a simple barrier transmission model is suggested. It is shown that this simple model in combination with a well-chosen α-nucleus potential is able to predict total α-induced reaction cross sections for a wide range of heavy target nuclei above A≳150 with uncertainties below a factor of 2. The new predictions from the simple model do not require any adjustment of parameters to experimental reaction cross sections whereas in previous statistical model calculations all predictions remained very uncertain because the parameters of the α-nucleus potential had to be adjusted to experimental data. The new model allows us to predict the reaction rate of the astrophysically important ^{176}W(α,γ)^{180}Os reaction with reduced uncertainties, leading to a significantly lower reaction rate at low temperatures. The new approach could also be validated for a broad range of target nuclei from A≈60 up to A≳200.
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Affiliation(s)
- P Mohr
- Institute for Nuclear Research (MTA Atomki), H-4001 Debrecen, Hungary
- Diakonie-Klinikum, D-74523 Schwäbisch Hall, Germany
| | - Zs Fülöp
- Institute for Nuclear Research (MTA Atomki), H-4001 Debrecen, Hungary
| | - Gy Gyürky
- Institute for Nuclear Research (MTA Atomki), H-4001 Debrecen, Hungary
| | - G G Kiss
- Institute for Nuclear Research (MTA Atomki), H-4001 Debrecen, Hungary
| | - T Szücs
- Institute for Nuclear Research (MTA Atomki), H-4001 Debrecen, Hungary
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32
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Libiger J, Mohr P, Horáček J, Czobor P, Bahbouch R. S42.03 Test of Serotonergic Activity in the Brain Predicts Therapeutic Response of Patients with Schizophrenia. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(00)94316-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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33
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Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Chiarion-Sileni V, Lebbe C, Mandalá M, Millward M, Arance A, Bondarenko I, Haanen JBAG, Hansson J, Utikal J, Ferraresi V, Mohr P, Probachai V, Schadendorf D, Nathan P, Robert C, Ribas A, Davies MA, Lane SR, Legos JJ, Mookerjee B, Grob JJ. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2019; 30:1848. [PMID: 31406976 PMCID: PMC6927319 DOI: 10.1093/annonc/mdz221] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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34
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Weber J, Kurt M, Edmondson-Jones M, Amadi A, Lobo M, Moshyk A, Kotapati S, Mohr P. Mixture-cure modeling for resected stage III/IV melanoma in the phase III CheckMate 238 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Knispel S, Gassenmaier M, Menzies A, Loquai C, Johnson D, Franklin C, Gutzmer R, Hassel J, Weishaupt C, Eigentler T, Schummer P, Kiecker F, Owen C, Schmidgen M, Kähler K, Cann C, Niebel D, Mohr P, Schadendorf D, Zimmer L. Outcome of patients with elevated LDH treated with first-line targeted therapy (TT) or PD-1 based immune checkpoint inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Krauss J, Eigentler T, Schreiber J, Weishaupt C, Terheyden P, Heinzerling L, Mohr P, Weide B, Ochsenreither S, Gutzmer R, Becker J, Kiecker F, Funkner F, Heidenreich R, Kays SK, Klinkhardt U, Gnad-Vogt U, Scheel B, Schönborn-Kellenberger O, Seibel T. A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Berking C, Livingstone E, Weichenthal M, Leiter U, Wittmann K, Eigentler T, Mohr P, Kiecker F, Loquai C, Debus D, Gutzmer R. Efficacy and safety of dabrafenib and trametinib in patients with metastatic BRAFV600 mutation-positive melanoma in the real-world setting: Interim results of the non-interventional COMBI-r study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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38
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Kopecek M, Svancer P, Andrashko V, Knytl P, Kohutova B, Kozeny J, Protopopova D, Mohr P. Effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics. Neuro Endocrinol Lett 2019; 40:75-78. [PMID: 31785213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/12/2018] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.
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Affiliation(s)
- Miloslav Kopecek
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Patrik Svancer
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Veronika Andrashko
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Barbora Kohutova
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Jiri Kozeny
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Dita Protopopova
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
| | - Pavel Mohr
- National Institute of Mental Health, Klecany, Topolová 748, 250 67, Czech Republic
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39
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Schadendorf D, Hassel J, Fluck M, Eigentler T, Loquai C, Berneburg M, Gutzmer R, Meier F, Mohr P, Hauschild A, Becker J, Menzer C, Kiecker F, Dippel E, Simon JC, Conrad B, Garbe C, Körner S, Livingstone E, Zimmer L. Adjuvant immunotherapy with nivolumab (NIVO) alone or in combination with ipilimumab (IPI) versus placebo in stage IV melanoma patients with no evidence of disease (NED): A randomized, double-blind phase II trial (IMMUNED). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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40
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Mohr P, Toor K, Goring S, Chan K, Besada M, Johnson H, Moshyk A, Kotapati S. Long-term efficacy of combination nivolumab and ipilimumab for first-line treatment of advanced melanoma: A network meta-analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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Rodriguez M, Zaytseva Y, Cvrčková A, Dvořaček B, Dorazilová A, Jonáš J, Šustová P, Voráčková V, Hájková M, Kratochvílová Z, Španiel F, Mohr P. Cognitive Profiles and Functional Connectivity in First-Episode Schizophrenia Spectrum Disorders - Linking Behavioral and Neuronal Data. Front Psychol 2019; 10:689. [PMID: 31001171 PMCID: PMC6454196 DOI: 10.3389/fpsyg.2019.00689] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/12/2019] [Indexed: 12/16/2022] Open
Abstract
The character of cognitive deficit in schizophrenia is not clear due to the heterogeneity in research results. In heterogeneous conditions, the cluster solution allows the classification of individuals based on profiles. Our aim was to examine the cognitive profiles of first-episode schizophrenia spectrum disorder (FES) subjects based on cluster analysis, and to correlate these profiles with clinical variables and resting state brain connectivity, as measured with magnetic resonance imaging. A total of 67 FES subjects were assessed with a neuropsychological test battery and on clinical variables. The results of the cognitive domains were cluster analyzed. In addition, functional connectivity was calculated using ROI-to-ROI analysis with four groups: Three groups were defined based on the cluster analysis of cognitive performance and a control group with a normal cognitive performance. The connectivity was compared between the patient clusters and controls. We found different cognitive profiles based on three clusters: Cluster 1: decline in the attention, working memory/flexibility, and verbal memory domains. Cluster 2: decline in the verbal memory domain and above average performance in the attention domain. Cluster 3: generalized and severe deficit in all of the cognitive domains. FES diagnoses were distributed among all of the clusters. Cluster comparisons in neural connectivity also showed differences between the groups. Cluster 1 showed both hyperconnectivity between the cerebellum and precentral gyrus, the salience network (SN) (insula cortex), and fronto-parietal network (FPN) as well as between the PreCG and SN (insula cortex) and hypoconnectivity between the default mode network (DMN) and seeds of SN [insula and supramarginal gyrus (SMG)]; Cluster 2 showed hyperconnectivity between the DMN and cerebellum, SN (insula) and precentral gyrus, and FPN and IFG; Cluster 3 showed hypoconnectivity between the DMN and SN (insula) and SN (SMG) and pallidum. The cluster solution confirms the prevalence of a cognitive decline with different patterns of cognitive performance, and different levels of severity in FES. Moreover, separate behavioral cognitive subsets can be linked to patterns of brain functional connectivity.
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Affiliation(s)
- Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czechia
| | - Yuliya Zaytseva
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Aneta Cvrčková
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czechia
| | - Boris Dvořaček
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Aneta Dorazilová
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czechia
| | - Juraj Jonáš
- National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czechia
| | - Petra Šustová
- National Institute of Mental Health, Klecany, Czechia
| | - Veronika Voráčková
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Marie Hájková
- National Institute of Mental Health, Klecany, Czechia
| | | | - Filip Španiel
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Pavel Mohr
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
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42
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Šebela A, Hanka J, Mohr P. Diagnostics and modern trends in therapy of postpartum depression. Ceska Gynekol 2019; 84:68-72. [PMID: 31213061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To bring actual summary of knowledge about diagnostics and modern trends in therapy of postpartum depression. DESIGN Review. SETTING National Institute of Mental Health, Klecany. METHODS Narrative review. RESULTS First assessment of depressive symptoms among puerperal women can be done by screening instruments. Baby blues and postpartum psychosis must be kept in mind during the differential diagnostics of postpartum depression. Both nonpharmacological and pharmacological interventions can be used for postpartum depression treatment. As for nonpharmacological interventions, cognitive behavioral therapy is the most evidence based one. Antidepressants from the selective serotonin reuptake inhibitor group (SSRI) are the first choice from pharmacological interventions. Parenting support is also an important component of modern care of women with postpartum depression. CONCLUSION Systematic cooperation between psychiatrist and gynecologists-obstetricians is a precondition of the effective postpartum depression treatment. The therapeutic intervention is chosen according to severity of depressive symptoms.
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43
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Knytl P, Voráčková V, Dorazilová A, Rodriguez M, Cvrčková A, Kofroňová E, Kuchař M, Kratochvílová Z, Šustová P, Čerešňáková S, Mohr P. Neuroactive Steroids and Cognitive Functions in First-Episode Psychosis Patients and Their Healthy Siblings. Front Psychiatry 2019; 10:390. [PMID: 31275177 PMCID: PMC6591670 DOI: 10.3389/fpsyt.2019.00390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/17/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Neuroactive steroids (NAS) affect neurotransmitter systems and cognition; thus, they play role in etiopathogenesis of psychiatric disorders. Aims: The primary aim was to examine cognition and effects of NAS on cognitive functioning in first-episode psychosis patients and in their healthy siblings. The secondary aims were to verify whether cognitive deficit is an endophenotype of psychosis and whether higher NAS levels represent a high-risk factor for psychosis. Methods: Studied participants were 1) patients with first episode of psychosis, 2) healthy siblings of the patients, and 3) matching healthy controls. Study procedures included administration of a battery of neuropsychological tests assessing six cognitive domains and examination of NAS plasma levels [cortisol (CORT), 11-deoxycorticosterone (DOC), testosterone (TEST), dehydroepiandrostendione (DHEA), dihydrotestosterone (DHT), and progesterone (PROG)]. Results: A total of 67 subjects were analyzed (16 patients, 22 siblings, and 29 controls). Significant group differences were found in most of the cognitive domains; the patients had the lowest scores. The Kruskal-Wallis test revealed significant group differences in CORT levels (p < 0.01), TEST (p < 0.01), and DHT (p < 0.001); no difference was found in PROG, DHEA, and DOC. All cognitive domains, except for attention, were affected by the NAS levels. CORT levels of patients correlated with speed of processing (r = 0.55) and working memory (r = 0.52), while PROG levels correlated with abstraction (r = -0.63). In siblings, there was a negative correlation between TEST levels and verbal memory (r = -0.51) and PROG with attention (r = -0.47). Conclusions: Our results verified that individual domains of cognitive deficit (abstraction and verbal memory) can be considered as an endophenotype of psychosis. Higher levels of cortisol and testosterone in siblings are consistent with high-risk states for psychosis. Multiple interactions between NAS and cognitive functioning, particularly memory functions, were observed. Study limitations (small sample size and administration of antipsychotic medication) did not allow us to establish unequivocally NAS as an endophenotype.
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Affiliation(s)
- Pavel Knytl
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Veronika Voráčková
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Aneta Dorazilová
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Arts, Masaryk University, Brno, Czechia
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Arts, Charles University, Prague, Czechia
| | - Aneta Cvrčková
- National Institute of Mental Health, Klecany, Czechia.,Faculty of Social Studies, Masaryk University, Brno, Czechia
| | | | - Martin Kuchař
- National Institute of Mental Health, Klecany, Czechia.,University of Chemistry and Technology, Prague, Czechia
| | | | - Petra Šustová
- National Institute of Mental Health, Klecany, Czechia
| | - Silvie Čerešňáková
- National Institute of Mental Health, Klecany, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Pavel Mohr
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
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Augustin M, Schäfer I, Krensel M, Reusch M, Mohr P, Greinert R, John SM, Zander N. Decreasing sunbed use in the German population between 2001 and 2015: survey in 155 679 working persons. J Eur Acad Dermatol Venereol 2018; 33:541-545. [PMID: 30408254 DOI: 10.1111/jdv.15309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 09/20/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND UV radiation is a proven cause of skin cancer. Use of sunbeds has been shown to provide an attributable risk. OBJECTIVE To evaluate the proportion of regular sunbed use in Germany based on large-scale population-based surveys over 15 years. METHODS Skin cancer screenings by dermatologists were conducted between 2001 and 2015 in more than 500 German companies, including a clinical examination and interviews on the risk behaviour related to sunburns and sunbeds. RESULTS Among 155 679 persons included regular sunbed use significantly declined from 11.0% in 2001 to 1.6% in 2015 (P < 0.001). There were significantly higher rates of sunbed use in women (12.5%/2.0%) vs. men (7.3%/1.3%; P < 0.001), in younger persons and in participants with darker skin (type II and III) vs. fair skin (type I). Individuals with sunburns in childhood were significantly more often sunbed users (5.1% vs. 4.6%; P = 0.002). A remarkable decline of sunbed use was observed after 2009 (7.0% in 2001-2008 and 2.2% in 2009-2015). This reduction occurred in the time of a legal ban of sunbed use for minors but also with the start of the national skin cancer screening programme. CONCLUSION Use of sunbeds in the German adult population has dropped by more than 85% in the past decade. Primary prevention, including the large public awareness following the legal ban of sunbed use for young people and the effects of the statutory skin cancer screening programme may have contributed to this.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - I Schäfer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Krensel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Reusch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Dermatological Practice Tibarg, Hamburg, Germany
| | - P Mohr
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - R Greinert
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - S M John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - N Zander
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Terheyden P, Weishaupt C, Heinzerling L, Klinkhardt U, Krauss J, Mohr P, Kiecker F, Becker J, Dähling (Submitter A, Döner F, Heidenreich R, Scheel B, Schönborn-Kellenberger O, Seibel T, Gnad-Vogt U. Phase I dose-escalation and expansion study of intratumoral CV8102, a RNA-based TLR- and RIG-1 agonist in patients with advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Winkler P, Broulíková HM, Kondrátová L, Knapp M, Arteel P, Boyer P, Galderisi S, Karkkainen H, Ieven A, Mohr P, Wasserman D, Park AL, Tinelli M, Gaebel W. Value of schizophrenia treatment II: Decision modelling for developing early detection and early intervention services in the Czech Republic. Eur Psychiatry 2018; 53:116-122. [DOI: 10.1016/j.eurpsy.2018.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Abstract:Background:Positive findings on early detection and early intervention services have been consistently reported from many different countries. The aim of this study, conducted within the European Brain Council project “The Value of Treatment”, was to estimate costs and the potential cost- savings associated with adopting these services within the context of the Czech mental health care reform.Methods:Czech epidemiological data, probabilities derived from meta-analyses, and data on costs of mental health services in the Czech Republic were used to populate a decision analytical model. From the health care and societal perspectives, costs associated with health care services and productivity lost were taken into account. One-way sensitivity analyses were conducted to explore the uncertainty around the key parameters.Results:It was estimated that annual costs associated with care as usual for people with the first episode of psychosis were as high as 46 million Euro in the Czech Republic 2016. These annual costs could be reduced by 25% if ED services were adopted, 33% if EI services were adopted, and 40% if both, ED and EI services, were adopted in the country. Cost-savings would be generated due to decreased hospitalisations and better employment outcomes in people with psychoses.Conclusions:Adopting early detection and early intervention services in mental health systems based on psychiatric hospitals and with limited access to acute and community care could generate considerable cost- savings. Although the results of this modelling study needs to be taken with caution, early detection and early intervention services are recommended for multi-centre pilot testing accompanied by full economic evaluation in the region of Central and Eastern Europe.
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Mohr P, Galderisi S, Boyer P, Wasserman D, Arteel P, Ieven A, Karkkainen H, Pereira E, Guldemond N, Winkler P, Gaebel W. Value of schizophrenia treatment I: The patient journey. Eur Psychiatry 2018; 53:107-115. [PMID: 30036773 DOI: 10.1016/j.eurpsy.2018.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The aim of the European Brain Council project "The Value of Treatment" was to provide evidence-based, cost-effective policy recommendations for a patient-centered and sustainable coordinated care model for brain disorders. The first part of schizophrenia study examined the needs and gaps in the patients' care pathway. METHODS Descriptive analysis was based on an inventory of needs and treatment opportunities, using focus group sessions, expert interviews, users' input, and literature review. Three patient pathways were selected: indicated prevention, duration of untreated psychosis, and relapse prevention. RESULTS The analysis identified several critical barriers to optimal treatment. Available health care services often miss or delay detection of symptoms and diagnosis in at-risk individuals. There is a lack of illness awareness among patients, families, and the public; scarcity of information, training and education among primary care providers; stigmatizing beliefs. Early symptom recognition and timely intervention result in better outcome and prognosis; effective management leads to a functional recovery. In the current model of care, there is insufficient cooperation between health and social care providers, patients and families, inadequate utilization of pharmacological and psychosocial interventions, lacking patient monitoring, and low implementation of integrated community care. CONCLUSIONS Early detection and early intervention programs, timely intervention, and relapse prevention are essential for effective management of schizophrenia. It requires a paradigm shift from symptom control, achieving and maintaining remission, to the emphasis on recovery. Since the current services are not able to accomplish this goal, changes in mental health policies are needed.
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Affiliation(s)
- Pavel Mohr
- National Institute of Mental Health, Klecany, Czech Republic; 3rd Faculty of Medicine, Charles University Prague, Czech Republic.
| | | | | | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), The Karolinska Institute, Stockholm, Sweden
| | - Paul Arteel
- Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN Europe), Belgium
| | - Aagje Ieven
- European Federation of Associations of Families of People with Mental Illness (EUFAMI), Belgium
| | - Hilkka Karkkainen
- Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN Europe), Belgium
| | - Eulalia Pereira
- European Federation of Associations of Families of People with Mental Illness (EUFAMI), Belgium
| | - Nick Guldemond
- Institute of Health Policy & Management, Erasmus University Rotterdam, Netherlands
| | - Petr Winkler
- National Institute of Mental Health, Klecany, Czech Republic; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Wolfgang Gaebel
- LVR-Klinikum, Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
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Bravermanová A, Viktorinová M, Tylš F, Novák T, Androvičová R, Korčák J, Horáček J, Balíková M, Griškova-Bulanova I, Danielová D, Vlček P, Mohr P, Brunovský M, Koudelka V, Páleníček T. Psilocybin disrupts sensory and higher order cognitive processing but not pre-attentive cognitive processing-study on P300 and mismatch negativity in healthy volunteers. Psychopharmacology (Berl) 2018; 235:491-503. [PMID: 29302713 DOI: 10.1007/s00213-017-4807-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023]
Abstract
RATIONALE Disruption of auditory event-related evoked potentials (ERPs) P300 and mismatch negativity (MMN), electrophysiological markers of attentive and pre-attentive cognitive processing, is repeatedly described in psychosis and schizophrenia. Similar findings were observed in a glutamatergic model of psychosis, but the role of serotonergic 5-HT2A receptors in information processing is less clear. OBJECTIVES We studied ERPs in a serotonergic model of psychosis, induced by psilocybin, a psychedelic with 5-HT2A/C agonistic properties, in healthy volunteers. METHODS Twenty subjects (10M/10F) were given 0.26 mg/kg of psilocybin orally in a placebo-controlled, double-blind, cross-over design. ERPs (P300, MMN) were registered during the peak of intoxication. Correlations between measured electrophysiological variables and psilocin serum levels and neuropsychological effects were also analyzed. RESULTS Psilocybin induced robust psychedelic effects and psychotic-like symptoms, decreased P300 amplitude (p = 0.009) but did not affect the MMN. Psilocybin's disruptive effect on P300 correlated with the intensity of the psychedelic state, which was dependent on the psilocin serum levels. We also observed a decrease in N100 amplitude (p = 0.039) in the P300 paradigm and a negative correlation between P300 and MMN amplitude (p = 0.014). CONCLUSIONS Even though pre-attentive cognition (MMN) was not affected, processing at the early perceptual level (N100) and in higher-order cognition (P300) was significantly disrupted by psilocybin. Our results have implications for the role of 5-HT2A receptors in altered information processing in psychosis and schizophrenia.
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Affiliation(s)
- Anna Bravermanová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,First Faculty of Medicine, Charles University Prague, Kateřinská 32, 121 08, Prague 2, Czech Republic
| | - Michaela Viktorinová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Filip Tylš
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Tomáš Novák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Renáta Androvičová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Jakub Korčák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Jiří Horáček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Marie Balíková
- First Faculty of Medicine, Charles University Prague, Kateřinská 32, 121 08, Prague 2, Czech Republic
| | - Inga Griškova-Bulanova
- Institute of Biosciences, Vilnius University, Sauletekio ave 7, 102 57, Vilnius, Lithuania
| | - Dominika Danielová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Přemysl Vlček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Pavel Mohr
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Martin Brunovský
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Vlastimil Koudelka
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Tomáš Páleníček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic. .,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic.
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Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Chiarion-Sileni V, Lebbe C, Mandalà M, Millward M, Arance A, Bondarenko I, Haanen JBAG, Hansson J, Utikal J, Ferraresi V, Mohr P, Probachai V, Schadendorf D, Nathan P, Robert C, Ribas A, Davies MA, Lane SR, Legos JJ, Mookerjee B, Grob JJ. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2018; 28:1631-1639. [PMID: 28475671 PMCID: PMC5834102 DOI: 10.1093/annonc/mdx176] [Citation(s) in RCA: 421] [Impact Index Per Article: 70.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Indexed: 02/07/2023] Open
Abstract
Background Previous analysis of COMBI-d (NCT01584648) demonstrated improved progression-free survival (PFS) and overall survival (OS) with combination dabrafenib and trametinib versus dabrafenib monotherapy in BRAF V600E/K-mutant metastatic melanoma. This study was continued to assess 3-year landmark efficacy and safety after ≥36-month follow-up for all living patients. Patients and methods This double-blind, phase 3 study enrolled previously untreated patients with BRAF V600E/K-mutant unresectable stage IIIC or stage IV melanoma. Patients were randomized to receive dabrafenib (150 mg twice daily) plus trametinib (2 mg once daily) or dabrafenib plus placebo. The primary endpoint was PFS; secondary endpoints were OS, overall response, duration of response, safety, and pharmacokinetics. Results Between 4 May and 30 November 2012, a total of 423 of 947 screened patients were randomly assigned to receive dabrafenib plus trametinib (n = 211) or dabrafenib monotherapy (n = 212). At data cut-off (15 February 2016), outcomes remained superior with the combination: 3-year PFS was 22% with dabrafenib plus trametinib versus 12% with monotherapy, and 3-year OS was 44% versus 32%, respectively. Twenty-five patients receiving monotherapy crossed over to combination therapy, with continued follow-up under the monotherapy arm (per intent-to-treat principle). Of combination-arm patients alive at 3 years, 58% remained on dabrafenib plus trametinib. Three-year OS with the combination reached 62% in the most favourable subgroup (normal lactate dehydrogenase and <3 organ sites with metastasis) versus only 25% in the unfavourable subgroup (elevated lactate dehydrogenase). The dabrafenib plus trametinib safety profile was consistent with previous clinical trial observations, and no new safety signals were detected with long-term use. Conclusions These data demonstrate that durable (≥3 years) survival is achievable with dabrafenib plus trametinib in patients with BRAF V600-mutant metastatic melanoma and support long-term first-line use of the combination in this setting.
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Affiliation(s)
- G. V. Long
- Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, North Sydney, Australia
- Correspondence to: Prof. Georgina V. Long, Melanoma Institute Australia, The University of Sydney, 40 Rocklands Road, North Sydney 2060, NSW, Australia. Tel: +61-2-9911-7200; E-mail:
| | - K. T. Flaherty
- Developmental Therapeutics and Melanoma Programs, Massachusetts General Hospital Cancer Center, Boston, USA
| | | | - H. Gogas
- First Department of Medicine, “Laiko” General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E. Levchenko
- Petrov Research Institute of Oncology, Saint Petersburg, Russia
| | - F. de Braud
- Dipartimento di Medicina Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J. Larkin
- Royal Marsden NHS Foundation Trust, London, UK
| | - C. Garbe
- Department of Dermatology, University of Tübingen, Tübingen, Germany
| | - T. Jouary
- Service D'oncologie Médicale, Hopital Francois Mitterrand, Pau, France
| | - A. Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - V. Chiarion-Sileni
- Melanoma and Oesophageal Oncology Unit, Veneto Oncology Institute–IRCCS, Padova, Italy
| | - C. Lebbe
- APHP Dermatology and CIC Departments, INSERM U976, University Paris Diderot, Paris, France
| | - M. Mandalà
- Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M. Millward
- Medical Oncology Department, Sir Charles Gairdner Hospital, Perth, Australia
| | - A. Arance
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - I. Bondarenko
- Dnipropetrovsk State Medical Academy, Clinical Hospital #4, Dnipropetrovsk, Ukraine
| | | | - J. Hansson
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - J. Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim and Heidelberg, Germany
| | - V. Ferraresi
- Department of Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy
| | - P. Mohr
- Dermatologisches Zentrum Buxtehude, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - V. Probachai
- Dnipropetrovsk Clinical Oncology Center of Dnipropetrovsk State Council, Dnipropetrovsk, Ukraine
| | - D. Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - P. Nathan
- Mount Vernon Cancer Centre, Northwood, UK
| | - C. Robert
- Gustave Roussy, Département de Médecine Oncologique, Service de Dermatologie et Université Paris-Sud, Faculté de Médecine, Villejuif, France
| | - A. Ribas
- Department of Medicine, Hematology/Oncology, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA
| | - M. A. Davies
- Melanoma Medical Oncology and Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S. R. Lane
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - J. J. Legos
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - B. Mookerjee
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - J.-J. Grob
- Service de Dermatologie, Centre Hospitalo-Universitaire Timone, Aix-Marseille Université, Marseille, France
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Šebela A, Hanka J, Mohr P. Etiology, risk factors, and methods of postpartum depression prevention. Ceska Gynekol 2018; 83:468-473. [PMID: 30848154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To bring actual summary of knowledge about etiology and risk factors for development of postpartum depression, and modern methods of its prevention. DESIGN Review. SETTING National Institute of Mental Health, Klecany. METHODS Narrative review. RESULTS Both biological (sex and stress hormones, thyroid hormones) and psychosocial factors take part in development of postpartum depression. Positive personal medical history for psychiatric illness, low level of social support and domestic violence during pregnancy or after delivery are the major risk factors for development of postpartum depression. Active screening and following treatment based on cooperation between gynecology-obstetrics and psychiatry is the major method of postpartum depression prevention. CONCLUSION Currently, there is no clear biomarker of postpartum depression available. Future use of modern technologies may increase the availability of information on mental health in perinatal period, and also bring the time non-consuming method of active screening for women at risk of postpartum depression. Keywords puerperium, postpartum depression, baby blues, etiology, risk factors, prevention.
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