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To estimate prevalence of Posttraumatic Stress Disorder (PTSD), depression, anxiety and substance misuse among university students after the 1992-1995 war in Bosnia-Herzegovina (BH).
Methods:
The sample of 372 students from University of Tuzla (234 females) aged of 21.9±2.4 years, divided in medical (n=108) and philosophy students group (n=264), were evaluated for prevalence of PTSD, depression, anxiety and substance misuse. The Harvard Trauma Questionnaire, Beck Depression Inventory, and Sheehan Patient-Rated Anxiety Scale were used.
Results:
In the sample PTSD prevalence was 20.7%; groups did not significantly differed (Chi-square=0.895; df=1; P=0.344). Girls presented significantly more PTSD (24.4%) than boys (14.2%) (Chi-square=5.424, df=1, P=0.020). The prevalence of depression and anxiety in the sample was 30.1% and 35.5% respectively, with no significant differences between groups (Chi-square=1.265; df=1; P=0.261; Chi-square=2.278; df=1; P=0.131, respectively). Gender had no influence on the prevalence of depression and anxiety.
Prevalence of cigarette smoking and alcohol drinking in whole sample was 35.2% and 41.4% respectively with no significant differ between groups. Significantly, more boys were drinking alcohol (57.3%) than girls (32.3%) (Chi-square=21.362; df=1; P<0.001). Prevalence of marijuana and heroin misuse in whole sample was 15.3% and 5.0% respectively; significantly, more boys misused marijuana (20.6%) than girls (12.2%) (Chi-square=4.525; df=1; P=0.033).
Conclusions:
The prevalence of PTSD, depression, anxiety, and substance misuse between groups of medical and philosophy university students in BH seven years after the war quitted did not significantly differ. Girls presented significantly more PTSD prevalence than boys. Boys significantly more frequently were drinking alcohol and misused marijuana than girls.
Clozapine is the most effective antipsychotic medication, but it has the highest propensity for metabolic side effects. A clozapine clinic was established within an early intervention for psychosis service to facilitate the timely commencement of clozapine and to manage the associated adverse effects. This study describes the changes in the weight, body mass index (BMI), waist circumference and blood pressure after 6 months in young people commenced on clozapine.
Method:
This was a prospective cohort study of all young people, aged 15–24 years, commenced on clozapine within an early intervention service in Melbourne, Australia, between 01.04.2016 and 30.06.2018. Continuous data were analyzed with paired t-test and categorical with Wilcoxon signed-rank test.
Results:
Twenty-six young people received 6 months of treatment with clozapine, of whom the mean age was 19.8 years (s.d. ±3.1) and 66.7% were male. After 6 months, the mean weight gain was 5.1 kg (s.d. ±10.1 kg) and over half (53.8%) gained clinically significant weight. The proportion of young people classified as either overweight or obese rose from 69.2% to 88.5% (p = 0.006). The proportion of young people with a waist circumference above the recommended parameters increased from 57.9% to 78.9% (p = 0.008). Hypertension was present in 30%, and after 6 months, 45% had hypertension (p = 0.64). Metformin was prescribed to 34.6%, typically to those with the greatest and most rapid weight gain.
Conclusion:
Among young people with treatment resistant psychosis, clozapine is associated with significant metabolic side effects in the early stages of commencement. More interventions aimed at attenuating this weight gain are needed.
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