A prospective follow-up study of first-episode acute transient psychotic disorder in Latvia

Background: Acute and transient psychotic disorder (ATPD) has been described as an acute psychosis with brief onset and polymorphous symptomatology (WHO, 1993). The study of ATPD is growing increasingly relevant as scientists start an active discussion of the possibility of changing the ATPD classification in the next International Classification of Diseases (ICD-11). The aims of this study were to describe the clinical features of the index episode of ATPD in patients in Latvia, to analyse the stability and longitudinal changes of the diagnosis, to explore potential correlations between the sociodemographic and disease characteristics and to describe stressful life events before the first ATPD episode.Methods: A prospective follow-up study of all first-time admitted patients from the Riga Centre of Psychiatry and Addiction Disorders who fulfilled the ICD-10 criteria for ATPD (WHO, 1993) during the 15-month period from 9 January 2010 to 30 March 2011 and followed up until 31 October 2012. Stressful life events, demographics and clinical features during the index episode were assessed.Results: One hundred two patients were admitted with first-episode ATPD. The majority were females (60.7%). Over an average 26.5-month follow-up period, 59.8% of the patients were not readmitted. The overall stability rate of ATPD diagnosis in our sample was 67.4% (p = 0.0001). In the subgroup of patients who were readmitted, 70.7% had their diagnosis converted to schizophrenia in subsequent visits. Stressful life events before the first episode were found in 49.0% of first-episode ATPD patients. Thought disorder was found to be the strongest statistically significant predictor of ATPD diagnosis conversation to schizophrenia (odds ratio 4.3), with high Wald's criterion (9.435) in binary logistic regression.Conclusions: ATPD is prevalent in Latvia, with rather high overall stability rate. Combining these data from first-episode ATPD patients in Latvia with data from other countries may help predict the development of the disease and provide a basis for potential changes to ICD-11.publishersversionPeer reviewe

Depression and suicidality among psychiatric residents - results from a multi-country study

Background Previous studies have highlighted risks for depression and suicide in medical cohorts, but evidence regarding psychiatric residents is missing. This study aimed to determine rates of depression, suicide ideation and suicide attempt among psychiatric residents and to identify associated individual, educational and work-related risk factors. Methods A total of 1980 residents from 22 countries completed the online survey which collected data on depression (PHQ-9), suicidality (SIBQ), socio-demographic profiles, training, and education. Generalized linear modeling and logistic regression analysis were used to predict depression and suicide ideation, respectively. Results The vast majority of residents did not report depression, suicide ideation or attempting suicide during psychiatric training. Approximately 15% (n=280) of residents met criteria for depression, 12.3% (n=225) reported active suicide ideation, and 0.7% (n=12) attempted suicide during the training. Long working hours and no clinical supervision were associated with depression, while more completed years of training and lack of other postgraduate education (e.g. PhD or psychotherapy training) were associated with increased risk for suicide ideation during psychiatric training. Being single and female was associated with worse mental health during training. Limitations Due to the cross-sectional nature of the study, results should be confirmed by longitudinal studies. Response rate was variable but the outcome variables did not statistically significantly differ between countries with response rates of more or less than 50%. Conclusion Depression rates among psychiatric residents in this study were lower than previously reported data, while suicide ideation rates were similar to previous reports. Poor working and training conditions were associated with worse outcomes. Training programmes should include effective help for residents experiencing mental health problems so that they could progress through their career to the benefit of their patients and wider society

Processing of spatial-frequency altered faces in schizophrenia: Effects of illness phase and duration

Low spatial frequency (SF) processing has been shown to be impaired in people with schizophrenia, but it is not clear how this varies with clinical state or illness chronicity. We compared schizophrenia patients (SCZ, n534), first episode psychosis patients (FEP, n522), and healthy controls (CON, n535) on a gender/facial discrimination task. Images were either unaltered (broadband spatial frequency, BSF), or had high or low SF information removed (LSF and HSF conditions, respectively). The task was performed at hospital admission and discharge for patients, and at corresponding time points for controls. Groups were matched on visual acuity. At admission, compared to their BSF performance, each group was significantly worse with low SF stimuli, and most impaired with high SF stimuli. The level of impairment at each SF did not depend on group. At discharge, the SCZ group performed more poorly in the LSF condition than the other groups, and showed the greatest degree of performance decline collapsed over HSF and LSF conditions, although the latter finding was not significant when controlling for visual acuity. Performance did not change significantly over time for any group. HSF processing was strongly related to visual acuity at both time points for all groups. We conclude the following: 1) SF processing abilities in schizophrenia are relatively stable across clinical state; 2) face processing abnormalities in SCZ are not secondary to problems processing specific SFs, but are due to other known difficulties constructing visual representations from degraded information; and 3) the relationship between HSF processing and visual acuity, along with known SCZ- and medication-related acuity reductions, and the elimination of a SCZ-related impairment after controlling for visual acuity in this study, all raise the possibility that some prior findings of impaired perception in SCZ may be secondary to acuity reductions

The Gothic Novel-History and Theory of the Genre

Bakalaura darbā „Gotiskais romāns – vēsture un žanra teorija” tiek aplūkota gotiskā romāna vēsture ar detalizētu ieskatu triju autoru, - Horasa Volpola, Annas Radklifas un Mērijas Šellijas, darbos. Šī darba pirmā nodaļa iepazīstina ar gotiskā žanra tradīcijām, raksturo žanra iezīmes un uzdevumus, kas tiek aplūkoti šo autoru darbos. Darba otrajā nodaļā tiek aprakstīti gotisko tradīciju elementi, kas ir atrodami analizēto autoru darbos. Darba trešajā daļā tiek analizēti divu rakstnieču, - Annas Radklifas un Mērijas Šellijas, darbi. Pētījuma mērķis ir noteikt sievietes vietu sabiedrībā, tajā laika posmā, kad tika uzrakstīti attiecīgie romāni, un kā tajos ir atspoguļoti dzimuma aizspriedumi. Pētnieciskās metodes apvieno dažādu kritiķu teorijas par gotiskās literatūras žanru, kā arī iepazīstina ar autoriem, kuri ietekmēja jaunā žanra aizsākšanos astoņpadsmitā gadsimta beigās un deviņpadsmitā gadsimta sākumā. Atslēgvārdi: gotiskais romāns, žanrs, dzimums, gotiskās tradīcijas, pamati, kritiskās teorijas.The present bachelor paper “The Gothic Novel – History and Theory of the Genre” looks into the history of the Gothic novel with a detailed study of three authors: Horace Walpole, Ann Radcliffe and Mary Shelley. The first chapter of this bachelor paper introduces the Gothic traditions, characterizes the features and functions of the Gothic traditions within the works of three authors being under consideration. The second chapter outlines examples of Gothic elements and relates those elements to the Gothic literary genre within the evaluated works. The third chapter of this paper is the analysis of two female writers – Marry Shelley and Ann Radcliffe. The purpose of the research is to determine the position of women in the society at the time when the respective novels were composed and to investigate how gender differences were reflected in them. The study methods combine the examination of critical theories about female writers, connected with the Gothic literature, introduction of the writers which influenced the beginning of the new genre in the late-eighteenth and early-nineteenth centuries. Keywords: The Gothic novel, genre, gender, Gothic traditions, elements, critical theories

Online Quizzes to Foster Autonomous Learning in English Lessons in Grade 5

Diplomdarba mērķis bija izpētīt kā tiešsaistes viktorīnas spēj veicināt patstāvīgu mācīšanos angļu valodas stundās 5. klasē. Patstāvīgas mācīšanās prasmes ir būtiskas svešvalodas apguvē. Darba autore uzskata, ka skolotājiem jāpielāgo mācību process atbilstoši digitālās paaudzes vajadzībām. Lai sasniegtu pētījumā izvirzīto mērķi, darba autore veica gadījuma pētījumu Rīgas Juglas vidusskolā. Pētījuma ietvaros tika veikta klātienes intervija ar angļu valodas skolotāju, analizē t i skolēnu mācīšanās žurnāli un veikta tiešsaistes anketa skolēniem. Pētījumā iegūtie dati norāda, ka skolotāji ir gatavi pielāgot savu mācīšanu atbilstoši digitālās paaudzes mācīšanās vajadzībām. Darbā tiek secināts, ka skolēniem piemīt tās īpašības, kas raksturīgas patstāvīgo zināšanu ieguvējiem. Pētījumā neapstiprinājās, ka tiešsaistes viktorīnas veicinātu efektīvu patstāvīgo mācīšanos. Turpmākajiem pētījumiem darba autore iesaka izmantot lielāku pētniecības grupu.The aim of the diploma paper was to explore how online quizzes can help to foster autonomous learning in English lessons in Grade 5. Autonomous learning skills are essential in foreign language teaching. The author believes that the learning needs of the digital generation show the need for adapting the teaching process accordingly. The chosen method of research was a case study in Riga Jugla Secondary school. The author used interview, learners’ logbooks and online questionnaires as data collection methods. The data showed that teachers are ready to adapt their teaching to fit the learning needs of the digital generation. The learners have got certain characteristics of autonomous learners. However, online quizzes as homework did not prove effective to foster autonomous learning. The author suggests carrying out further research with a greater sample size

Terminological analysis of frenchified borrowings in Italian fashion language

Šī darba tēma ir aizdevumi no franču valodas itāļu valodā. Īpaši tika pētīta semantiskā “modes” jomā. Šā pētījuma hipotēze ir, kas galicismu izmantošana mūsdienās ir bieži satikāma. Darba mērķis ir analizēt publicētos rakstus sieviešu modes žurnālos un paveikt galicismu analīzi.The theme of this work are loans borrowed from French into Italian. Particularly, it was studied the semantic field of "fashion" sector. The hypothesis of this study is that the use of French loans in the modern periode is very frequent. The aim of the thesis is to analyze the articles published in women's fashion magazines and do an analysis of the presence of French loans

Acute and Transient Psychotic Disorder (ATPD) Dynamic Development and Particularities in Diagnostics and Treatment in Latvia. Doctoral Thesis. Doctoral Thesis

Promocijas darbs izstrādāts: Rīgas Stradiņa universitātes Psihiatrijas un narkoloģijas katedrā. Aizstāvēšana: 2015. gada 2. februārī plkst. 16.30 Rīgas Stradiņa universitātes Medicīnas promocijas padomes atklātā sēdē Rīgā, Dzirciema ielā 16, Senāta zālē.Akūti un transitoriski psihotiski traucējumi (ATPT, F23, SSK-10) tiek definēti kā akūta psihoze ar īslaicīgu norisi un polimorfu simptomātiku. (1) Pēdējā laikā arvien pieaug ATPT pētījumu nozīme, jo zinātnieki sāk aktīvu diskusiju par iespēju mainīt ATPT diagnozes klasifikāciju Starptautiskās slimību klasifikācijas nākamajā redakcijā (SSK-11). (2) Pētījuma mērķis bija izpētīt akūtu un transitorisku psihotisku traucējumu (ATPT) pacientu agrīno simptomātiku un diagnozes noturību, raksturot pirmās hospitalizācijas īpatnības ATPT pacientiem un pacientiem, kuriem vēlāk attīstās šizofrēnija, izpētīt ATPT iespējamo saistību ar stresu radošiem dzīves notikumiem slimības premorbīdā un personības rakstura iezīmēm, kā arī noteikt ATPT ārstēšanas taktikas īpatnības Latvijā. Materiāls un metodes. 1) Retrospektīvajā daļā tika iekļauti visi pirmreizēji hospitalizētie pacienti, kas atbilda SSK-10 noteiktajiem ATPT kritērijiem (PVO, 1993) un kas 3 gadu periodā (no 01.01.2004. līdz 31.12.2006.) iestājās Rīgas Psihiatrijas un narkoloģijas centrā (RPNC). Turpmāk pacienti tika novēroti vidēji 6 gadus (līdz 31.12.2010.). 2) Prospektīvās daļas pētījumā tika iekļauti visi pirmreizējie pacienti, kas 15 mēnešu periodā (no 09.01.10. līdz 30.03.11.) tika hospitalizēti RPNC un atbilda SSK-10 noteiktajiem ATPT kritērijiem (PVO, 1993). Vēlāk pacienti tika novēroti līdz 31.10.2012. Rezultāti. 1) 3 gadu periodā pirmreizēji ar ATPT diagnozi bija hospitalizēti 294 pacienti, 54% no tiem bija sievietes. Vidējais vecums pirmās psihozes epizodes laikā bija 35,7 ± 12,3 gadi sievietēm un 30,0 ± 10,8 gadi vīriešiem (p < 0,0001).Vairāk nekā 51,0% pacientu netika atkārtoti hospitalizēti vidēji 6,1 gadu novērošanas periodā. No atkārtoti hospitalizētiem pacientiem 73,0% diagnoze vēlāk tika mainīta uz šizofrēniju, galvenokārt slimības pirmajos divos gados. Diagnozes vispārējā stabilitāte (DVS) sasniedza 58,0%. Stresu radošus dzīves notikumus 6 mēnešus pirms pirmās epizodes konstatēja 44% pacientu. 2) Ar ATPT pirmo epizodi bija hospitalizēti 102 pacienti. 60,7% (62) no tiem bija sievietes (p = 0,003). Vidēji 26,5 mēnešu novērošanas periodā 59,8% pacientu netika hospitalizēti atkārtoti. Rehospitalizētiem pacientiem diagnoze biežāk tika mainīta uz šizofrēnijas diagnozi (70,7%). Stresu radošus dzīves notikumus 6 mēnešus pirms pirmās epizodes konstatēja 49,0% (50) pacientu. Secinājumi. Pirmreizējās psihozes klīniskie simptomi “tīro” ATPT grupas pacientiem un pacientiem, kuriem vēlāk attīstījās šizofrēnija, bija atšķirīgi. Galvenais diagnozes prognostiskais rādītājs bija domāšanas traucējumi pirmreizējās psihozes laikā. Diagnozes vispārējā stabilitāte bija ap 50,0%. Stresu radošus dzīves notikumus pirms pirmās psihotiskās epizodes konstatēja lielai daļai ATPT pacientu. Pētījumā netika iegūti dati, kas apstiprinātu ATPT diagnozes korelāciju ar personības rakstura iezīmēm.Promocijas darbs veikts ar Eiropas Sociālā fonda projekta “Atbalsts doktorantiem studiju programmas apguvei un zinātniskā grāda ieguvei Rīgas Stradiņa universitātē” atbalstu

Akūtu un transitorisku psihotisku traucējumu dinamiskā attīstība, diagnostikas un ārstēšanas īpatnības Latvijā. Promocijas darba kopsavilkums

The Doctoral Thesis was carried out in the Department of Psychiatry and Narcology. Defence: on the 02 February 2015, at 16.30 in an open meeting of the Doctoral Council of Medicine at Rīga Stradiņš University, in Senate Hall, 16 Dzirciema Street, Riga, Latvia.Acute and transient psychotic disorder (ATPD; F23, ICD-10) has been described as an acute psychosis with brief onset and polymorphous symptomatology. (1, 2) To explore the first episode of ATPD in patients in Latvia by describing premorbid personality, association with stressful life events, the clinical features, analyzing the longitudinal changes of diagnosis and associated socio-demographic characteristics to provide the possible basis for potential changes to ICD-11. Material and Methods: 1) Retrospective chart review of all first-time hospitalized patients fulfilling the ICD-10 criteria for ATPD treated at the Riga Centre of Psychiatry and Addiction Disorders (RCPAD), Latvia during a 3-year period (from 01.01.2004. to 31.12.2006.). Later patients were followed-up about 6.1 years (to 31.12.2010.). 2) Prospective follow-up of all first-time hospitalized patients from RCPAD in Latvia who fulfilled the ICD-10 criteria for ATPD, during the 15 month period (from 09.01.2010. to 30.03.2011.). Cohort follow-up period was on average 26.5 months (to 31.10.2012.). Results: 1) during a 3-year period, 294 patients were first-time hospitalized with an ATPD diagnosis, 54.0% were women. The average age at first psychotic episode was 35.7 ± 12.3 years for women, and 30.0 ± 10.8 years for men, (p < 0.0001). Over an average of 6.1 years follow-up period 51.0% of patients were not re-hospitalized. Later diagnosis was changed to schizophrenia in 73.0% of the re-hospitalized patients, mostly within the first two years of illness. The overall stability rate of ATPD diagnosis reached 58.0%. Stressful life events in the 6 months prior to the first episode were found in 44.0% of patients. 2) 102 patients were hospitalized with first-episode ATPD. 60.7% were females (p = 0.003). Over an average 26.5-month follow-up period, 59.8% of patients were not re-hospitalized. In the subgroup of patients who were re-hospitalized, 70.7% had their diagnosis converted to schizophrenia in subsequent visits. Stressful life events before the first episode were found in 49.0% of patients. Conclusions. Certain differences in clinical symptoms during first episode of psychosis in patients between “pure” ATPD and ATPD which later diagnosed schizophrenia were observed. Thought disorder during the index episode was the main statistically significant “predictor” of schizophrenia. Overall stability of ATPD diagnosis was about 50.0%. Large group of ATPD patients had stressful fife events before first episode of psychosis. Personality traits did not show any statistically significant with ATPD.Thesis have been prepared with support of European Social Fund project “Support for Doctoral Students in Acquiring Study Programme and Acquisition of the Scientific Degree in Rīga Stradiņš University”