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Peripubertal Alterations of Leptin Levels in Patients with Autism Spectrum Disorder and Elevated or Normal Body Weight. Int J Mol Sci 2023; 24:ijms24054878. [PMID: 36902307 PMCID: PMC10003704 DOI: 10.3390/ijms24054878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Leptin, which plays a key role in energy homeostasis, is known as a neurotrophic factor possibly linking nutrition and neurodevelopment. Available data on the association between leptin and autism spectrum disorder (ASD) are confusing. The aim of this study was to explore whether plasma levels of leptin in pre- and post-pubertal children with ASD and/or overweightness/obesity differ from those of BMI- and age-matched healthy controls. Leptin levels were determined in 287 pre-pubertal children (mean age 8.09 years), classified as follows: ASD with overweightness/obesity (ASD+/Ob+); ASD without overweightness/obesity (ASD+/Ob-); non-ASD with overweightness/obesity (ASD-/Ob+); non-ASD without overweightness/obesity (ASD-/Ob-). The assessment was repeated in 258 of the children post-pubertally (mean age 14.26 years). There were no significant differences in leptin levels either before or after puberty between ASD+/Ob+ and ASD-/Ob+ or between ASD+/Ob- and ASD-/Ob-, although there was a strong trend toward significance for higher pre-pubertal leptin levels in ASD+/Ob- than in ASD-/Ob-. Post-pubertal leptin levels were significantly lower than pre-pubertal levels in ASD+/Ob+, ASD-/Ob+, and ASD+/Ob- and higher in ASD-/Ob-. Leptin levels, elevated pre-pubertally in the children with overweightness/obesity as well as in children with ASD and normal BMI, decrease with age, in contrast to the increasing leptin levels in healthy controls.
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Are we ready for Telepsychiatry? Benefits and challenges of digital
psychotherapy. CURRENT PROBLEMS OF PSYCHIATRY 2023. [DOI: 10.12923/2353-8627/2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background: Telemedicine is one of the most modern and fastest-growing branches of medicine. The most common form is video consultation. We distinguish between synchronous and asynchronous telepsychiatry. This study aims to show the benefits of using telepsychiatry services, the challenges it poses to users, and to evaluate its use against traditional therapy.
Materials and methods: A review of literature from 1956-2023 in EMBASE, OpenKnowledge and PubMed databases was conducted. Keywords used were: telepsychiatry, teletherapy, and digital psychiatry. Ninety-eight articles were included.
Discussion: Telepsychiatry is an opportunity for regions affected by medical staff shortages. It bypasses cultural barriers, the problem of traveling and reduces the cost of medical point-of-service. Telepsychiatry is an opportunity for patients who do not use psychiatrists due to discrimination in a conservative society. Groups that may find it challenging include the elderly, the blind, and the deaf. Creating a healthy therapeutic alliance through a screen can be impossible, making it difficult to achieve successful therapy. A barrier to developing telepsychiatry is the need for more guidelines for dealing with medical errors.
Conclusions: Telemedicine can help in accessing specialized care regardless of location. Telepsychiatry provides a safe and anonymous environment for patients reluctant to receive inpatient therapy. The effectiveness of online therapy is primarily debated. Telepsychiatry should be limited to follow-up consultations and well-known patients - it is a form of complementing the diagnosis and treatment process. The authors point to the need for developing specific guidelines for conducting teletherapy with particular attention to the problem of suicide.
Keywords: telepsychiatry, teletherapy, digital psychiatry.
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Application of artificial intelligence tools in diagnosis and treatmentof mental disorders. CURRENT PROBLEMS OF PSYCHIATRY 2023. [DOI: 10.12923/2353-8627/2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Introduction: Artificial intelligence research is increasing its application in mental health services. Machine learning, deep learning, semantic analysis in the form of transcriptions of patients' statements enable early diagnosis of psychotic disorders, ADHD, anorexia nervosa. Of great importance are the so-called digital therapists. This paper aims to show the use of AI tools in diagnosing, treating, the benefits and limitations associated with mental disorders.
Material and methodS: This literature review was conducted by searching scientific articles from 2015 to 2022. The basis were PubMED, OpenKnowledge, Web of Science, using the following keywords: artificial intelligence, digital therapy, psychiatry, machine learning.
Results: A review indicates the widespread use of AI tools in screening for mental disorders. These tools advance the clinical diagnosis medical specialists make up for several years. They impact solving medical staff shortages, lack of access to medical facilities and leveling patient resistance to treatment. The benefits are ultra-fast analysis of large sets of information, effective screening of people in need of specialized psychiatric care, reduction of doctors' duties and maximization of their work efficiency. During the current COVID 19 pandemic, robots in the form of digital psychotherapists are playing a special role.
Conclusions: The need for further research, testing and clarification of regulations related to the use of AI tools is indicated. Ethical and social problems need to be resolved. The tools should not form the basis of autonomous therapy without the supervision of highly trained professionals. Human beings should be at the center of analysis just as their health and well-being.
Keywords: artificial intelligence, digital therapy, psychiatry, machine learning
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Research into the Association of Cadmium and Manganese Excretion with Thyroid Function and Behavioral Areas in Adolescents with Autism Spectrum Disorders. J Clin Med 2022; 11:jcm11030579. [PMID: 35160030 PMCID: PMC8837100 DOI: 10.3390/jcm11030579] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 02/06/2023] Open
Abstract
Thyroid dysfunction and toxic metal exposure have been linked to the increased risk of autism spectrum disorders (ASD); however, the relationship between those factors remains unclear. We aimed to evaluate the relationship between the serum level of hormones, namely thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and urinary cadmium (U-Cd) and urinary manganese (U-Mn), in patients with ASD. The study group consisted of 129 adolescents with ASD, and the control group consisted of 86 healthy persons. Ion chromatography with spectrophotometric detection (IC-UV/ViS) was used to quantitatively determine Cd and Mn in all 24-h urine samples. These results indicate that severity of certain symptoms in autism is associated with thyroid function. Correlation analysis between Childhood Autism Rating Scale (CARS) results and the content of both U-Mn and U-Cd as well as fT3, fT4 and TSH values in ASD patients showed significantly positive correlation of CARS7 (visual reaction) with fT3 and fT4 and a negative correlation with TSH for the whole study group. In the group of adolescents over 14 years of age, it was also observed that CARS10 (anxiety reaction) negatively correlates with serum TSH levels, and among younger individuals, CARS9 (near receptor responsiveness, taste, smell) positively correlates with TSH.
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Subjective self-assessment of physical activity is negatively affected by monitoring awareness in subjects with mild cognitive impairment: a crossover randomised controlled trial. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 25:7858-7872. [PMID: 34982448 DOI: 10.26355/eurrev_202112_27633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Physical activity plays an important role in maintaining mental and physical health. This study assessed the effect of physical activity monitoring awareness on the physical activity level and subjective self-assessment of physical activity in middle-aged subjects with normal cognitive function (NCF) and mild cognitive impairment (MCI). PATIENTS AND METHODS Thirty-five subjects aged 50-65 years with NCF and MCI were randomised into two experimental groups, each taking part in two one-week intervention periods. Subjects in group A were not aware that their physical activity was monitored in the first week (phase I) and were aware of the monitoring in the second week (phase II), whereas it was the opposite order for group B. Physical activity was assessed using the ActiGraph GT9X accelerometer and International Physical Activity Questionnaire (IPAQ). RESULTS A total of 32 subjects (MCI: n = 12, NCF: n = 20) completed both intervention periods, with MCI subjects having significantly lower objectively assessed physical activity than NCF participants. Moreover, subjectively assessed physical activity in the MCI group was significantly higher when the participants were unaware of physical activity monitoring. A significant phase-group interaction was found in total (MET-min/d: p = 0.0072; min/d: p = 0.0194) and moderate (MET-min/d: p = 0.0015; min/d: p = 0.0020) physical activity as well as energy expenditure (p = 0.0366) assessed by the IPAQ and in the percentage of sedentary behaviour (p = 0.0330) and the average number of steps (p = 0.0342) assessed by ActiGraph. CONCLUSIONS The awareness of physical activity assessment might decrease the ability to subjectively assess physical activity in subjects with MCI.
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Alterations of urinary perchlorate levels in euthyroid postpubertal children with autism spectrum disorder. J Trace Elem Med Biol 2021; 68:126800. [PMID: 34102587 DOI: 10.1016/j.jtemb.2021.126800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Perchlorates ClO4(-) are known environmental and food contaminants that act as inhibitors of iodine uptake by the thyroid gland; however, information concerning their possible association with the development of autism spectrum disorder (ASD) is still missing. The current study is first presenting the alterations in perchlorate urine levels in euthyroid children with ASD. OBJECTIVES To examine urinary perchlorates and iodides in euthyroid children diagnosed with ASD, compared to age-, and BMI-matched neurotypical controls, and to verify the association between these two ions in ASD. METHODS Ions were determined in 24 h urine samples determined by ion chromatography-conductivity cell detection (IC-CD) and ion chromatography-pulsed amperometric detection (IC-PAD) techniques, respectively, in a total of 130 postpubertal euthyroid children with normal BMI (the mean age 14.46 years, SD = 1.32; the mean BMI 20.6, SD = 1.37), divided into age- and BMI-matched groups of ASD patients and neurotypical, healthy children (control). RESULTS The ASD group presented with significantly higher perchlorate urine levels than the controls (median = 1.05 μg/L, interquartile range(IQR) = 1.5 versus median = 0.09 μg/L, IQR = 0.097, respectively), as well as lower iodide urine levels (median = 100.2 μg/L, IQR = 37 versus median = 156.95 μg/L, IQR = 26.11, respectively). The ASD group presented significantly lower TSH and higher free thyroid hormone (fT4, fT3) levels than the controls. In regression analyses, perchlorate urine levels showed significant positive relationships with normal BMI values and serum TSH, and inverse relationships with serum fT4. Urinary iodide levels showed significant inverse relationships with BMI values. The absence of ASD was associated with decreased odds of perchlorate urine levels (OR = 0.012, 95 % confidence interval [CI] 0.0002-0.76), and increased odds of iodide urine levels (OR = 1.15, 95 %CI 1.05-1.27). CONCLUSIONS ASD may have an independent and significant impact on perchlorate as well as iodide levels in urine of euthyroid lean postpubertal children. Perchlorate levels do not appear to be directly associated with iodide levels in euthyroid children.
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What specifically contributes to disturbed non-verbal fluency in patients with bipolar disorder: Ineffective performance initiation, slowed processing or lack of the execution strategy? Psychiatry Res 2019; 271:15-22. [PMID: 30453217 DOI: 10.1016/j.psychres.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 12/29/2022]
Abstract
The study aimed at identifying the cognitive and clinical determinants of impaired design fluency in bipolar patients, with special reference to processing speed and performance strategy. A sample of bipolar disorder patients (BD, n = 45) and matched healthy controls (HC, n = 42) underwent the assessment of figural fluency, cognitive and manual speed, cognitive effort and affective state. An electronic version of design fluency test was applied, enabling assessment of performance speed, execution strategy and spontaneous fluctuations in production efficiency. Additional clinical variables were also controlled. BD patients produced significantly less unique designs, performed slower, utilized less effective strategy, their ability to concentrate designs production in the initial phase of performance was significantly reduced compared with HC. Regression analysis revealed that in BD patients design fluency main outcome was significantly predicted by slowed creation of designs and the number of hospitalizations, while in the HC group, the main fluency result was predicted only by the executive strategy indicators. Our study showed that non-verbal fluency in BD group was determined by essentially different neuropsychological functions than in healthy controls. Obtained findings confirm that cognitive slowdown should be an important goal of cognitive remediation and pharmacological interventions in bipolar disorder.
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Application of phase angle for evaluation of the nutrition status of patients with anorexia nervosa. PSYCHIATRIA POLSKA 2017; 51:1121-1131. [PMID: 29432507 DOI: 10.12740/pp/67500] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The evaluation of the nutrition status of patients has been the subject of interest of many scientific disciplines. Any deviation from normal values is a serious clinical problem. There are multiple nutrition status evaluation methods used including diet history, scales and questionnaires, physical examination, anthropometric measurements, biochemical measurements, function tests, as well as bioelectric impedance analysis or adipometry. Phase angle, obtained by means of bioelectric impedance analysis, is another parameter that is being more and more frequently applied in nutrition status monitoring. It is proportional to body cell mass. Its direct correlation with the cellular nutrition status has been documented. High phase angle values signify well-being, while low phase angle values indicate poor condition of cells. The purpose of this paper was to review the current state of knowledge about the application of phase angle in evaluation and monitoring of the nutrition status of patients with anorexia nervosa on the basis of available literature. It was proven that the phase angle values in patients with anorexia nervosa are much lower compared to healthy people. Detailed observations showed phase angle value increase in the course of treatment. The relevance of the commonly used body mass index (BMI) has been questioned due to significant degree of generalization in the nutrition status evaluation. Thus, there is a need for new, objective parameters for nutrition status evaluation, which will assist in the treatment and monitoring of patients in a more meaningful and reliable way. The existing independent studies equivocally confirm the usefulness of phase angle in the evaluation of nutrition status of patients with anorexia nervosa and its broader application in clinical practice is only a matter of time. However, these are merely attempts and they have not yet found wider application in clinical practice in the treatment of anorexia nervosa.
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Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: Non-Suicidal Self-Injury (NSSI) is the deliberate injury to one’s own body intended to cause mental or physical harm to oneself. In view of the growing scale of the NSSI, especially among young people without identifying any other psychiatric disorders, the disorder was included in both DSM-5 and ICD10 as independent diagnostic entity. Many etiopathogenetic hypotheses and research tools assessing various aspects of NSSI have been developed.
The aim of the work is to present and discuss the most commonly used scales for NSSI assessment.
Method: A review of available literature was made using the databases Medline / PubMed, using the key words: “self injury”, “self-mutilation”, “non-suicidal,”, “NSSI”, “self-harm” and time descriptors: 2005-2017
Results: Available tools were divided into three groups: I- scale of self-assessment made by the patient, II- assessment made by the clinician, and III- auxiliary scale.
Conclusions: None of the available scales covers the complexity of the NSSI phenomenon. For the overall NSSI assessment, several NSSI assessment tools are suggested, taking into account both self-assessment scales and clinical evaluation.
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“Pulling hair out of the head” - the importance of traumatic family events in the development and maintenance of trichotillomania symptoms - case report. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: Trichotillomania is a mental disorder characterized by a repetitive and compulsive hair pulling, classified in ICD-10 to a group of habit and impulse disorders, and in the DSM-5 to the group of obsessive-compulsive disorders.
Aim: The aim of the study is to present on the basis of case study:1). the importance of traumatic family experiences in releasing as well as maintaining the symptoms of Trichotillomania, 2). comprehensive medical care, the application of which has resulted in a beneficial therapeutic effect.
Results: In the described case of 16-year-old patient, Trichotillomania was triggered by traumatic events related to lack of support and family stabilization resulting from parental disputes and grandfather’s death, when she was 11 years old. The subsequent years of her life, in spite of the divorce of her parents and their separate residence, abounded in periods of turbulent quarrels between the parents in which she was involved. Each time this type of incident was associated with the recurrence of behavior associated with Trichotil-lomania, the course of which was more severe with the occurrence of self-harm and suicidal thoughts.
Conclusions: 1. In the described case, traumatic events and pathological relations of the immediate family members were not only thetriggering factor, but also maintaining the Trichotillomania symptoms. 2. In accordance with the guidelines of Trichotillomania Learning Center-Scientific Advisory Board (2008), the use of a comprehensive treatment including both the patient - individual psycho-therapy (especially cognitive-behavioral therapy) and pharmacotherapy, as well as her family (family psychotherapy, family mediation, workshops for parents), brought about positive therapeutic effects.
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Delirium in the course of dependence upon gamma-butyrolactone (GBL) - a case report. CURRENT PROBLEMS OF PSYCHIATRY 2016. [DOI: 10.1515/cpp-2016-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Gamma-butyrolactone (GBL) is an organic chemical compound of the lactones group, undergoing biotransformation into gamma-hydroxybutyrate after the intake (GHB). Because of the easy access, low price and fast psychotropic effect, GBL is becoming increasingly popular substance having intoxicating effect. Taking of GBL causes dose-dependent euphoric, sedative, hypnotic effects. Its use can quickly lead to physical dependence with severe course of withdrawal syndromes. Withdrawal symptoms resemble those occurring in the course of addiction to alcohol or benzodiazepines. In some patients, delirium develops during substance withdrawal. There are described severe, life-threatening complications in the course of delirium in GBL-dependent patients. The management of withdrawal syndromes and delirium mainly involves administration of benzodiazepines. In this paper, we present a case of delirium in 24-year-old man addicted to GBL hospitalized in a psychiatric ward. Delirium in this patient went without complications and was successfully managed with diazepam and lorazepam.
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Abstract
OBJECTIVE The aim of our study was to assess the iodine status of Polish boys with severe autism compared to their healthy peers and evaluate the relationship between urinary iodine, thyroid hormones, body mass index and Autism Spectrum Disorder (ASD) symptomatology. SUBJECTS AND METHODS Tests were performed in 40 boys with ASD and 40 healthy boys, aged 2-17 from the same geographic region in Poland. Urinary iodine (UI), free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), BMI, and individual symptoms measured by the Childhood Autism Rating Scale (CARS) were correlated. Validated ion chromatography method with pulsed amperometric detection was applied for the determination of urinary iodine after optimized alkaline digestion in a closed system assisted with microwaves. RESULTS 19 out of 40 children with ASD had mild to moderate iodine deficiency. Statistically significant lower levels of UI, fT3 and fT4 and higher levels of TSH were found in the autistic group when compared with the control group. Concentration of iodine in urine was negatively associated with clinician's general impression for children between 11 and 17 years. Emotional response, adaptation to environmental change, near receptor responsiveness, verbal communication, activity level, and intellectual functioning are more associated with UI than other symptoms listed in CARS. CONCLUSION The severity of certain symptoms in autism is associated with iodine status in maturing boys. Thyroid hormones were within normal reference ranges in both groups while urinary iodine was significantly lower in autistic boys suggesting that further studies into the nonhormonal role of iodine in autism are required.
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Changes in the electrical properties of the tissues in patients with anorexia nervosa measured by bioelectrical impedance analysis. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IntroductionMonitoring patient with anorexia nervosa (AN) include clinical, biological and psychological factors. In recent years many researchers criticize the BMI as useful measure for controlling evolution of AN.ObjectivesBioelectrical impedance analysis (BIA) is one of the main methods for nutritional status assessment.AimsThe aim of this study was the assessment of the nutrition status in a group of patients with anorexia nervosa in comparison to healthy population (HP).MethodsThe study involved 37 participants: 21 patients with AN and 16 healthy volunteers constituting the control group (HP). The patients were divided into two groups according a BMI: I group 14 < BMI < 15,5 (n = 11; age 18.0 ± 4.37) and II group: 15,5 < BMI < 17,5 (n = 10; age 17.82 ± 3.68). The mean age of HP was 17.68 ± 1.57 and BMI 20.56 ± 1.16 kg/m2. BIA was performed by using ImpediMed bioimpedance analysis SFB7 BioImp. The parameters: phase angle (PA), TBW%, ECW, ICW, ECW/ICW were analyzed.ResultsPA was decreased significantly in the I (4.5°±0,6) and II group (4.7°±0,6) of AN patients’ in comparison with HP (5.6°±0,7). TBW was 9% higher in I group and ECW was increased 6% in the both AN groups compared with HP (P < 0.01). Additionally ECW/ICW ratio indicated the higher transfer of water into the extracellular compartment in AN group (P < 0.01).ConclusionsBIA is accurate tool to indicate the valuable indicators of detecting malnutrition in AN. Further studies are needed to validate the significance of these parameters for the full identification of the nutrition status of AN patients’.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Vibronic spectra of single dibenzoterrylene molecules in anthracene and 2,3-dimethylanthracene crystals. Chem Phys Lett 2012. [DOI: 10.1016/j.cplett.2012.03.091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Testing of an Intrathoracic Artificial Lung in a Pig Model. ASAIO J 1996. [DOI: 10.1097/00002480-199603000-00259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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