The Role of COVID-19-Associated Fear, Stress and Level of Social Support in Development of Suicidality in Patients Diagnosed with Affective and Stress-Induced Psychiatric Disorders during the COVID-19 Pandemic-A Comparative Analysis.

Only a few studies seem to address suicidality as an effect of the COVID-19 pandemic in persons previously affected by psychiatric disorders. The relationship between fear and stress caused by the COVID-19 pandemic and the level of social support and suicidality in patients diagnosed with affective and stress-induced psychiatric disorders prior to the onset of the COVID-19 pandemic were investigated. This study was observational and involved 100 participants. The examined period was from April 2020 to April 2022. The Fear of COVID-19 Scale (FCV-19S), the Oslo Social Support Scale 3 (OSSS-3) and general psychiatric interviews were used to obtain data. A statistically significant relationship between the impact of COVID-19-related distress on the occurrence of suicidality and the year of the pandemic χ2(2, N = 100) = 8.347, p = 0.015 was observed. No statistically significant correlation was found between suicidal behavior, stress intensity, fear and the score on the social support scale (p > 0.05). Fear related to the COVID-19 pandemic can only be seen as a contributor to suicidality. Overall, social support does not always act protectively. Previously stressful experiences such as wars, poverty and natural disasters seem to play a significant role in the resilience to each new public health crisis.

The Impact of Comorbidity on Rehabilitation Outcome after Ischemic Stroke.

Comorbidity decreases survival but it still remains unknown to what extent functional recovery after ischemic stroke is affected. The aim of this research was to determine the prevalence of the most common comorbidities in patients with ischemic stroke and to examine their predictive value on the functional status and recovery. In order to obtain relevant information for this research, we conducted a prospective study over a two-year period. It included patients with acute/subacute ischemic stroke who had inhospital rehabilitation treatment in our institution. Functional status of the patients was evaluated by the following three aspects at the beginning and at the end of rehabilitation treatment: Rivermead Mobility Index was used for mobility, Barthel Index for independence in activities of daily living, and modified Rankin Scale for total disability. Modified Charlston Comorbidity Index was used to assess comorbidity. Multivariate analysis was applied to evaluate the impact of recorded comorbidities on the patient functional outcome. Independent predictors of rehabilitation success in our study were the value of modified Charlston Comorbidity Index, atrial fibrillation and myocardial infarction. Our study demonstrated that patients with more comorbidities had worse functional outcome after stroke, so it is important to consider the comorbidity status when planning the rehabilitation treatment.

[Expression of somatostatin in ischemia of rat brain]. / Ekspresija somatostatina pri ishemiji mozga pacova.

INTRODUCTION: This study used the immunohistochemical method to follow the expression of cytoplasmatic protein somatostanin in the course of ischemia of rat brain. The aim of the study was to define all the areas of expression of somatostain and to show the protein distribution on the map. MATERIAL AND METHODS: All the sections of telencephalon, diencephalon and midbrain were studied in resistant, and transitory ischemia, which enabled us to observe the reaction of neurons to an ischemic attack or to repeated attacks. RESULTS AND DISCUSSION: The results of this study show that there is a difference in the reaction between the resistant and transitory ischemia groups of rats, especially in the parietofrontal cortex, area amygdaloidea anterior, clastrum, nc. reuniens and nc. suprachiasmaticus. The mapping shows the reaction in the structures of motor, sensitive and sensory cortex, mostly in the laminae I/Ill and V/VI, hippocampus- gyrus dentatus and CA1, CA2, CA3, endopiriform nucleus, paraventricular and periventricular nucleus of hypothalamus, corpus amygdaloideum, claustrum and caudoputamen. The more primitive sections of the brain - rhinencephalon, also showed a reaction, which led us to conclude that both newer and older brain structures reacted immunohistochemically. Histological data showed that small neurons are most commonly found while the second most common are big pyramidal cells of multipolar and bipolar type, with the different body shape. CONCLUSION: Our findings have confirmed the results of rare studies that dealt with these issues, and offered a precise and detailed map of cells expressing somatostanin in the rat brain following ischemic attack.

Side effects of antipsychotic agents--neuroleptic malignant syndrome.

Summary - Neuroleptic malignant syndrome is a rare, potentially life-threatening complication which is an unpredictable, idiosyncratic reaction to antipsychotics. In patients receiving traditional antipsychotics, neuroleptic malignant syndrome occurs with an incidence of 0.2-3.3%. However, neuroleptic malignant syndrome also appears in patients treated with atypical antipsychotics, especially Clozapine. A possible cause of neuroleptic malignant syndrome is blockade of dopamine receptors in the nigrostriatal tracts or hypothalamic nuclei. If signs and symptoms of the Neuroleptic malignant syndrome are identified in time, full recovery is possible. This is a report of a female patient with neuroleptic malignant syndrome treated by traditional antipsychotics. As soon as neuroleptic malignant syndrome symptoms were recognized, the antipsychotic drugs were discontinued, symptomatic therapy was initiated and symptoms of neuroleptic malignant syndrome disappeared. However, the patient's psychotic symptoms persisted and an atypical antipsychotic was administered. During the next few days the psychotic symptoms gradually disappeared and the patient accomplished good recovery.

[Current issues in psychiatry].

INTRODUCTION: Psychiatry is the branch of medicine concerned with the defining and diagnosing mental disorders, finding ways of treatment, developing methods for determining causes, and conceiving measures for prevention of mental disorders. Psychiatry has greatly advanced over the last two decades. In our country, however, due to prejudice and ignorance, mental disorders are still often considered incurable and alarming by the general public as well as by physicians, and psychiatric patients are stigmatized and marginalized by the society. THE ROLE OF PSYCHIATRY IN MODERN MEDICINE AND SOCIETY: Psychiatry has an important role in the contemporary medicine and society in general, considering the increasing number of people suffering from mental disorders, disability they cause, and their frequent simultaneous occurrence with various physical illnesses, especially chronic ones. Comorbidity of physical and mental disorders makes the treatment more difficult and time-consuming, whereas an unrecognized and untreated mental disorder has a negative impact on the prognosis and outcome of the physical illness. PSYCHIATRY AS AN INTEGRATIVE DISCIPLINE: Because of the great advances in psychopharmacology and etiopathological research, as well as development of new classifications, contemporary psychiatry integrates biological, psychological and social aspects into an integrative biopsychosocial approach to etiopathogenesis, manifestations, course, treatment, and outcome of mental disorders. In fact, this means that the etiological factors of a psychiatric disorder include mutually interacting biological (genetic, neuroanatomical, biochemical, etc), psychological (personality/temperament), and social (background, stressful life events) factors. Therefore, the treatment itself involves application of biological, psychological and social methods. THE POSITION OF'PSYCHIATRY IN OUR COUNTRY: The significant increase in the number of people suffering fiom mental disorders (depression, anxiety disorders, substance abuse disorders) underlines the importance of psychiatry in our country. It is also clear that psychiatric services need to be reformed. In order for this reorganization to be effective it is necessary to review the current conditions, include both mental health specialists and general physicians, provide financial resources, and carry it out gradually, with an adequate support from the health care administration.

[Suicide risk in patients with depression]. / Suicidni rizik u depresivnih bolesnika.

INTRODUCTION: The purpose of this study was to examine the suicidal risk in regard to suicidal thoughts, ideas and attempts among delusional and non-delusional depressed patients. MATERIAL AND METHODS: 35 non-delusional and 30 delusional depressed patients were examined. All patients were hospitalized at the Psychiatric Clinic in Novi Sad, between 1995-2001. In regard to statistical methods t-test and multivariate discriminant analysis were used. RESULTS: Delusional depressives were older. They presented greater scores both on Hamilton Depressive Rating Scale and Beck Scale of Suicidal Thoughts. They were also at greater suicidal risk measured by Suicidal Risk Scale (M.Biro). However, delusional depressive patients plan suicide more carefully than non-delusional. DISCUSSION AND CONCLUSION: Patients with self-accusing ideas commit suicide most frequently. Delusional depressive patients were at higher suicidal risk; their suicidal thoughts were more intensive than in non-delusional patients; similar results were found in other articles as well.