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Present study focuses on metabolic and neuroendocrinologic effects of long-acting injectable risperidone (LAIR) treatment in a naturalistic sample of patients with schizophrenia spectrum disorders.
Twenty three outpatients with schizophrenia or schizoaffective disorder (ICD X) (age 32.3±6.5years, illness duration 8.7±5.1 years, PANSS 78.1±14.7) were included. At the time of evaluation the patients were treated with LAIR for 1.4±0.7 years, average dose 38.6±9.9mg. Total duration of antipsychotic therapy was 8.0±4.8 years. Control group (n=23) were healthy volunteers matched by age, sex and education.In the morning serum we measured leptin, prolactin, cortizol, IGF1, T4, FSH, LH, HbA1c, total cholesterol, HDL, LDL and triglicerides. Both groups were tested by oral glucose load (OGTT), with measuring insulin levels and anthropometric parameters.
In comparison to control group, the patients had higher BMI (p< .001), waist circumference (WC, p=.004), increased leptin (p=.013), prolactin (p< .001), triglycerides (p=.029) and fasting glucose (p=.004). After controlling for BMI, WC and sex, only prolactin (p< .001, ηp2= .50) and leptin (p=.040, ηp2=.13) were significantly increased in the patient group.
This is the first study of LRAI effects on metabolic and neuroendocrine parameters. Our cross-sectional study has shown that the most consistent side effects of LAIR were increased prolactin and leptin, while other deviations might be attributed to confounding covariates. Whether pharmacokinetic and pharmacodynamic advantages of LAIR over oral drug formulation are accompanied with favorable metabolic and neuroendocrine profile remains to be assessed by head to head studies.
This study was supported by a grant from the Ministry of Science, Republic of Serbia (Project 145019).
Influence of climatic factors on human’s mental health was research in a lot of studies in the world last years. The aim of this study is identifying a relationship between various climatic factors and the mortality of psychiatric patients in Specialized psychiatric hospital ‘Gornja Toponica’ - Nis, Serbia.
Data for our study we used from computer database in our Hospital. We analyzed one-year period. Climatic data we used from Meteorological station in Nis: temperature, pressure, moisture, wind, cloudiness and precipitation (rain, snow). We compared climatic factors in days when patients died and climatic factors in days without deaths in our hospital.
There were 108 died psychiatric patients during the year, average 2 per week. In 11 days there were two or three deaths. 270 days were without deaths. Minimum deaths were in spring (April and May: 4 per month), and maximum were in winter (December and January: 12 per month). Average age of died patients were 70 years old. After analyzing of climatic factors we concluded that quickly changes of weather conditions have a large influence on mortality of psychiatric patients, and only value of climatic factors don't have influence on mortality.
Traumatic brain injury (TBI) is recently recognized as a risk factor for hypopituitarism, presented most frequently with growth hormone deficiency (GHD). GHD is associated not only with changes in body composition, but also with impaired quality of life, cognitive dysfunctions and some psychiatric sequelae, usually classified as “depression” or “atypical depression”. The impact of GH therapy on mental status is still unknown.
Psychiatric and cognitive functions were tested in six adult GHD subjects at baseline (minimum three years after TBI), reassessed after six months of GH replacement therapy as well as twelve months after discontinuation of GH therapy. Psychiatric and cognitive examinations included semi-structured interviews and three instruments: Symptom-checklist (SCL-90-R), Zung Depression Inventory and standard composite neuropsychological battery.
Six months of GH therapy in GHD TBI patients improved cognitive abilities (particularly verbal and nonverbal memory) and improved psychiatric functioning. Severity of depression decreased, as well as intensity of interpersonal sensitivity, hostility, paranoid ideation, anxiety and psychoticism. In three GHD patients who stopped GH therapy for twelve months we registered worsening of the verbal and nonverbal memory, as well as increase in Zung score and three SCL dimensions: inter-personal sensitivity, anxiety and paranoid ideation.
This preliminary data suggest that GH therapy induced reduction of depression, social dysfunction and improvement in certain cognitive domains in GHD patients after TBI. Our data support the necessity of conducting randomized placebo-controlled trials on the effects of GH therapy on neuropsychological and psychiatric status in GHD TBI patients.
Dissociative fugue is one or more episodes of amnesia. It is a rare condition in which a person suddenly, without planning or warning, travels from home or work and leave behind past life and identity.The aim is to present a patient with such disorder.
In this paper is present the case of Joka K, from M.Grad. She is married, mother of two child. She lives in joint household with a father in law who is authoritative person. Her brother-in-law lives in the ground floor. Her housband, is the youngest of eight children. Systemic family therapy was aplied and the plan of work was produced- 1. Moral and ethical norms in family 2.Loyalitiy to the family of origin 3.Incomplete grieving time following the death of mother and mother-in-law. 4.Expectations in terms of marriage 5.Different cultural views, traditions and family miths.6. Historicaly stipulated second line changes occuring one after another, with the absence of plato period.
The first sessions were attended by J., S. and J.s father, where the point of work was loss and loyality to the family origin. Differencies in cultural views between the families of origin examined in genogram session. Next sessions constitute an expansion of the genogramic session where the accent was placed on the family life cycle and historical sequence of second-line changes.
Implementation of the systemic family therapy, improved communication, established dialogs without breaking up the relation with the family of origin.
This prospective study was carried out on 53 in-patients suffering from chronic schizophrenia. Before the Risperidone treatment they were on the convenient antipsychotic therapy - haloperidol average doses 9.6 mg pro die, or Fluphenazine average 4.2 mg pro die.
The aim of the study was to follow up therapeutically effects of Risperidone, using PANSS scale for schizophrenia, during two months, by two- weeks visits.
On average dose of Risperidone 5.1 mg pro die there was found 18.2% reduction on the Positive syndrome scale after two months. Negative syndrome scale showed improvement of 20.5%; General psychopathology scale was reduced for 15.7%. Finally, total PANSS score was reduced 17.2%. Results were also discussed according to sex, age, illness duration and schizophrenia type.
Therapeutically efficacy of Risperidone has been shown on the positive, as so as the negative schizophrenia symptoms. Better results were in disorganized form of schizophrenia then the paranoid form.
Depression is old as a humanity, it s the disease that has been described in the early days of medical history. Depression is the most common disorder nowadays. Sometimes alcoholism and narcomania can mask depression. The aim of our work was to find out about the efficiency of Trazodon in treating depressive disorder with alcoholics who were treated at the department for alcohol addiction in Special Psychiatric Hospital Gornja Toponica in the period May-October 2007 (18 patients). For our research we used Beck's scale (Beck and associates) to evaluate the degree of depression. The research lasted for six weeks (average length of hospitalization). After the first week of treatment there was a progress concerning sleeping and reduction of anxiety. The anti-depressing score was evident already after two weeks, there also has been a remarkable dropping of the amount on Beck's scale for evaluation of depression. Throughout the research of the efficiency with depression symptomatology, the dayly dosage for alcoholics wasn't over the 200 mg (mostly 150 mg). During 6 weeks of clinical study Trazodon successfully reduced the symptoms of depression in alcohol addicts and after hospitalized treatment significantly helped to maintain abstinency. It was equaly used on young and elderly patients and there haven t been notices of any negative effects.
Schizophrenia remains a severe disorder that is associated with a poor outcome in a large subgroup of patients. Major efforts should be made to improve treatment, especially in the long-term psychopharmacotherapy. In this study, we followed 10 patients on the post- hospital ambulatory treatment with long acting Risperidone (LAR) during the six months period.
We discussed the results according to: age, schizophrenia type, LAR- dose (25 mg, 37.5 mg, 50 mg), relapse with hospitalization, and therapeutically compliance (meaning satisfaction with the therapy and regular two- weeks controls), also the improvement on the CGI score.
The CGI improvement scores were significant, as so as compliance with the therapy. Only two patients have relapsed during the study. These results encourage us to believe that many more patients will benefit from the advantages of a second generation of long acting preparations, like Rispolept Consta is.
Disulfiram is one of most important drug in the treatment of alcoholics. Oral form of disulfiram was found 60 years ago. Subcutaneous form is in use more than 30 years. There are a lot of studies with dilemma is it effective therapy or placebo. We tried to elucidate this problem. We analyzed 36 alcoholics who implanted Disulfiram during one-year (2004.). We follow those patients during next two years (2005. and 2006.). During this more than two years period, 26 patients (72%) were in total abstinence, 6 patients (17%) were in abstinence more than one year and only 4 patients (11%) had abstinence less than one year. Social-demographic characteristics of patients with Disulfiram implant were: age between 31 and 40 years (36%), male (94%), with secondary education (61%), who live in town (53%), married (53%) and with agreement for hospital treatment (high motivation) (69%). We conclude that Disulfiram implant is very effective therapy, because ¾ of all implanted patients have longer abstinence than two years, related the standard oral therapy of Disulfiram (max. 60% patients have abstinence longer than one year).
Little is known about the levels of bully/victim behaviors in schools in Serbia and the aim of the present study was to overview of the extent of bullying in Serbia primary school. Data were collected as part of the school without violence project created by UNICEF. The ultimate goal of the project is to support development of the enabling and stimulative school environment and safe conditions for children learning and development. This study examined the prevalence of being bullied and bullying others among 26947 elementary school children through out Serbia. As part of the larger survey, five questions were asked relating to experience of bullying behaviors and being a victim of such behaviors. The findings suggests that the incidence of school bullying in Serbia is quite high – 67% of children experienced in last three months some form of bulling and 24% of children experienced repeated form of bulling. The most common forms of bulling in schools were name calling (33%), hitting (31%), threatening (21%). Our date point on the need for Increase the awareness of everyone at school toward bullying problems. After identification of a problem next steps should be on the intervention in a timely manner with clear and consistent consequences for the child who is bullying and with support and protection for the child who is being bullied.
Electroshock therapy is in fashion again, but modern psychiatry for this kind of treating is using up to date instruments and methods. Half a century ago this procedure was used for healing serious depression, but was substituted with pharmacotherapy due to side effects like short or long time lost of memory.
Today we have modern technology (ECT with pulse electricity), so side effects are milder, and effects of therapy are better.
With this work we want to present the latest concepts in use of ECT therapy and to present our modest, one year long experience in this area.
We also started prophylactic ECT therapy (in imitation on Military medical academy Belgrade), since we was forced to accept already started treatment some of our patients in above mentioned institution.
We will try to demonstrate this problem using the case of a patient who has a number of symptoms which are all related to different diagnoses.
We will describe a patient with a difficult life story which started in his early youth and which could potentially be the cause of his personality disorder, borderline, showing some symptoms of schizoid and compulsive personality disorder and recurrent depressive disorder which developed later in life. Some authors claim that when borderline personality disorder and depressive disorder are comorbid, they are sometimes not dependent upon each other during treatment, but more often improvements in depressive disorder are related to improvements in borderline personality disorder. Some authors have tested the hypothesis that in the population of older patients with depressive disorder, those with personality disorder who developed depression earlier in life (before 18 years of age) prevail in comparison with those who developed depression later. the problem with this patient is that he shows some traits characteristic of personality disorders from all 3 groups. the method used for treating this patient consists of using pharmacotherapeutic measures to treat the symptoms of depression, and psychotherapeutic approach for treating personality disorder (disorders).
In this text we are showing a patient with a very complex “life story”, dominated by extreme difficulties in the developmental period, strong family complications and personal problems, which probably significantly influenced the development of later psychological difficulties. The clinical picture is dominated by symptoms of borderline personality disorder (BPD), but also shows symptoms that would fall under bipolar affective disorder (BD) and cyclothymia. During the screening of the patient and during treatment, we tried to resolve the resulting diagnostic dilemma. Some authors even believe that BPD falls into the BD spectrum of disorders, whereas others insist on the viewpoint that it is a comorbidity of two separate entities. For clinical practice, the important fact is that BD and BPD multiplies the risk of suicidal patients, which requires prompt and adequate combined treatment. The primary psychopharmacological methods are used for BD, while primary psychotherapeutic treatment is used for BPD.
In this study, we’ll in detail deal with the comorbidity of BD and BPD, which are becoming more frequent psychiatric comorbidities, while emphasizing individual and integrative psychopharmacological therapies as the only approach that can act on several factors and ensure the best possible treatment outcome.
Patient G. D. born in 1975, trained as a textile worker, unemployed, married, mother of three children. The current hospitalization was due to suicide attempts and manifestation of depressive symptoms after a stressful event.
Our diagnostic dilemma was whether it concerns:
- depressive disorder with psychotic symptoms
- adjustment disorder in people with personality disorder
After applying diagnostic procedures and observations during individual psychotherapy sessions, as well as the response to a given therapy, psychotic depression is excluded. The stories provided from the patient were in conflict since they have changed in contact with different therapists in the same department, why we decided to consult other professionals from other departments at which the patient apparently was treated.
In this disorder the patient is aware that he is exaggerating and faking illness, but in core of the disease is irresistible urge for pointing attention, and the cause is most likely a lack of love and affection in childhood.
In psychoterapic process was included family therapist also. Family therapist confronted patient with family members, which resulted in a real insight into the mental state and allowed us to confirm a diagnose of histionic personality disorder with tendency to pathological lying- Munchausen syndrome.
In this presentation, we wanted to point out the necessity of cooperation of a psychiatrist with other specialists, considering that patients with this disorder are prone to change therapists, hospitals and faking the results of diagnostic tests.
Morgellons disease is a delusional disorder that leads to the belief that one has parasites or foreign material moving in, or coming out of, the skin. The name was coined in 2002 by Mary Leitao; a mother who rejected the medical diagnosis of her son's delusional parasitosis. She revived it from a letter written by a physician in the mid-1600s.
In this case report, we aim to describe the clinical characteristics and manifestation of morgellon disease in 26 years man.
Results and discussion
Bulgarian athlete of 26 years stopped to be actively involved with the sport after a severe contusion to the right knee during the race. Had a joint surgery in the Netherlands and of course when that will not be able to compete more professional sports began to use cannabinoids daily. After three months patient went to dermatologist because of skin rashes and intense itching, crawling sensation on and under the skin. The patient reported that pull out threads from his skin. Dermatologist Initiated treatment with antibiotic creams and corticosteroids. The symptoms persist and the patient has consulted a psychiatrist regarding appeared complaints of fatigue, poor concentration and increased anxiety. Psychiatrist based on clinical and medical history was diagnosed morgellon disease. We started treatment with risperidone in increasing doses up to 2 mg/day. After a month the patient has a significant reduction of symptoms.
Morgellons disease is a little-known disorder that is often associated with non-specific skin, nerve, and psychiatric symptoms.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Sexual abuse is of great public and high degree of public danger.
The aim of this study was to evaluate the influence of specific socio-demographic factors among sex crime offenders.
The subjects of study are 66 individuals in total, testified by expert psychiatrist and subsequently charged by law as of December 2010, up until today.
Patient record, providing information about different socio-demographic factors. Retrospective research of the available medical documentation. A statistician conducts data research analysis, using specialised software statistical packages for Statgraphics.
The highest percentage of the participants are from the age groups between 15–24 and 45–54 years old. Both age groups consist of 18 people (27%). The two groups with the lowest percentage of sex offenders are the ones between 25–34 –6 (9%) and above 64–6 (9%). The biggest share have secondary education–26 (40%), followed by those with elementary education–24 (36%). The smallest percentage are those with higher education – 2 (3%). There is no statistically significant correlation between the research sample and their residence–34 (51%) live in a city and 32 (49%) – In a village. There is also not a significant difference in their ethnical origins. The biggest percentage of sex offenders have been raised by both parents – 54 (82%).
Sex offenders represent an exceptionally heterogeneous group, our study did not find significant correlation of socio-demographic factors and the profile of the rapist.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The Working Party has produced this report in order to prompt readers to engage at an early stage in InsurTech projects, through considering (i) the full range of risks associated with InsurTech developments, (ii) the lifecycle of an InsurTech venture and how any risk considerations may vary over this lifecycle and (iii) the extent to which InsurTech ventures align with risk strategy and risk appetite.
The report contains practical guidance for actuaries, risk professionals, insurance companies and their Boards on these considerations, and can be used to facilitate appropriate questioning, to help ensure that InsurTech-related business decisions are fully cognisant of the risk management issues and to help ensure the success of projects.
The Working Party developed this guidance having carried out an industry survey on a number of risk management topics relating to InsurTech, as well as having carried out interviews with a number of relevant senior stakeholders across the insurance industry, in order to better understand current sentiment and how risk management plays a part when considering opportunities in InsurTech. The Working Party views on the findings from these activities are summarised in the report.
This study attempts to reconstruct food habits through carbon (C) and nitrogen (N) isotope analysis and C/N analysis of charred residues inside pottery from the Primorye in the Russian Far East (Luzanova Sopka 2, Sergeyevka 1, Boisman 2, and Vetka 2 sites). Dates were obtained that were from the later stages of the Rudnaya culture (6980–6485 BP, 7800–7400 cal BP), proto-Boisman type (6760–6330 BP, 7600–7300 cal BP), Boisman culture (6155–4720 BP, 7100–5400 cal BP), and Vetka culture (6030–5870 BP, 6900–6700 cal BP). There are major differences in the carbon and nitrogen isotope ratios between inland sites (δ13C –26.9 to –30.0‰, δ15N 7.6 to 9.3‰) and coastal sites (δ13C –18.1 to –24.2‰, δ15N 9.5 to 14.9‰). The results show that the diet of inland cultures consisted primarily of freshwater fish and terrestrial animals and plants, whereas that of coastal cultures consisted mainly of marine organisms.
In the present paper, the low-velocity impact of an elastic rod with a flat end upon a viscoelastic Timoshenko type beam has been considered. Viscoelastic properties of the beam out of the contact zone are described by the standard linear solid model with integer derivatives, while inside this zone they are governed by the fractional derivative standard linear solid model. The contact force for a concrete target has been defined experimentally at the concrete age of 7, 14, 28, 56, and 91 days. It has been found that an average maximum of the contact force increases with concrete age, whereas the contact duration decreases. Moreover, the most remarkable changes of both, contact force and contact time, occur at the concrete age earlier than 14 days, after that the rate of changes slows down. Experimental results have a good coincidence with theoretical expectations.