Abstract Background Brain-derived neurotrophic factor (BDNF) mediates neural plasticity, mood, different behaviours, and stress response. A functional BDNF polymorphism (BDNF Val66Met) was reported ...to influence the effects of stressful life events or childhood adversity on depression and suicidal behaviour in various psychopathologies. The study evaluated the association between BDNF Val66Met variants and suicide, committed with violent or non-violent methods, in victims with or without stressful childhood experience. Methods BDNF Val66Met polymorphism was genotyped on 560 DNA samples from 359 suicide victims and 201 control subjects collected on autopsy from unrelated Caucasian subjects and subdivided according to gender, method of suicide, and influence of childhood adversity. Results A similar frequency of BDNF Val66Met variants was found between all included suicide victims and the control groups, and also between the male groups. The frequency of the combined Met/Met and Met/Val genotypes and the homozygous Val/Val genotype was significantly different between the female suicide victims and female controls, between the female suicide victims who used violent suicide methods and female controls, and between all included suicide victims with or without stressful life events. The combined Met/Met and Met/Val genotypes contributed to this significance. Limitation A small group of suicide victims with available data on childhood adversity was studied. Conclusions The combined Met/Met and Met/Val genotypes of the BDNF Val66Met variant could be the risk factor for violent suicide in female subjects and for suicide in victims exposed to childhood trauma. These results confirm a major role of BDNF in increased vulnerability to suicide.
Izhodišča: Namen raziskave je bil ugotoviti povezanost med športno dejavnostjo (ŠD) in doživljanjem stresa ter vrednotenjem zadovoljstva z življenjem odraslih Slovencev.
Podatki so bili pridobljeni s ...pomočjo anketnega vprašalnika na reprezentativnem vzorcu 856 odraslih Slovencev in Slovenk (povprečne starosti 39 ± 13,7 leta). ŠD je bila opredeljena s številom dni ukvarjanja s katero koli športno dejavnostjo tedensko. Stres je bil opredeljen s pogostostjo doživljanja devetih znakov stresa na štiristopenjski lestvici. Pri oceni zadovoljstva z življenjem so udeleženci raziskave izrazili strinjanje oziroma nestrinjanje s petimi postavkami na petstopenjski lestvici. Vrednosti prve glavne komponente stresa in lestvice zadovoljstva z življenjem je bila določena z Anderson-Rubinovo metodo. Povezanost spremenljivk je bila ocenjena s Spearmanovim koeficientom korelacije in s splošnimi linearnimi modeli.
ŠD je bila statistično značilno povezana s stresom (p = ,03) in z zadovoljstvom z življenjem (p < ,01). V linearnih modelih imajo izbrani dejavniki (ŠD, starost, spol in izobrazba) skupaj statistično značilen vpliv (pri stresu: R
= ,040; p < ,001; pri zadovoljstvu: R
= ,068; p < ,001); ŠD ima statistično značilen vpliv le na oceno zadovoljstva z življenjem (η
.= ,020; p = ,002). Na stres statistično značilno vplivajo vsi preostali dejavniki, na zadovoljstvo z življenjem pa le izobrazba.
Na podlagi dobljenih rezultatov lahko sklepamo, da so športno dejavnejši odrasli Slovenci manj pod stresom in bolj zadovoljni s svojim življenjem, vendar je ta vpliv ob upoštevanju vpliva starosti, spola in izobrazbe razmeroma majhen.
Objective: The aim of the study was to investigate the correlation of sports activity (SA) with stress experience and evaluation of satisfaction with life among adult Slovenians.
Data was collected with a survey on a representative sample of 856 adult Slovenians (average age 39±13.73 years). We determined sports activity with incidence of any sports activity - times per week. To determine mental health, the respondents marked how often the 9 signs of stress appeared within a last month and how satisfied they were with their life. Scores on the first component of stress and satisfaction with life scale were computed using Anderson-Rubin method. The correlations between variables were evaluated using the Spearman correlation coefficient and general linear models.
SA is statistically significantly correlated with stress (p= .03) and satisfaction with life (p= .00). In the models for prediction of stress and satisfaction with life, the set of predictors (SA, age, gender and education) has a significant effect (R
= .040, p< .001; R
= .068, p< .001), with SA having a statistically significant effect only on value of life satisfaction (η
= .020, p= .002). A set of all mentioned predictors has significant effect on stress, while only education beside SA has a statistically significant effect on satisfaction with life.
It could be concluded that individuals that are more active in sports experience the signs of stress less often and that they are more satisfied with their lives, but taking age, gender and education into consideration, SA is not the main predictor.
Type 1 diabetes is one of the more common chronic conditions in childhood and adolescence. It is an autoimmune disorder that leads to destruction of beta cells in the pancreas and consequently ...hyperglycemia. Presently, approximately 700 children, adolescents and students up to the age of 25 years from entire Slovenia are followed up for type 1 diabetes. In young people with chronic disease adolescence itself often causes complications in the course of the disease. The risk of complications is even higher in the presence of various psychosocial risk factors. The present article focuses on the prevalence and the influence of risk-taking behavior, mental disorders and suicidal behavior on the course and management of type 1 diabetes in adolescence and summarizes the latest clinical guidelines for the management of adolescents with these comorbidities.
Background: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening ...questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women - 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition - 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results. Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficientBackground: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women - 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition - 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results. Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficient identification of depression. Targeted screening in high-risk groups, women and chronic patients in the age group from 46 to 55 years, would be reasonable. PUBLICATION ABSTRACT
Abstract Suicidal ideation and behavior are a frequent complication of schizophrenia. Although a number of risk factors have been identified, specific features of suicidality in schizophrenia remain ...poorly understood. In this study, 19 patients with schizophrenia were interviewed in depth on their suicidal ideation and intentions, followed by a qualitative phenomenological analysis of the material. Solitude with inability to participate in human interactions and feelings of inferiority were found to be the main sources of suicidal ideation. These experiences seem to resemble ordinary depressive reactions, yet we found them to be reflective of a more basic self-alienation and incapacity for immersion in the shared world. Ignoring this experiential level of patients' disturbances may lead to trivialization (and misjudgment) of the experiences at the root of suicidality in schizophrenia.
COST OF DISORDERS OF THE BRAIN IN SLOVENIA BVodusek, David; Kos, Mitja; VDolenc, Vinko ...
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
05/2008, Letnik:
77, Številka:
SUPPII
Journal Article
Recenzirano
Odprti dostop
Whereas there are many publications on disorders of, for instance, heart or kidney function, there are few, if any, on brain disorders, which are traditionally viewed separately asmental, ...neurological or neurosurgical disorders. There are, however, marked similaritiesand shared interests between the fields and, most importantly, basic neuroscience is equally relevant for all clinical problems. The European Brain Council has analysed the burdenand the cost of brain disorders in Europe. The aim of the present text is to report data forSlovenia.Twelve different disorders (or groups of disorders) of brain believed to have the highestcost (addiction, affective disorders, anxiety disorders, brain tumours, dementia, epilepsy,migraine and other headaches, multiple sclerosis, Parkinson's disease, psychotic disorders,stroke, and trauma) were analysed. Epidemiology data for Europe were collected as12-month prevalence data for disorders by country and stratified according to age,gender, and disorder severity. Because little original data were available for Slovenia,extrapolated data were used. Health economic data (representing direct medical costs,direct non-medical costs, and indirect costs) being transformed into euros for the year2004 were entered into a health economic model.The total number of brain disorders in Slovenia amounted to 570,000 in 2004, and whencorrected for co-morbidity, 1/5 of the Slovenian population have a brain disorder. Inparticular, this is 39,000 alcohol dependents and illicit drug dependants, 105.000 affectivedisorders, 195,000 anxiety disorders, 178,000 migraine, etc. The total cost of all includedbrain disorders in Slovenia was estimated at 833 million euros, the most costly beingaffective disorders, dementia, and addiction. It should be mentioned that both the epidemiological data and the resulting cost are significantly underestimated for several disorders,particularly stroke. Direct health care cost mounted to 403 million euros and constituted48 % of total cost; 6 % of the total cost present drugs for brain disorders. Thus brain disorders in Slovenia constituted 14 % of the total direct health care cost in Slovenia and 9 % oftotal drug costs. The total cost of brain disorders constituted 2 % of the gross nationalproduct of Slovenia.The preparations for this study have revealed an important lack of epidemiological andhealth economical data of brain disorders in Slovenia which should serve to promote thesestudies in future. The estimated costs are nevertheless thought to present a relatively good measure of the real picture. The significance of these costs has not really been appreciatedso far due to the particularisation of psychiatric, neurological, and neurosurgical disorders into individual compartments. Data should be useful for strategic planning of healthcare, research, and education.
Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental health disorders in childhood; symptoms persist into adulthood in a majority of patients. It is among the most ...heritable of psychiatric disorders with a high risk for familial aggregation and has been linked in adulthood with impairment across a variety of domains, including parenting. Parental gender, ADHD status and symptom expression could be related to the severity of ADHD symptoms in the child.
We used prospective, observational study of clinical group of 30 children with diagnosed ADHD and control group of 37 healthy subjects. Only children with both biological parents available were included. Data on ADHD symptomatology for all subjects was gathered by a set of clinical tools (CBCL1991, TRF1991, WURS, self-report scale modified from DSM IV). Under the assumption that ADHD is a dimensional disorder, raw scores from questionnaires were used as they display the complete range of values.
Clinical group showed higher values in all areas of children symptomatology, the same was observed for parental ADHD symptomatology. Significant correlation was found between children and paternal current ADHD symptomatology in the clinical group. This was not confirmed for mothers.
Our study stresses an importance of screening for ADHD symptoms in parents of clinically referred children with ADHD as the correlation between severity of paternal and child's ADHD symptoms was confirmed. Our results stress the importance of including the father into the clinical assessment.
Objective: To determine lifetime prevalence of suicidal and self‐injurious behaviors in Slovenian adolescents with type 1 diabetes compared with healthy controls.
Research design and methods: ...Adolescents (14–19 yr) with type 1 diabetes were compared with a normative control group of healthy secondary school students by means of a self‐reported questionnaire (according to Kienhorst) containing questions on demographic and family characteristics, suicidal ideation, intended suicide, attempted suicide, possible future suicide, and self‐injurious behavior. Patients received the questionnaires at regular outpatient visits to the pediatric diabetes clinic, completed them in private, and returned them by mail. Questionnaires for control subjects were administered in classrooms.
Results: The responses of 126 eligible patients and 499 controls were analyzed. The control group trended toward higher lifetime prevalence of all suicidal behaviors and self‐injurious behavior. The lowest prevalence of all suicidal behaviors and self‐injurious behavior was reported by males with diabetes. Compared with male controls, the differences were statistically significant for suicidal ideation (p < 0.05) and intended suicide (p < 0.05). Compared with females with diabetes, the differences were statistically significant for suicidal ideation (p < 0.001), intended suicide (p < 0.01), attempted suicide (p < 0.05), and self‐injurious behavior (p < 0.05). Females with diabetes reported highest prevalence of all suicidal but not self‐injurious behaviors. More patients than controls reported receiving counseling the year preceding the study (p < 0.001).
Conclusions: In the study, type 1 diabetes showed a protective effect for suicidal behavior in adolescent males but not in adolescent females. Professionals working with adolescents with type 1 diabetes should be alert to possible suicidality, especially among females.
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