SUICIDAL IDEATION AND THOUGHTS OF DEATH IN EPILEPSY PATIENTS

Background: Suicidal behavior is an important worldwide health problem. Psychiatric disorders, especially mood disorders, are the main risk factors for suicidal behavior. Suicide is an important cause of death in patients with epilepsy. The aim of this study was to analyze the presence of suicidal ideation in patients with epilepsy. Subjects and methods: The study included 50 epilepsy inpatients and outpatients of both genders, aged 18 years and older, treated at the Department of Neurology, Clinical Center University of Sarajevo in the period from 1st of April – October 1st 2007. The sample was selected randomly. Applied research instruments were general questionnaire, HAM-D-17, BHS and BSS. Results: Suicidal ideation and thoughts of death were present in 38% epilepsy patients. Symptoms of depression as well as feelings of hopelessness were found in half of the participants (52% and 48%), and were significantly more common in epilepsy patients with suicidal ideation. There was a significant relation of suicidal ideation with the presence of chronic pain (3.86; p=0.49), sexual/physical abuse history (5.95, p=0.015), level of hopelessness (20.7; p=0.000) and severity of depression (14.48; p=0.000) in epilepsy patients. Multiple logistic regression analysis showed that unemployment (Exp(B) 33.9; p=0.007) and the level of hopelessness (Exp(B) 14.9; p=0.001) were independently related to suicidal ideation in these patients. Conclusions: The study has shown that the level of hopelessness and unemployment have a predictive value for appearance of suicidal ideation in epilepsy patients. In the prediction of suicidal ideation in this population of patients, there is no single variable that should be considered as specific and separate

THE SIGNIFICANCE OF INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-ALPHA LEVELS IN COGNITIVE IMPAIRMENT AMONG FIRST-EVER ACUTE ISCHAEMIC STROKE PATIENTS

Background: Acute ischemic stroke (AIS) frequently results in the development of cognitive impairment, which quite often persists. The pathophysiological mechanisms involved in the development of cognitive impairment are only partially elucidated. The aim of this study was to evaluate the correlation between interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-) serum levels with cognitive impairment in AIS patients. Subjects and methods: This hospital-based case-control study was performed during December 2014 May 2018. A total number of 130 randomly selected patients were prospectively recruited from the Department of Neurology, Clinical Center University of Sarajevo. The study examined 100 first-ever AIS patients, while 30 comprised the non-stroke control group of patients with discogenic lumbosacral radiculopathy. All participants were evaluated using the Mini-Mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery, and the Addenbrooke\u27s Cognitive Examination-Revised. Cognitive testing and laboratory analyses were performed within the first three days of admission in all patients while AIS patients were reassessed on the 15th day of hospitalization. Results: Female stroke patients with cognitive impairment had significantly higher baseline levels of IL-6 (p<0.017), and TNF- (p<0.017) than those without cognitive impairment. In the control measurement, a significant difference in IL-6 levels (p=0.037) in male and TNF-=0.042) in female stroke patients with cognitive impairment was observed. Conclusions: These findings indicate that pro-inflammatory cytokines are probably implicated in the pathogenesis of cognitive decline in AIS patients

THE SIGNIFICANCE OF INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-ALPHA LEVELS IN COGNITIVE IMPAIRMENT AMONG FIRST-EVER ACUTE ISCHAEMIC STROKE PATIENTS

Background: Acute ischemic stroke (AIS) frequently results in the development of cognitive impairment, which quite often persists. The pathophysiological mechanisms involved in the development of cognitive impairment are only partially elucidated. The aim of this study was to evaluate the correlation between interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-) serum levels with cognitive impairment in AIS patients. Subjects and methods: This hospital-based case-control study was performed during December 2014 May 2018. A total number of 130 randomly selected patients were prospectively recruited from the Department of Neurology, Clinical Center University of Sarajevo. The study examined 100 first-ever AIS patients, while 30 comprised the non-stroke control group of patients with discogenic lumbosacral radiculopathy. All participants were evaluated using the Mini-Mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery, and the Addenbrooke\u27s Cognitive Examination-Revised. Cognitive testing and laboratory analyses were performed within the first three days of admission in all patients while AIS patients were reassessed on the 15th day of hospitalization. Results: Female stroke patients with cognitive impairment had significantly higher baseline levels of IL-6 (p<0.017), and TNF- (p<0.017) than those without cognitive impairment. In the control measurement, a significant difference in IL-6 levels (p=0.037) in male and TNF-=0.042) in female stroke patients with cognitive impairment was observed. Conclusions: These findings indicate that pro-inflammatory cytokines are probably implicated in the pathogenesis of cognitive decline in AIS patients

SUICIDAL IDEATION AND THOUGHTS OF DEATH IN EPILEPSY PATIENTS

Background: Suicidal behavior is an important worldwide health problem. Psychiatric disorders, especially mood disorders, are the main risk factors for suicidal behavior. Suicide is an important cause of death in patients with epilepsy. The aim of this study was to analyze the presence of suicidal ideation in patients with epilepsy. Subjects and methods: The study included 50 epilepsy inpatients and outpatients of both genders, aged 18 years and older, treated at the Department of Neurology, Clinical Center University of Sarajevo in the period from 1st of April – October 1st 2007. The sample was selected randomly. Applied research instruments were general questionnaire, HAM-D-17, BHS and BSS. Results: Suicidal ideation and thoughts of death were present in 38% epilepsy patients. Symptoms of depression as well as feelings of hopelessness were found in half of the participants (52% and 48%), and were significantly more common in epilepsy patients with suicidal ideation. There was a significant relation of suicidal ideation with the presence of chronic pain (3.86; p=0.49), sexual/physical abuse history (5.95, p=0.015), level of hopelessness (20.7; p=0.000) and severity of depression (14.48; p=0.000) in epilepsy patients. Multiple logistic regression analysis showed that unemployment (Exp(B) 33.9; p=0.007) and the level of hopelessness (Exp(B) 14.9; p=0.001) were independently related to suicidal ideation in these patients. Conclusions: The study has shown that the level of hopelessness and unemployment have a predictive value for appearance of suicidal ideation in epilepsy patients. In the prediction of suicidal ideation in this population of patients, there is no single variable that should be considered as specific and separate