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Biomedical subjects

Sagnik Bhattacharyya

Publications and source records attributed to Sagnik Bhattacharyya.

6 recordsLinked to original sources

Anti-depressive therapies after heart transplantation.

OBJECTIVE: Despite an improved quality of life, about 33% of heart transplant recipients will develop depressive symptoms post-operatively. To date, no review has explored the efficacy and safety of pharmacologic or psychologic interventions in this patient group. METHODS: We conducted a comprehensive Medline, EmBase, Psycinfo search for studies of the treatment of depression in heart transplant recipients. RESULTS: We identified 34 studies of variable methodologic quality. Selective serotonin re-uptake inhibitors (SSRIs), particularly citalopram and new-generation anti-depressants (mirtazapine), seem to represent the best therapeutic choices for this population. Tricyclic anti-depressants (TCAs), and electroconvulsive therapy (ECT) should be reserved for severe depression unresponsive to other treatments, whereas monoamine oxidase inhibitors (MAOIs) should be avoided. St John's wort, an alternative herbal drug, has been associated with life-threatening immunosuppression. Psychologic therapy offers further advantages after heart transplantation. CONCLUSIONS: Further well-conducted, randomized, controlled trials are needed to clarify the efficacy and the safety of pharmacologic (SSRIs and atypical anti-depressants) and psychologic interventions in the management of depression after heart transplantation.

Antidepressive Agents↗

Depressive and anxiety disorder comorbidity in obsessive compulsive disorder.

BACKGROUND: Depressive and other anxiety disorders are commonly found to coexist with obsessive compulsive disorder (OCD). Although western studies have looked at this issue, there are no reports from India investigating anxiety and depressive comorbidity in adult OCD. METHODS: Between January and December 2001, charts of 218 OCD patients seen in the OCD clinic at the National Institute of Mental Health and Neurosciences, Bangalore, were evaluated using the OPCRIT criteria for ICD-10 for the presence of comorbid depressive and anxiety disorders. RESULTS: There were 146 males and 72 females; their mean age at OCD onset was 21.32 +/- 0.64 years. Thirty-six (16.5%) patients had depressive episodes, 12 (5.5%) dysthymia and 15 (6.9%) any anxiety disorder. No significant difference in terms of age, sex, marital status or age at onset was found between the OCD patients with and without comorbid anxiety disorder, major depression or dysthymia, except that female OCD patients were more likely than males to have comorbid major depressive disorder. CONCLUSIONS: The results of our study are in keeping with previous data from other parts of the world, though the actual rates of comorbidity in our sample appear to be much lower. It remains to be seen whether the differences in rates are a result of methodological issues or different characteristics of sample populations. Further long-term, prospective, methodologically sound studies investigating the comorbidity of depressive and other anxiety disorders in OCD patients are needed to clarify this issue.

Adult↗

Glutamatergic dysfunction in OCD.

The role of glutamatergic dysfunction in the pathophysiology of OCD has hardly been explored despite recent reports implicating glutamatergic dysfunction in OCD. We decided to investigate CSF glutamate levels in adult OCD probands compared to psychiatrically normal controls. In total, 21 consenting psychotropic drug-naïve adult OCD patients, diagnosed using SCID-IV-CV, and 18 consenting psychiatrically normal controls with age within 10 years of age of the patients, who did not have any history of head injury or neurological illness, were included into the study. Aseptically collected and stored CSF samples obtained from the patients and control subjects were used for glutamate estimation, which was carried out by a modification of the procedure described by Lund (1986). CSF glutamate (micromol/l) level was found to be significantly higher [F(1,31)=6.846, p=0.014] in OCD patients (47.12+/-4.25) compared to control subjects (41.36+/-3.63) on analysis of covariance. There was no effect of gender, age, duration of illness, Y-BOCS score, or CGI-S score on CSF glutamate levels. Our study provides preliminary evidence implicating glutamatergic excess in the pathophysiology of OCD, which needs to be further explored by studies from other centers involving larger sample sets from different age groups.

Adolescent↗

A family genetic study of clinical subtypes of obsessive-compulsive disorder.

OBJECTIVE: The results of various family studies of obsessive-compulsive disorder have varied widely, possibly because of heterogeneity in the obsessive-compulsive disorder phenotype. The current study was conducted to determine familiality of checker and washer subtypes of obsessive-compulsive disorder compared with normal controls. METHODS: In this study, all available first-degree relatives of 25 checker, 34 washer and 40 psychiatrically normal control probands were interviewed directly, using structured interviews. RESULTS: The morbid risk of syndromal and subsyndromal obsessive-compulsive disorder was significantly greater among the relatives of checker probands (19.4%) than in the relatives of washer (8.7%) or control probands (5.4%), while the morbid risk for the relatives of washer and control probands was not significantly different. In all, 67% of the checker relatives with syndromal and subsyndromal obsessive-compulsive disorder were checkers, while 54% of the washer relatives with syndromal and subsyndromal obsessive-compulsive disorder were washers. CONCLUSIONS: Our study provides preliminary evidence of familiality of the checker subtype of obsessive-compulsive disorder. Future studies using patients subtyped on the basis of symptom dimensions, in larger obsessive-compulsive disorder samples, are needed, to further validate the genetic basis of obsessive-compulsive disorder.

Adolescent↗

Late onset OCD.

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Age Factors↗