METABOLIC ISSUES IN PSYCHOTIC DISORDERS WITH THE FOCUS ON FIRST-EPISODE PATIENTS: A REVIEW

Before the onset of the illness, future schizophrenia patients do not weigh more comparing to their peers. However, during the later course of the illness, obesity is twice as prevalent as in general public, afflicting the half of schizophrenia patient population. There is a list of potential factors that contribute to this, including lifestyle, dietary habits, unsatisfactory monitoring of physical health etc, but nowadays side effects of antipsychotic medication become the most prominent concern when weight gain and metabolic issues in psychosis are addressed. The fact is that second generation antipsychotics (SGA) are associated with weight gain and metabolic syndrome, but that might be the case with the first generation antipsychotics (FGA) too. Besides, obesity might be evident in patients before any exposure to medications, and all that bring lot of dilemmas into the field. This paper critically reviews available data on metabolic problems in patients with psychotic disorders, raging from genetic to molecular and environmental factors, and highlights the necessity of screening for the early signs of metabolic disturbances, as well as of multidisciplinary assessment of psychiatric and medical conditions from the first psychotic episode

TYPE D PERSONALITY IN PATIENTS WITH CORONARY ARTERY DISEASE

Background: During the past decade studies have shown that Type D personality is associated with increased risk of cardiac events, mortality and poor quality of life. Some authors suggested that depression and Type D personality have substantial phenomenological overlap. Subjects and methods: The sample consisted of non-consecutive case series of seventy nine patients with clinically stable and angiographically confirmed coronary artery disease (CAD), who had been admitted to the Clinic of Cardiology, University Clinical Centre, from May 2006 to September 2008. The patients were assessed by the Type-D scale (DS14), The Beck Depression Inventory (BDI), and provided demographic information. Risk factors for CAD were obtained from cardiologists. Results: The findings of our study have shown that 34.2% patients with CAD could be classified as Type D personality. The univariate analysis has shown that the prevalence of Type D personality was significantly higher in individuals with unstable angina pectoris and myocardial infarction (MI) diagnoses (p=0.02). Furthermore, some components of metabolic syndrome were more prevalent in patients with Type D personality: hypercholesterolemia (p=0.00), hypertriglyceridemia (p=0.00) and hypertension (p=0.01). Additionally, the distribution of depression in patients with a Type D personality and a non-Type D personality were statistically significantly different (p=0.00). Conclusion: To our knowledge, this study is the first one to describe the prevalence and clinical characteristics of the Type D personality in patients with CAD in this region of Europe. We have found that the prevalence of Type D personality in patients with CAD is in concordance with the other studies. We also have found that Type D personality and depression are two distinctly different categories of psychological distress

METABOLIC ISSUES IN PSYCHOTIC DISORDERS WITH THE FOCUS ON FIRST-EPISODE PATIENTS: A REVIEW

Before the onset of the illness, future schizophrenia patients do not weigh more comparing to their peers. However, during the later course of the illness, obesity is twice as prevalent as in general public, afflicting the half of schizophrenia patient population. There is a list of potential factors that contribute to this, including lifestyle, dietary habits, unsatisfactory monitoring of physical health etc, but nowadays side effects of antipsychotic medication become the most prominent concern when weight gain and metabolic issues in psychosis are addressed. The fact is that second generation antipsychotics (SGA) are associated with weight gain and metabolic syndrome, but that might be the case with the first generation antipsychotics (FGA) too. Besides, obesity might be evident in patients before any exposure to medications, and all that bring lot of dilemmas into the field. This paper critically reviews available data on metabolic problems in patients with psychotic disorders, raging from genetic to molecular and environmental factors, and highlights the necessity of screening for the early signs of metabolic disturbances, as well as of multidisciplinary assessment of psychiatric and medical conditions from the first psychotic episode

TYPE D PERSONALITY IN PATIENTS WITH CORONARY ARTERY DISEASE

Background: During the past decade studies have shown that Type D personality is associated with increased risk of cardiac events, mortality and poor quality of life. Some authors suggested that depression and Type D personality have substantial phenomenological overlap. Subjects and methods: The sample consisted of non-consecutive case series of seventy nine patients with clinically stable and angiographically confirmed coronary artery disease (CAD), who had been admitted to the Clinic of Cardiology, University Clinical Centre, from May 2006 to September 2008. The patients were assessed by the Type-D scale (DS14), The Beck Depression Inventory (BDI), and provided demographic information. Risk factors for CAD were obtained from cardiologists. Results: The findings of our study have shown that 34.2% patients with CAD could be classified as Type D personality. The univariate analysis has shown that the prevalence of Type D personality was significantly higher in individuals with unstable angina pectoris and myocardial infarction (MI) diagnoses (p=0.02). Furthermore, some components of metabolic syndrome were more prevalent in patients with Type D personality: hypercholesterolemia (p=0.00), hypertriglyceridemia (p=0.00) and hypertension (p=0.01). Additionally, the distribution of depression in patients with a Type D personality and a non-Type D personality were statistically significantly different (p=0.00). Conclusion: To our knowledge, this study is the first one to describe the prevalence and clinical characteristics of the Type D personality in patients with CAD in this region of Europe. We have found that the prevalence of Type D personality in patients with CAD is in concordance with the other studies. We also have found that Type D personality and depression are two distinctly different categories of psychological distress