No abstract available.
Aged* ; Dementia* ; Humans

No abstract available.
Diagnosis*

No abstract available.

Alcoholism, a major public health problem throughout the world, causes an enormous damage to health and quality of life and undermines the well being of families and society. It is associated with liver disease, cancer, cardiovascular problems, accidental deaths, suicides, and homicides. Over the last 20 years, a significant progress has been made in the pharmacological treatment of alcoholism owing to the better understanding of the neurobiological substrates of alcohol dependence, including adaptive changes in amino acid neurotransmitter systems, stimulation of dopamine and opioid peptide systems, and, possibly, changes in serotonergic activity. Disulfiram, naltrexone and acamprosate are the only pharmacological agents currently approved for the management of alcohol dependence. Data from studies of ondansetron and topiramate in alcohol dependence are somewhat promising, but it appears that the evidence of efficacy of these drugs in large controlled clinical trials are still lacking. Trials with SSRIs and some antipsychotics have shown disappointing results. Because the biological basis of alcohol dependence appears to be multifactorial, the future of management of alcoholism would involve combination therapy, using drugs acting on different neuronal pathways, such as acamprosate and naltrexone. Pharmacotherapy should be used in association with appropriate psychosocial support and specific treatment for any underlying psychiatric comorbidities.
Alcoholism* ; Antipsychotic Agents ; Comorbidity ; Disulfiram ; Dopamine ; Drug Therapy ; Homicide ; Humans ; Liver Diseases ; Naltrexone ; Neurons ; Neurotransmitter Agents ; Ondansetron ; Opioid Peptides ; Public Health ; Quality of Life ; Suicide

No abstract available.

OBJECTIVE: A multi-center, open-labeled, prospective, observational study was conducted to evaluate the efficacy of fluoxetine on energy level over 8 weeks in a group of Korean patients with major depressive disorder. METHODS: Of 635 (Ed- to avoid having to say "Six hundred..") patients with major depressive disorder in 24 centers who were recruited to 8 weeks treatment with fluoxetine, 136 were terminated at initial session, leaving 499 patients to be included in the final analysis. They were predominantly female (59.5%), with a mean age of 45.7+/-15.9 years. At three visits to the clinic (weeks 0, 4 and 8), a record was made of Retardation Factor score of Hamilton Rating Scale for Depression (HD-RF), Lack of Energy score of Symptom Check List-90R (SCL-E), Energy score (QOL-E) and Fatigue score (QOL-F) of Quality of Life, and Visual Analogue Scale for Energy Level (VAS-E). RESULTS: The average dose of fluoxetine was 18.5+/-6.8mg/day for the first 4 weeks and 25.3+/-10.6 mg/day for the second 4 weeks. Of the patients, 85.4% in the first 4-week period and 86.8% in the second 4-week period took more than 85% of the prescribed medication. At least one of the concomitant anxiolytic drugs with fluoxetine was prescribed to 79.8% of the patients (alprazolam 47.9%, lorazepam 21.4%). The energy symptoms were significantly improved by fluoxetine over time, according to the analysis controlling the improvement effect of global depressive symptoms using repeated measures ANCOVA with the change of total HAM-D score as a covariate. Even comparing with the patients who took concomitant anti-anxiety medication, those who did not take concomitant anti-anxiety medication showed greater improvement of energy symptoms irrespective of the severity of baseline anxiety symptoms. CONCLUSION: These findings demonstrate that fluoxetine is effective in restoring the energy of patients with major depressive disorder. They also suggest that physicians should be careful in prescribing sedating antidepressants or concomitant anti-anxiety medication with fluoxetine for patients with major depressive disorder.
Antidepressive Agents ; Anxiety ; Depression ; Depressive Disorder, Major* ; Fatigue ; Female ; Fluoxetine* ; Humans ; Lorazepam ; Observational Study* ; Prospective Studies ; Quality of Life

Alcoholism, a major public health problem throughout the world, causes enormous damage to health and quality of life and undermines the well-being of families and society. It is associated with liver disease, cancer, cardiovascular problems, accidental Over the last 20 years, rational drug treatment have arisen from better understanding of the neurobiological substrates of alcohol dependence, including adaptive changes in amino acid neurotransmitter systems, stimulation of dopamine and opioid peptide systems, and, possibly, changes in serotonergic activity. Disulfiram, naltrexone and acamprosate are currently the only treatments approved for the management of alcohol dependence. Data from studies of ondansetron and topiramate in alcohol dependence are somewhat promising, but it appears that these drugs have not yet demonstrated evidence of efficacy in large controlled clinical trials. Trials with SSRIs and some antipsychotics have yielded disappointing results. Because the biological basis of alcohol dependence appears to be multifactorial, the future of management of alcoholism may be combination therapy, using drugs acting on different neuronal pathways, such as acamprosate and naltrexone. Pharmacotherapy should be used in association with appropriate psychosocial support and specific treatment provided for any underlying psychiatric comorbidities.
Alcoholism ; Antipsychotic Agents ; Comorbidity ; Disulfiram ; Dopamine ; Drug Therapy* ; Humans ; Liver Diseases ; Naltrexone ; Neurons ; Neurotransmitter Agents ; Ondansetron ; Opioid Peptides ; Public Health ; Quality of Life

Alcohol use disorders and related problems continue to constitute a significant public health problem, leading to many psychiatric conditions, physical illnesses, and social problems such as domestic violence and occupational sabilities. Here, we provide an update on alcohol use disorders;1) genetic and neurobiological aspect, 2) neuroimaging study findings, 3) treatment of medical complications 4) psychotherapeutic approaches 5) pharmacological treatment and 6) women and offsprings issues of alcohol use disorders.
Domestic Violence ; Female ; Humans ; Neuroimaging ; Public Health ; Social Problems

Alcohol dependence is a chronic disorder that results from a variety of genetic, psychosocial, and environmental factors. Relapse prevention for alcohol dependence has traditionally involved psychosocial and psychotherapeutic interventions. Pharmacotherapy, however, in conjunction with behavioral therapy, is generating interest as another modality to prevent relapse and enhance abstinence. Naltrexone and acamprosate are at the forefront of the currently available pharmacological options. Naltrexone is an opioid receptor antagonist and is thought to reduce the rewarding effect of alcohol. Acamprosate normalizes the dysregulation of N-methyl-D-aspartate (NMDA)-mediated glutamatergic excitation that occurs in alcohol withdrawal and early abstinence.These different mechanisms of action and different target neurotransmitter systems may endow the two drugs with efficacy for different aspects of alcohol use behavior. Since not all patients seem to benefit from naltrexone and acamprosate, there are ongoing efforts to improve the treatment outcomes by examining the advantages of combined pharmacotherapy and exploring the variables that might predict the response of the medications. In addition, novel medications are being investigated to assess their efficacy in preventing relapse and increasing abstinence.
gamma-Aminobutyric Acid/metabolism ; Taurine/analogs & derivatives/therapeutic use ; Recurrence ; Receptors, Opioid, mu/genetics/metabolism ; Receptors, Opioid/antagonists & inhibitors ; Polymorphism, Genetic ; Neurons/metabolism ; Naltrexone/therapeutic use ; N-Methylaspartate/metabolism ; Models, Neurological ; Models, Biological ; Humans ; Glutamine/metabolism ; Disulfiram/therapeutic use ; Alcoholism/*drug therapy ; Alcohol Deterrents/*therapeutic use

PURPOSE: Alexithymia, defined as a deficit in the ability to recognize and describe one's own feelings, may be related to the development and maintenance of obsessive-compulsive symptoms. The aim of this study was to evaluate the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and alexithymia in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: We recruited 244 patients with OCD (169 males, 75 females). Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20), and genotyping of the COMT Val(158)Met polymorphism was evaluated. RESULTS: Patients with the COMT Val/Val genotype had significantly higher total and "difficulty identifying feelings" (DIF) subdimension scores than those with the Val/Met or Met/Met genotypes. Patients with the COMT Val/Val genotype had significantly higher "difficulty describing feelings" (DDF) subdimension scores than those with the COMT Val/Met genotype. However, there were no differences in the scores for the "externally oriented thinking" (EOT) subdimension among the three genotypes. CONCLUSION: These results indicate that the high-activity Val allele of the COMT Val(158)Met polymorphism is associated with increased alexithymic traits in patients with OCD. The present finding suggests that alexithymia is an endophenotype of OCD that is mediated by the COMT Val(158)Met polymorphism.
Adult ; Affective Symptoms/*diagnosis/genetics/psychology ; Alleles ; Catechol O-Methyltransferase/*genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/*diagnosis/genetics/psychology ; Phenotype ; *Polymorphism, Genetic ; Republic of Korea