Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic.

AIM: To compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used. METHODS: Male war veterans (N=176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used. RESULTS: Direct exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping. CONCLUSION: The severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.

Cortical gray matter loss in schizophrenia: Could microglia be the culprit?

Cortical gray matter loss in schizophrenia remains a great therapeutic difficulty. Each psychotic episode causes irreversible cortical gray matter loss, that causes the patients to never regain their previous state of functioning. Microglial cells are part of the innate immune system and their functions, among others, include phagocytosis and release of neurotrophic factors. They have a key impact on developmental and plasticity-induced removal of neuronal precursors, live-but-stressed neurons and synapses, while also stimulating synaptic growth and development. We hypothesize that microglia are the culprit for the cortical gray matter loss in schizophrenia through abnormal synaptic pruning, phagocytosis of stressed neurons and lacking neurotrophic factor release. Furthermore, we propose a research that could validate the hypotheses using serum samples of first-episode early-onset patients. By measuring the serum levels of milk fat globule-EGF factor 8 (MFG-E8), subcomponent in the classical pathway of complement activation (C1q), brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6) and interleukin-10 (IL-10), we could gain an insight into the state of microglial activation during various stages of the disease. If this hypothesis is valid, new targeted drugs could be developed in order to reduce the deterioration of cortical gray matter, thereby possibly improving negative symptoms and cognitive deficits.

Negative and positive life experiences in patients with psoriatic arthritis.

Recent data suggest that childhood and adulthood stressors may play a significant role in the development of an autoimmune disease. The present study explores the relationship between psoriatic arthritis (PsA) and positive and negative life events during childhood and adulthood in psoriatic patients. Forty-five patients with psoriatic arthritis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences [Traumatic Antecedents Questionnaire (TAQ)]. The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The patients with psoriatic arthritis exhibited lower mean scores of total positive experiences during late childhood (latency) as compared to the control group. Negative experiences during four developmental periods appeared more frequently in patients with psoriatic arthritis than in the controls. The most frequently reported negative experiences were neglect, emotional abuse, physical abuse, sexual abuse, alcohol/drug abuse and other traumas. The present findings add evidence to the relationship between retrospectively reported childhood experiences and psoriatic arthritis. Furthermore, a high amount of reported emotional and physical abuse occurs in patients with psoriatic arthritis during latency and adolescence.

Connection of depression and bone loss in perimenopausal and postmenopausal women.

Depression has been implicated as a possible risk factor for low bone mineral density (BMD). However, there is still no solid evidence that could connect these two different illnesses. This research examined the association between self-reported depression and low BMD in perimenopausal and postmenopausal women. This research screened 130 female patients who were 44 to 72 years old and registered at the densitometry clinic of KBC Rijeka during a three month period. Densitometry was performed in order to establish their BMD and according to the results two groups of participants were formed: normal BMD - 38 participants with normal BMD at hip and spine and reduced BMD - 75 participants with lower BMD at hip and spine. Depression was assessed using Beck depression inventory. Both groups of participants were compared regarding their depression scores. There were no significant differences between the groups with normal and reduced BMD regarding mean age, age of menopause, length of menopause and number of births (p = 0.001). Difference regarding depressiveness between the two groups was not significant (t = 0.73; p = 0.468). Also, there were no differences between the groups regarding the frequency of certain levels of depression. (chi2 = 2.27; p = 0.52). Results of this research suggest that self-reported depression is not associated with low BMD in perimenopausal and postmenopausal women.

Tianeptine in the combined treatment of combat related posttraumatic stress disorder.

BACKGROUND: The aim of this study was to evaluate the efficacy of tianeptine, an antidepressant that acts by increasing serotonin reuptake, in the treatment of posttraumatic stress disorder and to compare the effects of tianeptine and fluoxetine, an antidepressant from the selective serotonin reuptake inhibitors class. SUBJECTS AND METHODS: 43 war veterans suffering from posttraumatic stress disorder were included in the study. During the 5.5 months of treatment 21 patients were receiving tianeptine and 22 were receiving fluoxetine. In addition, all patients took part in intensive trauma specific group psychotherapy. The effects of the two antidepressants on symptoms of PTSD, depression and anxiety after 5.5 months of treatment were assessed using the Harvard Trauma Questionnaire, Beck Depression Inventory, STAI and the List of Drug Use and Side Effects. RESULTS: There was no significant difference between the two treatment groups regarding their effect on symptoms and severity of depression. The level of anxiety was the same in the first measurement but the difference became significant in other three measurements in favor of tianeptine. The anxiolytics and other co-prescribed drugs remain the same in both groups, the use of analgesics significantly increase in fluoxetine group during the course of treatment. CONCLUSION: The study demonstrated that tianeptine is as effective as fluoxetine in the treatment of PTSD, with even stronger effect on anxiety and equal tolerance.

Aggresiveness in institutionalised schizophrenic patients and the selection of antipsychotics.

The selection of antipsychotics as medications used primarily for treating schizophrenia and disorders similar to schizophrenia is an important aspect of the treatment of forensicpatients. This study examines the effect of antipsychotics selection (typical or atipycal) on the level of aggressiveness, side effects and the hospitalisation length. The research is conducted on 98 psychiatric patients diagnosed with schizophrenia or similar disorders (F 20-F 29) in two forensic psychiatric institutions. The patients committed aggressive criminal offence in state of insanity. The patients are currently treated in inpatient psychiatric institutions. The research was conducted by using the Aggressiveness Questionnaire (AG-87), the Simpson-Angus Scale for the assessment of extrapyramidal side effects, the Barnes Akathisia Rating Scale for the assesment of akathisia and the Abnormal Involuntary Movement Scale. The results show no significant difference between the groups of patients treated with typical and atypical antipsychotics in all the variables.

Childhood and adulthood traumatic experiences in patients with psoriasis.

It is well known that several psychiatric disorders may be related to childhood psychological trauma. Recent studies have associated childhood exposure to trauma to some skin diseases. Our study aimed at exploring whether psoriasis is related to the reported positive and negative traumatic life events in different age intervals beginning from early childhood to adulthood. Furthermore, we investigated differences between psoriatics with early and late onset according to traumatic experiences in different age intervals. Also, we investigated the possible correlation of traumatic experiences with the disease severity. One hundred patients with psoriasis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The severity of psoriasis was estimated according to the Psoriasis Area and Severity Index (PASI), a standardized measuring instrument. The amount of positive experiences did not differ significantly among groups, except for safety scores that were higher in controls compared with both psoriatic groups (early and late onset). On the other side, negative traumatic experiences appeared more frequently in patients with psoriasis during all developmental periods. We found no correlation between severity of psoriasis and traumatic experiences. The present study demonstrates an increased history of childhood and adulthood negative traumatic experiences in patients with psoriasis compared to the control group. Our findings suggest a relationship between retrospectively reported negative traumatic experiences and psoriasis.

Predictors of aggressiveness in schizophrenic patients treated in inpatient forensic institutions.

Aggressiveness is a frequent and problematic aspect of the treatment of forensic patients. This study examines the correlation of aggressiveness and its subtypes with quality of life enjoyment and satisfaction, personality dimensions and family functioning. The research is conducted on 99 psychiatric patients diagnosed with schizophrenia or psychotic disorder similar to schizophrenia (F20-F29) in two forensic psychiatry institutions. The patients committed criminal offence in state of insanity. These offences had signs of aggressive acts and the patients were therefore admitted to inpatient psychiatric forensic institutions. The research was conducted by using the Aggressiveness Questionnaire (AG-87), the Eysenck Personality Questionnaire, the Quality of Life Enjoyment and Satisfaction Questionnaire and the Family Functioning Scale. The results show that aggressiveness has a negative correlation with the quality of life enjoyment and satisfaction. Regression analyses indicate that bad family relations and psychoticism are significant predictors of aggressiveness and its subtypes. We can conclude that forensic patients who committed aggressive offence in psychotic state, who at the same time score higher values on psychoticism scale and report negative family relations, are more likely to express aggressiveness also during their stay in forensic psychiatric hospital.

Correlation of anaemia and cognitive functions measured by the complex reactiometer Drenovac.

Cognitive impairment impinges significantly on the quality of life. Previous research revealed that anaemia can have a major influence on cognitive functioningt. The article is a correlational study examining the relationship between anaemia levels and cognitive functioning in adult patients. Sixty-one patients (both inpatients and outpatients), among them 30 anemic and 31 non-anaemic, 33 female and 28 male, aged 32-60 (median 43) treated at the Dept. of Hematology, Clinical Hospital Center Rijeka, Croatia were analysed according to hemoglobin (Hb) level and cognitive ability. Assessment of cognition (convergent inductive thinking) was performed by the Complex reactiometer Drenovac (CRD). The results showed that anaemia significantly undermines cognitive functions in adult patients (p < 0.01). Even in non-anaemic patients (Hb higher than 120 g/L), Hb level is related to better cognitive ability.

Psychotic symptoms in combat-related post-traumatic stress disorder.

The presence of psychotic symptoms in post-traumatic stress disorder (PTSD) has already been recognized. Using the Structured Clinical Interview Diagnostic and Statistical Manual, we searched for and assessed psychotic symptoms in 91 males suffering from combat-related PTSD. Hallucinations and delusions were present in 20% of patients. We divided all patients into three groups: the group with hallucinations and delusions, the group without these symptoms, and the group with "subthreshold" psychotic symptoms. Using the Harvard Trauma Questionnaire, Clinician-Administered PTSD Scale, and Structured Clinical Interview Diagnostic and Statistical Manual, we investigated differences between groups in the intensity of traumatization, severity of PTSD symptoms, and the frequency of depression. There were no significant differences between groups; however, there was one exception: severity of hyperarousal symptoms was positively correlated with occurrence of psychotic symptoms.