Similarly, our results from the PTSD-7 questionnaire must be interpreted cautiously, as they cannot be equated with a PTSD diagnosis. Psychosomatics. Ehlert U., Gaab J., Heinrichs M. Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: The role of the hypothalamus-pituitary-adrenal axis. Vigo D., Thornicroft G., Atun R. Estimating the true global burden of mental illness. Among micronutrients, magnesium (Mg2+) plays a critical role in brain function and mood since it is essential for optimal nerve transmission and it is involved in the formation of membrane phospholipids. -, Am J Psychiatry. Bethesda, MD 20894, Web Policies Firstly, we explored the RCT studies (Table 1) that explored magnesium levels in depressed patients. The cohort did not show a marked difference in micro-nutrient intake in relation with their resident geographical area and their dietary habit or metabolic state; a slight difference in the levels of magnesium and phosphorus was retrieved due to sex difference. (1982) 66, 13341345 (2008). How does illness severity influence depression, health satisfaction and life satisfaction in patients with cardiovascular disease? Li W., Yu J., Liu Y., Huang X., Abumaria N., Zhu Y., Huang X., Xiong W., Ren C., Liu X.G., et al. In the general population, the mental status of a care recipient was associated with the caregiver burden and, more importantly, the caregiver burden was nearly significant in predicting depression in caregivers43. was partially supported by grants from the Italian Ministry of Health (RF-2016-02364582). Ryszewska-Pokraniewicz B., Mach A., Skalski M., Januszko P., Wawrzyniak Z.M., Poleszak E., Nowak G., Pilc A., Radziwo-Zaleska M. Effects of Magnesium Supplementation on Unipolar Depression: A Placebo-Controlled Study and Review of the Importance of Dosing and Magnesium Status in the Therapeutic Response. Psychiat. The study is the first double-blind, randomised, crossover study that explores the effect of a single dose of a proprietary saffron extract (Safr'InsideTM), or its main volatile compound safranal, on the biological and psychological stress responses in healthy young men after experiencing a physically and psychologically challenging laboratory stress test (MAST), compared to a placebo group. Google Scholar. Dis. Introduction As interest in Animal-Assisted Interventions (AAI) grows, there is increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-Assisted Psychotherapy (CAP). Nervenarzt 79(5), 577. https://doi.org/10.1007/s00115-008-2467-5 (2008). However, other components of glutamatergic transmission, such as the -amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid AMPA receptor, appear to be modulated by magnesium as well [40]. Muscle Nerve 58, 9098 (2018). (2005) found that magnesium enhanced the antidepressant effect of imipramine in mice using a forced swim test (FST) [95]. Suzuki, Y. et al. Escalation therapy with Rituximab and IVIG was reported by 3.4% and 8.2%, respectively. Elia M., Normand C., Norman K., Laviano A. In addition to the effect of depression, patients' HRQoL as well as caregiver burden were negatively associated with the patients female gender and positively associated with thymectomy. Burns, T. M. et al. Finally, a single, smaller study [79] addressing the efficacy and safety of magnesium as an augmentation to antidepressant treatment, found no significant differences. PubMed CAS motivational general-mastery (MG-M) imagery has been shown to increase self-efficacy among athletic populations (O, et al., 2014); however, there is a paucity of research regarding the influence of imagery, particularly individualized MG-M imagery, on the self-efficacy of youth athletes specifically. The case report presented here shows exemplary that psychopathological disturbances in exacerbated myasthenic patients are temporary and completely reversible after adequate somatic therapy. https://doi.org/10.1007/s00415-010-5549-9, https://doi.org/10.1007/s00115-008-2467-5, https://doi.org/10.1001/archneur.1993.00540060055018, https://doi.org/10.1080/13548506.2020.1807577, https://doi.org/10.2165/00023210-200721060-00004, https://doi.org/10.1016/S0272-6386(12)80589-0, https://doi.org/10.1080/08870446.2012.759223, https://doi.org/10.1016/S0140-6736(18)32279-7, https://www.aerzteblatt.de/int/article.asp?id=51635, http://creativecommons.org/licenses/by/4.0/. 1). Med. A group of studies investigated several microelements, including serum magnesium, in depressed patients vs. healthy controls. Mg supplementation was effective on depression status in depressed patients with Mg deficiency, 55 randomized to Immediate treatment (22 M, 33 F; mean age 55.2 12.3) + 57 randomized to Delayed treatment (22 M, 35 F; mean age 50.1 13.0). The primary goal of taking on the condition is to manage the associated fatigue and motor challenges, swallowing difficulties (clinically called dysphagia), and vision problems (double vision). Zinc, ferritin and Mg levels were significantly lower than controls (, Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD), Cr, Mg, and Zn levels in children with ADHD were 21% (, Evaluation of Whole Blood Trace Element Levels in Chinese Children with Autism Spectrum Disorder, 113 ASD children, 141 age- and gender-matched neurotypical children, No significant differences in the whole blood Cu, Zn/Cu ratio, Fe, or Mg was detected between the ASD group and the control group. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Received 2020 Apr 11; Accepted 2020 May 25. Unsatisfactory outcomes in myasthenia gravis: influence by care providers. From day one, it influences how employees behave. Vennemeyer J.J., Hopkins T., Kuhlmann J., Heineman W.R., Pixley S.K. Relevant disease-related information such as current disease severity (low, medium, high), antibody status, age at onset of myasthenia-related symptoms and time of diagnosis, comorbidities (autoimmune, cardiac or psychiatric (depression, anxiety disorder, PTSD, other)), medication, history of myasthenic crisis and exacerbation. supported the second phase of the analysis, reading the article and reviewing the manuscript. Clinically significant net improvement in PHQ-9 scores of -6.0 points and (GAD-7 in scores of -4.5 points. Poleszak E., Wla P., Kedzierska E., Radziwon-Zaleska M., Pilc A., Fidecka S., Nowak G. Effects of acute and chronic treatment with magnesium in the forced swim test in rats. psych is the most popular phrase on the web. Perspectives on organizational climate and culture. - APA PsycNet ; D.M., U.H., S.L. CAS J. No significant superiority of Mg augmentation therapy on depressive and anxiety symptoms, 99 women (3 groups, mean age 29.4 5.4, 26.4 4.8, and 27.6 5.1 respectively), 27 mg Zn-sulfate or 320 mg Mg-sulfate/die. https://doi.org/10.1038/s41598-022-22078-3, DOI: https://doi.org/10.1038/s41598-022-22078-3. Arch Neurol. In our record screening process, we identified four studies that analyzed the concentration of magnesium in patients suffering from anxiety disorders. For patients who reported a myasthenic crisis and were treated in a normal ward setting, we assumed that they had an exacerbation. Dunand M, Botez SA, Borruat FX, Roux-Lombard P, Spertini F, Kuntzer T. J Neurol. Neurosci. Cognitive Science, Medical. MG disease severity and the caregiver burden were strongly associated. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. and P.B. Antidepressants increased Ca and lowered Mg levels. Thus, psychiatric comorbidities including PTSD may then also be captured too sensitively. Seven showed a significant correlation between reduced plasma magnesium values and depression measured with psychometric scales. doi: 10.1136/bmjopen-2011-000313. We identified three studies [61,62,63] that correlated magnesium levels with the severity of symptoms, measured with a variety of tools, but reporting mixed results. Billyard A.J., Eggett D.L., Franz K.B. Winther G., Pyndt Jrgensen B.M., Elfving B., Nielsen D.S., Kihl P., Lund S., Sorensen D.B., Wegener G. Dietary magnesium deficiency alters gut microbiota and leads to depressive-like behaviour. The data that support this studys findings are available on request from the corresponding author. Psychiatry. Raj K.S., Keane-Miller C., Golden N.H. Hypomagnesemia in adolescents with eating disorders hospitalized for medical instability. Specifically, Rucklidge et al. Twork, S., Wiesmeth, S., Klewer, J., Phlau, D. & Kugler, J. Importantly, the majority of patients who underwent psychotherapy (93.9%) reported benefiting therefrom. Moher D., Liberati A., Tetzlaff J., Altman D.G., The PRISMA Group Preferred Reporting Items for Systematic Reviews and Meta- Analyses: The PRISMA Statement. Myasthenia gravis patients usually present with fluctuating, asymmetrical stress-dependent weakness in the absence of other neurological disturbances. & Feng, L. Fatigue, self-efficacy and psychiatric symptoms influence the quality of life in patients with myasthenia gravis in Tianjin, China. MG patients with symptoms of depression and anxiety disorder had a corresponding diagnosis in only 23.3% and 12.7%, respectively. We thank Jane Thmmler for support in data management and Inken Padberg for statistical advice. Interestingly, from the reviewed studies, it emerged that the results showing an association between mental disorders and magnesium are still largely inconclusive. Interestingly, the PTSD-7 results revealed similar rates of PTSD in MG patients with a history of an exacerbation and a myasthenic crisis. Double-blind, andomized crossover study of intravenous infusion of magnesium sulfate versus 5% dextrose on depressive symptoms in adults with treatment-resistant depression. However, they did not differ in eating disorder diagnosis, Body Mass Index, or other electrolyte disturbances. This is due to the overlapping complaints as well as the methodological limits of a patient survey. Myasthenia gravis. Biol. In two other papers, a reduced Hamilton Anxiety Rating Scale (HAM-A) score in depressed patients correlated with higher levels of magnesium and beneficial levels of magnesium in stressed patients was found. Both haloperidol and risperidone were found to increase intra-erythrocytic magnesium levels [46] and treatment of hypoparathyroidism-induced psychosis seems to be dependent on magnesium level, with hypomagnesemia causing treatment resistance to antipsychotics [47]. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Effects of haloperidol on human plasma magnesium. Notably, the presence of many studies on depression is not surprising since the use of magnesium is mostly reserved to depressive disorders, because of its involvement in several core mechanisms of depressive physiopathology, including glutamatergic transmission in the limbic system and cerebral cortex [89], regulation of the HPA axis [41,90], inflammation and oxidative stress [91], response to NMDA receptor antagonist [92], serotonin, dopamine, and noradrenaline modulation [43], BDNF expression [40], as well as the modulation of the sleepwake cycle [93]. To distinguish between myasthenic crisis and exacerbation, we asked patients not only whether they had a "myasthenic crisis" but also whether they were treated in an intensive care unit setting in that case. We further hypothesize that the self-perceived MG severity, as well as comorbid depression, have a significant impact on patients HRQoL and caregivers burden. National Library of Medicine One dose of saffron extract 'tones down' psychological stress response While the other characteristics of the MG patients were very similar to our study with both being conducted in Germany, the difference is likely due to a changed situation in MG patients care (previously combined specialty for neurology and psychiatry with now often separated residency tracks). developed the study design and questionnaire supervised by Andreas Meisel; statistical analyses were performed by D.M. Fatigue in patients with myasthenia gravis. A - ScienceDirect Mg supplementation alleviated stress in healthy adults with hypomagnesemia. The majority of patients (60.8%) also visited a registered neurologist or general practitioner regularly. Nurs. Since MG may wax and wane in severity, taking it on is often an evolving and dynamic process. 103(22), A1557. Indeed, the total concentration of magnesium is mainly intracellular and free ion concentration does not always correlate with whole concentration. -, Psychiatr Prax. General linear models were used to estimate the association between self-reported disease severity as the independent variable and MG-QoL15 and caregiver burden as dependent variables, respectively. PubMedGoogle Scholar. U.H. Also, MG patients experience a reduced health-related quality of life (HRQoL). Basta, I. All authors have read and agreed to the published version of the manuscript. Perez-Nellar, J. Can we predict treatment response in children with ADHD to a vitamin-mineral supplement? This may be sufficient in mild disease. Bethesda, MD 20894, Web Policies Lee, I., Kaminski, H. J., Xin, H. & Cutter, G. Gender and quality of life in myasthenia gravis patients from the myasthenia gravis foundation of America registry. Therefore, it is necessary to design ad hoc clinical trials to evaluate the efficacy of magnesium alone or together with other drugs (antidepressants) in order to establish the correct use of this cation with potential therapeutic effects. Epilepsy Behav. Additionally, the same research group, in 2006, showed that combining sub-therapeutic doses of Mg2+ in combination with sub-therapeutic doses of imipramine leads to a significant antidepressant-like effect in animal models [96]. We aim to quantify the effect of MG severity and symptoms of depression on patients' HRQoL and caregivers' burden. Prospective study of stress, depression and personality in myasthenia gravis relapses. [Myasthenia gravis in the frontier of psychiatric diagnosis]. The female gender was strongly associated with lower HRQoL corroborating findings of previous studies5,34. Stoppe, G., Bramesfeld, A., Schwartz, F.-W. (2006) Volkskrankheit Depression? 60(2), 150155 (1998). (2013) reported that magnesium and ketamine showed an overlap of action in animal models because of both of them could lead to synaptic sprouting [99], ultimately suggesting that they both have a similar action in SNC. Starting and incremental dosages (mg per day)* Usual target dosage (mg per day) Usual maximal dosage (mg per day) Occasionally prescribed maximal dosage (mg per day) Citalopram (Celexa) 20: 40 . In the meantime, to ensure continued support, we are displaying the site without styles Open Access funding enabled and organized by Projekt DEAL. Psychiatric comorbidities like depression, anxiety disorder, or posttraumatic stress disorder (PTSD) are highly prevalent in smaller cohorts of MG patients, with prevalences of depression ranging from 14 to 58%8,9. Screening of depression in overweight and obese pregnant women and its predictors. Elevated C-reactive protein levels, psychological distress, and Experience of at least one myasthenic crisis was reported by 17.2% of patients, whereas 22.8% reported exacerbations of MG. Stangherlin A., ONeill J.S. Myasthenia Gravis: Coping, Support, and Living Well - Verywell Health Miech, R. A. James, S. L. et al. Another limitation is our definition of myasthenic crisis. Meet Dr. Maribel Gonzalez | MG Psychology | Miami Beach, FL 33140 Our data based on the HADS questionnaire suggests an underdiagnosis of depression and anxiety disorder MG patients. Rajizadeh A., Mozaffari-Khosravi H., Yassini-Ardakani M., Dehghani A. Eur. Since our founding in 2009, The Assistance Fund has helped more than 160,000 children and adults access the treatment they need to stay healthy or manage a life-threatening, chronic, or rare disease. Kanner, A. M. Should neurologists be trained to recognize and treat comorbid depression of neurologic disorders? Studies have found this disease has a consistent impact on overall quality-of-life, as those with it suffer higher rates of depression, anxiety, and social withdrawal. Liu, C., Li, T., Wang, Q., Xu, A. Symptoms of depression and anxiety disorder were indicated by 31% and 36% of patients. ), 3Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; ti.iminu@oihccevled.eppesuig. Negative correlations between SDS and Ca intake and animal Ca after adjusting for age, menopause and energy intake, Correlation between Depression with Serum Levels of Vitamin D, Calcium and Magnesium in Women of Reproductive Age, Womens depression scores showed a significant inverse correlation with the serum level of vitamin D (, Plasma magnesium levels and treatment outcome in depressed patients, No association between Mg levels and psychopathological severity Patients who responded to antidepressant treatment showed higher Mg levels and higher retardation scores at basal evaluation in comparison with non-responders, Variability in serum electrolytes in different grades of depression, All the depression patients were having higher level of Na, K, and Ca and lower level of Mg. A comprehensive search of all studies using or analyzing the effect of magnesium in psychiatric disorders were conducted on the PubMed database from 1 January 2019 to 30 March 2020. J. Gold, R., Hohlfeld, R. & Toyka, K. V. Progress in the treatment of myasthenia gravis. Balon R. The inexplicable rise of medication prices. [45] found that concentrations of both magnesium and zinc (Zn) were reduced in the hippocampal tissue of suicide victims, along with an altered glutamatergic NMDA activity in the hippocampus. MG Psychological & Counselling in Kajang, reviews by real people. Methods: A systematic search of scientific records concerning magnesium in psychiatric disorders published from 2010 up to March 2020 was performed. Muscle Nerve 43(1), 1418 (2011). Miller A.H., Raison C.L. During our journey together, we'll set goals for treatment and consider changing thinking and behavior patterns that are now getting in the way of your life goals. Sci. 1990 Oct;147(10):1297-303 Burns, T. M., Grouse, C. K., Wolfe, G. I., Conaway, M. R. & Sanders, D. B. & Ismail, M. Thymektomie bei myasthenia gravis TT - thymectomy in Myasthenia gravis. Three of them reported no significant differences in magnesium serum levels in Generalized Anxiety Disorder (GAD), Panic Disorder and anxiety symptoms during a major depressive episode [55,61,66]. Interestingly, Medhi et al. As depicted above, Fard et al. N. Engl. A multi-national, multi-disciplinary Delphi consensus study on using omega-3 polyunsaturated fatty acids (n-3 PUFAs) for the treatment of major depressive disorder. http://creativecommons.org/licenses/by/4.0/, https://www.mdpi.com/2072-6643/12/6/1661/s1, Total and ionized calcium and magnesium are significantly lowered in drug-nave depressed patients: effects of antidepressants and associations with immune activation. As with many other chronic conditions, there's a significant emotional and psychological toll associated with myasthenia gravis. Search results were exported into the reference manager software Rayyan QCRI; duplicates detected by the software were resolved manually by (AB). 2010 Mar;257(3):338-43. doi: 10.1007/s00415-009-5318-9. In contrast, adjustment for gender in model 3 as well as for age, education, marital status, myasthenic crisis, duration of disease, disease latency, and treatment escalation (IVIG/rituximab) in model 4 only slightly affected the effect estimates of self-reported severity (estimated marginal means of MG-QoL15 score for severe vs. mild MG severity=14.36 95%CI [12.23 16.48]; Adj R2=0.560; Table 3). Our results suggest that depressive symptoms areamongst the variables we investigatedthe most influential factor affecting the perceived MG severity and HRQoL. Sowa-Kuma M., Szewczyk B., Sadlik K., Piekoszewski W., Trela F., Opoka W., Poleszak E., Pilc A., Nowak G. Zinc, magnesium and NMDA receptor alterations in the hippocampus of suicide victims. Detecting acute distress and risk of future psychological morbidity in It can help with things such as choosing a . Liao Y., Xie B., Zhang H., He Q., Guo L., Subramaniapillai M., Fan B., Lu C., Mclntyer R.S. Adjusting for gender in model 3 and for the other potentially confounding variables in model 4 showed no substantial change in effect estimates, suggesting that these factors did not have an impact on the association between MG severity and caregiver burden (Table 4), except thymectomy having a minor impact. Also, MG is an unpredictable disease with a relapsing and remitting course necessitating the use of chronic medication with potential side-effects that impair quality of life [6,7,8] and may cause psychological stress and predispose to depression . The efficacy and safety of nutrient supplements in the treatment of mental disorders: A meta-review of meta-analyses of randomized controlled trials. Psychiatric comorbidities are relevant in patients with Myasthenia gravis (MG). The influence of some antipsychotics on erythrocyte magnesium and plasma magnesium, calcium, copper and zinc in patients with paranoid schizophrenia. The simultaneous presence of MG and symptoms of depression, for instance, can be challenging for diagnosing depression in MG patients and vice versa. In general, female caregivers experience a more significant caregiver burden than men44. Regression analyses showed varying predictors across outcomes with no one of the predictors being consistently identified across different variables. J. Neurosurg. Beyond MG severity, symptoms of depression have negative effects on HRQoL as well as on caregivers burden. psych vs Mg psysch. Patient-reported impact of myasthenia gravis in the real world: findings from a digital observational survey-based study (MyRealWorld MG). PTSD has been reported in 51% of MG patients after an episode of respiratory insufficiency. There is inconsistent data about the reduction of psychological domains in the HRQoL5,6. Derin Marbin. This element facilitates calcium (Ca2+) absorption and both ions are regulated by the parathyroid hormone; however, free ion concentration does not always correlate with total concentration. 2011;2011:968181. doi: 10.1155/2011/968181. Verschuuren, J. J. G. M., Palace, J. Consistent with our results, gender differences in HRQoL were abolished in MG patients after thymectomy34. 10(1), 46. https://doi.org/10.1186/1471-2377-10-46 (2010). He is the chairman of the German Myasthenia Gravis Societys medical advisory board. Boyle N.B., Lawton C., Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. The estimated strength of association for MG severity on MG-QoL15 decreased after adjusting for symptoms of depression, whereas model fit increased. Berrih-Aknin S, Palace J, Meisel A, Claeys KG, Muppidi S, Sacc F, Amini F, Larkin M, Quinn C, Beauchamp J, Philips G, De Ruyck F, Ramirez J, Paci S. BMJ Open. When the diagnosis of myasthenia gravis (MG) has been secured, the aim of management should be prompt symptom control and the induction of remission or minimal manifestations. The psychological contract is an agreement, unwritten but understood, that outlines the expectations, beliefs, ambitions, and obligations that characterize the relationship between employer and employee. Moreover, although the majority of drugs currently used to treat the more common psychiatric disorders have been proven to be effective by recent robust meta-analyses [4,5], most of the psychiatric pharmacotherapy must be continued for years (or even lifelong), bringing severe adverse side effects [6,7]. Models were stepwise adjusted for potential effect mediation by depression according to HADS scores (1:<8; 2: 810; 3: 1114; 4:>14), as well as the potential confounding factors gender, age, education, marital status, myasthenic crisis/exacerbation, duration of disease, disease latency and treatment escalation (IVIG/Rituximab) as well as a history of other autoimmune disease or cardiovascular disease as binary variables. (2012) [68] that described a decrease in magnesium levels, together with Zn and Fe levels, in OCD patients when compared to healthy controls. Nat Rev Immunol. -, Acta Neurol Scand. Furthermore, Singewald et al. Med. OBJECTIVE To test whether elevated plasma levels of C-reactive protein (CRP) are associated with psychological distress and depression. (1993) [84] reported that patients with SCZ had increased magnesium plasma concentrations and also that magnesium levels were reduced after the administration of haloperidol. Islam M.R., Islam M.R., Shalahuddin Qusar M.M.A., Islam M.S., Kabir M.H., Mustafizur Rahman G.K.M., Islam M.S., Hasnat A. Alterations of serum macro-minerals and trace elements are associated with major depressive disorder: A case-control study. Rehm J., Shield K.D. Adv. Am I Crazy? The Psychiatric Side Effects of Prednisone
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