9 research outputs found
Metabolic Syndrome and C-reactive protein in patients with depressive disorder on antidepressive medication
Introduction Recurrent depression is a psychiatric disorder of which etiology and pathogenesis might be related to immune response. Metabolic Syndrome (MetS) and its components are also strongly associated with elevated inflammatory indicators, as so as the body mass index (BMI) and total cholesterol levels. Objective Objective of this study was to investigate if there was any difference in C-reactive protein (CRP) levels in patients with recurrent depressive disorder, treated with antidepressants, compared to a healthy control group of subjects and if there was an association between increased CRP levels and the presence of MetS in these two groups. Methods Sixty subjects entered the study; of these 35 patients with the diagnosis of recurrent depressive disorder, while the healthy control group included 25 subjects. MetS was defined according to the NCEP ATP III criteria. The cut-off point for CRP was set at >5 mg /L. Results There was no statistically significant difference in the prevalence of MetS and CRP values between the studied groups. Waist circumference and total cholesterol levels were significantly higher in the experimental group. Patients that fulfilled the criteria for MetS showed significantly higher values of central obesity and arterial hypertension in the experimental group as well. The elevated CRP levels were associated with increased frequency of MetS in depressed patients. Conclusion Both CRP levels and metabolic risk profile screening, according to the international criteria, may be beneficial in order to obtain better assessment for depressive long term medicated patients
Metabolic syndrome and C-reactive protein in patients with depressive disorder on antidepressive medication
Introduction. Recurrent depression is a psychiatric disorder of which etiology and pathogenesis might be related to immune response. Metabolic Syndrome (MetS) and its components are also strongly associated with elevated inflammatory indicators, as so as the body mass index (BMI) and total cholesterol levels. Objective. Objective of this study was to investigate if there was any difference in C-reactive protein (CRP) levels in patients with recurrent depressive disorder, treated with antidepressants, compared to a healthy control group of subjects and if there was an association between increased CRP levels and the presence of MetS in these two groups. Methods. Sixty subjects entered the study; of these 35 patients with the diagnosis of recurrent depressive disorder, while the healthy control group included 25 subjects. MetS was defined according to the NCEP ATP III criteria. The cut-off point for CRP was set at >5 mg /L. Results. There was no statistically significant difference in the prevalence of MetS and CRP values between the studied groups. Waist circumference and total cholesterol levels were significantly higher in the experimental group. Patients that fulfilled the criteria for MetS showed significantly higher values of central obesity and arterial hypertension in the experimental group as well. The elevated CRP levels were associated with increased frequency of MetS in depressed patients. Conclusion. Both CRP levels and metabolic risk profile screening, according to the international criteria, may be beneficial in order to obtain better assessment for depressive long term medicated patients
Long-term treatment with olanzapine in hospital conditions: Prevalence and predictors of the metabolic syndrome
© 2015, Serbia Medical Society. All rights reserved. Introduction The risk of metabolic abnormalities is greatly increased in schizophrenic patients started on an atypical antipsychotic medication. Patients with psychiatric disorders exceed mortality ranges resulting from, among others, increased risk of cardiovascular events. Other factors contributing to the development of metabolic syndrome include prolonged duration of illness, increasing age, female sex and lifestyle factors. Objective This cross-sectional study was taken up to assess the prevalence of the metabolic syndrome (MetS) in schizophrenic patients receiving olanzapine monotherapy for at least six months and to determine the most important risk factors associated with metabolic syndrome presence in these patients. Methods A total of 93 long term hospitalized schizophrenic patients (71 men, 22 women), had a screening of the following: case-history data, psychiatric scales, anthropometric measures, blood (fasting glucose, lipid status, C-reactive protein – CRP) and urine samples (microalbuminuria). Results Prevalence of MetS according to International Diabetes Federation criteria in our study was 34.4%. The multivariate analysis distinguished the following significant predictors of MetS presence (in order of appearance): data about diabetes mellitus in family history (p=0.002), body mass index >25 kg/m2 (p=0.002), hyperlipidemia in family history (p=0.008), and elevated CRP value (p=0.042). Conclusion High rate of MetS in patients treated with olanzapine in this study exceeds MetS prevalence in general population. Among observed parameters, our study pointed to several “high risk” predictors associated with MetS presence. Regular monitoring of cardiometabolic risk factors is highly recommended. Positive heredity distress mentioned above may direct a psychiatrist to prescribe some other drug than olanzapine in the long term treatment of schizophrenia
THE HISTORICAL DEVELOPMENT OF PSYCHIATRY IN SERBIA
The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known as Dušan’s Code. The Historical data on the establishment of the first psychiatric hospital in the Balkans “Home for the Unsound of Mind” at Guberevac, Belgrade, in 1861 and its founders is reviewed. After World War I, in 1923, the Faculty of Medicine was established in Belgrade to which the coryphaei of Serbian medicine educated in Europe, mostly in France and Germany, flocked and that same year the Psychiatry Clinic of the Faculty of Medicine in Belgrade was set up. Its first seat was on the premises of the Mental Hospital in Belgrade, and it became a
training base and laid the foundations of the future Neuropsychiatry Clinic in Belgrade, which in time evolved into the nursery of psychiatric professionals for all of Serbia. The most important data on the further development of psychiatry up to date are presented
Long-term treatment with olanzapine in hospital conditions: Prevalence and predictors of the metabolic syndrome
Introduction. The risk of metabolic abnormalities is greatly increased in
schizophrenic patients started on an atypical antipsychotic medication.
Patients with psychiatric disorders exceed mortality ranges resulting from,
among others, increased risk of cardiovascular events. Other factors
contributing to the development of metabolic syndrome include prolonged
duration of illness, increasing age, female sex and lifestyle factors.
Objective. This cross-sectional study was taken up to assess the prevalence
of the metabolic syndrome (MetS) in schizophrenic patients receiving
olanzapine monotherapy for at least six months and to determine the most
important risk factors associated with metabolic syndrome presence in these
patients. Methods. A total of 93 long term hospitalized schizophrenic
patients (71 men, 22 women), had a screening of the following: case-history
data, psychiatric scales, anthropometric measures, blood (fasting glucose,
lipid status, C-reactive protein - CRP) and urine samples (microalbuminuria).
Results. Prevalence of MetS according to International Diabetes Federation
criteria in our study was 34.4%. The multivariate analysis distinguished the
following significant predictors of MetS presence (in order of appearance):
data about diabetes mellitus in family history (p=0.002), body mass index >25
kg/m2 (p=0.002), hyperlipidemia in family history (p=0.008), and elevated CRP
value (p=0.042). Conclusion. High rate of MetS in patients treated with
olanzapine in this study exceeds MetS prevalence in general population. Among
observed parameters, our study pointed to several “high risk” predictors
associated with MetS presence. Regular monitoring of cardiometabolic risk
factors is highly recommended. Positive heredity distress mentioned above may
direct a psychiatrist to prescribe some other drug than olanzapine in the
long term treatment of schizophrenia
FIRST GENERATION ANTIPSYCHOTICS SWITCH WITH RISPERIDONE IN THE TREATMENT OF CHRONIC SCHIZOPHRENIC PATIENTS
Background: Schizophrenia is a severe chronic psychiatric disorder for which treatment compliance is important in the
prevention of relapse. Second generation antipsychotics (SGA), such as Risperidone, have been found to be more effective in the
treatment of such patients than the high potency first generation antipsychotics (FGA). This is an open study where the same group
of patients was first treated with FGA and then were switched to Risperidone, in controlled hospital conditions, after a wash- out
period. The aim of the study was to examine whether patients with schizophrenia who were judged to be stable on long-term
treatment with FGA would further benefit from a switch to an atypical antipsychotic drug.
Subjects and methods: Eighty hospitalized patients suffering from Schizophrenia or Schizoaffective disorder (male 54, female
26) were first treated with Haloperidol (N=60) or Fluphenazine (N=20), and then were switched to Risperidone. Their clinical state
was monitored using the PANSS scale for Schizophrenia, measuring the Total PANSS score. The KLAWANS scale for assessment of
extrapyramidal syndrome (EPS) was also used. Administration and dosage of Trihexiphenidil (THF) was recorded. The study lasted
for 8 weeks, with 4 screenings (Visit 0-baseline- FGA, Visits 1-3 Risperidone on Day 14, 28 and 56, respectively).
Results: The average age was 38. Patients usually suffered the paranoid form of Schizophrenia (55%). The duration of illness
was more than 5 years (38.8%). During the eight- week trial on Risperidone, using the PANSS total scores, we observed clinical
improvement where the therapy switch had caused an initial worsening (p<0.05). Also, the compared baseline (FGA) and last visit
showed a low, but statistically significant benefit in favor of Risperidone (t=5.45, df=79, p<0.005). Intensity of EPS measured by
KLAWANS scores significantly decreased during time (F=4.115; p=0.016; Partial Eta Square=0.058). Average Trihexiphenidil
doses followed Risperidone in a dose dependent manner (r=0.748, r=0.661, respectively, p<0.01) with the consequent decrease of
patients needing THF corrective therapy (68.8% at the baseline toward 22.5% on last visit).
Conclusion: Switch to Risperidone medication provided significant additional improvement in symptom severity, extrapyramidal
side effects and need for anticholinergic medication. This suggests that one might expect better compliance in future treatment in this
population of chronic schizophrenic patients
Characteristics of suicide in the City of Niš within the period 2000-2010.
Background/Aim. Suicide is a significant public health problem worldwide. Numerous factors contribute to suicide. The aim of this study was to investigate the characteristics of suicide in the city of Niš in the period 2001–2010. Methods. The retrospective study consisted of 608 persons divided into three groups: suicide committers with mental disorders, somatic disorders or without registered disorders. Data on socio-demographic characteristics, previous suicide attempts, methods of suicide and presuicidal syndrome were obtained from the Police Directorate for the city of Niš, Ministry of Internal Affairs, Republic of Serbia and from the Statistical Office of the Republic of Serbia. Results. Persons with mental disorders were the most prevalent group of people who committed suicide (54.3%), followed by persons without registered disorders (31.9%) and with somatic disorders (13.8%). Persons with mental disorders who committed suicide were most often divorced, with high school education, monthly salary and with at least one previous suicide attempt. The hanging was the most frequent method of committing suicide in all investigated groups, followed by self-poisoning using drugs or liquid substances. The presuicidal syndrome was significantly more frequent among persons with mental disorders compared to persons with somatic disorders or without registered disorders others (45.8% vs. 16.7%, and 45.8% vs. 28.4% respectively p < 0.001). Conclusion. Although the persons with mental disorders are in the greatest risk of suicide, they are under medical care. In this regard, the prevention programs should be directed towards persons with severe somatic disorders and to old persons without registered disorders
Effects of antidepressants on serum concentrations of bone metabolism markers and major electrolytes in patients from routine psychiatric practice
Background/Aim. Data about effects of antidepressant on calcium, phosphorous and magnesium metabolisms are very scorce. The aim of this study was to investigate effects of antidepressants on serum concentration of bone metabolism markers and main electrolytes in patients from routine psychiatric practice. Methods. A prospective, before-and-after, time-series research included 9 males and 24 females, with average 53.3 ± 11.5 years-of-age, suffering from depression (n = 26) and neurotic disorders (n = 7), mostly taking selective serotonin reuptake inhibitors. We measured analytes at baseline, and 4th, 6th and 12th weeks during the treatment and tested the parameter changes from baseline and the trends with appropriate statistics at p ≤ 0.05 significance level. Results. The age above 60 years was a significant factor for appearance of negative cumulative changes (in percent) of 25-hydroxyvitamin D – 25(OH)D concentrations from the base-line (OR = 11.4, 95% CI 1.2–113.1, p = 0.037). Serum concentrations of calcium significantly correlated with sodium (rs = 0.531, p < 0.001), with chloride (r = 0.496, p < 0.001), with magnesium (rs = 0.402, p < 0.001) and with osteocalcin (r = 0.240, p = 0.019). Significant correlations were among phosphorous with chloride (r = -0.218, p = 0.035); magnesium with sodium (r = 0.295, p = 0.004) and with potassium, (r = 0.273, p = 0.009); osteocalcin with C-telopeptide (r = 0.760, p < 0.001) with sodium (r = 0.215, p = 0.039) and with chloride (r = 0.209, p = 0.041); sodium with chloride (r = 0.722, p < 0.001). There were no statistically significant changes between antidepressant treatment and changes of absolute serum concentration of calcium, magnesium, phosphorous, 25(OH)D, osteocalcin, C-telopeptide, sodium, potassium and chloride. There were no statistically significant changes in frequency of disturbances in values of laboratory analytes (below/above lower/upper normal limits), too. Conclusion. Antidepressant treatment was not significantly associated with the changes in study analytes but some of them positively correlated with each other, suggesting the need for individual patient approach and further research in the field of bone metabolism in patients with mental disorders