ABSTRACT
Background: Thyroid disorders are an area of public health concern worldwide. The study aimed to examine the incidence and severity of psychosomatic symptoms (distress, depression, anxiety and somatization) in patients with hypothyroidism, hyperthyroidism, Graves' disease and Hashimoto thyroiditis in relation to clinically healthy subjects. Methods: This case control study was carried out from Feb to Jul 2019 in Serbia. Total sample consisted of 335 subjects, of both sex. The examined group included patients with thyroid disorders treated at the Special hospital for thyroid gland and metabolism disease. Control group included clinically healthy subjects. The Four Dimensional Symptom Questionnaire a self-assessment questionnaire for psychosomatic symptoms was the measuring instrument. Groups were compared using parametric (t-test) and nonparametric (Pearson chi-square test, Mann-Whitney U test, Kruskal-Wallis test) tests. Results: The incidence of all psychosomatic symptoms was high in patients with thyroid disease. Distress was found in 59.8% of the patients in the examined group comparing to the control group (12.8±8.2 vs. 8.9±8.1). The score of depression was twice higher in the examined group (2.05±2.99 vs. 1.23±2.47). Anxiety was present in 46.2% patients in the examined group, while somatization was found in 69.7% subjects. In hypothyroidism there was no difference between the examined and the control group regarding the level of anxiety, likewise with the level of depression in the control group and subjects with Graves' disease and Hashimoto thyroiditis. Conclusion: Psychosomatic symptoms were significantly more severe in patients with thyroid disorders compared to the control group.
ABSTRACT
BACKGROUND: In treatment-resistant schizophrenia a combination of ECT with antipsychotics has been reported to have superior outcomes compared to other strategies, however the results were inconsistent. We investigated the long-term effects of the combination of unilateral, non-dominant hemisphere ECT with three antipsychotics. SUBJECTS AND METHODS: The clinical study was a naturalistic, prospective, open-labeled, active-controlled study in adult outpatients of both genders suffering from treatment-resistant schizophrenia with a follow up of 2 years. The patients received sulpiride (n=17, 100-400mg/day, PO), risperidone (n=26, 2-8 mg/day, PO) or olanzapine (n=27, 5-10mg/day, PO). Unilateral ECT was applied in 1 unit (0.5A, 0.8 mS) in six single applications, once a week and further according to the clinical need, in fortnight steps. Clinical efficacy was established using the PANSS and CGI psychometric scales. RESULTS: According to the results, the most effective treatment mode was olanzapine plus ECT, then risperidone plus ECT, while sulpiride plus ECT had lower clinical efficacy. Olanzapine plus ECT was significantly superior in all scale scores vs sulpiride plus ECT, as well as risperidone plus ECT except for PANSS-P (t=1.85, p>0.05). During the study, 38 of 70 patients were withdrawn due to treatment failure (n=21), side effects (n=6) and non-compliance (n=11). CONCLUSION: The combination of novel antipsychotics and ECT can be used safely and effectively in treatment-resistant schizophrenia.
