Aleksandar Janca - Academia.edu (original) (raw)

Papers by Aleksandar Janca

European Psychiatry, Oct 1, 2000

280s S35. Somatoform disdrders and related disorders: the clinical concepts and the neurobiologic... more 280s S35. Somatoform disdrders and related disorders: the clinical concepts and the neurobiological basis produced. Rabbit liver membranes were solubilized with CHAPS and IR purified using a ReactiGel-amiloride resin. The purified protein (Iz-type) was used to immunize rabbits, and the IgG fraction was used after purification. The antibody immunoprecipitated the binding of 3H-2-BFI (Iz-IR) in rabbit liver. Western blot analysis of human brain membranes (prefrontal cortex) with this antibody '(AMI, I: 12,000 dilution) resulted in the labeling of a unique protein of about 77 kDa (putative lz-IR). In a well-defined population of depressed suicides, the immunodensity of this 77 kDa IR protein in the prefirontal cortex was marginally increased (4lf21%, n = 10, p > 0.05) compared to that in matched controls. This increase was clearly apparent in antidepressant-tree (69f29%, n = 6, p < 0.05) but not in antidepressant-treated (lf20%, n = 4) depressed suicides. These preliminary data suggest that this putative Iz-IR, in contrast to the 30-kDa IR protein, is up-regulated in brains of depressed suicides and down-regulated by antidepressant drugs. The functional relevance of altered IR in the pathogenesis of mood disorders (e.g. modulation of monoaminergic neurones by IR) is unknown, but brain It/z-IR appear to be targets for the effects of antidepressant drugs.

Psychiatry Research, 2018

This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behaviou... more This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment. Sleep profiling was conducted using latent class analysis on baseline Pittsburgh Sleep Quality Index data (N = 74 outpatients with schizophrenia who were poor sleepers, 52% male, mean age = 41.4 years). Of these, 40 took part in CBT-I treatment. Analyses revealed three sleep subtypes based on total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) parameters: Cluster 1 ('classic severe insomnia', 44.6%), Cluster 2 ('insomnia with normal sleep duration', 37.8%), and Cluster 3 ('insomnia with hypersomnia', 17.6%). Gains analysis of pre-and post-treatment data from CBT-I participants revealed improvements in sleep and psychopathology in all three clusters, although there were some group differences in the areas and magnitude of improvement. Cluster 1 showed the greatest benefits with longer TST and improved SE. Cluster 2 showed a comparatively blunted treatment response although TST moved closer to recommended sleep guidelines. Cluster 3 showed significant reductions in TST. Altogether, this is the first demonstration of different sleep profiles in schizophrenia and their influence on treatment response to CBT-I. It also supports the notion that therapies should be tailored to the person and their insomnia presentation.

Journal of Nervous & Mental Disease, 2015

This study examines cognitive and behavioral factors linked to insomnia in individuals with schiz... more This study examines cognitive and behavioral factors linked to insomnia in individuals with schizophrenia and other psychotic disorders (with and without insomnia) and healthy controls (with and without insomnia). Fiftyfive psychiatric inpatients and 66 healthy controls (n = 25 with insomnia in both groups) completed the Insomnia Severity Index, Thought Control Questionnaire for Insomnia-Revised, Dysfunctional Beliefs and Attitudes about Sleep scale, Sleep Hygiene Knowledge scale, and Beliefs about Causes of Sleep Problems questionnaires. Both insomnia groups demonstrated night-time rumination, aggressive suppression as a thought control strategy, and exaggerated views regarding the health consequences of poor sleep. In addition, the psychiatric group with insomnia frequently reported the causes of insomnia to be related to their illness (rather than to their lifestyle factors) and had an incomplete understanding of good sleep habits. Psychological interventions should be more commonly pursued as a first line of treatment for insomnia in schizophrenia and psychosis, and these should be adapted to address the unique knowledge gaps and cognitive style of patients.

Stress and Immunity, 1998

Psychiatric Diagnosis and Classification, 2002

... Edited by Mario Maj, Wolfgang Gaebel, Juan JoseÂ LoÂpez-Ibor and Norman Sartorius Copyright ©... more ... Edited by Mario Maj, Wolfgang Gaebel, Juan JoseÂ LoÂpez-Ibor and Norman Sartorius Copyright © 2002, John Wiley & Sons, Ltd. ... Bech P., Hjorts S., Lund K., Vilmar T., Kastrup M. (1987) An integration of the DSM-III and ICD-8 by global severity for measuring multidimensional ...

Past, Present and Future of Psychiatry, 1994

Psychological Medicine, 1998

Background. Significant alterations in total serum protein (TSP) patterns obtained in serum prote... more Background. Significant alterations in total serum protein (TSP) patterns obtained in serum protein electrophoresis and serum proteins have been reported in patients with major depression and in subjects submitted to a combination of psychological and physical stress. The aim of the present study was to examine the effects of academic examination stress, on TSP and patterns obtained in serum protein electrophoresis. Methods. TSP and the concentrations and percentages of the major electrophoretically separated serum proteins were measured in 41 healthy biomedical students the day before a difficult academic examination (i.e. the stressful condition), as well as a few weeks before and after the stressful condition (i.e. two baseline conditions). Results. Academic examination stress increased TSP and the α1, α2, β and γ concentrations in stress-reactors, but not in stress non-reactors (as defined by changes in the Perceived Stress Scale). Academic examination stress reduced the percentage of albumin in the stress-reactors, but not in stress non-reactors. There were significant positive relationships between the stress-induced changes in TSP and serum α2, β and γ concentrations and the stress-induced changes in the Perceived Stress Scale. Conclusions. The results show that even mild psychological stress of short duration can lead to measurable changes in TSP and in patterns obtained in serum protein electrophoresis.

Psychiatry Research, 1999

The effects of academic examination stress on serum concentrations of interleukin (IL)-1 receptor... more The effects of academic examination stress on serum concentrations of interleukin (IL)-1 receptor (R) antagonist (A), soluble(s) IL-2R, sIL-6R, soluble glycoprotein 130 (sgp130), Clara cell protein (CC16), sCD8 and sCD14 were evaluated in 38 university students. The relationships among changes in the above immune-inflammatory variables, levels of serum cortisol, and scores on the Perceived Stress Scale (PSS) or the State-Trait Anxiety Inventory (STAI) were examined. Academic examination stress was associated with significant increases in PSS and STAI scores, and in serum sgp130 and sCD8 values. Academic examination stress was associated with significantly decreased serum sCD14 concentrations in students with high, but not low, stress perception. There were stress-induced differences in serum IL-1RA, sIL-6R and CC16 concentrations between students with high vs. low stress-induced anxiety. The stress-induced increase in serum sCD8 was significantly more pronounced in male students, whereas the increase in serum sgp130 was more pronounced in female students taking contraceptive drugs. These results suggest that: (1) psychological stress induces immune-inflammatory changes pointing toward complex regulatory responses in IL-6 signalling, a decreased anti-inflammatory capacity of the serum, and interactions with T cell and monocytic activation; and that (2) sex hormones may modify stress-induced immune-inflammatory responses.

Neuropsychobiology, 1999

The aim of this study was to determine platelet α2-adrenergic receptor (α2-AR) binding sites in f... more The aim of this study was to determine platelet α2-adrenergic receptor (α2-AR) binding sites in fibromyalgia both before and after treatment with sertraline or placebo. The maximum number of binding sites (Bmax) and their affinity (Kd) for [3H]rauwolscine, a selective α2-AR antagonist, were measured in 13 normal volunteers and 22 fibromyalgia patients. Severity of illness was evaluated by means of the Hamilton Depression Rating Scale (HDRS) and dolorimetric assessments of tenderness at tender points. Fibromyalgia patients had repeated measurements of [3H]rauwolscine binding characteristics both before and after subchronic treatment with sertraline or placebo for 12 weeks. [3H]rauwolscine binding Kd values were significantly higher in fibromyalgia patients than in normal volunteers. There were significant inverse correlations between [3H]rauwolscine binding Kd values and duration of illness, age and lower energy. Significantly higher [3H]rauwolscine binding Kd values were found in fi...

The Journal of Nervous and Mental Disease, 1996

Journal of Mental Health, 1996

It has been traditionally believed that somatization occurs predominantly in non-Western and deve... more It has been traditionally believed that somatization occurs predominantly in non-Western and developing societies and among ethnic groups in the West. Somatic complaints have also been described as altered expressions of emotional distress by less sophisticated patients who are unable to express emotional states. However, there is growing evidence that suggests that somatic expression of psychological distress is a universal phenomenon and that the presence of large numbers of somatic symptoms is strongly associated with the overt expression of psychological distress in Western cultures too. There is an urgent need to develop appropriate training strategies and educational materials for all types of health professionals to identify and manage psychological problems in their patients.

European Psychiatry, 2002

Major depression is accompanied by an activation of the intlammatory response system (IRS), with ... more Major depression is accompanied by an activation of the intlammatory response system (IRS), with an increased production of pro-intlammatory cytokines, such as interleukin-I (IL-l), IL-6 and interferon-o (IFNa). Administration of the latter to animals and humans may induce depression/sickness behavior (psychomotor retardation, anorexia, weight loss, sleep disorders and anhedonia), anxiety and psychosomatic symptoms. Although depression may be causally related to IRS activation, a possible link between IRS activation and somatoform disorders has remained elusive. We found that somatizing disorder is accompanied by significantly lower serum IL-6 values than in normal controls, whereas serum IL-l receptor antagonist (II-IRA) concentrations are significantly higher in somatization. Fibromyalgia is characterized by lowered serum IL-6 concentrations and increased serum gp130 (the IL6 signal transducing molecule). These findings suggest that both fibromyalgia and somatization are not accompanied by activation of the IRS. physical symptoms during the last 2 years. Six symptoms have frequencies in the general population of above lo%, with pain symptoms being the most frequent (back pain: 30%). The high frequency of symptoms makes it necessary to develop intervention programmes which are feasible in Primary Care. We present first data of 2 primary care studies, one evaluating the effect of a lsession (34 hour) intervention, the other evaluating the effects of a GPs training package (1 day of training course). The studies included data of 100 (intervention) resp. 200 (GP training) patients with somatofotm symptoms. General satisfaction scores of >90% revealed that both appoaches were highly accepted from the patients resp. physicians, and are associated with a reduction of insecurity and unnecessary treatment attempts Further aspects of the interventions will be outlined in the presentation.

Current Opinion in Psychiatry, 2002

Recent findings: At least 28-35% of people exposed to a terrorist attack may develop post-traumat... more Recent findings: At least 28-35% of people exposed to a terrorist attack may develop post-traumatic stress disorder. Whereas persons directly exposed to terrorist attacks have a greater risk of developing post-traumatic stress disorder, the secondary effects of vicarious exposure on people not ...

Annals of General Psychiatry, Apr 1, 2008

Annals of General Psychiatry, Feb 1, 2006

European Psychiatry, Jun 1, 2022

Introduction: Cultural barriers and prejudices of mental healthcare professionals may promote ine... more Introduction: Cultural barriers and prejudices of mental healthcare professionals may promote inequalities in the provision of care to immigrant population and have a negative impact in provided service quality. Objectives: To identify barriers and facilitators of immigrants' accessibility to mental health services. Methods: A literature review has been made through PubMed database. Results: Immigrants' accessibility to mental health services may be related to social insurance problems, inadequate knowledge about their health rights, inadequate knowledge of the local language, as well as the bureaucracy of Greek State which may complicate mental health examination and treatment. The challenges faced by mental healthcare professionals in terms of diagnosis and treatment of migrants include communication difficulties due to linguistic and cultural differences as far as verbal presentation of symptoms and illness behavior is concerned. Culturally competent mental health professionals should work to erase racism and prejudice, to be familiar with cultural issues and have adequate knowledge related to cultural groups, to learn the life story of each patient separately and encourage patients to explain how their illness affects their lives, promoting a trustful communication environment in the context of healthcare provision. Conclusions: Exploring the specific needs of migrants as well as assessing the degree of satisfaction from their access to healthcare services are essential to providing integrated mental health care for people from different culture.

American Journal of Psychiatry

Current Opinion in Psychiatry, 2005

Purpose of review From the very moment of their inclusion in contemporary classification systems ... more Purpose of review From the very moment of their inclusion in contemporary classification systems in psychiatry, the concept of somatization and diagnostic categories of somatoform disorders became a matter of controversy that created an ongoing debate about their validity, reliability and applicability in clinical and research settings. The aim of this review is to provide an insight into the current theoretical, research and clinical dilemmas in the area of somatoform disorders and to illustrate them with brief summaries of scientific papers recently published in this field. Recent findings In the period covered by this review, the most valuable scientific contributions to the current state of knowledge on somatoform disorders were (surprisingly numerous) review papers produced by the leading experts in this field. These comprehensive and critical metaanalyses covered historical, conceptual, epidemiological and cross-cultural aspects of somatoform disorders. Another and a relativel...

Current Opinion in Psychiatry, 2010