This study assessed the association between serum lipid levels and aggression in female patients with schizophrenia. The study included female patients with schizophrenia (N = 120). The participants ...were subdivided into two groups (aggressive and nonaggressive), with 60 participants in each group. Serum lipids—cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol), and low-density lipoproteins (LDL cholesterol)—were determined. The clinical part of the study included an evaluation using psychiatric scales: the positive and negative syndrome scale (PANSS), the aggression subscale of the PANSS scale (PANSS-AG), and the overt aggression scale (OAS). Significant differences were only observed in HDL cholesterol levels, where aggressive subjects had significantly lower values of HDL cholesterol (t = 2.540; p = 0.012), and the representation of subjects with low cholesterol values was almost three-times higher in the group of subjects with aggression (χ2 = 7.007; p = 0.008) compared to the nonaggressive group. The nominally significant predictor for HDL cholesterol in nonaggressive and aggressive participants was the total value of the PANSS scores. In subjects with aggression, suicidality was not significantly associated with HDL cholesterol levels. Our findings suggest that lower HDL cholesterol is significantly associated with aggression in women with schizophrenia.
Schizophrenia is a psychiatric disease which affects one percent of population. It is most common in young adults. It is primarily treated with typical and atypical antipsychotics. Resistant ...schizophrenia is a condition diagnosed after no response is noticed to two different antipsychotics of which one is atypical. The treatment has to be undertaken with adequate doses and duration of therapy. Clozapine is the golden standard in the treatment of therapy-resistant schizophrenia. It has shown its superiority among other antipsychotics in various studies. Aside from greater effectiveness, advantages include absence of extrapyramidal side effects. During clozapine treatment, regular blood tests should be performed as a screening method for agranulocytosis. Twenty to thirty percent od schizophrenia patients suffer from treatment resistant schizophrenia. Sixty percent of the latter ones show no therapeutic response to clozapine. In conclusion twelve to eighteen percent of all patients suffering from schizophrenia show no response to any form of treatment. Attempts to augment clozapine effectiveness are being made by increasing the dose of monotherapy, using antipsychotic polipharmacy or adding other types of drugs to clozapine. Unfortunately, these augmentation methods have not yet proven themselves to be effective enough to be added to standard therapy algorythms. On the other hand, electroconvulsive therapy is neuromodulatory method that shows promise in increasing therapeutic success. Although many methods of treatment are being researched, therapy-resistant schizophrenia remains a clinical challenge which affects a significant percentage of population and will require additional research.
Psihijatrijski bolesnik i debljina Herceg, Miroslav; Puljić, Krešimir; Herceg, Dora
Medicus (Zagreb, Croatia : 1992),
04/2018, Letnik:
27, Številka:
1 Debljina i ...
Journal Article
Recenzirano
Odprti dostop
Debele osobe i osobe s prekomjernom tjelesnom težinom imaju više psihičkih poremećaja u usporedbi s osobama normalne tjelesne težine. Debljina je jedan od najčešćih tjelesnih problema u osoba ...oboljelih od teških i dugotrajnih psihičkih bolesti i poremećaja. Dok je prevalencija debljine u općoj populaciji 20 – 30%, prevalencija debljine u populaciji oboljelih od shizofrenije jest između 40 – 60%. Debljina se kod osoba oboljelih od shizofrenije povezuje s karakteristikama i značajkama same bolesti kao što su loše i nezdrave prehrambene navike, sjedilački način života, socijalno povlačenje, psihomotorna usporenost i činjenica da mnogi psihotropni lijekovi (antipsihotici, stabilizatori raspoloženja i antidepresivi) koji se rabe u liječenju ove bolesti povećavaju tjelesnu težinu. U liječenju debljine kod psihijatrijskih bolesnika mogu se primjenjivati farmakološke i nefarmakološke metode.
The gender differences in onset, symptom severity, and outcome of schizophrenia are now thought to support the hypothesis that sex hormones may also have a role in etiology, as well as treatment, of ...schizophrenia. A number of reproductive hormones may be implicated, including testosterone, progesterone, or luteinising hormone, and thus it is important to acknowledge that there is a complex interplay of hormones occurring. This study was introduced to highlight the effect of the menstrual cycle, and sex hormones on female patients with schizophrenia.
The sample consisted of 31 consecutively acute admitted women, aged 18 to 45 years with schizophrenia diagnosed by DSM-5 criteria. The sample consisted of women who were regulary menstruating and to be undergoing regular hormonal fluxes. Each subject was enrolled and received psychopathology and hormone (estradiole, progesterone, testosterone) assessments. Psychopathology was measured with Positive end Negative Syndrome Scale (PANSS). The subjects were divided into folicular (high estrogen) and luteal (low estrogen) phase admissions. Data were analyzed by regression analysis and t-test for independent samples. Values are given as means ±SD.
There were no differences between the folicular and luteal phase admission grups with regard to age, duration of illness and age at onset of illness. We found that significantly more women were admitted during the luteal (low estrogen) phase of menstrual cycle (68%) as compared to follicular (high estrogen) phase (32%).
There was a significant increase in hospital admissions in the luteal phase of menstrual cycle in women suffering from exacerbation of schizophrenia. The influence of particulary sex hormones (estrogen, progesterone and testosterone) on admission rate and clinical psychopatology was found insignificant.
BACKGROUNDUnlike in female population, the effect of testosterone on aggression in men has been investigated countless times so far. A scarce number of studies have examined the effect of ...testosterone on aggression in women. The results obtained so far are inconsistent for some studies indicated a positive, whilst others showed a negative correlation. Since testosterone turned out to be an important factor related to aggression in men, the aim of our study was to investigate whether this correlation existed in aggressive female patients with schizophrenia. SUBJECTS AND METHODSThe sample consisted of 120 women, aged from 18 to 45 years, diagnosed with schizophrenia by DSM-5 criteria. Those who were breastfeeding or suffered from specific hormonal or other physical disorders were excluded from the study. They were divided into two groups of 60 - those with aggressive behavior and those with nonaggressive behavior. Psychopathology was measured by several tests (Positive and Negative Syndrome Scale - PANSS, Overt Aggression Scale - OAS and PANSS Extended Subscale for Aggression Assessment). Serum testosterone hormone assays were performed. Statistical data analysis was done by parametric statistical tests, Kolmogorov-Smirnov test, Student's t-test and simple linear regression. All data were presented as mean values and corresponding standard deviations (SD). RESULTSTestosterone levels didn't differ significantly between aggressive and nonaggressive subjects. There were no significant differences between testosterone levels in suicidal aggressive subjects compared to nonsuicidal aggressive respondents (t=0.616; p=0.540). The largest number of subjects in both groups had referent testosterone levels. CONCLUSIONSDespite expecting a significant effect of testosterone levels on aggression in women with schizophrenia, conducted by previous studies, no correlation has been found. Suicidal behavior surprisingly didn't depend on the subjects' testosterone levels.
The prevalence of hyperprolactinemia among psychiatric patients receiving antipsychotic medications was estimated to be between 30% and 70%. A review of the literature on prolactin and schizophrenia ...symptoms suggests that the correlation between them is complex and not limited to the adverse effects of antipsychotics. Relations with specific symptom dimensions have not been found consistently across studies. The association between increased prolactin and recurrent episodes of schizophrenia needs to be replicated in larger samples and in a population of female patients. The aim of this study was to find out whether elevated prolactin is related to specific symptoms or dimensions of schizophrenia, which is a heterogenic entity.
The sample consisted of 119 consecutively acute admitted women, aged 18 to 45 years with recurrent schizophrenia diagnosed on bases of DSM-5 criteria. Assessment for all the enrolled subjects comprised a psychiatric evaluation and blood draw to determine the prolactin level. Symptoms of schizophrenia were determined using the Positive and Negative Syndrome Scale (PANSS). Data were analyzed by regression analysis and the Independent Samples t Test. Values are given as means ±SD.
Hyperprolactinemia was detected in 74.79% patients (n=89), whereas the group without hyperprolactinemia comprised 25.21% of the sample. When plasma prolactin levels and clinical features between groups were compared, there was a statistically significant difference in the negative subscale scores of the PANSS (p=0.0011), positive subscale scores of the PANNS (p=0.0043), general subscale scores of the PANSS (p=0.0226) and total scores of the PANNS (p=0.0003).
There were statistically significant differences in the clinical symptoms between two compared groups in total score and in the positive, negative and general subscores.
S obzirom na kontinuirano povećanje broja starijih osoba u ukupnoj populaciji u Hrvatskoj, za očekivati je da će se broj starijih osoba s akutnim psihičkim smetnjama koje zahtijevaju hitno ...zbrinjavanje sve više povećavati. Najčešći psihički poremećaji kod starijih osoba su: depresivni poremećaji, kognitivni poremećaji, demencija, poremećaji
vezani uz uzimanje alkohola, poremećaji vezani uz druga zdravstvena stanja i lijekovima izazvani poremećaji. Gerijatrijski bolesnici bi u pravilu prvo trebali biti pregledani od strane stručnjaka somatske medicine (internista, neurologa, kirurga) prije nego što se upućuju u hitnu psihijatrijsku službu, kako bi se ustanovilo da su primarne
smetnje iz psihijatrijske domene. Izražena depresija, suicidalnost, agitacija, sklonosti lutanju i ostalim rizičnim ponašanjima kod kuće, izražena anksioznost i smanjena sposobnost brige o sebi, glavni su razlozi hospitalizacije kod ovih bolesnika.
Farmakološka terapija može biti korisna kao dodatak redukcijskoj prehrani i tjelesnoj aktivnosti u smanjenju
tjelesne mase. Međutim, treba imati na umu da farmakološka terapija ne bi smjela biti ...jedini način za smanjenje tjelesne mase. Redukcijska prehrana i tjelesna aktivnost su ključni za zdrav i održiv gubitak tjelesne mase. Farmakološka terapija treba biti korištena samo pod nadzorom stručnjaka i u slučajevima kada druge strategije za gubitak tjelesne mase nisu uspješne. Pandemija pretilosti i povećanja tjelesne mase nastavlja rasti alarmantnom brzinom. Trenutni dokazi za preporuku specifičnih dijeta i kombinacija dijete i lijekova za mršavljenje te kombinacija lijekova i tjelesnih aktivnosti i dijeta i dalje slabi, što se djelomično
može pripisati razlikama u prehrambenim protokolima, razlikama u praćenju tjelesne aktivnosti i različitim
vremenima praćenja u dostupnim ispitivanjima. Budući da su modifikacije stila i načina života ograničene u svom uspjehu u održavanju gubitka tjelesne mase, farmakoterapija igra važnu ulogu u postizanju klinički značajnog gubitka tjelesne mase. Farmakoterapija za smanjenje tjelesne mase indicirana je kao dodatak dijeti sa smanjenim unosom kalorija i povećanoj tjelesnoj aktivnosti u odraslih osoba s ITM ≥30 kg/m², ali i u osoba s preuhranjenošću s ITM-om ≥27 do 35 kg/m² s komorbiditetima ili ITM >40 kg/m2 s komorbiditetima ili bez njih. Farmakoterapija pretilosti značajno se razvila u posljednjih 60 godina. Federalna uprava za lijekove (FDA) je za sada odobrila šest lijekova za dugotrajno liječenje pretilosti. Malo je vjerojatno da će jedno farmakološko sredstvo biti učinkovito u liječenju pretilosti. Stoga će buduće strategije za liječenje pretilosti
morati potaknuti učinkovit gubitak težine i vjerojatno će zahtijevati istodobnu primjenu lijekova koji djeluju
kroz različite mehanizme. Ciljevi kontrole tjelesne mase naglašavaju važnost realističnog pristupa mršavljenju kako bi se postiglo smanjenje zdravstvenih rizika, a uključuju promicanje gubitka tjelesne mase, održavanje postignute niže tjelesne mase i prevenciju ponovnog debljanja. Ako se želi smanjiti tjelesnu masu, potrebno je pristupiti tome s više različitih strategija, uključujući i farmakološku terapiju.
Digital transformation is a major organisational challenge for manufacturing firms due to the extremely low success rate of such transformations to date. Capability Maturity theory suggests that ...firms need to develop digital transformation capability incrementally by focusing on a 'vital few' improvement priorities for advancing progress. The practitioner literature lacks empirical studies that validate extant capability maturity models (CMM) for digital transformation despite their importance. Moreover, there is a lack of assessment methods, and those that exist do not specify improvement points explicitly, nor prioritise them. Our research aims to address this gap through a systematic, quantitative analysis of digital capability by understanding the deployment of IT-enabled resources. Based on a sample of 302 manufacturing firms, results indicate that the digital transformation stages are punctuated by various resource-capability combinations. Results highlight that strategy- and organisation-related IT-enabled resources are the key drivers of digital transformation. We also observe that as a firm's digital capability grows at each maturity stage, successively greater IT-enabled resources are required to support this in a stepwise function. To succeed, firms should be incentivised and supported to think beyond technology and develop five specific digital capabilities simultaneously. We also indicate the limitations that underlie our empirical work.
PDF
