Valentin Matei - Academia.edu (original) (raw)

Papers by Valentin Matei

Romanian Journal of Psychiatry, 2016

Abstract: The prevalence of depression increases with the age, elderly depressed patient requirin... more Abstract:
The prevalence of depression increases with the age, elderly depressed patient requiring an increased attention, probably due to changes associated with aging, life events (death of family members, reduction of social interactions, retirement and lack of activities etc.), somatic illnesses, medications used to treat somatic illnesses and so on. The aim of this study was to illustrate, in terms of depression and anxiety, the situation of elderly depressed patients that are addressing to a geriatric institution for a medical
examination due to various conditions specific to age. For that we performed an analysis of a group of 90 patients, aged between 41 and 96 years old, who addressed to the National Institute of Geriatrics and Gerontology Ana Aslan, for various diseased related to the age. Depression and anxiety were evaluated based on HADS scale (Hospital Evaluation of Depression and Anxiety Scale). Performing the HADS-D scale to this group of elderly patients has identified the presence of depression in 40% of patients. Anxiety was much more present compared with depression, 69% of patients addressing to the geriatrician experienced different degrees of this disease. The data obtained confirm the higher prevalence of depression in women compared to men, in a ratio of 2:1. Key words: elderly, depression, anxiety, diagnosis, HADS

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: Schizophrenia represents a chronic and debilitating illness listed by the... more Abstract:
Introduction: Schizophrenia represents a chronic and debilitating illness listed by the international organisms as top priority for public health actions to reduce disability
and improve the function and quality of life for people living with chronic illness.
Objective: The aim of this study was to compare psychosocial functioning of schizophrenic patients after 1 year of neuroleptic treatment in a first episode schizophrenia population treated with atypical or typical antipsychotics. Methods: Procedures of the European First Episode
Schizophrenia Trial study (EUFEST) have been previously described. Data analyzed in this paper refers to Romanian patients (N = 113) included in the EUFEST study. Psychosocial functioning was assessed by Global Assessment of Functioning (GAF). GAF questionnaire was applied at baseline and at 1, 2, 3, 6, 9 and 12 months (end of study). Results: Mean value at 1 year compared with baseline was 76.88 (±16.20) vs. 39.06 (±13.56) for Haloperidol, 75.58
(±18.41) vs. 40.67 (±12.71) for Olanzapine, 78.57 (±10.15) vs. 37.65 (±17.05) for Quetiapine, 82.35 (±10.16) vs. 38.24 (±12.52) for Amisulpride, 76.11 (±9.47) vs. 38.33 (±10.26) for Ziprasidone. Statistical comparison with ANOVA revealed no statistically significant differences, p = 0.533. The improvement in functionality in patients did not differ between antipsychotics from one evaluation to another. During the antipsychotic treatment, the psychosocial functioning of patients improved significantly more during the first 6 months, irrespective of
treatment arms. After that, the improvement continued to develop, but at a slower pace.
Conclusions: Our study didn't support the superiority of atypical neuroleptics versus classical ones regarding functionality in first episode schizophrenic patients. The improvement starts fast with both classes of drugs and the larger part of improvement in functionality took part during the first 3−6 months of treatment. Key words: Antipsychotic, functionality, first episode
schizophrenia

Elevated hs-CRP plasma level as a biological marker in elderly depressed adults R. Grigoras(1), T... more Elevated hs-CRP plasma level as a biological marker in elderly depressed adults
R. Grigoras(1), T. Purnichi(2), M. Grigoras(3), V. Matei(4)

(1)Spitalul Voila, 1st, Campina, Romania
(2)University of Medicine and Pharmacy of Craiova, PhD student, Craiova, Romania
(3)UMF “Carol Davila”, Student, Bucharest, Romania
(4)UMF “Carol Davila”, Senior Lecturer, Department of Psychiatry, Bucharest, Romania
Background: Depression in older adults represents a major health problem [1]. Even though there is much data looking into putative biological markers for depression [2] the data for such markers in elderly depressed people is scarce. Previous studies have shown an association between high levels of high-sensitivity C-reactive protein (hs-CRP) and depressed mood among younger [3] and older adults [4].
Objective: The aim of our paper was to examine the association between depression and high sensitivity C-reactive protein (hs-CRP) among the elderly.
Methods: Data analyzed in our paper refers to the elderly patients (age ≥ 60; N = 82) included in a prospective study with N = 100 patients who presented for laboratory 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. For all the participants socio-demographic information collected included: gender, age, marital status, environmental origin, level of education, socio-economic status, also data about somatic comorbidities were recorded. Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). Laboratory data included the serum hs-CRP determination for all the patients. This study was approved by the I.O.S.U.D. U.M.F. Craiova ethical committee and also had a collaboration protocol with the outpatient clinic NIGG “Ana Aslan” Details of the study were explained to the patients and a written consent was obtained from all participants. We used the recommended cut-off of ≥8 points to identify the cases of elevated levels of depressive symptoms at the HADS depression subscale. Statistical Package for Social Sciences version 22 was used to analyze the data, specifically descriptive data and logistic regression in order to control the results for the somatic comorbidities.
Results: From the total number of patients, 63.4% (N = 52) were female, with a mean age of 71.6 (±7.51) years, from the urban area 92.7% (N= 76). A number of 81(98.8%) presented comorbidities. After controlling for somatic comorbidities, logistic regression model revealed that elevated levels of hs-CRP increased the likelihood of being diagnosed with depressive symptoms in elderly patients (β =.174; SE of β =.059; p = 0.003; 95% CI = 1.061–1.337).
Conclusions: Our study found a relationship between higher levels of high-sensitivity C-reactive protein (hs-CRP) and increased risk for depression in older adults. That may be important as hs-CRP represents a vulnerability marker for cardiovascular diseases too. Understanding the mechanisms underlying the onset of depression, and identifying early markers that predict its occurrence in elderly patients could have major clinical implications in both the optimal management of depression and secondary prevention of cardiovascular diseases. Using this marker may help to identify people at risk for both cardiovascular illnesses and depression. The relationship between the 3 above variables is a complex one, since depression represents a risk factor for cardiovascular diseases and viceversa and hs-CRP seems to be a marker for both conditions. However, the cross sectional nature of our study doesn't allow us to clarify this relationship.

References

[1] Fiske, A., Wetherell, J.L., Gatz, M., 2009. Depression in Older Adults. Annual Review of Clinical Psychology 5, 363–389.

[2] Miller, A.H., Raison, C.L., 2016. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews Immunology 16, 22–34.

[3] Liukkonen, T., Silvennoinen-Kassinen, S., Jokelainen, J., Räsänen, P., Leinonen, M., Meyer-Rochow, V.B., Timonen, M., 2006. The association between C-reactive protein levels and depression: Results from the Northern-Finland 1966 Birth Cohort Study. Biol Psychiatry 60, 825–830.

[4] Penninx, B.W., Kritchevsky, S.B., Yaffe, K., Newman, A.B., Simonsick, E.M., Rubin, S., Ferrucci, L., Harris, T., Pahor, M., 2003. Inflammatory markers and depressed mood in older persons: results from Health, Aging and Body Compositum Study. Biol Psychiatry 54, 566–572.

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.

INTRODUCTION. The number of old people is increasing fast in both developed and underdeveloped co... more INTRODUCTION. The number of old people is increasing fast in both developed and underdeveloped countries. Both depression and anxiety have high prevalence in the old age group. There are some conflicting reports regarding the prevalence of depression and anxiety across separate older age groups. The purpose of our study is to compare the prevalence of depression and anxiety in the old age group with very old age group. OBJECTIVES. We compared the prevalence of depression and anxiety in two groups of old people, the first one aged 60-79 years and the second one with aged ≥80 years. METHODS. We applied the Hospital Anxiety and Depression Scale (HADS) to 82 of people aged ≥60 years. HADS is a self-rating scale with 14 items, 7 attributed to depression and 7 to anxiety symptoms (27). On each item, the patient can score from 0 to 3, meaning that a person
can score between 0 and 21 for either anxiety or depression; the cut-off point is ≥ 8 for anxiety or
depression. Then we compared with chi-square the differences in prevalence of depression and anxiety in the two age groups. RESULTS. From the total number of very old, 83.33% experienced depression compared to 42.85% from their younger counterpart. A statistically significant higher
percent from the very old compared to the old people experienced depression: OR=1.309, CI=1.066-1.609, p=.005. From the total number of the old patients, a number of 71.4% presented anxiety compared to 58.3% from the very old age group, without statistically significant differences
between the two groups: OR=.686, CI=.319-1.474, p=.498. CONCLUSIONS. Depression and anxiety are present with very high rates of prevalence in the old age patients. Still, there is an increase in risk for depression in the very old age group. More research for identifying risk and protective factors in different segments of the old age people are necessary for both depression and anxiety.

Introduction: The most important predictors of response in schizophrenia are: family history of m... more Introduction: The most important predictors of response in schizophrenia are: family history of mental disorder, gender, early age at onset of schizophrenia, number of relapses, duration of untreated psychosis. Regarding clinical criteria, severity of symptomatology seems to predict in some studies, but not all, poor response to treatment during acute phases. Objectives: To study how severity of symptomatology in first episode schizophrenic patients predicts response at 1 year. Methods: I analyzed data from European First Episode Schizophrenia Trial (EUFEST), Romanians patients. I created 2 groups (group 1"Moderate severity group" and group 2 "Severely group") of patients based on PANSS severity. I compared the two groups regarding d

Objective: To examine the relationship between early childhood cognitive functioning and late ado... more Objective: To examine the relationship between early childhood cognitive functioning and late adolescence psychotic symptoms and depressive symptoms. Methods: A prospective cohort study (based on the 1970 British Cohort) which includes data about childhood (age 5) cognitive functions and about development of psychotic and depressive symptoms at age 16. Results: Male adolescents with psychotic or depressive symptoms had lower age 5 IQ, and visual-constructional abilities compared to controls (p<0.05). Females did not show significant impairments at age 5. Conclusions: early onset cases with psychotic symptoms and depressive symptoms, present significant differences concerning earlier cognitive functioning in cases of males versus females.

Background: There are strong evidences indicating that people with depression present a degree of... more Background: There are strong evidences indicating that people with depression present a degree of cognitive impairment. It seems that the cognitive impairment in depression persist beyond recovery in depression, suggesting it is a trait-like of depression. Evidence has emerged from the rapidly evolving field of cognitive epidemiology that low IQ is related to risk of other psychiatric conditions, including -although not across all studies -depression. The association between specific pre-morbid cognitive functions and depression has not been yet fully investigated. Aims: To investigate the association between specific cognitive functions measured in childhood and depressive symptoms in adult life. Methods: This study builds on the 1970 British cohort study (BCS70). The BCS70 is a cohort study that enrolled all babies born in England, Scotland, and Wales on 5-11 April 1970. We used data collected on study participants at age 5 (cognitive functioning) and 30 (depression). Results: People with depression at 30 years performed statistically significant poorer on cognitive functioning at cognitive tests administered at 5 years. Patients with depression at age 30 performed poorer than controls at cognitive test evaluating verbal intelligence (p=0.001), constructional performance praxis (p=0.009) and visualmotor coordination (p=0.001). Conclusions: We replicated recent findings showing an association between poor premorbid cognitive functioning and depression. The premorbid cognitive deficits are evident already at age 5 and involve both language and visual perceptual abilities, representing a putative risk for depression (still, other hypothesis regarding relationship between cognitive impairment and depression cannot be excluded). Key words: Early cognitive impairment, depression Rezumat: Introducere:Existã în prezent suficiente dovezi ce sugereazã cã persoanele cu depresie prezintã un grad de afectare cognitivã. Dovezile sugereazã cã afectarea

Psychiatria Danubina, Dec 1, 2014

Schizophrenia treatment has been debated at length and presently pharmacological treatment is bei... more Schizophrenia treatment has been debated at length and presently pharmacological treatment is being advocated as the most beneficial for patients. However, research has shown contradictory results regarding the suitability of pharmacological treatment for certain groups of schizophrenia patients. The present review discusses results from the literature indicating good outcomes only for patients who adhered to prescribed pharmacological treatments. It also describes studies favoring non-drug treatments in certain schizophrenic patients. The authors described two groups of patients where the long-term use of neuroleptics may be useless, if not harmful. The first group comprised schizophrenic people with a single psychotic episode and therefore very good prognosis. In their case, the prolonged use of antipsychotics would not be beneficial due to pharmacological and social (stigma) side effects. Further research is warranted to identify and investigate biological, environmental, and psychological factors associated with single-episode schizophrenia. The second group comprised ultra-resistant schizophrenic patients. In their case, in the absence of a therapeutic response in acute episodes or aggressive behavior, clinicians should use short episodes of treatment with benzodiazepines or other sedative medications such as mood stabilizers. The present paper attempted to answer the important question as to whether all schizophrenic people should be treated with antipsychotics for the same good prognosis. The authors have provided solutions for better outcomes in a greater number of patients using alternative treatment after identifying schizophrenic patients who should not receive neuroleptic treatment. Suggestions for future research are also discussed.

Mædica, 2015

The aim of this non-interventional, investigator driven study was to assess the functionality of ... more 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. 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 collected during clinical intervi...

European Archives of Psychiatry and Clinical Neuroscience, 2015

Many patients do not respond to the first antipsychotic drug prescribed, but require multiple tri... more Many patients do not respond to the first antipsychotic drug prescribed, but require multiple trials with different drugs before response is achieved. Current treatment guidelines vary substantially in their recommendations as to how long clinicians should wait before an antipsychotic treatment attempt should be considered as failed and the compound switched. It has, however, recently been shown that poor early response to an antipsychotic is associated with continuous poor later response in the course of the same treatment attempt. This finding suggests that patients who do experience poor early response might benefit from a switch in antipsychotic medication as early as 2 weeks after treatment initiation. In the SWITCH trial, 350 patients suffering from an acute episode of schizophrenia are randomly assigned to double-blind treatment with either olanzapine or amisulpride. The primary endpoint is symptomatic remission at week 8. Patients not experiencing at least minor response after 2 weeks are randomized again to either staying on the initially assigned drug or being switched to the alternative compound for another 6 weeks. In case early switching proves superior to maintaining treatment, time wasted for unsuccessful treatment attempts could be minimized, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; outcomes improved, duration of hospital stays reduced, and thus overall treatment expenses saved. The current report will present the methods of the trial, focusing on various specific features which could be adopted by future studies.

For a debilitating illness like schizophrenia, iden-tifying the risk factors leading to its manif... more For a debilitating illness like schizophrenia, iden-tifying the risk factors leading to its manifestation is crucial towards prevention of the disease as well as for understanding its pathophysiology. However, identifi-cation of the relationship between risk factors and the disease whose likelihood they are presumed to herald, is encumbered by the fact that the risks for schizophre-nia are affected by a multitude of interacting genetic and environmental variables, each with its own limited contribution. Furthermore, prediction of any rare event such as the incidence of schizophrenia is partic-ularly burdensome. Moreover, the vague definition of the schizophrenia phenotype and the blurry bound-aries between it, other mental illnesses and normality further hamper efforts to use risk factors to predict the manifestation of the illness. A number of remedies have been suggested, none of which are fully satisfactory. Identifying risks for dis-ease manifestations, which are biologically si...

International Journal of Clinical Practice

Psychiatria Danubina, 2014

romjpsychiat.ro

Conceptul de endofenotip a aparut din cauza dificultatilor asociate studierii unei afectiuni atât... more Conceptul de endofenotip a aparut din cauza dificultatilor asociate studierii unei afectiuni atât de complicate precum schizophrenia. Aceste dificultati sunt generate printre altele de complexitatea si lipsa relativa de specificitate a geneticii schizofreniei (o afectiune multifatetata cu numeroase influente epigenetice si de mediu). Relativa lipsa de specificitate a fenotipului schizofreniei, a tratamentului si a factorilor de risc (atât genetici cât si de mediu) asociati schizofreniei reprezinta alte câteva dintre numeroasele impedimente ce însotesc studierea acestei boli. Cercetarea, în cazul bolilor complexe, poligenice, precum schizofrenia (dar si diabetul ori afectiunile cardiovasculare), a factorilor de risc genetici si de mediu poate fi sprijinita de identificarea endofenotipurilor care se spera ca reprezinta aspecte fundamentale, dar în acelasi timp mai simple, ale functionarii creierului, aflate de-a lungul caii dintre gene si fenotip. Nu exista deocamdata algoritmuri standardizate pentru selectarea unor endofenotipuri specifice, dar recent au aparut numeroase încercari de dezvoltare a unor criterii pentru evaluarea validitatii si utilitatii unor endofenotipuri în psihiatrie. Afectarea cognitiva reprezinta unul dintre cele mai importante aspecte ale schizofreniei. Între 75% si 85% dintre toti pacientii cu schizofrenie manifesta tulburari ale functionarii intelectuale în domenii precum memoria declarativa, memoria de lucru, atentia ori functiile executive. Mare parte din functionarea sociala, familiala si profesionala a pacientilor cu schizofrenie pare sa fie relationata cu functionarea lor cognitiva. Anormalitati cognitive subtile preced adeseori primul episod psihotic în cazul acestor pacienti. Studii prospective longitudinale ale pacientilor schizofreni cu prim episod psihotic arata ca disfunctiile cognitive ramân stabile în timp în majoritatea domeniilor, inclusiv atentia, memoria, functiile executive si abilitatile cognitive generale. Mai mult, afectarea cognitiva si a functiilor executive este prezenta atât la pacienti cât si la rudele de gradul întâi, neafectate de boala, ale acestor pacienti. Toate acestea sugereaza ca într-adevar afectarea cognitiva a pacientilor cu schizofrenie poate reprezenta un endofenotip valid, care la randul sau poate fi o cale productiva de studiere a unei afectiuni de o asa complexitate precum schizophrenia.

Although multiple studies have assessed symptoms of anxiety and depression in young individuals w... more Although multiple studies have assessed symptoms of anxiety and depression in young individuals with various somatic diseases, less studied is the prevalence of self-reported depression and anxiety in young adult population, apparently healthy. Objectives: 1. To assess the relationship between emotional distress (stress, anxiety and depression) and cortisol levels in the period of acute stress 2. To investigate perceived stress, depression and anxiety, in a sample of medical students which will be followed up at one year. 3. To see if there are correlations between the instruments of measuring perceived stress and self-rating scales of anxiety and depression. Methods and participants: 28 young healthy adults, medical students were given questionnaires on stress, anxiety and depression and were assessed salivary cortizol levels in conditions of academic stress. The scales used for the assessment of stress, anxiety and depression were Perceived Stress Scale (PSS), Zung self rating anx...

Romanian Journal of Psychiatry, 2016

Romanian Journal of Psychiatry , 2016

Romanian Journal of Psychiatry, 2016

References

[1] Fiske, A., Wetherell, J.L., Gatz, M., 2009. Depression in Older Adults. Annual Review of Clinical Psychology 5, 363–389.

[2] Miller, A.H., Raison, C.L., 2016. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews Immunology 16, 22–34.

Psychiatria Danubina, Dec 1, 2014

Mædica, 2015

European Archives of Psychiatry and Clinical Neuroscience, 2015

International Journal of Clinical Practice

Psychiatria Danubina, 2014

romjpsychiat.ro