Cross-sectional study among medical students in Latvia: Differences of mental symptoms and somatic symptoms among Latvian and international students

Introduction. This research aims to determine the prevalence of mental symptoms (depressive symptoms, anxiety and adjustment disorders) and somatic symptoms among medical students at Riga Stradins University in Latvia, as well as to display the differences between local and international medical students. Methods. A cross-sectional study was conducted by means of onlinebased questionnaires among medical students in their 1st, 4th and 6th years studying in Riga, Latvia, during March 2017. The mental and somatic symptoms were screened with the PHQ-D Option C (PHQ-15, PHQ-9, GAD-7). Symptoms of adjustment disorder were obtained by the ADNM-6. Medical students were divided into three groups according to their answers of the PHQ-D: Group A: no symptom, group B: a single symptom, group C: multiple symptoms. A general questionnaire and a questionnaire regarding stressful life events over the past half-year were distributed additionally. Results. 67 (40.1%) participants were Latvian students; 100 (59.9%) were international students. 23 (34.3%) Latvian students were in group A, 20 (29.9%) in group B, 24 (35.8%) in group C. 51 (51%) international students were in group A, 34 (34%) in group B, 14 (14%) in group C. Latvians displayed statisti cally significantly more health-related symptoms (0.003). 11 (11%) international students who reported a stressful life event over the last half-year were in group C. 21 (31.3%) of Latvian students who reported a stressful life event over the last half-year were in group C. 73 (43.7%) of all students had experienced stressful life events and displayed troubles adjusting to them. 65 (63.1%) students of the two groups with a stressful life found the event to have a great burden on them, 63 (61.2%) were wondering whether it could happen again, and 73 (70.9%) tried to suppress their feelings. Conclusion. Medical students in Latvia have a high prevalence of healthrelated symptoms. Latvian medical students display more health-related symptoms and symptoms of adjustment disorder. Further research needs to be performed to investigate whether Latvians have a lower threshold for stressors or whether they are exposed to more stressors than international students. The high prevalence of symptoms of adjustment disorder may impact the prospective patient-doctor relationship and the treatment outcome

Insufficient assessment of sexual dysfunction : A problem in gynecological practice

Background and Objective: Sexual health is an important part of a woman's life and well-being. Female sexual dysfunction is a complicated problem, it is often underestimated in the healthcare process, and its management is complex. Giving women the opportunity to talk about sexual problems is a fundamental part of healthcare and may improve their quality of life. The aim of this study was to find out patients' experience and attitudes toward the involvement of gynecologists addressing sexual issues, to disclose the main barriers to initiate a conversation, and to assess the prevalence of sexual disorders among patients in a gynecological clinic. Material and Methods: A questionnaire-based approach was used to survey 18- to 50-year-old voluntary patients in the gynecological clinic. The study population comprised 300 different gynecological (except oncologic) patients independently of reasons for being in the clinic. The duration of the study was 6 months. Results: Only one-third of the patients had ever been asked about their sexual life by a gynecologist, whilst the majority (80%) of the respondents reported they would like to be asked and discuss sexual issues. The patients mostly did not complain because of psychoemotional barriers, and shame was the main barrier for patients to talk about their problems. Sexual dysfunction was a frequent disorder among gynecological patients, reaching especially high levels in the arousal (46.41%) and lubrication (40.67%) domains. Conclusions: The assessment of sexual health is insufficient in gynecological care, and sexual history-taking and evaluation of sexual functions should be included in routine gynecological health assessments.publishersversionPeer reviewe

Oxidative stress parameters in Posttraumatic Stress Disorder risk group patients

Funding Information: The research is supported by European Social Foundation co-financing: Project for Doctoral students support, at Rîga Stradiòð University (No. 2009/0147/1DP/1.1.2.1.2/09/IPIA/ VIAA/009). The views expressed in this article are those of the authors and do not reflect the official policy or position of the Latvian government, Latvian National Armed Forces, Medical Support Centre of Latvian National Armed Forces or any of the institutions with which the authors are affiliated. The authors state no conflict of interest. All authors read and approved the final manuscript.Increased excitotoxity in response to stressors leads to oxidative stress (OS) due to accumulation of excess reactive oxygen/nitrogen species. Neuronal membrane phospholipids are especially susceptible to oxidative damage, which alters signal transduction mechanisms. The Contingent of International Operations (CIO) has been subjected to various extreme stressors that could cause Posttraumatic Stress Disorder (PTSD). Former studies suggest that heterogeneity due to gender, race, age, nutritional condition and variable deployment factors and stressors produce challenges in studying these processes. The research aim was to assess OS levels in the PTSD risk group in CIO. In a prospective study, 143 participants who were Latvian CIO, regular personnel, males, Europeans, average age of 27.4, with the same tasks during the mission, were examined two months before and immediately after a six-month Peace Support Mission (PSM) in Afghanistan. PCL-M questionnaire, valid Latvian language "Military" version was used for PTSD evaluation. Glutathione peroxidase (GPx), superoxide dismutase (SOD) and lipid peroxidation intensity and malondialdehyde (MDA) as OS indicators in blood were determined. Data were processed using SPSS 20.0. The MDA baseline was 2.5582 μM, which after PSM increased by 24.36% (3.1815 μM). The GPx baseline was 8061.98 U/L, which after PSM decreased by 9.35% (7308.31 U/L). The SOD baseline was 1449.20 U/gHB, which after PSM increased by 2.89% (1491.03 U/gHB). The PTSD symptom severity (total PCL-M score) baseline was 22.90 points, which after PSM increased by 14.45% (26.21 points). The PTSD Prevalence rate (PR) baseline was 0.0357, which after PSM increased by 147.06% (0.0882). We conclude that there is positive correlation between increase of OS, PTSD symptoms severity level, and PTSD PR in a group of patients with risk of PTSD - CIO. PTSD PR depends on MDA intensity and OS severity. OS and increased free radical level beyond excitotoxity, is a possible causal factor for clinical manifestation of PTSD.publishersversionPeer reviewe

A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders: Results of an estimate-talk-estimate delphi expert study

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe

A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders : Results of an estimate-talk-estimate delphi expert study

Publisher Copyright: © 2018 van der Feltz-Cornelis, Elfeddali, Werneke, Malt, Van den Bergh, Schaefert, Kop, Lobo, Sharpe, Söllner and Löwe.Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.publishersversionPeer reviewe

Interrelations of paranormal and pseudoscientific beliefs and critical thinking disposition among undergraduate medical students of RSU

Magical and paranormal beliefs have been found in all cultures and strata of society, including medical university students. Critical thinking skills and dispositions are generally considered desirable outcomes of the educational process. Nevertheless, there is the lack of conceptual clarity about interrelations between the magical and critical thinking. Aim of the study is to explore prevalence of magical, paranormal beliefs and pseudoscientific beliefs among undergraduate medical students, as well as to explore prevalence of critical thinking dispositions among medical students and to assess interrelations and psychodynamics between “noncritical” forms of thinking – magical, paranormal and pseudoscientific beliefs, and critical thinking disposition. The results showed statistically significant negative correlation between paranormal beliefs and critical thinking disposition if students are put in optional situation between opposite statements. If statements in assessment scales do not put respondents in optional situation, their results do not show significant correlations

Results of an estimate-talk-estimate delphi expert study

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.publishersversionpublishe