Keyword: major depressive disorder

Beyond grief: Developing a transdiagnostic conceptual model of bereavement-related psychopathology

Bereavement constitutes a shared environmental exposure that may result in distinct psychopathological outcomes, including prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). The objective of this research was to construct a transdiagnostic conceptual model for interpreting bereavement-related pathologies that integrates core psychopathological data. A structured conceptual synthesis of the literature was conducted, focusing on diagnostic, epidemiological, pathophysiological, clinical, and therapeutic findings related to PGD and associated disorders. Shared and disorder- specific mechanisms were identified and mapped across diagnostic categories in order to construct an integrative framework. The proposed model suggests that bereavement-related psychopathology can be conceptualized as a spectrum of partially overlapping syndromes organized around three principal domains: attachment dysregulation and separation distress (PGD), trauma- and threat- processing abnormalities (PTSD, acute stress disorder, adjustment disorder), and depressive-cognitive vulnerability (MDD). This framework provides a clinically relevant perspective on the relationship between grief-, trauma-, and depression-related disorders following loss. More research is needed to empirically validate this model, but at a theoretical level, it can serve as an orienting aid for mapping bereavement-related diagnoses and treatments.

Effect of the selective serotonin reuptake inhibitors over coagulation in patients with depressive disorders – a systematic review and retrospective analysis

Several problems related to coagulation dysfunctions induced by selective serotonin reuptake inhibitors (SSRIs) were reported in literature, as serotonin is widely distributed in the human organism and it has significant contribution in various vascular and hematologic regulatory mechanisms. First, a systematic review has integrated main results from the field of SSRIs and anticoagulants pharmacologic interactions. Secondly, a retrospective analysis was performed, based on the medical charts of hospitalized patients diagnosed with SSRI-treated depressive disorders, who also received concomitant anticoagulant treatment with acenocoumarol. Platelet count, prothrombin time, activated partial thromboplastin time, and bleeding time were monitored during hospitalization and their values before and after SSRI initiation treatment were compared.

The Psychiatric, Psychological, and Psychotherapeutic Approach to Erectile Dysfunction – Between Good Practices and Clinical Challenges

Erectile dysfunction (ED) has an intricate pathogenesis, with organic and psychosocial factors contributing to the shaping of its clinical manifestations and functional impairment. ED disrupts not only an individual’s sexual life but may also contribute to impairments of self-esteem, social functioning, quality of life, overall well-being, mood, etc. The assessment process and therapeutic interventions should be adequate to the specific profile of each patient, therefore an interdisciplinary approach is usually recommended, in order to find the vulnerability factors, recent triggers, psychiatric and organic comorbidities or causes, and elements that contribute to maintaining the sexual dysfunction, such as lifestyle factors, interpersonal conflicts, or inadequate sexual education. This narrative review explores the evidence-based approaches to structured psychiatric, psychological, and therapeutical assessment in patients with ED, and the most validated psychosocial treatments available. The results support the use of recognized diagnostic criteria within DSM-5TR and ICD-11, together with structured instruments (scales, questionnaires, and inventories), in a multidisciplinary approach. The cognitive model and cognitive-emotional model of ED support the initiation of cognitive-behavioral therapy in these patients. Other interventions, like the PLISSIT model, sexual therapy, couple therapy, and sexual-focused psychoeducation are also supported by evidence. In conclusion, ED requires a combined, psychiatric, psychologic, psychotherapeutic, and organic-oriented assessment, with the purpose of tailoring the treatment to the patient’s particularities.