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The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
Methods
The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
Results
About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
Conclusions
The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Even if breast cancer is a severe pathology that can cause the death of a person, nowadays there are effective screening methods that could help us to discover in due time the tumor formation and thus be able to benefit from conservative breast surgery.
Objectives
Evaluating the feasible relationship between the noted levels of procrastination and the educational level of subjects
Methods
The analyzed group comprises a number of 152 female subjects (n=152). They were divided in three subgroups: subgroup I(26) composed of women with lower education, subgroup II(66), women with medium education level and subgroup III(60), women with higher education. A socio-demographic questionnaire and the Tuckman Procrastination Scale have been applied.
Results
Comparing the three subgroups, the levels of procrastination were similar. Low levels of procrastination were most common in all three subgroups: in the subgroup I 57,69%, in the subgroup II 56,06% and in the subgroup III 53,33%. Average procrastination levels were observed in 34,61% of women in subgroup I, 42,42% of women in subgroup II and 45% of women in subgroup III. Concerning high levels of procrastination we can affirm that they involve a small number of subjects. Measuring the degree of connection between the two variables, we obtained as a result r=0.13, which means a very weak, non-existent correlation.
Conclusions
The study revealed that there is no relationship between the level of education and the levels of procrastination that include postponing the presentation to the doctor.
Breast cancer is a severe pathology that once detected completely changes the patient’s perception of life.
Objectives
Evaluating the relationship that is established between the level of stress, the type of surgery applied and, the instructive level of women.
Methods
We selected 67 patients which were divided into 2 groups: group I(31) women who benefited from immediate reconstruction and group II(36) subjects who benefited from a late reconstruction. We split each group into two subgroups: women with secondary education and women with higher education. A socio-demographic questionnaire and the DASS-21 scale were applied.
Results
Comparing the two groups we noticed that stress level was more present in group I(38,7%) than in group II(25%). The differences were not statistically significant(p>0,05). In the subgroup of women with higher education in group I, high levels of stress were observed at 23,08% and, in the subgroup of patients with secondary education, 50% had high levels of stress. The differences were not statistically significant (p>0,05). We also analyzed the two subgroups of group II and we identified increased levels of stress in 20% of patients with higher education compared to those with secondary education where 26,93% had high levels of stress. Also, the differences were not statistically significant(p>0,05). A statistically significant difference(p<0,05) was found when we compared the level of stress between women with secondary education of group I and those of group II.
Conclusions
The study revealed that stress levels tend to be higher in women with immediate breast reconstruction and secondary education.
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.
Methods
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.
Results
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.
Discussion
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 samples.
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.
Methods
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.
Results
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.
Conclusions
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.
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