ECG STUDY IN PATIENTS ON HIGH DOSE ANTIPSYCHOTICS

Objectives: There are many antipsychotic medications that have been shown to be associated with the prolongation of the rate-corrected QT (QTc) interval on the electrocardiogram (ECG). Studies have shown that QTc prolongation is associated with increased risk of arrhythmias and sudden cardiac death. This study aims to identify and study the risk profile of patients on high-dose antipsychotic and to examine the prevalence of rate and rhythm abnormalities, in particular, QTc prolongation. We hope that this study could throw a light on current practice patterns and also could potentially guide us towards safe practice in the future. Methods: We recruited 37 adult outpatients who are on high-dose antipsychotic from the 3 outpatient clinics of the Institute of Mental Health in Singapore. Baseline characteristics risk profiling was performed to identify their pre-existing risk, including checks on Calcium, Potassium and Magnesium levels to rule out confounders. 12 lead ECG was done and reviewed manually by our resident physician. Results: It showed that rate abnormality was detected in 8 patients (22%) and QTc interval prolongation was detected in nearly 12 patients (32.4%) but of those only 3 patients had significantly prolonged QT interval needing the primary treating team to review their psychopharmacology regime. Conclusion: QTc Prolongation was positively linked with a number of cardiovascular risk factors

Working conditions, self-perceived stress, anxiety, depression and quality of life: A structural equation modelling approach

<p>Abstract</p> <p>Background</p> <p>The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia.</p> <p>Methods</p> <p>The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation.</p> <p>Results</p> <p>The results of the SEM supported the hypothesized structural model (<it>χ</it>²= 22.801, <it>df </it>= 19, <it>p </it>= 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF.</p> <p>Conclusion</p> <p>These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.</p