Symptoms of Anxiety and Depression and Sense of Coherence in Patients Undergoing Carotid Artery Stenting.

BACKGROUND: The sense of coherence is lower in patients with somatic diseases and psychiatric disorders. PURPOSE: The purpose of this study was to evaluate the intensity of depression and anxiety symptoms and their relationship with the sense of coherence and to try to determine the relationship between the strength of sense of coherence and symptoms of depression and anxiety with the presence of symptoms of carotid atherosclerosis in a group of patients undergoing carotid artery stenting. METHODS: 35 patients, including 13 with symptomatic atherosclerosis in the carotid arteries, completed self-report tests: Hospital Scale of Depression and Anxiety (HADS) and the SOC-29 Life Orientation Questionnaire (SOC-29), 22 of whom also rated their subjective feelings of anxiety and depression on a scale included in the author's questionnaire. RESULTS: Both symptomatic and asymptomatic patients did not differ significantly in the severity of depression, but they differed in anxiety levels as assessed by the HADS scale. There were no differences in the overall strength of sense of coherence and its individual components. Nearly 12% of those undergoing carotid artery stenting have pronounced anxiety symptoms, and just over 14% have pronounced depression symptoms. A higher overall sense of coherence and its components are associated with lower severity of depression symptoms. Lower severity of anxiety correlates negatively with a higher sense of understanding, meaningfulness, and holistic Sense of Coherence (SOC). Manageability appeared higher in men. CONCLUSIONS: SOC is an important health-promoting factor that is preferably related to mental health parameters of patients with carotid atherosclerosis.

Impact of Venlafaxine on Platelet Count and Activity-Case Report and Narrative Review.

Venlafaxine (VEN) is considered to be one of the most effective antidepressants. It belongs to the group of serotonin (5-HT) and noradrenaline (NA) reuptake inhibitors (SNRIs). NA and 5-HT have receptors on the surface of platelets and are involved in platelet aggregation. In this case study, we present the case of a patient treated for one of the types of myeloproliferative neoplasm (MPN), essential thrombocythemia (ET), in whom VEN was added to pharmacotherapy during the treatment of a severe episode of depression with psychotic symptoms. We observed a gradual reduction in platelet count when increasing the dose of VEN. We also present a narrative review of literature about the effect of VEN on platelet counts and activity. We conclude that, in the group of patients taking VEN, attention should be paid to the rare adverse effect of a decrease in the number of platelets.

The effect of aripiprazole on leptin levels of patients with chronic schizophrenia and a comparison of leptin, acute phase protein, and cytokine levels with regard to body mass and body composition indexes.

INTRODUCTION: The aim of this study was to test the effect of aripiprazole on leptin, insulin, acute phase proteins, and selected cytokines levels in patients with chronic schizophrenia. Additionally, levels of leptin, insulin, acute phase proteins, and cytokines were compared with body mass and body composition indexes. MATERIAL AND METHODS: Levels of leptin, insulin, serum amyloid A (SAA), tumour necrosis factor alpha (TNF-α), and interleukins 17A (IL-17A) and 18 (IL-18) in blood serum were measured for 17 patients before and after 28 days of administering aripiprazole by means of enzyme-linked immunosorbent assay (ELISA). Before and after the study, body mass and waist circumference (WC) were also measured, and body mass index (BMI) and body fat percentage (BF%) were estimated. The sex of each patient was taken into account. RESULTS: After administration of aripiprazole the reduction of levels of leptin, insulin, SAA, and TNF-a were statistically significant, similarly to body mass reduction and decrease in WC, BMI, and BF%, which were also statistically significant. A positive correlation between leptin and BF% and negative correlation between insulin and body mass and body composition indexes were observed before and after the study. High sensitivity C-reactive protein (hsCRP) and hsCRP/albumin positively correlated with BMI before the treatment. In the group of women a statistically significant positive correlation between TNF-α and IL-17A and body mass and body composition indexes was observed, and in the group of men a negative correlation between IL-18 and BMI, WC, and BF% was noted. CONCLUSIONS: The effect of aripiprazole is connected to its anti-inflammatory activity. A 28-day treatment resulted in reduction of adipose tissue, and in the group of women it returned their leptin sensitivity to normal levels. A change of psychotropic treatment and administration of aripiprazole reduces cardiometabolic risks.

Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly.

The aim of the study was to assess cognitive functions and sleep quality after a 3-month holistic intervention including physical, social and cognitive rehabilitation in patients 65+. Twenty-nine people participated in the study. The study was divided into two stages. In the first stage, a self-administered questionnaire consisting of sociodemographic questions was used, and cognitive functions were assessed using the Rey-Osterrieth complex figure test, Addenbrooke's Cognitive Examination III (ACE III) test, Montreal Cognitive Function Assessment Scale (MoCA) and digit repetition test. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS). After three months, the patients were assessed for cognitive functions and sleep quality, which was the second stage of the study. Analysis of the results obtained by patients in the study showed a statistically significant improvement in sleep quality and cognitive function. Rehabilitation activities, including physical training, cognitive exercises and occupational therapy, reduce the severity of mild cognitive disorders and reduce insomnia.

Assessment of the Impact of a Daily Rehabilitation Program on Anxiety and Depression Symptoms and the Quality of Life of People with Mental Disorders during the COVID-19 Pandemic.

Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors' questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient's age.

Depressive and anxiety disorders in patients with primary hyperparathyroidism. / Zaburzenia depresyjne i lekowe u chorych z pierwotna nadczynnoscia przytarczyc.

OBJECTIVES: The objective of the study was to evaluate the prevalence and severity of anxiety and depression in patients with primary hyperparathyroidism (PHPT), and to determine a relationship between the severity of these disorders and the serum calcium ion and parathyroid hormone level, as well as to evaluate the usefulness of self-rating scales in screening for depressive disorders in PHPT patients. METHODS: Using the 17-item Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory-II (BDI-II) and Hospital Anxiety and Depression Scale (HADS), study was performed on a group of 101 patients with PHPT. A control group included 50 patients diagnosed with non-toxic thyroid goiter. RESULTS: The HAM-D indicated higher prevalence and severity of depressive symptoms in the whole population of patients and in women with PHPT. Such a relationship was not observed in men. The BDI-II indicated higher prevalence and severity of depressive symptoms in the whole population of patients and in women with PHPT. Such a relationship was not observed in men. The HADS did not show significant differences in the prevalence of depressive and anxiety symptoms between the study and control groups in the whole population and after taking into account the gender division. CONCLUSIONS: A relationship between PHPT and depression was confirmed. Such a relationship was not confirmed for anxiety. A relationship between the severity of depression and the serum calcium ion and parathyroid hormone level was also not confirmed. A statistically significant negative correlation between the severity of anxiety and the serum calcium ion level in the whole population of patients, and an additional positive correlation between the serum parathyroid hormone level and the severity of anxiety in women were confirmed. Self-rating tests are not sufficient for screening for depressive disorders in PHPT patients.

[Insomnia in shift workers of a zinc smelter]. / Bezsennosc u pracowników zmianowych huty cynku.

BACKGROUND: The aim of this study was to assess the prevalence of insomnia among the employees of a zinc smelter in Miasteczko Slaskie using the Athens Insomnia Scale. MATERIAL AND METHODS: The examined group of plant employees and the control group were asked to fill in a questionnaire composed of the AIS and questions relating to the place and nature of their work, accidents over the last year, medications, diseases and conditions, sleep, naps and sleepiness during the day. RESULTS: The result leading to a diagnosis of insomnia as indicated by the AIS was found in significantly more instances in the test group than in the control group (29.5% vs. 8.4%). While comparing the test subgroup, which was not employed in shift-work, with the control group did not result in a statistically significant difference, slightly more respondents from the day-work test subgroup obtained the result of ≥ 8 pts. CONCLUSIONS: The prevalence of insomnia assessed by means of the AIS in the group of employees of a zinc smelter is significantly higher than in the control group. Based on the AIS, the highest percentage of individuals with insomnia occurred in the subgroup employed in shift-work. Med Pr. 2019;70(5):611-6.

Relationships between various temperament dimensions, levels of selected cytokines and Posttraumatic Stress Disorder (PTSD) in males, incurred as a result of mechanical injuries of lower extremities.

OBJECTIVES: This analysis addresses the relationships between various temperament dimensions, levels of selected cytokines and PTSD in males, incurred as a result of mechanical injuries of lower extremities. METHODS: PTSD was assessed with a PTSD Factorial Version Inventory. Temperamental traits were evaluated by means of Formal Characteristics of Behaviour - Temperament Inventory (FCB-TI). Cytokine levels were determined using ELISA kits. The study population was selected from among a larger population of 80 persons. 15 persons with signs of inflammation were excluded. PTSD group included 33 persons, 32 subjects were included in the control group. RESULTS: Positive statistical correlation with PTSD was observed for: perseverance and emotional reactivity. On the other hand, negative relationship was shown between PTSD and: briskness, endurance and activity. No statistically significant correlations were revealed between the levels of selected cytokines (sIL-2, IL-6, IL-10, TNF-alpha & IFN-gamma) and temperamental traits. Moreover, this study investigates the relationships between temperamental traits, PTSD and various personality dimensions. CONCLUSIONS: 1. Patients with temperamental traits such as high perseverance and emotional reactivity had a greater risk of PTSD. 2. Patients with temperamental traits such as high briskness, endurance and activity had lower risk of PTSD. 3. The level of cytokines (sIL-2, IL-6, IL-10, TNF-alpha, IFN-gamma) was not dependent on the temperamental traits.

[Hypochondria yesterday and today].

The publication aims to discuss hypochondriacal disorders. This paper presents the history of the concept of hypochondria from antiquity to modern times, also includes brief information regarding etiopathogenesis, etiology, classification and treatment of hypochondria with particular emphasis on psychotherapy. Our goal was to make the subject hypochondriacal disorders, as a disease entity often encountered in everyday medical practice.

[The sense of coherence in women undergoing coronary arteriography]. / Poczucie koherencji w grupie kobiet poddanych koronarografii.

AIM: The examination referred to two groups of female patients: with and without significant coronary stenoses in coronarography. There were two stages of the examination: before and 6-9 months after coronarography. The factor dividing patients into two groups: without significant atheromatosis and with coronary atheromatosis, was the result of invasive diagnostics of coronary heart disease. METHODS: The sense of coherence scale (SOC-29) and sociodemographic questionnaires were used to evaluate the condition of the two groups. RESULTS: In group of patients with irrelevant coronary stenoses statistically lower values of sense of comprehension were noticed in the first and the second examination and also sta- tistically lower values of sense of manage were observed, comparing to the group of patients with significant stenoses. The initial value of general coherence was comparable in both groups and did not significantly change in 6-9 months after coronarography. The characteristic parameters: lack of social support, intensity of depressiveness and anxiety before getting information about necessity of coronarography and worse education were connected with lower sense of coherence. CONCLUSIONS: The baseline strength of the total sense of coherence was not different between groups. Patients with no significant stenosis of coronary arteries demonstrate a lower sense of comprehensibility before and after the coronary arteriography and lower sense of manageability after the procedure compared to the group of patients with significant atherosclerotic lesions. No social support, tendency for depression and anxiety and lower level of education were associated with lower sense of coherence in both groups.