paul naarding

@psycheureka @threadreaderapp unroll please

For decades, Major Depressive Disorder (MDD) has been clinically framed primarily through mood symptoms. However, recent clinical studies have described a potential emerging biotype of MDD whose core pathology leans more towards cognition than just mood symptoms. Here are 5 key clinical insights clinicians need to know about this emerging cognitive MDD biotype:🧵👇

@kees_boef Maar wat dan? Help!!

Het is helder. Van Persie en Te Kloese zijn weg. Kwestie van dagen #feyenoord #rvp #dtk

@psycheureka @threadreaderapp unroll

Can Prolonged Lithium Therapy Contribute to Chronic Kidney Disease (CKD)? While lithium remains the gold standard for mood stabilisation, chronic exposure carries a cumulative risk of progressive renal dysfunction. Existing clinical data indicate that prolonged lithium exposure can disrupt distal tubular homeostasis, leading to a specific tubulointerstitial pathology that may progress to irreversible CKD. Here’s what clinicians need to know about the lithium-CKD link:🧵👇

@psycheureka where do I find the original article by Reve, 2025?

Experienced psychiatrists don’t merely assign diagnoses. They construct dynamic formulations. Diagnosis begins the process. Formulation guides the intervention. Here’s how hypothesis-driven thinking reshapes psychiatric practice. 1/12 🧵

De psychiater van morgen (of gisteren?) Soort van boekbespreking, wel aardig uitgesproken.substack.com/p/de-psychiate…

@psycheureka @threadreader unroll

The brain doesn't just react to medications. It adapts. Opponent Process Theory (OPT) explains how tolerance, withdrawal, and paradoxical effects emerge. One of the most under-taught concepts in psychopharmacology. 🧵1/15

@NTFabiano Further reading, maybe the heterogeneity is only a theoretical/mathematical problem. jamanetwork.com/journals/jamap…

Overall, I hope this sheds light on how our simplistic approach to diagnosis in psychiatry fails to capture the true complexities and individual experiences of mental disorders, thus hindering treatment. 13/13

There are 60,479,984 ways that symptoms can be combined for the diagnosis of a major depressive disorder. 🧵1/13

@kees_boef Nu nog zoveel mogelijk leuke contacten van twitter opzoeken en meenemen en dan twitter elimineren

@kees_boef Ben er al 😎

Leuk hoor op Blue Sky. Best druk al. Wie gaat er nog meer heen?

Zo, er heeft iemand even een grondige critical appraisal gedaan…#covid #geheugenklachten

Much more likely to reflect early symptoms of dementia before cognitive problems become prominent. Amyloid deposition and neuronal loss begin many years before detectable cognitive deficits.

Could but it didn’t.

@StefanBolder Mooie samenvatting

Conclusie JC schaal: Feyenoord en PSV kunnen allebei niet meer verdedigen en Mansfeld kan niet fluiten. 8 goals en 10 kaarten het eindresultaat. #psvfey

@kees_boef @Feyenoord Ja, gewoon doen

@Feyenoord 4 3 3 please!

Morgenavond, 19:30 uur: 🎟 𝐅𝐞𝐲𝐞𝐧𝐨𝐨𝐫𝐝 - 𝐀𝐒 𝐌𝐨𝐧𝐚𝐜𝐨

@sanilrege @psycheureka Better refer to them as classifications (which they are) instead as diagnoses. A psychiatric diagnosis encompasses more than just counting and classifying symptoms.

Which are the symptoms that most commonly repeat in DSM diagnoses? 📚 This study was a very interesting and valuable one for clinical practice. The top 3 symptoms that are frequently repeated in 22, 17, and 16 DSM diagnoses respectively were 1. Insomnia 2. Difficulty concentrating 3. Irritability Not surprising and I’ve covered in previous tweets - 👉If you want to know if you're treatment is working - examine all phases of sleep 👉In the context of illness - address sleep first (not sedation only- but the architecture) - It’s an intervention that sets the foundation for better fronto-striato-limbic functioning and treatments. Basic principles: 👉In the beginning get to 40-60% improvement - one can’t push for more through night time intervention as a significant component of sleep architecture improvement comes through improvement of Day time Activity and Cognitive dimensions ( e.g Adenosine creates homeostatic sleep pressure after ATP ( energy ) breakdown) Insomnia is transdiagnostic because good sleep requires adequate functioning of the Frontistriatolimbic circuits which underpin psychiatric disorders - The balance between the Cognitive and Arousal Systems ( See Diagram) 🧠 Isn't it fascinating the two other commonly repeated symptoms map on to Cognitive ( Difficulty concentrating) and Arousal (Irritability) domains? To learn more we cover sleep in the following courses with the course on Neuropsychiatry of Sleep and Clinical Application Coming up in the future 1. Precision Sleep Medicine - academy.psychscene.com/courses/precis… 2. Basic Principles and application through case studies are also covered in course on psychopharmacology ( Part 3) and ADHD ( sleep disorders highly comorbid) academy.psychscene.com

Zie hier @zusterIris

@zusterIris Maar goed, NL is groter dan Amsterdam hè, hier in het Oosten van het land is het wel pittig hoor.

Fascinerend draadje

Gelukkig nog dit soort posts op twitter 😂

The neuroplasticity framework of depression has the potential to replace the serotonin deficit hypothesis. 🧵1/17