Dissociative symptoms reflect levels of tumor necrosis factor alpha in patients with unipolar depression.

Recent evidence indicates that the nature of interactions between the nervous system and immune system is important in the pathogenesis of depression. Specifically, alterations in pro-inflammatory cytokines have been related to the development of several psychological and neurobiological manifestations of depressive disorder, as well as to stress exposure. A number of findings point to tumor necrosis factor alpha (TNF-α) as one of the central factors in these processes.

Depression, traumatic stress and interleukin-6.

Background: Recent evidence indicates that various types of interactions between nervous and immune system are important in pathogenesis of depression. These findings show that a significant role in developing depression play pro-inflammatory cytokines that may mediate its psychological, and neurobiological manifestations. Great importance among these cytokine molecules plays interleukin-6 (IL-6).

Dissociative symptoms and neuroendocrine dysregulation in depression.

Background: Dissociative symptoms are traditionally attributed to psychological stressors that produce dissociated memories related to stressful life events. Dissociative disorders and dissociative symptoms including psychogenic amnesia, fugue, dissociative identity-disorder, depersonalization, derealization and other symptoms or syndromes have been reported as an epidemic psychiatric condition that may be coexistent with various psychiatric diagnoses such as depression, schizophrenia, borderline personality disorder or anxiety disorders. According to recent findings also the somatic components of dissociation may occur and influence brain, autonomic and neuroendocrine functions.

Depression, cortisol and somatoform dissociative symptoms.

Objective: According to recent findings neuroendocrine response related to dissociative symptoms is related to dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis but HPA axis functioning as related to dissociation is only partially understood.

Method: With the aim to test the relationship between basal serum cortisol and dissociative symptoms measured as somatoform and psychic dissociation we performed clinical testing and biochemical analysis in 30 inpatients with diagnosis of unipolar depression (mean age 41.46, SD=13.

Dissociation, epileptic-like activity and lateralized electrodermal dysfunction in patients with schizophrenia and depression.

Objectives: Recent evidence indicates frequent EEG abnormalities in dissociated patients. This evidence is in agreement with findings that in certain psychiatric patients, psychosensory symptoms of epileptogenic nature, the so-called complex partial seizure-like symptoms occur. With respect to these findings, a hypothesis examined in this study states that increased level of experienced traumatic stress and dissociation in pathological conditions such as schizophrenia or depression relates to increased score of complex partial seizure-like symptoms.

Depression, prolactin and dissociated mind.

Objectives: Usual neuroendocrinological manifestation of traumatic stress and dissociation is dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis as indexed by basal serum prolactin and test its relationship to dissociative symptoms and symptoms of traumatic stress.

Patients And Methods: 25 inpatients treated at the university hospital with diagnosis of unipolar depression mean age 41.

Psychobiology of dissociation and its clinical assessment.

Objective: Dissociation is often defined as partial or total disconnection between memories of the past, awareness of identity and of immediate sensations, and control of bodily movements, often resulting from traumatic experiences, intolerable problems, or disturbed relationships. This type of reaction to a psychological and/or physical trauma has often various neurobiological consequences and its clinical assessment has received enormous interest in recent psychological and neuroscience research.

Methods: Psychometric parameters of the Czech version of the Dissociative Experiences Scale were tested from the viewpoints of internal consistency, validity and factor structure, using data from a sample of n=783 adults, divided into three groups (epilepsy n=243, depression n=357, norm n=183), average age 39 years, SD=13.

Chaotic neural response during conflicting Stroop task reflects the level of serum cortisol in patients with unipolar depression.

Objective: According to recent findings detecting a cognitive conflict is related to activation of anterior cingulate cortex (ACC) and central autonomic network. Several recent findings also suggest the hypothesis that the cognitive conflict is related to specific nonlinear chaotic changes of the neural signal. This conflict related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI).

Lateralized electrodermal dysfunction and complexity in patients with schizophrenia and depression.

Objective: Recent evidence indicates that in psychiatric patients with schizophrenia and depression, lateralized EDA changes linked to temporal-limbic electrophysiological dysfunction occur. These clinical findings provide evidence for brain asymmetry and disruptions related to integrative brain activity in pathological conditions.

Methods: These changes in brain asymmetry may be assessed by linear analysis of EDA measurement and nonlinear analysis of brain complexity calculated as information entropy.

Limbic irritability and chaotic neural response during conflicting stroop task in the patients with unipolar depression.

According to recent findings activation of anterior cingulate cortex (ACC) is related to detecting cognitive conflict. This conflict related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI). Recent findings in neuroscience also suggest that cognitive conflict is related to specific nonlinear chaotic changes of the signal generated by neural systems.

Depression, traumatic dissociation and epileptic-like phenomena.

Objectives: According to recent findings trauma and stress are important etiological factors in pathogenesis of depression. As characteristic features of depressive cognition have been reported intrusive thoughts and memory disturbances similar to posttraumatic symptoms known in patients with posttraumatic stress disorder or dissociative disorders. Hypothetically is also suggested a close relationship of traumatic dissociation and epileptic-like phenomena.

[The overworked physician. II].

Medical doctor is exposed to various types of professional stress. One of the risk factors is the lack of awareness of the fact that patients frequently do not do what is necessary, and that possibilities of therapy are limited. Another risk factor is a deep identification with patient.

[The stressed physician. I. What conditions of the profession are stressful for the physician? What disorders do physicians experience and what are the effects on patients?].

Beside the traditional stress of the medical profession (namely the stress of time, dealing with tiresome patients, non-success in therapy, outgrowing of profession into the private life), during the last decades doctors have to cope with the growing instrumentalization and byrocratization of medicine. It may impair the personal relations of doctors and their attitude to patients. Medical doctors are more than other professionals under the pressure of worries and potential risks and therefore they are more anxious.

[Results of training in communication skills at the First Medical School of Charles University in Prague].

Consistent with new trends in medical training the First Medical Faculty, Charles University Prague included in its curriculum of general medicine a mandatory programme devoted to communication skills. The main objective is to teach students to establish valuable contact with the patient and elucidate the problem presented by the patient. Another objective is to show the therapeutic potential of a well conducted interview.

[Teaching communication skills].

Curriculum of medicine on most of medical faculties reshapes rapidly in last decades. The main afford aims to reform the classic curriculum so that students would be able to enter actively the teaching process and acquire the theoretic knowledge in course of solving practical medical problems. This trend led to complete restructuring of medical curriculum on Mcmaster university in Canada and Maastricht university in the Netherlands.