ORCID Profile
0000-0001-6884-171X
Current Organisations
Queen's University
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Providence Care
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Publisher: Cambridge University Press (CUP)
Date: 09-08-2021
DOI: 10.1017/S1092852921000742
Abstract: The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. There was a 3-year later age at onset for females ( P .001) and lower rates of negative symptoms ( P .01) and higher depression/anxiety measures ( P .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages ( P = .001). No significant effects were found concerning duration of illness. Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative s les.
Publisher: Wiley
Date: 06-03-2023
DOI: 10.1002/CPT.2854
Abstract: The P‐glycoprotein efflux pump, encoded by the ABCB1 gene, has been shown to alter concentrations of various antidepressants in the brain. In this study, we conducted a systematic review and meta‐analysis to investigate the association between six ABCB1 single‐nucleotide polymorphisms (SNPs rs1045642, rs2032582, rs1128503, rs2032583, rs2235015, and rs2235040) and antidepressant treatment outcomes in in iduals with major depressive disorder (MDD), including new data from the Canadian Biomarker and Integration Network for Depression (CAN‐BIND‐1) cohort. For the CAN‐BIND‐1 s le, we applied regression models to investigate the association between ABCB1 SNPs and antidepressant treatment response, remission, tolerability, and antidepressant serum levels. For the meta‐analysis, we systematically summarized pharmacogenetic evidence of the association between ABCB1 SNPs and antidepressant treatment outcomes. Studies were included in the meta‐analysis if they investigated at least one ABCB1 SNP in in iduals with MDD treated with at least one antidepressant. We did not find a significant association between ABCB1 SNPs and antidepressant treatment outcomes in the CAN‐BIND‐1 s le. A total of 39 studies were included in the systematic review. In the meta‐analysis, we observed a significant association between rs1128503 and treatment response (T vs. C‐allele, odds ratio = 1.30, 95% confidence interval = 1.15–1.48, P value (adjusted) = 0.024, n = 2,526). We did not find associations among the six SNPs and treatment remission nor tolerability. Our findings provide limited evidence for an association between common ABCB1 SNPs and antidepressant outcomes, which do not support the implementation of ABCB1 genotyping to inform antidepressant treatment at this time. Future research, especially on rs1128503, is recommended.
Publisher: Royal College of Psychiatrists
Date: 12-2015
DOI: 10.1192/BJP.BP.114.156992
Abstract: No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. To (a) compare reported discrimination across different countries, and (b) explore the relative weight of in idual and contextual factors in explaining levels of reported discrimination in people with MDD. Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. People living in ‘very high HDI’ countries reported higher discrimination than those in ‘medium/low HDI’ countries. Variation in reported discrimination across countries was only partially explained by in idual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD.
Publisher: BMJ
Date: 02-2016
Publisher: Elsevier BV
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 09-02-2016
Publisher: Frontiers Media SA
Date: 29-06-2022
DOI: 10.3389/FPSYT.2022.871119
Abstract: The study aims to investigate the rate of clinical depression in the adult population during the COVID-19 pandemic, as well as the changes in anxiety, distress, suicidal ideation, and their relations with several personal and interpersonal/social variables. This is an epidemiological, non-interventional study. It is part of an international multi-center study, with the main site at the Aristotle University of Thessaloniki, in Greece (COMET-G Study). We are presenting aspects of the research involving the Canadian site, based on 508 Canadian responders to the online survey (QAIRE). Of the 508 responders, 72.2% were females aged 42.57 ± 14.00 years 27.2% were males aged 42.24 ± 15.49 years and 0.6% were others aged 46.33 ± 17.79 years. Increased anxiety during the lockdown was reported by 69.3% of those surveyed. The rate of suicidal thoughts increased in 19.5% of participants during the lockdown. Depression was reported by 22% of responders, while distress was present in 18.4%. We found a greater prevalence of depression, but not distress, in in iduals with a history of any mental disorder. Based on the multiple regression analysis, we found four CORE factors equally influencing the changes in mental health during the lockdown (gender, quality of sleep, family conflicts, and changes in daily routine). In the Canadian population, two major changes acted as protective factors, significantly expressed when compared with the worldwide tendencies: fewer financial difficulties and an increase in religious beliefs. The rate of major depression, distress, and suicidal ideation was higher in Canadians than in the worldwide population (per COMET-G), but the relative risk to develop depression in the presence of a history of mental disorders was lower. Almost 90% of Canadians believed in the real story of COVID source of provenience.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 2022
Publisher: Wiley
Date: 24-10-2011
DOI: 10.1111/J.1600-0447.2011.01772.X
Abstract: The aim of this study was to evaluate the level of anticipated discrimination in people with schizophrenia (n = 732) from 27 countries in the International Study of Discrimination and Stigma Outcomes (INDIGO). Anticipated discrimination was assessed through four questions of Discrimination and Stigma Scale. Twenty-five in iduals were identified at each site who were reasonably representative of all such treated cases within the local area. Sixty-four per cent of the participants reported that they had stopped themselves from applying for work, training or education because of anticipated discrimination. Seventy-two per cent of them reported that they felt the need to conceal their diagnosis. Expecting to be avoided by others who know about their diagnosis was highly associated with decisions to conceal their diagnosis. Those who concealed their diagnosis were younger and more educated. The participants who perceived discrimination by others were more likely to stop themselves from looking for a close relationship. Anticipated discrimination in finding and keeping work was more common in the absence than in the presence of experienced discrimination, and the similar findings applied to intimate relationships. This study shows that anticipated discrimination among people with schizophrenia is common, but is not necessarily associated with experienced discrimination.
Publisher: Cambridge University Press (CUP)
Date: 15-04-2020
DOI: 10.1017/S1092852920001091
Abstract: The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Roumen Milev.