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Piotr Boguta, Dariusz Juchnowicz, Paulina Wróbel-Knybel, Agnieszka Biała-Kędra and Hanna Karakuła-Juchnowicz

Abstract

Introduction: Warfarin has been considered as a “gold standard” in the prevention and treatment of thromboembolic events since 1954. Since the introduction of direct oral anticoagulants in the last few years (NOAC-Non-Vitamin K antagonist Oral Anticoagulants) prescriptions volume for apixaban, edoxaban, dabigatran and rivaroxaban have been gradually surpassing warfarin. The benefits include: anticoagulation from day one, fixed daily dosing, elimination for the need of international normalised ratio (INR) monitoring, fewer interactions with food and co-administered medicines with reduced risk of bleeding and better overall life quality.

Objectives: Assessing evidence for the safe use of Non-vitamin K Oral Anticoagulants (NOAC) with Selective Serotonin Reuptake Inhibitors (SSRI) and Serotonin and Noradrenaline Reuptake Inhibitors (SNRI).

Method: Review of literature published between 2014 and 2016 was made using the key words: Selective Serotonin Reuptake Inhibitor, Serotonin and Noradrenaline Reuptake Inhibitors, apixaban, dabigatran, edoxaban, rivaroxaban, bleeding, interaction, depression with time description from 2014 to 2018. Evidence within the literature was then compared with guidelines from the National Institute for Health and Care Excellence (UK), British National Formulary (UK), Clinical Excellence Commission (Australia), Thrombophilia and Anticoagulation Clinic (USA) and Summaries of Product Characteristics (SPC).

Results: 1. Serotonin plays a critical role in maintaining homeostasis. Use of SSRI/SNRI compromises its platelet reuptake increasing risk of bleeding.

2. Increased tolerability and safety of NOAC over Warfarin, although caution is advised when NOAC is used with SSRI/SNRI with less evidence suggesting pharmacodynamic interactions.

3. It is not recommended to use NOAC with strong CYP and P-gp inhibitors.

Conclusions: With limited literature evidence, caution is advised when co-prescribed NOACs with SSRI/SNRI, especially with other cofactors and interacting medicines further increasing risk of bleeding.

Open access

Jakub Siembida and Kaja Karakuła

Abstract

Introduction: Gamma-hydroxybutyric acid (GHB) is commonly known as a recreation drug or the so-called “date rape drug”. It is also used in medicine to treat narcolepsy and alcohol addiction. GHB has an affinity for two types of receptors: GABAB and the relatively recently discovered GHB receptors. GHB receptors were first cloned in 2003 in mice and then in 2007 in humans. So far, evidence has been presented for their impact on dopaminergic transmission, which may imply that they play a role in the pathogenesis of diseases such as schizophrenia. At the same time, it has been demonstrated that benzamide antipsychotic drugs have an affinity for GHB receptors, which is why it is postulated that some of the effects of these drugs may result precisely from this affinity.

Aim: The study presents the current state of knowledge about GHB receptors and their potential role in the pathogenesis of schizophrenia, and discusses drugs which show an affinity for this receptor.

Material and method: The literature review was based on a search of articles indexed between 1965 and 2018 in Medline, Google Scholar, ScienceDirect and Research Gate databases. The following search terms were used: GHB receptor, GHB, sulpiride, and amisulpride.

Result and discussion: 1. It is possible that GHB receptors are involved in the pathogenesis of schizophrenia, although more research is needed in this area.

2. Part of the effects of some benzamide antipsychotic drugs (such as amisulpride) may be due to their affinity for GHB receptors.

Open access

Karolina Mielko, Ewelina Soroka, Karolina Sprawka and Marcin Olajossy

Abstract

Introduction. The authors present an overview of current views on the treatment of obsessive-compulsive disorder refractory to pharmacological and psychological treatment.

Aim: To review the mechanisms of stimulation of deep brain structures and to evaluate the effectiveness of therapy in obsessive-compulsive disorder.

Method: Review and analysis of the Polish and foreign scientific articles from the years 1999-2016.

Conclusions: According to the literature considered, in half of the examined patients there was an improvement of over 35% on the Y-BOCS scale, in some patients even a reduction of symptoms reaching 81-83% was described. Previous studies have been carried out on small groups of patients. Since 2009, the method of invasive treatment with deep brain stimulation of the obsessive-compulsive syndrome is registered in the EU. In spite of the above, additional studies are necessary on a larger group of patients in order to precisely estimate the effectiveness of the procedure and elaborate the criteria for qualifying patients for inclusion in the procedure.

Open access

Karolina Dańko, Piotr Dańko, Ewelina Soroka, Véronique Petit and Marcin Olajossy

Abstract

The progress of medicine in the recent decades has strongly improved perinatal care, especially its somatic-related aspects. Pregnancy and childbirth have become much safer, but the mental strain and stress have remained the same. The models of motherhood and the number of children in a family have changed, giving rise to significant requirements concerning the quality of life of the offspring. These changes have brought about new psychological challenge for women and a team of psychiatrists and gynaecologists – obstetricians. The aim of this study is to look at the affective disorders affecting women during pregnancy and postpartum: the postpartum depression and so-called baby blues, which were both compiled in the form of a table in the final part of this work to illustrate the differences between these two mental disorders.

Open access

Dinesh Bhugra

Abstract

In the past 40 years, the practice of psychiatry has changed dramatically from asylums to community care to personalized home-based treatments. The personal history of working in various settings and changing NHS indicates that an ability to change one’s clinical practice is a critical skill. Being a migrant and an International Medical Graduate brings with it certain specific challenges. Personal histories provide a very specific account that is inherently incomplete and perhaps biased, but personal accounts also give history a tinge that academic accounts cannot. In this account, changes in the NHS have been discussed with regards to changes in clinical care of patients with psychiatric disorders as well as research and training.

Open access

S.M. Yasir Arafat, M A Al Mamun and Md. Saleh Uddin

Abstract

Objectives

Early detection of depression has been assumed to lead to its earlier and better care. Increased depression literacy among the general population might play a vital role in the early and successful detection and treatment. We aimed to investigate depression literacy among the first year university students, to be able to compare their depression literacy with those of other previously investigated groups, we hypothesized that depression literacy might be different from other groups such as patients and other subjects from the general population. Knowledge about depression might also be different in female and male students.

Methods

This cross-sectional study was conducted among the first-year students of Jahangirnagar University, Bangladesh between January and May 2018. A convenience sample of 306 students was randomly identified from a list of students obtained from the authority. Relevant sociodemographic variables were collected. Students were interviewed using the Bangla Depression Literacy scale (D-Lit Bangla). This was a semi structured interview asking for the knowledge on 20 different characteristics of depression. Collected data were analysed to estimate the mean score and 95% confidence intervals of D-Lit Bangla scores.

Results

The mean score of the correctly identified characteristics of depression was 6.55 (95% CI = 6.31 to 6.89). Only five characteristics of depression were correctly identified by more than 50% participants, that is, sleep change (76.7%), feeling of guilt (75.2%), low self-esteem (81.8%), psychomotor changes (64.6%) and identification of famous people suffering from depression (66.7%). Only a very small portion of the participants correctly knew about psychotic symptoms and different options for the treatment of depression. There were no significant differences between male and female students in the amount and pattern of knowledge of depression.

Conclusions

The study revealed poor literacy status among the first-year university students of Bangladesh. Both male and female gender have similar amount of depression literacy.

Open access

S.M. Yasir Arafat

Abstract

Objectives

Bangladesh is a densely populated country in south-east Asia with paucity of research in suicide. This systematic review was aimed at critical appraising various aspects of suicide in Bangladesh based on available literature and systematic search.

Methods

Extensive literature search was conducted in Scopus, PubMed, PubMed Central, Google, Google Scholar and BanglaJOL with searching key words without any date boundary and without any basis of types of studies, that is, all types of studies were scrutinised. The author focused on sources of suicide data along with epidemiological variables of suicides in Bangladesh such as suicide rate, gender of victims, methods of suicides, risk factors and prevention activities and role of media in suicide.

Results

After exclusion of repetitions, screening was performed, and finally, 35 articles were selected for review. Amongst the 35 articles, 16 articles were original contributions, 2 systematic reviews, 6 narrative reviews, 2 scoping reviews, 3 editorials, 3 case reports and rest correspondence article. The review revealed that the actual rate of suicide in Bangladesh is yet to come out and quality data is a real challenge. Women are dying more than the men, and early adulthood is the most vulnerable time of life.

Discussion

Suicide is a under attended problem in Bangladesh, as the country yet to reveal the actual rate of suicide along with the challenge of quality data. Prevention activities have been started but yet to be visualised. Decriminalisation of suicide in the legal criteria and establishment of suicide surveillance can be the top priorities in the country.

Open access

Violet Pietrantonio

Abstract

What kind of functions does a theory carry out in the analyst’s mind at work? The author tries to describe, using a few analytic trailers, how Bion Field Theory (BFT) can become an oneiric psychoanalytic tool in the mind of the analyst working with inaccessible states of mind and the violence of nameless turbulences. The hypothesis expressed is that BFT, as described in the works of its principal authors (Ferro, Grotstein, Ogden et.c), seems to evoke a psych-O-analysis that chooses O as psychoanalytic vertex, developing the bionian idea of unconscious as psychoanalytic function of the mind. BFT introduces explains and illustrates an oneiric model of the mind and of the analytic cure. The priority given by this theory to the contact with emotional experience and the capacity to stay at one ment with the unknown emotional experience circulating in the hic et nunc, seems, in author’s analytical experience, to promote both the development of an authentic analytic Self and analytic ethic and a process of subjectivation in analyst, patient, analytic experience.

Open access

Giuseppe Civitarese

Abstract

Terms such as vitality and authenticity are difficult to define. Moreover, they cannot be considered true psychoanalytic concepts. If, however, as is happening, psychoanalysis tries to theorize in a more fine-grained manner the non-specific aspects of treatment, such as those related to the person of the analyst, then it becomes inevitable to refer to them. The thesis of the article is that vitality should emerge from its vagueness and be transformed into a precise psychoanalytic concept. This can be done if we discuss it in light of Bion’s concept of negative capability and the post-Bionian theory of the analytic field. Every time the analyst rediscovers to his surprise the dreamlike dimension of the session, he becomes vital gain and reinvests the patient, the analysis and the psychoanalytic method.Then he realizes that he is always a character in the stories of the analysis and has the chance to try to guess what happens by relying on his intensified bodily or emotional reaction.