We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Preliminary studies providing evidence of the neuroprotective effect of SSRIs in patients with Multiple Sclerosis (MS) by improving the metabolic function of axons. The aim of this, open label, randomized, controlled, one year follow-up prospective study was to investigate the effect of escitalopram in the prevention of relapses in women with MS.
Methods
Forty eight ambulating women with relapsing-remitting MS were randomly assigned to receive 10 mg of escitalopram per day (e-group, N=24) or to continued the study without medication as a control group (c-group, N=24). Neurological examination was performed, by the same neurologist, at baseline and at every regular (4 weeks) and additional visit after a suspect exacerbation.
Results
During the study period 55 exacerbations occurred in 33/48 (68.7%) of the patients, and these were confirmed by the study neurologist. E- group patients’ present a mean of 0.8 (SD=0.8) and c-group patients’ a mean of 1.4 (SD=1.0) exacerbations per year. Patients treated with escitalopram present a statistically significant reduction in the mean number of MS relapses respect to the previous year (paired t-test, df=23, t=4.9, p< .001). There was no significant difference between the mean number of MS relapses during the year of the study and the previous year in c-group (paired t-test, df=23, t=-0.68, NS). The cumulative risk for relapse was 2.9 times higher for the controls than for escitalopram-treated patients (95% CI= 1.7- 5.1, p< .001).
Discussion
This study provides evidence that escitalopram tends to decrease MS disease activity in women with MS.
Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.
Methods
In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout.
Results
This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8–65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (P < 0.001), without children (P = 0.010), and had not opted for psychiatry as a first career choice (P = 0.043). After adjustment for socio-demographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours (P < 0.001), lack of supervision (P < 0.001), and not having regular time to rest (P = 0.001). Main findings were replicated in a sensitivity analysis with countries with response rate above 50%.
Conclusions
Besides previously described risk factors such as working hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees’ burnout.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.