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Editorial 2008; 29(Suppl 1): 1-4 PubMed PMID: 19029879 Citation  Keywords:  Electric Stimulation, Electroconvulsive Therapy, Humans, Mental Disorders:physiopathology, Seizures:chemically induced,.   

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Journal Article 2008; 29(Suppl 1): 33-64 PubMed PMID: 19029878 Citation  Keywords:  Circadian Rhythm:physiology, Depressive Disorder:therapy, Humans, Light:adverse effects, Phototherapy:adverse effects, Seasonal Affective Disorder:therapy, Seasons,.   

: Bright light is a treatment of choice for seasonal affective disorder. Other indications for bright light therapy have also been tested. These include non-seasonal depression, bipolar depression, chronic depressive disorder, ante- and postpartum depression, late luteal phase dysphoric disorder, circadian phase sleep disorders, jet lag, shift work problems, and behavioral disturbance and insomnia in organic dementia. Future studies should focus on exploring the use of light therapy in combination with sleep deprivation, other classes of antidepressants, and with psychotherapy and their possible combined effect on subtypes of depression or other mentioned diagnoses, light treatment duration, and the applicability and efficacy of adjunct light treatment for in-patients....

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Journal Article 2008; 29(Suppl 1): 123-132 PubMed PMID: 19029877 Citation  Keywords:  Deep Brain Stimulation:adverse effects, Humans, Mental Disorders:therapy, Psychiatry, Treatment Outcome,.   

: Deep brain stimulation (DBS) is a reversible surgical procedure that involves stereotactic implantation of electrodes into the targeted brain regions, with a subcutaneously placed pulse generator powering the electrodes via one or two leads. The mechanism of action can be explained by the stimulation-induced modulation of impaired network activity. So far, the main use of DBS has been for neurological conditions, such as essential tremor, motor symptoms in Parkinson's disease, dystonia, epilepsy, and chronic pain. In psychiatry, case series and open studies indicate treatment efficacy of DBS in Gilles de la Tourette syndrome, treatment-resistant obsessive-compulsive disorder, and refractory major depression. Neuroimaging studies have confirmed the effects of DBS on the brain regions implicated in specific neuropsychiatric disorders. It is a well-tolerated method with relatively few serious side effects. Additional well-designed and appropriately powered controlled clinical trials are needed to conclusively establish the efficacy and safety of DBS and to identify the patient population(s) who may benefit most. Ongoing research with stimulation techniques may also significantly contribute to our understanding of major neuropsychiatric disorders....

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Historical Article 2008; 29(Suppl 1): 11-32 PubMed PMID: 19029876 Citation  Keywords:  Clinical Trials as Topic, Electroconvulsive Therapy:adverse effects, Ethics, Medical, History, 20th Century, Humans, Mental Disorders:therapy, Practice Patterns, Physicians', Psychiatry:methods, Treatment Outcome,.   

: Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the limitations, ECT seems to have real value in selected mental conditions in which it can even be considered a life-saving procedure....

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Journal Article 2008; 29(Suppl 1): 93-104 PubMed PMID: 19029875 Citation  Keywords:  Clinical Trials as Topic, Ginkgo biloba:chemistry, Herbal Medicine, Humans, Hypericum:chemistry, Kava:chemistry, Mental Disorders:drug therapy, Phytotherapy, Plant Preparations:therapeutic use, Valerian:chemistry,.   

: Herbal drug treatment has been known for centuries as a part of traditional medicine. Nowadays, it is still considered a useful and natural way to treat several medical conditions, including mental disturbances. The most frequently treated mental conditions include mood disorders (mainly depression), anxiety disorders, somatoform disorders, age-related cognitive decline, and sometimes psychotic disorders. Some herbal formulations, such as St. John's wort, have been analyzed in clinical trials to estimate their real value. The use of other herbal medicines, such as Kava-kava, valerian, and Ginkgo biloba is discussed....

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Historical Article 2008; 29(Suppl 1): 105-122 PubMed PMID: 19029873 Citation  Keywords:  Brain:anatomy & histology, History, 20th Century, Humans, Magnetic Resonance Imaging, Mental Disorders:surgery, Neurosurgical Procedures:methods, Obsessive-Compulsive Disorder:therapy, Poland, Psychosurgery:history,.   

: Surgical intervention to the brain has a long history, but contemporary psychosurgery started in the mid-1930s. The first psychosurgical operation was a prefrontal leucotomy. In this chapter, a history of psychosurgery is described with a special focus on so-called "ablation" procedures such as anterior cingulotomy, anterior capsulotomy, subcaudate tractotomy, and limbic leucotomy. The expectations that psychiatrists linked to the surgical intervention have grown along with the progress of diagnostic neuroimaging procedures used in brain research. In recent years, the introduction of neuromodulation techniques seemed to produce a qualitative progress in modern psychosurgery. However, the controversies about these surgical interventions to the brain among psychiatrists still restrict the indications for psychosurgery to highly selected cases....

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Journal Article 2008; 29(Suppl 1): 65-92 PubMed PMID: 19029872 Citation  Keywords:  Antipsychotic Agents:therapeutic use, Circadian Rhythm:physiology, Clinical Trials as Topic, Combined Modality Therapy, Depressive Disorder:physiopathology, Flumazenil:therapeutic use, GABA Modulators:therapeutic use, Humans, Lithium Compounds:therapeutic.   

: Sleep deprivation is a useful therapeutic option in the treatment of depressive disorders, especially in pharmacoresistant disorders. Its therapeutic efficacy in other indications has not, however, been confirmed. According to current knowledge, application of sleep therapy requires concomitant therapy to prevent early relapses of depression. Total sleep deprivation is the classic variant of its clinical use. Partial sleep deprivation has a somewhat less pronounced antidepressant effect, and the duration of sleep deprivation rather than application timing determines its therapeutic effect. The most reliable predictors of sleep deprivation efficacy are marked diurnal fluctuations of depressive mood, patient locomotor activity, and limbic hyperactivity in the central nervous system. The mechanism of the antidepressant effect of sleep deprivation remains unknown....

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Historical Article 2008; 29(Suppl 1): 147-160 PubMed PMID: 19029871 Citation  Keywords:  Clinical Trials as Topic, History, 19th Century, History, 20th Century, Humans, Schizophrenia:physiopathology, Transcranial Magnetic Stimulation:history,.   

: Transcranial magnetic stimulation (TMS) is a non-invasive and painless way of stimulating the neural tissue (cerebral cortex, spinal roots, and cranial and peripheral nerves). The first attempts at stimulating the neural tissue date back to 1896 by d'Arsonval; however, it was successfully carried out by Barker and colleagues in Sheffield, UK, in 1985. It soon became a useful tool in neuroscience for neurophysiologists and neurologists and psychiatrists. The original single-pulse TMS, largely used as an investigative tool, was further refined and developed in the early 1990s into what is known as repetitive TMS (rTMS), having a frequency range of 1-60 Hz. The stimulation by both TMS and rTMS of various cortical regions displayed alteration of movement, mood, and behavior, leading researchers to investigate a number of psychiatric and neuropsychiatric disorders, as well as to explore its therapeutic potential. There is now a large amount of literature on the use of TMS/rTMS in depression; however, its use in schizophrenia, both as an investigative and certainly as a therapeutic tool is relatively recent with a limited but increasing number of publications. In this article, we will outline the principles of TMS/rTMS and critically review their use in schizophrenia both as investigative and potential therapeutic tools....

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