Bipolar disorder: "pure" versus mixed depression over a 1-year follow-up
INTERNATIONAL JOURNAL OF PSYCHIATRY IN CLINICAL PRACTICE
Authors: Mazza, Marianna; Mandelli, Laura; Zaninotto, Leonardo; Di Nicola, Marco; Martinotti, Giovanni; Harnic, Desiree; Bruschi, Angelo; Catalano, Valeria; Tedeschi, Daniela; Colombo, Roberto; Bria, Pietro; Serretti, Alessandro; Janiri, Luigi
Abstract
Objectives. To compare two samples of Bipolar (BD) patients presenting "pure" (D) and mixed (Mx) depression to assess any difference in terms of clinical outcome, social functioning and quality of life during a 1-year follow-up. Methods. A total of 114 depressed outpatients (HDRS > 13) were included. "Pure" depressed (D, n = 76) were divided from "mixed" depressed (Mx, n = 38) by the number of concomitant manic symptoms. All patients were evaluated by the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Young Mania Rating Scale (YMRS), the Global Assessment of Functioning (GAF), the Social Adjustment Self-reported Scale (SASS) and the Quality of Life Scale (QoL), at baseline and after 1, 3, 6 and 12 months of treatment. Results. Mx patients were significantly younger at the onset of BD. Manic features persisted significantly higher in Mx than in D patients all over the follow-up period. Axis I comorbidities had a negative impact on the course of social functioning over the medium term period, while Mx patients showed a faster improvement in social adjustment than "pure" depressed patients. Conclusions. Mixed features may persist relatively stable throughout a depressive episode, having a negative impact over clinical and functional outcome, but not on social adjustment.
Sympathetic nervous system function in HIV-ssociated adipose redistribution syndrome
AIDS
Authors: van Gurp, PJ; Tack, CJ; van der Valk, M; Reiss, P; Lenders, JWM; Sweep, FGJ; Sauerwein, HP
Abstract
It was recently suggested that HIV-associated adipose redistribution syndrome (HARS) results from an autonomic dysbalance. We investigated the local and global sympathetic nervous system function of patients with HIV-1 infection and HARS. Interstitial noradrenaline concentrations in skeletal muscle and subcutaneous adipose tissue were increased in the absence of changes in global sympathetic nerve activity, consistent with locally increased sympathetic activity. This could promote localized lipolysis in subcutaneous adipose tissue and contribute to the development of HARS.