26 research outputs found

    CAUSES OF MORTALITY IN SCHIZOPHRENIA: AN UPDATED REVIEW OF EUROPEAN STUDIES

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    Background: The excess mortality in schizophrenia is still a phenomenon insufficiently studied on the cross-national level. It is important to analyse current studies on morality in schizophrenia since significant changes have recently taken place in psychiatric health care systems and guidelines of pharmacological treatment have been developed in European countries. Subjects and methods: This article reviews studies addressing mortality in schizophrenia in Europe that were published in English in the Pubmed database in 2009-2014. It aimed at determining countries where studies were conducted, methodologies and tools used, and current main mortality rates, as well as direction of causality in this group of patients. Results: The recently published studies were conducted only in few European countries. The majority of data was obtained from general medical records and death records. The studies indicate that schizophrenia patients are characterized by higher mortality rate than the general population, with natural causes (cardiovascular diseases and cancers) and suicides predominating. The increasing mortality gap with significantly shorter life expectancy of patients with schizophrenia in comparison with the general population is considerable. Conclusions: Death records are a crucial tool in studies on mortality in schizophrenia patients; however they are insufficiently employed. Recent European reports do not show positive tendencies, indicating that standardized mortality rates in schizophrenia remain on the same level or even increase, particularly for deaths resulting from natural causes. Due to various methodologies used in studies, their direct comparison is difficult. This limitation warrants further discussion on methods used in future studies on schizophrenia mortality in Europe

    Psychoactive substance use in patients diagnosed with attention-deficit/hyperactivity disorder: an exploratory study

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    IntroductionAttention-deficit/hyperactivity disorder (ADHD) was originally treated as a neurodevelopmental disorder that occurs mainly in children and tends to diminish or disappear with age, but we now know that symptoms persist into adulthood in over 50% of ADHD patients. Undiagnosed individuals often turn to psychoactive substance to minimize the negative aspects of functioning and improve quality of life.MethodsThe study was conducted online using random sampling through a Facebook group administered by physicians and targeted to patients diagnosed with ADHD. The study was naturalistic and exploratory, therefore no hypothesis was made. 438 correctly completed questionnaires were received. Analysis of the results showed that people with ADHD turn to psychoactive substances relatively frequently.ResultsThe most commonly used stimulants include alcohol, marijuana, 3,4-methylenedioxymethamphetamine (MDMA), amphetamine/methamphetamine, and psilocybin. In the study population, methylphenidate is the most commonly used drug among patients. After treatment with psychostimulants, the majority of respondents note a decrease in symptoms of hyperactivity disorder, especially in male patients.ConclusionIt is necessary to perform proper diagnostics and actively look for ADHD symptoms in patients who tend to use psychoactive substances

    The impact of the COVID-19 pandemic on the well-being, work conditions, and education of early career psychiatrists in the WHO Eastern Mediterranean Region: study protocol

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    BackgroundThe COVID-19 pandemic placed great strain on healthcare professionals, leading to a substantial impact and a redistribution of the workforce. Despite the active involvement of the Eastern Mediterranean Region Office (EMRO) and the World Health Organization in managing mental health crises, there is a knowledge gap concerning the working conditions and training opportunities available for early career psychiatrists (ECPs) during the pandemic period.ObjectivesThis study aims to investigate the impact of the COVID-19 pandemic on ECPs and how it affected their well-being, employment, and educational opportunities.MethodsA mixed methods study has been conducted in Iran, Egypt, and Tunisia, three EMRO member countries. It includes a cross-sectional survey with self-reported questions, and a qualitative study with individual in-depth interviews.DiscussionThe findings of this study will raise awareness to the working conditions of ECPs within the EMRO region and its member societies, both during the COVID-19 pandemic and beyond. The results will serve as a basis for encouraging supervisors and policymakers to mitigate the pandemic’s impact on psychiatric training, strengthen healthcare systems’ preparedness, and equip early career psychiatrists with the necessary skills to deal with the mental health consequences of the COVID-19 pandemic

    People with diabetes need a lower cut-off than others for depression screening with PHQ-9

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    Aims: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. Results: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes. Conclusions: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population

    Results of the COVID-19 mental health international for the general population (COMET-G) study.

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    INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them
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