The Correlation of Positive and Negative Symptoms (PANSS Scores) in Patients with Schizophrenia According to Gender.

Background: Schizophrenia is chronic and debilitating psychiatric disorder, characterized by a constellation of clinical signs and symptoms that are categorized into distinct positive, negative, disorganization and cognitive symptom domains. The outcome of the disease is better in female patients compared to male patients who have a higher risk of rehospitalization and twice as long duration of hospital treatment. In male patients with schizophrenia an earlier onset of the disease, negative symptoms and a more severe clinical picture are noted, with a less promising therapeutic response to neuroleptics. The onset of negative symptoms is more variable. Objective: The aim of the study was to determine the correlation of positive and negative symptoms (PANSS scores) in patients with schizophrenia according to gender. Methods: The sample included 40 subjects with schizophrenia (21 males; 19 females). The study was conducted at the Department of Psychiatry Clinical Center University of Sarajevo. Results: All male subjects have a PANSS negative symptoms score of 17 or higher, while all female subjects have a PANSS negative symptoms score of less than 17. While the difference in the variances is not statistically significant, the results show that the difference in the average values of the PANSS symptom score between male and female subjects is statistically significant for both positive and negative symptoms (p=0.026). Conclusion: Diminished sociality, emotional responsiveness, and drive during childhood have been reported in a substantial minority of patients with schizophrenia. This aspect of the illness may account for the low level of emotional expression and neuromotor dysfunction in infants who subsequently have schizophrenia. In other patients, the negative symptoms first occur after the onset of psychosis.

Cognitive Imapirment in Multiple Sclerosis: Relation to Dysability, Duration and Type of Disease.

Background: Cognitive dysfunctions are often presented as a symptom in multiple sclerosis which is associated with both structural and functional imapirments of neuronal networks in the brain. Objective: The aim of the study was to evaluate the influence of dysability, duration and type of disesase on cognitive functions in multiple sclerosis patients. Methods: This study included 60 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were clinically definite diagnosis of multiple sclerosis, 18 years of age or older and were able to give written informed consent. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCa) screening test. Mann-Whitney and Kruskal-Wallis test were used for comparisons between clinical characteristics and MoCa test scores. Results: Out of 63.33% of patients had EDSS <=4.5. Disease lasted longer than 10 years in 30% of patients. 80% had relapsing-remitting MS and 20% had secondary progressive MS. 84,2 % of patients with EDSS ≤ 4.5 had cognitive dysfunction. Higher disability (rho=0,306, p<0,05), progressive type of disease (rho=0,377, p< 0,01) and longer disease duration (rho=0,282, p<0,05) were associated with worse overall cognitive functions. Level of disability showed statistical significant correlation with the executive functions and language domains of cognition (p<0.01). Longer disease duration was significant correlated with executive functions (p<0,01) and language domains (p<0,01), while progressive type of disease was signifacant correlated only with executive functions domain (p<0,01). MoCa score variables did not show a statistically significant difference in relation to the number of relapses per year and the use of imunoterapy. Statistically significant negative correlation was obtained between executive functions domain and level of disability, disease duration and progressive type of disease, while language domain significantly correlated only with disability level and progressive type of disease. Conclusion: High percentage of MS patients has cognitive impairment. Patients with higher disability were presented with lower cognitive abilities, especially in executive functions and language domains. Higher frequency of cognitive impairment were presented in progessive forms of disaese and longer disease duration with strong influence on executive functions domains of cognition.

The Correlation of PANSS Scores and P100 Latency in Patients with Schizophrenia and Migrene Hedache Using Visual Evoked Potentials (VEPS) According to Gender and Age.

Background: The VEPs provide an objective measure of brain function, analyzing integrity of visual processing. With patients affected with schizophrenia, the changes with the implementation of VEP are evident, such as symmetrical deceleration of the impulse and the continuance of latency, which points to a degenerative illness, suggesting the presence of optical neuritis or hemianopsia conjoined with mentioned intracranial illness. Objective: The aim of the study was to determine the correlation of positive and negative symptoms (PANSS scores) and P100 latency between patients with schizophrenia and patients with migraine headache according to gender and age. Visual evoked potentials (VEPs) were applied. Methods: The sample included 80 subjects: a) S group- 40 patients with schizophrenia (21 males; 19 females); b) H group-40 healthy subjects with migraine headache (10 males; 30 females). The study was conducted at the Department of Psychiatry and Neurology University Clinical Center Sarajevo. Results: Our research revealed positive correlation of the P100 latency and the PANSS score of negative symptoms, which means that the subjects of the observed group with a higher latency of the P100 wave of the entire visual field in both eyes have higher PANSS scores of negative symptoms. The correlation is significantly higher in female subjects (37% shared variance) than in male subjects (12% shared variance). All male subjects have a PANSS negative symptoms score of 17 or higher, while all female subjects have a PANSS negative symptoms score of less than 17 positive correlations were registered in P100 latency in left view field of both eyes and in P100 amplitude in the region of right eye (p=0.01) in comparation with left eye region (p=0.05) in patients with schizophrenia. Conclusion: Results imply that the cognitive impairment seen in schizophrenia is not just due to deficits in higher order aspects of cognition but also encompasses significant deficits in early sensory processing. Our study is useful to initiate new questions and recommendations for further studies, specifically on changes in the occipital lobe in the schizophrenic patient's brain.

Psychological Consequences of COVID-19 on Health Care Workers.

Background: The COVID-19 pandemic has generated significant symptoms of stress, anxiety, and depression among health care workers, which can negatively affect the health and well-being of individuals. Although the WHO stressed the importance of nurturing mental health in the context of the COVID-19 pandemic, a more significant response focused on this area was still lacking in most countries. Objective: The aim of the study was to examine the differences in the levels of depression, anxiety, and stress in healthcare professionals in relation to exposure to contact with COVID-19 positive patients, as well as to examine the differences and correlation of sociodemographic characteristics of health workers in the experience of symptoms of depression, anxiety and stress. Methods: The research included 266 respondents, and it used a socio-demographic questionnaire and the DASS-21 scale. Mann-Whitney U tests, Kruskal-Wallis test and Spearman correlation coefficient were used in data processing. Results: The prevalence of high to extremely high symptoms of depression was reported in 45.49% of employees, anxiety 63.91% and stress 23.22%. Those who have been in continuous contact with COVID-19 positive patients, or 27.07%, report experiencing high or extremely high symptoms of depression, 36.60%, high to extremely high symptoms of anxiety, and 22.18% high to extremely high symptoms of stress. Discussion: The degree of self-care and family care, education level, and work experience were found to be a statistically significant factor in experiencing symptoms of depression, anxiety, and stress. Workers who were more in contact with COVID19 patients reported a higher degree of symptom on the DASS-21 scale. Those employees with more work experience had previously encountered similar situations of uncertainty and pressure, had better developed defense mechanisms, and showed less pronounced symptoms. A higher level of education often implies a higher degree of involvement in active treatment around each patient, which results in more responsibility and pressure in a given situation. Conclusion: High levels of stress, anxiety and depression in healthcare workers can lead to repercussions in their work with patients. Therefore, the mental health of health workers should be put in focus, as a very important part of the public health problem during the COVID19 pandemic.