Papers by Traian Purnichi
Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems... more Background: Nowadays, depression affects more than 300 000 million persons worldwide and it seems to be the main cause for disability by the World Health Organization report from 2017. The aetiology of depression seems to be heterogenous and remains uncertain. Aims: In this context, no matter the depression form, the chronic neuro-inflammation and depression are linked by a bidirectional connection and this is important because in order to try to identify o biomarker for depression screening you need to research at the foundation of the disease. Method: The data analysed are from a prospective study with N=100 patients who presented for laboratory routine evaluations between 1st February-30th June 2016 in the outpatient clinic of the National Institute of Gerontology and Geriatrics “Ana Aslan” (NIGG “Ana Aslan”), Bucharest, Romania. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). We used the recommended cut-off of ≥ 8 points for the HADS de...
Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), ac... more Neuro-inflammation represents the immunerelated processes in the central nervous system (CNS), acute, appearing after psychological stress, trauma, infections or neurological pathologies, and chronic, associated with neurodegenerative disease and possible cognitive degradation. The inflammatory process is also directly linked with CNS and cardiovascular disease, being predicted by the levels of high sensitivity C protein. Cellular biological and biochemical mechanisms of inflammatory processes are very complex, our paper aimed to gather the latest and the most relevant proofs that link the psychiatric, and especially affective disorders, stress and neuro-inflammation.
Acta Endocrinologica (Bucharest), 2016
context. Schizophrenia is a chronic disease most frequently necessitating lifelong antipsychotic ... more context. Schizophrenia is a chronic disease most frequently necessitating lifelong antipsychotic treatment. Selecting which antipsychotic is to be prescribed in an individual schizophrenia patient represents an important clinical decision that need to take into account efficacy and side effects. objective. Evaluating weight gain related with one year antipsychotic treatment in antipsychotic naive firstepisode schizophrenia patients. design. This study is an analysis of weight gain associated with typical or atypical antipsychotics used in European First Episode Schizophrenia Trial (EUFEST) study. subjects and methods. 113 first episode naïve antipsychotic schizophrenia patients included in EUFEST-Romanian cohort, who were randomized to one of the 5 treatment arms. Weight was obtained at baseline, 3, 6, 9 and 12 months for the 5 antipsychotics (typical-Haloperidol; atypical-Olanzapine, Amisulpride, Ziprasidone, Quetiapine). results. There are no statistically significant differences between groups treated with typical or atypical antipsychotics or between any individual antipsychotics concerning weight gain during the study. Weight gain was the highest in the first 3 months (57.49%) for all the studied neuroleptics. At the end of the study, the less increase was observed with ziprasidone (3.87 kg) and the highest with olanzapine (9.83 kg). conclusion. Increase in weight has taken place for each individual neuroleptic, but also as a group (all neuroleptics) in the first three months (57.49%). Therefore, we should address the issue of weight gain with great care, especially in first period of antipsychotic administration, in order to fast deploy intervention tailored to maintain pretreatment weight.
European Psychiatry, 2016
IntroductionDepression leads to substantial suffering for the patients, their families and become... more IntroductionDepression leads to substantial suffering for the patients, their families and becomes an economic burden for system [1,2]. Patients and clinicians tend to rate the remission differently [3].Objectives and methodsWe investigate if clinicians and patients rate different the treatment response. This study assed the evolution of major depressive episode (MDE) in patients treated with Agomelatine, in Romania. It was designed as a multicentre, observational study that included 1213 adult patients evaluated in 75 sites in 2014. The design included 3 visits (baseline (V1); visit at 2/3 weeks (V2); visit 6/8 weeks (V3)). The scales used were: MADRS, SHAPS, CGI-I, CGI-S, PGI-I, PGI-S.ResultsThe MDE improvement was significant (P < 0.001) for all aspects evaluated. At baseline, more clinicians vs. patients considered the moderately or markedly ill as best descriptors of the state. The difference between the two assessments was even higher for V2 and V3. During V2 clinicians rep...
European Psychiatry, 2016
IntroductionPrimary or secondary CNS tumors are among the most difficult to manage forms of cance... more IntroductionPrimary or secondary CNS tumors are among the most difficult to manage forms of cancer. Treatment of these tumors remains a challenge in oncology and the success rates for treatment of brain tumors are much lower than in extracerebral localizations. Because most chemotherapeutic agents do not cross the blood-brain barrier effectively and surgery is sometimes only palliative, radiotherapy remains the main method of treatment of these lesions. Both localized and generalized brain radiotherapy have numerous psychiatric complications.ObjectivesThe objective of the study was to assess the psychiatric comorbidities in patients with brain tumors receiving radiotherapy.AimsThis is an intermediate report of a larger study that assesses comorbidities in patients with brain tumors after radiotherapy.MethodsTwenty-five patients with different localization brain tumors were included in this observational study before receiving radiotherapy. All patients were assessed using Hospital A...
European Neuropsychopharmacology, 2016
clinical and basic research studies are warranted to elucidate the mechanisms underlying the elev... more clinical and basic research studies are warranted to elucidate the mechanisms underlying the elevated CSF fibrinogen levels and to develop a new treatment option for the patient's subgroup.
Results: We studied 820 mood disorders patients (60% women) of which 77.5% had BD. The mean age a... more Results: We studied 820 mood disorders patients (60% women) of which 77.5% had BD. The mean age at intake (±SD) was 38.3 (±14.8), and the mean age at illness onset was 27.5 (±12.4). The average number of years before and during lithium treatment was 10.8 (±10.7) and 6.5 (±8.2), respectively. The average lithium dose and lithium serum levels was 767 (±306) mg/day and 0.63 (±0.18) mEq/L, respectively. We found a significant reduction of the rate of episodes/year (F = 2.23, p = 0.03), especially for mania (F = 2.43, p = 0.01), but not for depression (F = 1.07, p = 0.28). However, illness time was significantly reduced during lithium treatment for both depressive (F = 7.61, p < 0.0001), and manic (F = 4.79, p < 0.0001) episodes. Rates of mood disorder patients with symptomatic values of metabolic parameters were 14.3% for white blood cell count (WBC) ≥10000/μl, 26.1% for glucose levels ≥100 mg/dl, 54.7% for cholesterol levels ≥200 mg/dl, 9.3% for BUN ≥50 mg/dl, 18.7% for creatinine levels ≥1.2 mg/dl, 21.4% for TSH levels ≥3.50 mU/l. Conclusions: We were able to confirm that long-term lithium treatment is effective in both polarities (depressive and (hypo) manic) of a BD. The effectiveness is more evident with the percentage of illness time than with the number of episodes per year. We also found that about 20% of the patients presented renal or thyroid side-effects. Blood glucose and cholesterol were also elevated in a substantial proportion of the sample. However, it is hard to separate these effects from the age-associated metabolic modifications. Purpose: Digoxin is a cardiac glycoside, it is used as an antiarrhythmic agent in the treatment of atrial fibrillation, heart failure P.2.h Mood disorders and treatment-Other (clinical) S878
Objectives: The aim of this non-interventional, investigator driven study was to assess the funct... more Objectives: The aim of this non-interventional, investigator driven study was to assess the function-ality of patients with major depression under treatment with agomelatine in real life clinical practice. Material and methods: The study was multicenter, non-interventional and evaluated the func-tionality of the adult patients with a DSM-IV diagnosis of MDD (single or recurrent episode and no treatment in the previous 6 months). It took place in Romania and it was a 10-weeks study. After the clinicians took the medical decision of treatment with agomelatine and if the patient agreed to be evaluated more accurate in this study, in order to assess functionality, patients completed at each visit the Sheehan Disability Scale (SDS). Patients were assessed also with QIDS-C (Quick Inventory of Depres-sive Symptomatology), a measure of depression symptoms severity and CGI scale severity (CGI-S), CGI scale improvement (CGI-I) and therapeutic index. Also, data about demographics and disease w...
Journal of Mind and Medical Sciences, 2016
Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is... more Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the risks of myocardial infarction and decreases diabetes control, and adherence to treatment. The mechanism through which these effects are produced is still uncertain. Objectives of this study were to evaluate the metabolic alterations in female Wistar rats with induced depression, with and without administration of Agomelatine. The methods included two experiments. All data were analyzed by comparison with group I (control), and with each other. In the first experiment we induced depression by: exposure to chronic mild stress-group II; olfactory bulbectomy-group III; and exposure to chronic mild stress and hyperlipidic/ hyper caloric dietgroup IV. The second experiment was similar with the f...
Maedica, 2015
OBJECTIVES The aim of this non-interventional, investigator driven study was to assess the functi... more OBJECTIVES The aim of this non-interventional, investigator driven study was to assess the functionality of patients with major depression under treatment with agomelatine in real life clinical practice. MATERIAL AND METHODS The study was multicenter, non-interventional and evaluated the functionality of the adult patients with a DSM-IV diagnosis of MDD (single or recurrent episode and no treatment in the previous 6 months). It took place in Romania and it was a 10-weeks study. After the clinicians took the medical decision of treatment with agomelatine and if the patient agreed to be evaluated more accurate in this study, in order to assess functionality, patients completed at each visit the Sheehan Disability Scale (SDS). Patients were assessed also with QIDS-C (Quick Inventory of Depressive Symptomatology), a measure of depression symptoms severity and CGI scale severity (CGI-S), CGI scale improvement (CGI-I) and therapeutic index. Also, data about demographics and disease were c...
Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is... more Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the risks of myocardial infarction and decreases diabetes control, and adherence to treatment. The mechanism through which these effects are produced is still uncertain. Objectives of this study were to evaluate the metabolic alterations in female Wistar rats with induced depression, with and without administration of Agomelatine. The methods included two experiments. All data were analyzed by comparison with group I (control), and with each other. In the first experiment we induced depression by: exposure to chronic mild stress-group II; olfactory bulbectomy-group III; and exposure to chronic mild stress and hyperlipidic/ hyper caloric dietgroup IV. The second experiment was similar with the f...
Revista de Chimie
Alzheimer�s disease (AD) is a complex neuropsychiatric condition characterized by progressive cog... more Alzheimer�s disease (AD) is a complex neuropsychiatric condition characterized by progressive cognitive symptoms.The social and psychological costs associated with the care of AD patients are very high; therefore, significant funds for research in this field are being invested worldwide. The accuracy of medical methods for establishing the diagnosis of AD with specific neuropathology is very important. Biomarkers can detect AD in their pre-clinical stage, monitor the disease progression, and detectmore objectively the treatment response. We performed a retrospective study of 100 patients admitted to the Gheorghe Preda Psychiatric Hospital of Sibiu with the diagnosis of Mild Cognitive Impairment and Alzheimer�s Dementia. The diagnosis was established according to the Diagnostic and Statistical Manual Disorders-4th edition criteria and the severity of the condition was determined by the Mini Mental State Examination. Our retrospective study revealed that in a certain period of time, m...
Revista de Chimie
Hyperdopaminergia has been identified at impulsive or psychotic patients, the polymorphism of COM... more Hyperdopaminergia has been identified at impulsive or psychotic patients, the polymorphism of COMT or other enzymes that metabolize dopamine could be involved. The deficiencies of the serotoninergic system in suicidal behaviour has been mentioned by many studies that indicate the reduction of 5-HT, 5-HIAA in CSF or 5-HTT polymorphism. Young patients with psychotic or depression symptoms manifest, frequently, aggressive and self-harm behaviour. Besides the association between the young age and the aggressivity of the patients with serious mental disorders, our study shows gender differences and this matter is sustained by hormonal factors. The study was conducted at the Gheorghe Preda Psychiatric Hospital in Sibiu. The study comprises 52 patients aged between 18 and 35 who were diagnosed with the diagnosis of Schizophrenia, Bipolar Affective Disorder, Depressive Episode and Major depressive disorder according to the DSM-5 criteria. Evaluation of the severity of psychiatric and depres...
Abstract: Around 25% of adults experience a mental illness in each year and approximately 60% rec... more Abstract: Around 25% of adults experience a mental illness in each year and approximately 60% received no mental health care. There are still long delays between the onset of symptoms and the first psychiatric consult and treatment. Objective: To understand the pathway to care and to determine the delay in seeking help for mental health problems, considering sociodemographic variables in patients admitted in two Romanian acute psychiatric inpatients settings. Methods: Between May-August 2015, WHO's Pathway Encounter Form was applied to 200 individuals, at their first admission, consecutively
hospitalized in acute psychiatry clinics from Targu Mures and Craiova, Romania. Results: The profile of the participants in this study was: woman in the sixth decade of life, having an average economic status and without psychiatric history, searching help for depressive symptoms (by themselves or at the advice of the family), mainly to a psychiatrist or a General Practitioner. The average delay from the onset of symptoms to the first psychiatry consult was 16 weeks. Only previous positive personal history for MH problems and current diagnosis had a high statistically significant influence on the moment when subjects of our study decided to access the MH services. Conclusions: A better knowledge and understanding on the factors that influence people to seek help in mental health problems would be useful for improving the future organization of healthcare services and programs. Keywords: psychiatric consult, onset of symptoms, duration access
Romanian Journal of Psychiatry , 2016
Abstract: Background: Depression is a common and disabling psychiatric condition which cause subs... more Abstract: Background: Depression is a common and disabling psychiatric condition which cause substantial impairment in daily functioning and increases the risk for both social and physical disability, and as a result, increases the costs for other medical services. Objectives: The study aims at underlining particularities regarding the evolution and functionality of patients with major depressive disorder (MDD) under Agomelatine treatment. The most important objectives were to evaluate the daily functionality in MDD patients under treatment, the evolution of the symptomatology and treatment adherence. Methods: We included in a prospective, observational and longitudinal study 1194 patients with depressive episode, who were assessed with Clinical Global Impressions Scale (CGI scale) and Quick Inventory of Depressive Symptomatology Scale (QUIDS-C16), in order to perform a correlational analysis. Results: In this study, the target group had a moderate symptomatology (depressed mood, loss of concentration, anhedonia) and had a good evolution from the second week of treatment and a considerable improvement of anhedonia after 10 weeks of treatment. Conclusions: The antidepressant treatment with Agomelatine was considered efficient and safe, with an important improvement of the symptomatology after 10 weeks of treatment, a good treatment adherence and improvement in daily functioning. Key words: CGI scale, anhedonia, antidepressant treatment.
Romanian Journal of Psychiatry, 2016
Abstract:
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. ... more Abstract:
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we
used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
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Papers by Traian Purnichi
hospitalized in acute psychiatry clinics from Targu Mures and Craiova, Romania. Results: The profile of the participants in this study was: woman in the sixth decade of life, having an average economic status and without psychiatric history, searching help for depressive symptoms (by themselves or at the advice of the family), mainly to a psychiatrist or a General Practitioner. The average delay from the onset of symptoms to the first psychiatry consult was 16 weeks. Only previous positive personal history for MH problems and current diagnosis had a high statistically significant influence on the moment when subjects of our study decided to access the MH services. Conclusions: A better knowledge and understanding on the factors that influence people to seek help in mental health problems would be useful for improving the future organization of healthcare services and programs. Keywords: psychiatric consult, onset of symptoms, duration access
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we
used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment
hospitalized in acute psychiatry clinics from Targu Mures and Craiova, Romania. Results: The profile of the participants in this study was: woman in the sixth decade of life, having an average economic status and without psychiatric history, searching help for depressive symptoms (by themselves or at the advice of the family), mainly to a psychiatrist or a General Practitioner. The average delay from the onset of symptoms to the first psychiatry consult was 16 weeks. Only previous positive personal history for MH problems and current diagnosis had a high statistically significant influence on the moment when subjects of our study decided to access the MH services. Conclusions: A better knowledge and understanding on the factors that influence people to seek help in mental health problems would be useful for improving the future organization of healthcare services and programs. Keywords: psychiatric consult, onset of symptoms, duration access
Introduction: Parkinson's disease is a general invalidating neurodegenerative disease. The impaired non-motor functions are well recognized as part of the clinical course of the disease with great impact over the quality of life of the patients. On the other hand, they are highly unrecognized by clinicians and pose great difficulty in detection and measurement. The UPDRS is widely used to assess and follow up PD patients and Part I is used to assess non motor functions such as mentation, behavior and mood disorders. Therefore, we
used it in our study for the assessment of the prevalence of the non-motor symptoms measured by UPDRS Part I in PD patients. Objective: To show that there's high prevalence of mentation, behavior and mood disorders as measured by UPDRS Part I in PD patients. Methods: 293 patients with Parkinson's disease (129 men and 164 women) aged 58-79, randomly picked for an 8-year period (2005-2012) were studied. The study used the following assessment tools: І. Unified Parkinson's Disease Rating Scale; Modified Hoehn and Yahr scale for assessment of clinical symptoms; Schwab and England Activities of Daily Living Scale. Statistical methods for processing the data received – SPSS statistics software with analysis of variances and alternates was used. Results: The mentation, behavior and mood functions were studied in 293 patients diagnosed with Parkinson's disease. Lack of motivation/initiative was most frequently observed – in 245 patients (83.6%), followed by depression – in 200 patients (68.2%)and memory disorders – in 199 patients (67.9%). Thought disorder was the least frequent (26.9%). As a result of these disorders all patients had a considerably reduced quality of life mainly due to the development of significant cognitive impairment. Conclusion: This results confirm the observation that mentation, behavior and mood dysfunctions are a highly prevalent and important feature of PD. Therefore, treating physicians should look for them routinely. The UPDRS showed that it is sensitive and reliable tool for detecting such symptomatology.Key words: Parkinson's disease, depression, UPDRS, cognitive impairment