Psychological well-being of Ukrainian students three months after the emerge of full-scale war. / Dobrostan psychiczny ukrainskich studentów trzy miesiace po wybuchu wojny na pelna skale.

OBJECTIVES: To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war. METHODS: A total of 1,142 participants were asked to measure their psychological well-being on a 0-10 scale before and after the onset of full-scale war. Mental health symptoms were measured with questionnaires targeting depression (PHQ-9), anxiety (GAD-7), sleep problems (ISI), eating disorders (SCOFF), alcohol abuse (CAGE), and PTSD symptoms (PC-PTSD-5). To evaluate the connection between variables a χ2 was conducted. Phi and Cramer's V coefficient were stated to demonstrate the power of the relationships. Additionally, machine learning (the XGBoost regression model) was used to build a predictive model for depressive symptoms. RESULTS: Of all respondents, 66% screened positive for PTSD symptoms, 45% - moderate and severe anxiety symptoms, 47% - moderate and severe depressive symptoms. Regarding sleep, alcohol use and eating behavior, 19% of surveyed students had signs of moderate and severe insomnia, 15% reported alcohol abuse and 31% disordered eating. The severity of the aforementioned disorders varied depending on gender, year of study, social status, etc. According to the predictive model, lower initial psychological well-being, female gender, younger age, first years of study and any traumatic experience, including multiple trauma, predicted increases in depression score. Return to home after relocation was a protective factor. CONCLUSIONS: The study demonstrated the high prevalence of mental health symptoms among university students in Ukraine during the first months of the full-scale war. The psychological well-being pre-war was the strongest predictor of depressive symptoms in the model.

The impact of the COVID-19 pandemic on patients with migraine.

Objectives: The aim of our work was to assess the impact of the COVID-19 pandemic and quarantine measures on migraine patients in regards to the activity of the disease, the psycho-emotional background of the patients and their quality of life. Methods: his study included 133 patients with established diagnosis of migraine. All study participants were divided into two clinical groups: A-patients with chronic and episodic forms of migraine, who had a history of positive PCR test for COVID-19, and B-patients with chronic and episodic forms of migraine who did not have a history of coronavirus disease. Results: We detected increase in the number of antimigraine medication (p = 0.04), frequency of headache attacks (p = 0.01), and the psycho-emotional state deterioration (increase in the Hamilton anxiety scale score) (p = 0.002) in patients after recovery from the coronavirus disease. There was no significant difference in the headache's intensity according to the VAS scale (p = 0.51) as well as in the dynamics of the Beck depression scale score (p = 0.09) before and after the COVID-19 infection. Conclusion: Patients with a history of migraine who recovered from COVID-19 showed increased frequency of migraine headache attacks and anxiety.

PECULIARITIES OF THE GUT MICROBIOTA IN PATIENTS WITH MIGRAINE COMPARING TO HEALTHY INDIVIDUALS.

OBJECTIVE: The aim: Analyze the gut microbiome state in patients with migraine (M) and healthy individuals, to assess possible correlations between the detected changes in patients with migraine and the frequency, intensity of headaches, psycho-emotional state of the patients, and their quality of life. PATIENTS AND METHODS: Materials and methods: 100 objects were enrolled, divided into 2 groups: main - patients with M and control - healthy volunteers. Investigation of the intestinal microbiome was performed by chromato-mass spectrometry. For M patients the following scales were used: Visual Analogue Scale (VAS), Migraine Disability Assessment (MIDAS), Back Depression Inventory (BDI). RESULTS: Results: In main group increased amount of Alcaligenes spp (p = 0.0061), Clostridium coccoides (p = 0.0021), Clostridium propionicum (p = 0.0287), Eggerthella lenta (p = 0.0138), Pseudonocardia spp (p = 0.0210), Rhodococcus spp (p = 0.0164), Candida spp (p = 0.0079), Micromycetes spp (campesterol) (p = 0.0011) were found. Patients with M had a raised amount of Herpes simplex (p = 0.0305) and endotoxin level (p = 0.0459). Differences in gut microorganisms in both groups were significant. In patients with M negative correlations were observed between Alcaligenes spp ammount and BDI score (r = -0.6226, p =0.007), VAS score (r = -0.489, p = 0.046), headache frequency (r = -0.487, p = 0.046); between the levels of Clostridium coccoides and MIDAS score (r =-0.51, p = 0.035), BDI score (r = -0.54, p = 0.025) and positive correlation between Eggerthella lenta level and VAS score (r =0.4830, p=0.049). CONCLUSION: Conclusions: Correlations between changes of gut microbiome and M are promising for further research.

Prognostic Assessment of Stress-Related Factors in Healthcare Workers During the COVID-19 Pandemic.

INTRODUCTION: The COVID-19 pandemic is an extraordinary challenge for all countries and affects the psychological wellbeing of healthcare professionals working with people suffering from COVID-19 and puts them at a high risk of mental health problems. The aim of the study was to identify stress-related factors that affect the mental health of healthcare workers during the COVID-19 pandemic in Ukraine. SUBJECTS AND METHODS: A total of 1098 Ukrainian healthcare workers were surveyed using an online questionnaire consisting of questions relating to a) socio-demographic characteristics; b) perceptions of the COVID-19 related situation; and c) stress and protective factors. Respondents were divided into two groups, depending on whether they provided care to the patients with COVID-19 or not. RESULTS: Of the 1087 healthcare workers, 863 (79.4%) were found to have anxiety / fear caused by the COVID-19. No significant difference was detected between professionals who did and did not provide personal assistance to patients with COVID-19 concerning anxiety / fear related to COVID-19 (p=0.0776). Based on logistic regression model (χ2(6)=263.70, p=0.000) the most significant predictive factors for anxiety / fear caused by the COVID-19 were factors related to safety and risk perception (the risk of getting infected, dying, infecting loved ones, perception of the threat of the epidemic spread), information factors (constant news about COVID-19), as well as factors related to the organisation of care (lack of staff in health care facilities). CONCLUSIONS: Negative risk perception, high consumption of COVID-19 news, and shortage of staff in health care facilities were significant predictors of anxiety / fear caused by the COVID-19.

Pros and cons of remote medical education in Ukraine in terms of COVID-19 pandemics.

Introduction: COVID-19 is an ongoing pandemic, which forced countries across the globe to adapt all daily activities to the new reality in order to stop the disease from spreading. The educational process was not an exception, it caused a sudden shift towards the exceptional introduction of online teaching and Kyiv Medical University was one of the first universities in Ukraine to assess the quality of education under the restrictive measures. Objectives: The aim was to analyze the advantages and disadvantages of online education during the COVID-19 pandemic in the learning of neurology at the Department of Neurology, Psychiatry and Physical Rehabilitation, Kyiv Medical University. Methods: 169 students were interviewed using an online questionnaire consisting of 18 items focused on different angles of educational process. Results: According to the obtained results, the biggest pros of online teaching included: flexibility of learning schedule, learning at your own pace; ability to develop deeper problem-solving and clinical thinking skills. Social distancing, family distractions, and internet connection issues negatively affected most students' feelings during online learning. One of the most prominent cons of online learning of neurology pointed out by the majority of medical students was a lack of practical component of training and contact with patients. Conclusions: Online teaching, along with a number of advantages, has significant disadvantages, especially in medical education in case of studying clinical disciplines.

ANALYSIS OF RISK FACTORS FOR DENTAL CARIES IN PATIENTS WITH DIABETES MELLITUS.

OBJECTIVE: The aim: To identify, structure and evaluate the degree of influence of risk factors on the intensity of dental caries in patients with type 1 diabetes mellitus to improve caries-preventive measures. PATIENTS AND METHODS: Materials and methods: 179 patients with type 1 diabetes mellitus aged 18 to 56 years with a disease duration from 1 to 50 years were examined. 157 patients had various chronic diabetic complications. In patients the prevalence and intensity of caries were determined according to the DMFT index and the DMFS index, as well as the state of oral hygiene according to the OHI- S index. To determine the risk factors for dental caries, patients were interviewed using the developed questionnaire "The state of dental health of a patient with diabetes mellitus." RESULTS: Results: The most significant factors associated with indicators of the intensity of caries of the DMFT and the DMFS in patients with type 1 diabetes mellitus are xerostomia (r=0.61, p<0.01, and r=0.66, p<0.01), oral hygiene (r=0.57, p<0.01, and r=0.58, p<0.01), sharp fluctuations in blood glucose level (r=0.54, p<0.05, and r=0.59, p<0.05), frequent hypoglycemia (r=0.53, p<0.05, and r=0.56, p<0.05) and consumption of sweets (r=0.52, p<0.01, and r=0.55, p<0.01). CONCLUSION: Conclusions: When introducing individualized caries prevention measures in patients with type 1 diabetes, it is necessary to take into account the identified leading cariogenic factors for their elimination or partial correction.

EMOTIONAL IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE WORKERS IN UKRAINE.

OBJECTIVE: The aim: To study the emotional impact of the COVID-19 pandemic on healthcare workers in Ukraine. PATIENTS AND METHODS: Materials and methods: 1087 healthcare workers across all regions of Ukraine completed an online questionnaire. Respondents were divided into two groups: A - 863 (79.4%), В - 224 (20.6%), according to whether or not they experienced anxiety/fear related to COVID-19. RESULTS: Results: Such factors as risk of contracting COVID-19, news of new cases, insufficient staff in healthcare facilities, risk of transmission of COVID-19 to family or friends, risk of death from COVID-19, the threat of the spread of the COVID-19 pandemic were associated with high level of anxiety/fear among healthcare workers. Factors that facilitate coping with stress included absence of Covid-19 cases among staff, recovering patients, availability of gear and protective equipment and absence of COVID-19 infected among loved ones, relieving stress (relaxation, going info sports and so on), communication with family and friends to relieve stress and get support, avoidance of COVID-19 media reports in particular on deaths connected cases, getting information about the spread of Covid-19 only from legitimate sources. CONCLUSION: Conclusions: The data obtained in this study indicate an urgent need for the development and implementation of preventive and rehabilitation measures aimed at stabilizing the psycho-emotional state of health workers and improving the quality of care in the special conditions of the COVID-19 pandemic. Achieving these goals will be facilitated by taking into account the specifics of the response to COVID-19 and measures to reduce the effects of stress while enhancing the effects of stressors among health care workers.

COGNITIVE FUNCTIONS IN MULTIPLE SCLEROSIS PATIENTS DEPENDING ON THE DIFFERENT RISK FACTORS PRESENCE.

OBJECTIVE: The aim: To clarify the influence of different risk factors on cognitive impairment (CI) in general and in separate domains and their association with MRI findings in patients with relapsing-remitting (RRMS) and progressive forms of multiple sclerosis (SPMS and PPMS). PATIENTS AND METHODS: Materials and methods: One hundred and thirty-seven participants with MS (102 females and 35 males) aged from 22 to 69 years were enrolled into this study. All patients completed the Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A) and undergone MRI. RESULTS: Results: According to MS phenotypes all participants were divided into two groups: patients with RRMS (n= 106) and with progressive phenotypes (n= 31). A significant positive correlation was present between MoCA and BDI scores in all participants (p= 0,0015). Presence of anxiety did not demonstrate any valid influence on cognitive performance, although severe anxiety was significantly more often found in subjects with progressive phenotypes in presence of brain atrophy (p= 0,0028). Patients with higher education had no CI more frequently compare to those without it (p= 0,0019), whereas, participants smoking cigarettes had higher prevalence of severe CI than non-smokers (p= 0,0061). CONCLUSION: Conclusions: Among cognitive domains memory, visual-spatial and executive functions, abstract thinking were impaired the most in MS patients, though abstract thinking was more often affected in progressive forms. The results demonstrated that physical disability, depression and smoking negatively impacted cognitive performance, meanwhile presence of higher education demonstrated a favorable influence on cognition in MS patients.

Cognitive impairment and depression in patients with relapsing-remitting multiple sclerosis depending on age and neuroimaging findings.

BACKGROUND: Multiple sclerosis is an insidious, disabling, both physically and mentally, demyelinating disease of the central nervous system. This work aims to evaluate relationships between cognitive impairment in separate domains, depression and their correspondence with MRI-findings, as well as the influence on each other's manifestations, in patients with relapsing-remitting multiple sclerosis. RESULTS: Visual-spatial/executive functions and memory domains suffered more frequently than others in the study subjects under 40 years; in patients over 40 years old memory, visual-spatial/executive functions and abstract thinking impairment prevailed the most. Such cognitive domains as memory, language, abstract thinking, visual-spatial and executive functions were impacted in both groups of patients even without the apparent cognitive decline according to MoCA scale. Presence of depression impacted language and attention more prominently than the rest of the domains only in participants younger 40 years. According to the MRI, frontal lobe, corpus callosum and periventricular area were affected more often compared to other brain regions in case of cognitive impairment; meanwhile, combined lesions of frontal lobe and corpus callosum, fronto-temporal region were associated with depression. CONCLUSION: Cognitive impairment and depression are one of the common, yet disabling and socially disrupting manifestations of MS. Quite frequently such complaints are neglected or considered as parts of comorbidities. At the same time cognitive impairment can be amplified by depression, especially in patients under 40 years.

The effect of hyaluronic acid on the periodontium in spontaneous periodontitis in rats / El efecto del ácido hialurónico sobre el periodonto en periodontitis espontánea en ratas

SUMMARY: The aim of the article was to study changes in periodontal tissues in rats with spontaneous periodontitis (SP) and to evaluate the effect of hyaluronic acid (HA) on the state of the periodontium. Wistar rats with signs of SP were divided into 6 groups: 1) intact group; 2) intact animals with HA "HD-1,0 MDa"; 3) SP group; 4) SP with HA "S-2,4 MDa"; 5) SP with HA "ST-2,4 MDa"; 6) SP with HA "HD-1,0 MDa". The study of the periodontium rats with SP noted the main structural changes (collagen reduction, resorption of alveolar bone, dilatation and stasis of the vessels of the periodontium, gingival papilla and tooth pulp), which were assessed as moderate. Morphological evidence of inflammation was infiltration of neutrophils into the connective tissue of the gums, without the formation of abscesses. Local administration of HA did not cause additional structural damage in periodontal tissues of rats with SP, but also did not affect changes in the microvascular system of periodontium and tooth pulp, periodontal ligaments, only a tendency to inhibit alveolar bone resorption in rats was noted. One can consider the tendency to improve the condition of periodontal tissues in the group of rats injected with high molecular HA and HA with mannitol (2.4 MDa).

RESUMEN: El objetivo del artículo fue estudiar los cambios en los tejidos periodontales en ratas con periodontitis espontánea (PE) y evaluar el efecto del ácido hialurónico (HA) sobre el estado del periodonto. Las ratas Wistar con signos de PE se dividieron en 6 grupos: 1) grupo intacto; 2) animales intactos con HA "HD-1,0 MDa"; 3) grupo PE; 4) PE con HA "S-2,4 MDa"; 5) PE con HA "ST-2,4 MDa"; 6) PE con HA "HD-1,0 MDa". En las ratas con PS se observaron los principales cambios estructurales (reducción de colágeno, reabsorción del hueso alveolar, dilatación y estasis de los vasos del periodonto, papila gingival y pulpa dentaria), que fueron evaluados como moderados. La evidencia morfológica de inflamación fue la infiltración de neutrófilos en el tejido conectivo de las encías, sin la formación de abscesos. La administración local de HA no causó daño estructural adicional en los tejidos periodontales de las ratas con PE, pero tampoco se produjo cambios en el sistema microvascular del periodonto y en la pulpa dental y ligamentos periodontales.Se observó una tendencia a inhibir la resorción del hueso alveolar. Se puede considerar la tendencia a mejorar el estado de los tejidos periodontales en el grupo de ratas inyectadas con HA de alto peso molecular y HA con manitol (2,4 MDa).

The Implementation of the WHO Mental Health Gap Intervention Guide (mhGAP-IG) in Ukraine, Armenia, Georgia and Kyrgyz Republic.

Despite the increasing burden of mental disorders, a lot of people worldwide suffer a gap in receiving necessary care in these countries. To close this gap, the WHO has developed mhGAP training modules aimed at scaling up mental health and substance use disorders services, especially in low- and middle-income countries. This article presents the experience of implementing the Mental Health Gap Action Programme (mhGAP) in Ukraine, Armenia, Georgia, and Kyrgyz Republic. Data were gathered from an electronic questionnaire administered to representatives from higher educational institutions where the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) was implemented in existing curricula for medical students, interns, and residents in family medicine and neurology, practicing physicians, and master's program in mental health students. More than 700 students went through the programs that provided the feedback. Evaluations of program effectiveness mainly involved standard discipline tests or pre- and post-tests proposed in the mhGAP trainer manual. This finding suggested that mhGAP-IG can be successfully adapted and implemented both on undergraduate and on postgraduate education levels and among medical and nonmedical specialists. Future evaluations need to more definitively assess the clinical effectiveness of mhGAP-IG implementation.

SLEEP DISORDERS IN RELAPSING-REMITTING MULTIPLE SCLEROSIS PATIENTS.

OBJECTIVE: The aim: Our study aimed at evaluating the relationships between sleep disorders (SD), cognitive impairment (CI), anxiety and depression in patients with relapsing-remitting multiple sclerosis (RRMS). PATIENTS AND METHODS: Materials and methods: One hundred and five patients with RRMS (80 females and 25 males) aged from 22 to 67 years (mean age: 41,8±10,7; EDSS:3,5±1,6; disease duration (DD): 10,3±8,5 years) were enrolled into the study. All participants completed questionnaires on sleep (the Pittsburgh Sleep Quality Index /PSQI), cognitive functions (The Montreal Cognitive Assessment /MoCA), anxiety (Hamilton Anxiety Rating Scale /HAM-A), depression (Beck Depression Inventory/ BDI). RESULTS: Results: According to PSQI score the patients were divided into two groups: with (n=42) and without SD (n=63). The patients with SD were older (45,36±1,66 vs 39,41±1,27, p=0.005), had higher EDSS score (3,98±0,26 vs 3,14±0,19, p=0,008), BDI (13,79±1,14 vs 8,96±0,86, p=0,0009) and HAM-A (24,52±1,42 vs 16,56±0,99, p<0,0001) scales compared with patients without SD. The frequency of anxiety (p=0,0034) and depression (p=0,038) was significantly higher in RRMS patients with compared to those without SD. No significant difference was found in gender, DD and MoCA score. In patients with SD significant negative correlation between MoCA and BDI score (r = -0,42, p<0,005) was found. In the group of patients without SD significant negative correlation between MoCA and EDSS (r = -0,27, p=0,03), MoCA and BDI (r = -0,26, p=0,043),) MoCA and HAM-A (r = -0,25, p=0,041) score was detected. CONCLUSION: Conclusions: Insomnia type SD in RRMS patients were associated with older age, higher EDSS score and presence of anxiety and depression.

VASCULAR RISK FACTORS AND COGNITIVE FUNCTIONS IN THE PATIENTS WITH CEREBROVASCULAR DISEASE.

OBJECTIVE: The aim: To assess the severity of cognitive impairment (CI) in patients with cerebrovascular disease (CVD) depending on the number of vascular risk factors (VRF). PATIENTS AND METHODS: Materials and methods: The study consisted of five hundred and eighty patients with CVD (247 females and 333 males) aged from 45 to 89 years (mean age: 64,1±8,9 years). The patients were divided into 6 groups (I, II, III, IV, V, VI) depending on the number of VRF. The examination consisted of a standard clinical evaluation, neurological examination, the application of neuropsychological tests (the MMSE; the PALT/The Paired Associates Learning Test; clock drawing test), laboratory tests, MRI of brain. RESULTS: Results: According to ANOVA, the greater the number of VRF the patients had, the lower was their total MMSE score corresponding to more pronounced cognitive decline (F=2,97, p=0,012). A significant negative correlation between patients' age and their MMSE score was detected regardless of their VRF count. The patients of the V and VI groups had substantially lower parameters of immediate, delayed memory and clock drawing test score comparing to the patients of the I group. CONCLUSION: Conclusions: The presence of 4 and more VRF was related to more pronounced CI in the patients with CVD. Decline of different aspects of memory, attention, spatial orientation, abstract thinking, planning, concentration, executive and visuospatial skills in groups of patients with 4,5 and 6 vascular risk factors was established. Age was substantially associated with cognitive decline in all the group of patients.

Retrospective analysis of leptospirosis morbidity in ivano-frankivsk region (epidemiological and clinical characteristics).

OBJECTIVE: The aim: To perform a retrospective analysis of leptospirosis morbidity in Ivano-Frankivsk region, to give the etiological characteristics of leptospirosis according to clinicallaboratory parameters, to determine the peculiarities of the course, prognostic features. PATIENTS AND METHODS: Materials and methods: Data of the State Enterprise "Ivano-Frankivsk Regional Laboratory Center of the Ministry of Health of Ukraine", reports and abstracts of medical records of the Regional Clinical Infectious Diseases Hospital for 2009-2018 were used. Clinical observation of patients, analysis of general-clinical, biochemical, and serological indices were carried out. RESULTS: Results: The leptospirosis morbidity in Ivano-Frankivsk region during 2009-2018 was higher than in general in Ukraine. Activation of foci of leptospirosis L. pomona and grippotyphosa in 2009-2013, decrease of L. grippotyphosa and increase of L. pomona foci and "new" L. autumnalis, australis, bataviae, cynopteri in 2014-2018 were noted. The emergence of leptospirosis L. autumnalis, which had a high virulence and caused a severe course, was noted. CONCLUSION: Conclusions: The leptospirosis morbidity in the Ivano-Frankivsk region over the past 10 years has exceeded the incidence in Ukraine and varied within 0.62-2.2 per 100,000. During the last 5 years, the serological structure has changed: L. pomona (27.7%) prevailed, L. grippotyphosa decreased (2.1%), L. bataviae and cynopteri, autumnalis increased (by 8.5%). Seasonality is shifted in the autumn-winter period (November-February) (L. grippotyphosa, australis, pomona, canicola). According to forecasts, leptospirosis induced by L. autumnalis was most adverse. Leptospiroses of serogroups L. australis, bataviae, cynopteri had a mild course, there were fewer complications.

Reforming Undergraduate Psychiatry Training in Ukraine.

In Ukraine, mental health problems are common yet the mental health services available are still old fashioned and based on healthcare approaches used in the Soviet Union, providing mainly inpatient services and rudimentary community services. The World Health Organization (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to reduce the mental health treatment gap all over the world and 2 years later introduced the WHO mhGAP-Intervention Guide (mhGAP-IG), version 2.0 (2016) as not only an educational tool, but also an evidence based guideline to scale up services for mental, neurological and substance use (MNS) conditions with an objective to reduce gap between available health systems capacity and resources for mental health. The main aim of this paper is to describe reforms of undergraduate psychiatry training in Ukraine using Kyiv Medical University as a case example. Kyiv Medical University (KMU) is the first university in Ukraine to introduce the mhGAP-IG in Ukraine. The revised psychiatry curricula in KMU aims to strengthens the evidence based teaching practices, to put emphasis on community orientated mental health care, and to use interactive teaching methods that the university hopes will attract more future doctors to psychiatry and ideally contribute towards the reduction of the mental health treatment-gap in Ukraine.

Age related characteristics of cognitive changes in patients with metabolic syndrome.

OBJECTIVE: Introduction: According to World Health Organization (WHO) forecasts, by 2050 the number of people suffering from dementia will constitute about 150 millions in the world. Nowadays, Alzheimer's disease plays the leading role in dementia emergence; it is the cause of age related dementia in 60% of cases. The aim: This study aimed to assess the age related cognitive changes in patients with metabolic syndrome (MetS). PATIENTS AND METHODS: Materials and methods: 503 patients aged 45 to 89 years with chronic cerebral ischemia were included into the study. All the patients were divided into two groups: group 1 - without MetS (n = 198), group 2 - with MetS (n = 305). Patients of both groups were divided into 3 age subgroups: 1st - 45-59, 2nd - 60-74, 3rd - 75-89 years old.The MetS was defined according to the criteria of the American Heart Association, the World Heart Federation, the International Atherosclerosis Society, and the International Association for the Study of Obesity. To evaluate patients' cognitive functions wide range of neuropsychological tests were used. RESULTS: Results: Patients of both groups had significant age related cognitive deficit. MetS patients of all age subgroups with mild cognitive impairment syndrome revealed a significant decline of immediate and delayed memory on the verbal stimuli (especially in patients of elderly and senior age groups), the rate of sensorimotor reactions, mental capacity, and the active attention amount in comparison to the patients without MetS. MetS patients with dementia of the middle age had significantly lower parameters of immediate and delayed memory on the verbal stimuli, the rate of sensorimotor reactions, mental capacity, and the active attention amount in comparison to the patients without MetS but with dementia. CONCLUSION: Conclusions:The presence of MetS was associated with more pronounced cognitive decline in the patients, concerning different aspects of memory, attention and executive functions.

Association between depressive symptoms and cognitive impairment in patients with metabolic syndrome.

INTRODUCTION: Metabolic dysregulation is intimately associated with wide array of seemingly unrelated disorders, including cognitive impairment and depression. The aim was: to identify special characteristic features of depressive disorder in patients with metabolic syndrome (Mets); to identify possible association between depressive disorder (DD) and cognitive impairment in patients with Mets; to establish whether metabolic syndrome and its components are associated with severity of DD. MATERIALS AND METHODS: The study group consisted of 108 patients with depressive disorders aged from 45 to 84 years. All patients were divided into two groups: main- with Mets (n=60) and control - without metabolic syndrome (n=48), comparable for age, sex and level of education. The examination consisted of physical and neurological examination and the application of neuropsychological tests (Mini-Mental State Examination/MMSE, Hamilton Depression Rating Scale / HAM-D) magnetic resonance imaging and laboratory tests. RESULTS: It has been found more pronounced severity of depressive disorder (DD) in patients with Mets compared with patients without it (p<0,05). In the group of patients with Mets there was significantly higher incidence of somatic anxiety (p <0,01), hypochondria (p <0,05), reduced criticality (p <0,05) compared with patients without Mets. It has been found significantly higher incidence of dementia in patients with DD and Mets comparing with patients with DD without Mets (p<0,05). Statistically significant negative correlation was found between the total score on the Hamilton scale and the total MMSE score (r = -0,56, p <0.05) only in the group of patients with Mets. Of all Mets components a reliable positive correlation was found only between high triglyceride levels of blood and the total Hamilton scale score (rs = 0,27). CONCLUSIONS: Our study adds to the mounting evidence that links depression and Mets. Some specific features of DD in patients with MetS were established. The severity of DD was significantly associated with severity of cognitive impairment in patients with Mets. Of all components of Mets, only elevated levels of triglycerides of blood was significantly associated with the severity of DD in our maim group of patients.