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.

Influence of Sociodemographic and Clinical Characteristics on Sexual Function Domains of Health Related Quality of Life in Multiple Sclerosis Patients.

Background: Multiple sclerosis is a progressive inflammatory disease of the the central nervous system. Problems with sexual functions are the common features of multiple sclerosis and important factor that contribute to the quality of life among affected persons. Objective: The aim of the study was to evaluate the influence of sociodemographic and clinical characteristics on sexual functions domains of health related quality of life (HRQOL) in multiple sclerosis patients. Methods: This study included 100 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were an Expanded Disability Status Scale score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. HRQOL was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire. Mann-Whitney and Kruskal-Wallis test were used for comparisons between sociodemographic and clinical characteristics and HRQOL scores. Results: Out of 60% of patients reported to have sexual dysfunction, and 55 % were female patients. Younger patients had statistical significant higher median value of sexual function score (91.68 vs. 58,28, p=0.001) and satisfaction with sexual life scores (62.5 vs 37.5 , p =0.019) comparing to older patients. Employed patients also showed statistical significant higher median value of sexual function score (82 vs. 66.7, p=0.003) comparing to unemployed patients and also statisticaly significant higher median scores considering satisfaction with sexual life among employed patients (p=0,001). There were no differences in sexual functions scores considering gender, marital status and education. Patients with higher level of disabilty, progressive type of disease, more relapses and longer diseas duration had statistical significant lower median value of sexual function score and also satifaction with sexual life scores, except for disease duration. Conclusion: Aging, dysability and progression are major factors that contribute to lower sexual function scores and satisfaction with sexual life among multiple sclerosis patients. Althoug women reported sexual problems more often then men, impact of these problems on quality of life are similar in men and women with MS.

Quality of Life in Multiple Sclerosis Patients: Influence of Gender, Age and Marital Status.

Background: Multiple sclerosis (MS) is a chronic disease characterised by a wide range of symptoms and a highly unpredictable prognosis, which can severely affect patient quality of life. Objective: The aim of the study was to evaluate the influence of gender, age and marital status on health-related quality of life (HRQoL) in MS patients. Methods: This study included 100 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were an Expanded Disability Status Scale score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. HRQOL was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Mann-Whitney and Kruskal-Wallis test were used for comparisons. Linear regression analyses were performed to evaluate prediction value of gender, age and marital status on both physical and mental HRQOL. Results: Women had significantly lower QOL scores then men in pain scale (55.00 vs. 76.67; p<0, 05). Younger patients had better physical (54.58 vs. 37.90; p<0.05) and mental health (59.55 vs. 45.90; p<0.05) composite scores. Patients with earlier age of onset scored significantly higher in health perception domain scale (45.00 vs. 32.50, p<0.05). Married patinets scored higher in physical and mental composite scores but with no significant difference except in sexual function (87,51 vs 70, 86, p<0,05) and emotional well being (66,67 vs 33,33; p<0,05) scales. Patient age retined its independent predictivity of physical health composite score (r2=0.063). Conclusion: Aging in MS proved to be important negative factor in predicting physical domains of QOL. Interventions for reducing difficulties caused by physical limitations in older patients, higher level of psychological support for patients with late onset disease and social support for those living alone are important factors in improving HRQOL in MS patients.

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.

Review of Standard Laboratory Blood Parameters in Patients with Schizophrenia and Bipolar Disorder.

INTRODUCTION: Symptomatic and etiopathologic heterogeneity of schizophrenia (SCH) and bipolar disorder (BD) can be adequately addressed using a dimensional approach to psychopathology, as well as interpreting physiological properties and markers as predictors of disease onset and relapse. Risk factors, genetic and environmental, are likely to modify the neurobiological processes characteristic of certain physiological processes that manifest to a greater degree of overlapping symptoms. One of the most common laboratory tests in psychiatric patients is a standard laboratory blood test. It gives us an insight into the general somatic condition of the patient. It assesses the ability to transport oxygen to tissues and carbon dioxide back to the lungs via erythrocytes (RBC) and hemoglobin (HGB) as their most important constituents, and is also an indicator of iron status and blood oxygenation. AIM: Schizophrenia (SCH) and bipolar disorder (BD) are psychiatric disorders whose complex etiology and pathogenesis are still far from known. A correlation between red blood cell abnormalities and these diseases has been recognized in some studies. One of the most common laboratory tests in psychiatric patients is a standard laboratory blood test. However, so far there is a small number of published papers that relate to the relationship between laboratory parameters of blood and the aim of this paper is to reveal more light in this subject. METHODS: The research was done as an observational prospective clinical study that has evaluated different physiological and pathological parameters in patients with BD and SCH over a two-year period. A total of 159 patients with schizophrenia, 61 patients diagnosed with bipolar disorder and 82 healthy subjects participated in this study. RESULTS: At baseline, BD compared to SCH patients had higher mean lymphocyte count (2,6±0,7 vs. 2,0±0,6x109; p=0,006) and haemoglobin concentration (146,8±12,2 vs. 140,2±14,7 g/L; p=0,03), and significantly lower red cell distribution width (13,6±2,2 vs. 14,7±1,8%; p=0,008). In both BD and SCH patients there was a significant number of patients with low red blood cells count and low haemoglobin concentration, and high MCH and MCHC at baseline and at 3 and 6 months of follow up. CONCLUSIONS: The finding that SCH as well as BD differed from controls with respect to red blood cells, hemoglobin, lymphocytes, and average platelet count was consistent with previous findings and could be understood as a qualitative measure in the evaluation of this sample. The fact that no association with other parameters was found, as well as an association with the diagnosis, does not exclude that these associations can be found in larger samples.

Magnetic Resonance Imaging (MRI) and Visual Evoked Potentials (VEPs) of Occipital Region in Patients with Schizophrenia and Migraine Headache.

AIM: To examine the morphologic variations of occipital sulci patterns in patients with schizophrenia and migraine haeadache regarding gender and laterality as well as damage of visual pathway in patients with schizophrenia using magnetic resonance imagining (MRI) and visual evoked potentials (VEPs). METHODS: This study included 80 patients and brain scans and visual evoked potential responses recorded over the occipital cortex were performed to analyze the occipital region of both hemispheres. Average total volumes of both hemispheres and average values of amplitude of the healthy population for the comparasion were used. RESULTS: There was statistically significant difference between subjects considering gender (p=0.012). Parameters of parieto-occipital fissure (p=0.0314) showed statistically significant positive correlation with P100 amplitude (p=0.05), body of the calcarine sulcus (p=0.0213) had significant positive correlation with P100 amplitude (p=0.04), retro calcarine sulcus (p=0.0516) and P100 amplitude (p=0.03) showed statistically significant difference only of left hemisphere in male patients with schizophrenia with shallower depth of the sulcus and P100 amplitude reduction. CONCLUSION: Schizophrenia is associated with the volume changes of the occipital lobe. Comparative analysis of morphologic differences in the gray matter of occipital lobe using MRI and VEPs revealed changes especially of the left hemisphere (shallower depth of sulcus and P100 amplitude reduction) only among a group of male patients.

Morphologic differences of occipital region in patients with schizophrenia and migraine headache using magnetic resonance imaging (MRI) and visual evoked potentials (VEPs).

Aim To compare morphologic variations of occipital sulci patterns in patients with schizophrenia and migraine headache regarding gender and laterality using magnetic resonance imaging (MRI) and visual evoked potentials (VEPs) as well as damage of visual pathway in patients with schizophrenia. Methods This study included 80 patients. Brain scans and visual evoked potential responses recorded over the occipital cortex were performed to analyze the occipital region of both hemispheres. Average total volumes of both hemispheres and average values of latency of the healthy population were used for comparison. Results There was statistically significant difference between subjects considering gender (p=0.012). Parameters of body of the calcarine sulcus (p=0.0325) showed statistically significant positive correlation with P100 latency (p=0.0449), inferior sagittal sulcus (p=0.0443) had significant positive correlation with P100 latency (p=0,0413), lateral occipital sulcus (p=0.0411) and P100 latency (p=0.0321) showed statistically significant difference only of left hemisphere in male patients with schizophrenia with shallower depth of the sulcus and P100 latency prolongation. Conclusion The consistency of the findings reveals distinct multiple brain regions, which show changes in the gray matter of patients with chronic forms of schizophrenia. The neurocognitive deficits of schizophrenia show highly consistent cross-sectional relationships to each type of functional outcome.

Occipital sulci patterns in patients with schizophrenia and migraine headache using magnetic resonance imaging (MRI).

Aim To examine the presence of morphologic variations of occipital sulci patternsin patients with schizophrenia and migraine headacheregarding gender and laterality using magnetic resonance imaging (MRI). Methods This study included 80 patients and brain scans were performed to analyze interhemispheric symmetry and the sulcal patterns of the occipital region of both hemispheres. Average total volumes of both hemispheres of the healthy population were used for comparison. Results There was statistically significant difference between subjects considering gender (p=0.012)with no difference regarding age(p=0.1821). Parameters of parieto-occipital fissure (p=0.0314), body of the calcarine sulcus (p=0.0213), inferior sagittal sulcus (p=0.0443), and lateral occipital sulcus (p=0.0411) showed statistically significant difference only of left hemisphere in male patients with schizophrenia with shallowerdepth of the sulcus. Conclusion Representation of neuroanatomical structures suggests the existence of structural neuroanatomic disorders with focal brain changes. Comparative analysis of occipital lobe and their morphologic structures (cortical dysmorphology) in patients with schizophreniausing MRI, according to genderindicates a significant cortical reduction in the left hemisphere only in the group of male patients compared to female patients and the control group.