A comparison between Pyridoxine (vitamin B6) and a placebo for the treatment of premenstrual syndrome (PMS).

A double blind randomized clinical trial was performed on 160 university students who were suffering from PMS (according to the retrospective diagnostic criteria which had been recorded during the last 3 menstrual cycles). Then the patients were randomly assigned into two groups, and finally 94 patients who had finished the study were statistically analyzed.

In the Pyridoxine group (46 patients) vitamin B6 was prescribed at a dose of 40 mg twice daily (total 80 mg), and in the placebo group (48 patients) a tablet similar to vitamin B6 tablets in size, smell, shape and taste was prescribed 1 tablet twice daily. In both groups the tablets were started from the first day of the fourth menstrual cycle and continued for the next two cycles, and during these two cycles the symptoms were recorded.

The severity of PMS in the second cycle of the treatment (in both groups) showed a statistically significant decrease (p <0.05, Pair T test) and the comparison between the two groups showed that the severity of PMS in the Pyridoxine group decreased more than the placebo group, which was statistically significant (p < 0.05, Student T Test) and this was because of the reduction in the psychiatric rather than somatic symptoms of PMS.

Regarding the effect of Pyridoxine in reducing the severity of PMS, it can be suggested as a treatment for PMS.

Although Generalized Anxiety Disorder (GAD) usually has a chronic course with up sights-down, there are only a few references on the factors which affect the course of the disease. The present study aims to investigate factors which could play a role in the clinical course of GAD.

Forty patients -with GAD as diagnosis on Axis-I (DSM-IV)- who attended a Community Mental Health Center (CMHC) in Thessaloniki (Greece)- were examined.

Thirteen of the patients (Group A, 32.5%) reported only one episode of GAD, and the rest of them (Group B, 67.5%) reported chronic course of the disease with multiple episodes. Thirty-eight patients (95%) reported a stressful factor before the beginning of the episodes. There were no statistically significant differences regarding sex, educational level, marital status, stressful life events in general and comorbidity with other disorders on Axis I and II (DSM-IV). However, it was found that patients of Group B reported disturbed relationships with their parents in childhood (p<0.05). Furthermore, they reported more frequently a death or illness of a beloved person during childhood –this difference shows a tendency for statistical significance (0.05<p<0.1).

Stressful factors play an important role in the appearance of the GAD. The existence of disturbed relationships with the parents in the childhood and the death or illness of a beloved person contribute on the chronic course of the disease.

Premature ejaculation (PME) is the most prevalent sexual disorder. It affects more than 30% of male population. Thus far SSRI,s clomipramine, local anesthetic along with psychological therapies are the mainstay in the treatment of PME. However, not all the cases are amenable to these treatments. Attempts are underway to find out better remedies for this problem. Gabapentine an anticonvulsant drug is being tested for treatment of PME.

Electronic search was made at database websites, using key words gabapentine, premature ejaculation. It was followed by manual research to find out possible mechanism by which gabapentine could delay orgasm.

Search could not provide concert mode of action which explain inhibitory action on premature ejaculation by gabapentine; except for its anti anxiety effect mediated by gabanergic properties.

Gabanergic action explains its anti anxiety, muscle relaxant and CNS depressant properties which could be beneficial, for premature ejaculation. Gabapentine has anti glutamate properties as well. This action further imparts anti excitatory effect which is helpful for PME. Excellent efficacy on neuralgic pains and neuropathies indicates that gabapentine desensitize the receptors which are oversensitive as are found in erogenous zones of premature ejaculators. Orgasm and partial seizure share many common features. Hence anti antiepileptic properties increase threshold of physiological seizure that is orgasm.

Gabapentine can be considered as medicine which works on PME with a mode of action different from SSRI,s.

Identification of the mechanisms, caused by feature structure of the somatoform syndromes at the anxiety-depressive disorders.

We surveyed 247 patients with following disorders: F-32.8, F-40.01, F-41.1, F-45.0, F-45.2, F-45.31, F-45.4, F-45.8. Researching was held according diagnostically indicates of ICD-10, and used diagnostically indicates of D. Goldberg, for more verified of diagnostically somatizing affective disorders.

Basis methods of researching: clinical, clinic-quantitative, inventory of the clinic- behavioral markers of feeling of guilty.

Feeling of guilty for disorders; F-40.01, F-41.1; 2,8±0,73 (P<0.01), F-32.8; 5,7±0,27 (P<0.01), F-45.0, F-45.2, F-45.31, F-45.4, F-45.8; 6,2±0,36 (P<0.01), has tendency to increased.

Clinic- behavioral markers of feeling of guilty are one from mechanisms of conversion somatoform syndromes caused by initiation correlative comorbidity of depressive and anxiety disorders.

Feeling of guilty and variants his transformation in structure of the somatoform syndromes is get significant diagnostic-pathogenically role in development and at the caused by hard identification of defects to emotional sphere.

In the time of, especially transformation feeling of guilty, is determining of features clinical manifestations of the somatoform syndromes at the anxiety-depressive disorders.

Problem on clinical definitions of schizotypal disorder abides still actual. The majority of disorders of schiziphrenic spectrum includes continuum of states from personal features (personality schizotypal disorder) up to mild schizoprenia.

Cohort of 75 patients with schizotypal disorders were studied by clinical psychopathological and experimental psychological methods.

So, the magic thinking is psychopathologically connected and formed at patients with the following clinical features are characteristic:

1. - Sensation of loneliness, vulnerability, that it is clinically possible to interpret as autistic features of the person;

2. - Infringement of understanding of interrelations in surrounding and a private world, the "Ego" in system of these communications, attempt to establish them at other level.

3. - Experience of "existential" anxiety, uncertainty, animosities of world around;

4. - Affective disorders with prevalence of fear, sensation of threat, danger. On this position they adjoin to so-called to “delirious mood” and give representation about formation of psychotic disorders which can develop further;

5. - Formed thinking disorders with gradual loss of rational logic connections (the subjective consciousness spreads on untied elements, attempt to establish the lost connections;

6. - The broken mechanisms of adaptation and their restoration at other level, pathological adaptation.

Thus, clinical interpretation of a phenomenon of magic thinking allows to attribute it to schizophrenic spectrum of mental disorders and to consider it as cardinal criterion of diagnostics of schizotypal disorder.

war- trauma, adolescents, child- experience, depression

Cognitive functions improvement was found to be correlated with the intensification of the initial disorder. An improvement in concentration and attention was present on average after 6-8 weeks of treatment and was most prominent in patients treated with both forms of therapy.

The purpose of this study was to assess the effect of lento music on examination anxiety among nursing students.

A randomized crossover classroom-based trial was conducted. Thirty eight students with a mean age of 19.4 years (SD=0.54) were randomly assigned to either a music/silence or a silence/music group sequence. The physiological measures of anxiety assessed in this study were finger temperature and pulse rate. Two additional psychological measures were also collected, the State-Trait Anxiety Inventory (STAI) and Test Anxiety Inventory (TAI). The students in the music group were given a 40-minute group-based music intervention in a classroom, whereas the students in the silence group received the regular test without music. The students had their physiological measures taken and the TAI and STAI were completed both immediately before the intervention/silence period and at the end.

Using paired t-tests, there were no significant different in pretest scores for STAI, TAI, finger temperature and pulse rate between the two conditions. Nonetheless, the findings indicated that music intervention did effectively decrease examination anxiety and state of anxiety as well as reducing pulse rate and increasing higher finger temperature (p=0.05 to 0.001). In addition, significant differences were detected between the pretest and posttest measures for silence (p=0.001).

Lento music intervention is beneficial and is able to decrease anxiety among nursing students who are taking an examination. The results suggest that lento music is effective at anxiety reduction.

Several clinical studies have indicated the effectiveness of music on stress; however, the study results are inconsistent. Moreover, no known published studies have investigated nurses' appreciation of music and the effects of music on job-related stress.

To examine the effects of music preference and intervention on stress indices.

Using a cross-over design, 54 subjects were randomly assigned to music/ chair rest or chair rest/music sequence for 30 minutes respectively. Subjects in the music condition listened to lento music by headphones throughout 30 minutes. In the chair rest condition subjects sat quietly for 30 minutes. Using a repeated measures design, subjects' heart rate, mean arterial pressure(MAP), finger temperature, and cortisol were measured before the study and every 15 minutes interval until the end of the whole procedure. Subjected stress was measured with visual analogue scale before the study, and at the end of the each condition. Data were analyzed with repeated-measures analysis of variance.

The mean score of music appreciation was 8.81 (SD = 1.05), and was significantly associated with MAP, cortisol, stress, and finger temperature. Subjects when listened to music compared with chair rest had lower perceived stress level, cortisol, heart rate, and MAP as well as higher finger temperature (all p < 0.05 to 0.001). Paired t-test results were also significant for posttest heart rate, cortisol, finger temperature and MAP between the two conditions (p < 0.05 to 0.001).

The findings provided evidence to use soothing music as a research-based intervention for stress reduction.

The aim of this study was to indicate on the most common somatic illnesses in patients with panic disorder with agoraphobia and to estimate possible association between panic disorder with agoraphobia and somatic illnesses.

The participants in this study were 93 patients with primary DSM IV diagnosis of panic disorder with agoraphobia and 48 control subjects without psychiatric diagnosis. The presences of somatic illnesses were ascertained from the modified National Institute of Mental Health Panic Questionnaire (NIMH PQ), where the patients and control subjects answered on the questions about presence of specified somatic illnesses.

The most common somatic syndromes in the group of panic disorder patients were hypertension, hypotension, hyperthyroidism, constipation, and hypoglycaemia. Concerning somatic illnesses, in the sample of panic disorder patients most frequent were cardiovascular (61.3%), gastrointestinal (25.8%), endocrinology (19.4%) and urology (17.2%) illnesses. Comparing to control group, psychiatric healthy subjects, patients with panic disorder with agoraphobia have had statistically significant higher rate of cardiovascular (chi square=9.40, p<0.01) and endocrinology (chi square=19.31, p<0.01) illnesses.

The overall results of the study indicate that: 1. There is a high level of comorbidity between panic disorder with agoraphobia and somatic illnesses, 2. Cardiovascular diseases was the most common illnesses in patients with panic disorder with agoraphobia, 3. Cardiovascular and endocrine illnesses have had statistically significant higher rate in the patients than in the control group.

Benzodiazepines impair cognitive function, especially in the elderly. The current analysis sought preliminary data on the effect of pregabalin on cognition in elderly patients with GAD.

Patients aged ≥65 years who met DSM-IV criteria for GAD, with HAM-A≥20 and MMSE≥24, were randomized to 8 weeks of treatment with flexible-dosage pregabalin (150-600 mg/d) or placebo. A subgroup (N=89; 81% female; mean age=70.4 years; mean HAM-A=27.3) completed a cognitive battery including the Digit Symbol Substitution Test (DSST) and the Set Test at baseline and endpoint.

At baseline, scores for pregabalin and placebo on the DSST were 13.75±3.51 vs 13.39±3.89 and on the Set Test 37.88±3.25 vs 37.63±3.69. There was significant (P<.05) inverse Pearson correlation between HAM-A item-5 (intellectual) and DSST (-0.32) and Set Test (-0.30) scores. There were also moderate inverse correlations between the DSST and HAM-A total score (-0.35) and age (-0.25). Weaker correlations (with the same directionality) were observed between the Set Test and these variables. At 8-week LOCF-endpoint, scores were comparable on the DSST (13.82 vs 14.54) and the Set Test (38.24 vs 37.95). Endpoint improvement in the HAM-A was moderately correlated with improvement in the Set Test (-0.23, P<.05) but not with DSST. Univariate and multivariate analyses showed treatment with pregabalin had no effect on endpoint cognitive function.

Pregabalin significantly improved the symptoms of GAD in patients aged ≥65 years and caused no impairment of cognitive function. A more extensive cognitive battery is needed to confirm this preliminary finding.

To evaluate the safety and efficacy of pregabalin in relieving the symptoms of GAD in patients ≥65 years of age.

This was a multicenter, randomized, flexible-dose, placebo-controlled, double-blind, parallel-group trial of pregabalin in the treatment of GAD. Randomization was 2:1, pregabalin:placebo. Patients underwent an 8-week double-blind, flexible-dosage (150-600 mg/d) treatment phase, including a 1-week dose-escalation period (50 mg/d to 150 mg/d). The primary efficacy assessment was change from baseline to endpoint-LOCF in HAM-A total score. Additionally, change from baseline to week 8 (observed cases) in HAM-A psychic and somatic factors was evaluated.

Mean age at GAD onset was 56 years; 77% of patients were women; mean age at enrollment was 72 years; mean duration of GAD was 17 years. Mean change from baseline in HAM-A total score was –12.84 (n=177) for the pregabalin group and –10.7 (n=96) for the placebo group (P=.0437). At week 8, patients treated with pregabalin had significant improvement in both the HAM-A psychic (–7.8 vs –6.3, P=.0111) and somatic (–6.6 vs –5.4, P=.0248) factors. The most common adverse events (AEs) among pregabalin-treated patients were dizziness (20.3%), somnolence (13.0%), headache (10.2%), and nausea (9.0%). Most AEs were mild-to-moderate and self-limiting. Discontinuation rates due to AEs were 10.7% and 9.4% in the pregabalin and placebo groups, respectively.

Pregabalin was effective in reducing the symptoms of GAD in patients aged 65 years and older, and it was safe and well tolerated in this population.

IBS is a heterogeneous condition of unknown etiology. With a one-year prevalence above 10%, it is second only to common cold in terms of causes for work absenteeism.

An association of psychiatric disturbance and the gastrointestinal system is well established:

1. • Psychiatric comorbidity, mainly anxiety and depression, is common.

2. • In what is known as the Brain-gut axis, noxious stimulation to the gut activates parts of the central nervous system involved in fear and arousal.

3. • Negative evaluation of symptoms has been shown to predict the amount of worry about symptoms that patients experience

4. • Patients with IBS frequently display abnormal illness behaviors, such as excessive requests for medical help.

This suggests that IBS can conceptualized as a disorder in which negative evaluation of bodily symptoms increases intensity, frequency, and duration of symptoms. Trials of CBT for IBS have been conducted, but few studies have evaluated group treatment. Since treatment-needs presently cannot be met, more cost-effective ways of delivering CBT for IBS are needed.

We are currently conducting a pilot study of group-delivered manualized CBT for 19 IBS-patients.

Treatment is ongoing, and results from the first 9 patients taking part in the treatment will be presented as single case studies. For a subgroup of patients, 6-month follow up data will be available.

Preliminary post-treatment data suggest that group-delivered CBT may be feasible for this group. Experiences from this trial will be used in a larger study comparing group treatment to web-based treatment, further utilizing scarce CBT resources.

In the present study we aimed to explore the possible relationships between plasma oxytocin levels and romantic attachment in a group of healthy subjects.

Forty-five healthy subjects with no family or personal history of any major psychiatric disorder were enrolled in the study. Thirty-three subjects had a current romantic relationship with a mean duration of 80.5 months (ranging from a minimum of one month to a maximum of 25 years); the remaining 12 had no current relationship. The romantic attachment was assessed using the Italian version of the “Experiences in Close Relationships” (ECR).

Plasma oxytocin levels were unrelated with age, gender, marital status, or length of the relationship and ranged between 0.13 and 4.59 pg/ml (mean+SD: 1.53+1.18). A significant and positive correlation was observed between the anxiety scale of the ECR and oxytocin levels (r= 0.30, p= 0.04). On the other hand, the correlation between the avoidance scale and oxytocin levels was not significant (r= 0.12, p=0.42). The distribution of attachment styles was twenty-six (57.8%) subjects showed a secure attachment, 12 (26.7%) a preoccupied, 5 (11.1%) a fearful/avoidant and 2 (4.4%) a dismissing style. Although no statistical correlation was observed between these styles and oxytocin levels, the preoccupied style of attachment was related to higher peptide concentrations.

It could be speculated that the observed link between anxiety and oxytocin represents the biological basis of those processes resulting in positive emotions related to romantic attachment and, possibly, to all social bondings.

Earthquake disaster of Pakistan caused massive destruction. Survivors have experienced several recurrent aftershocks since then. Many of them measured above 5. Data was collected from various agencies including WHO, Turkish Red Crescent, Canadian team of relief and some other NGOs working with earth quake hit communities in NWFP and Azad Kashmir. Diagnosis was made using semi-structured interviews. The objective of this paper is to measure the impact of neurobiological and socio cultural underpinnings.

Data analyses of women (1056), men (281) and children (204) indicate high prevalence of anxiety disorders including PTSD (853 women, 153 men) and depression (73 women, 31 men). Results vary from the observations made from other disasters. Sex ratio shows huge difference in prevalence between males and females. The major factors responsible are loss of life and property and uncertainty regarding future, harsh weather and repeated tremors.

Patients with PTSD have dysregulation of HPA axis response. This alteration is more pronounced in case of women. Studies show that estrogen plays important role in the genesis of disease. Dexamethasone suppression test also indicates greater dysregulation of glucocorticoid receptor. Studies reveal predisposition in women for PTSD and depression.

Women and children were affected most because most of them were at home and in schools. Hence, large number of women sustained more physical injuries and psychiatric consequences.

In our study depression came out to be more prevalent in females. This can be explained as comorbidity of PTSD and because of its own dynamics.