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Suicide rates are implicit indicators of how effective social, religious and medical services address personal and economic crisis.
The assessment of suicide risk factors and patterns in a Romanian sample.
To identify the most relevant suicide risk factors in the present context.
The study included all suicide cases autopsied at Timisoara Institute of Legal Medicine from 2009 to 2012. The following data were analyzed: socio-demographic records, blood alcohol levels and the number of committed suicides.
The study included 310 (81% men and 19% women) individuals who committed suicide, with ages ranging between 13 and 93 years. In women, the mean age was 52.34 years (std.dev. = 19.1), while in men was 49.4 (std.dev. = 17.4). The most common suicide method regardless of age, sex and residence area was hanging (68.3%). The greatest number of suicides was found in the 40-60 age group / adults (47%), followed by the 20-40 age group / young adults (26.7%) and over 60 years / seniors (26.1%). The percentage of suicides under 20 years old / adolescents was 3.5 %. There was a statistically significant difference (t = 2.06; p < 0.05) regarding alcohol blood levels between adults (0.8‰) and seniors (0.4‰), but not when compared with adolescents (0.56‰), or young adults (0.6 ‰). The average percentage of suicides committed under alcohol influence was 40% regardless of age group.
In the studied sample adults have the highest suicidal risk and alcohol is an important risk factor.
There are only a few studies focusing on the religious delusion in relation to Schneider’s first rank symptoms, compared to the presence of these symptoms in paranoid delusions.
This study aims to explore the particularities of Schneider’s first rank symptoms in relation to religious delusion.
Material and method
The study included 40 subjects with religious delusions. The cases were chosen from the Case Register of Psychoses of the Psychiatric Clinic in Timisoara and they have been followed longitudinally during a 15 year period. All of them had a stable 5 year ICD-10 diagnosis of Schizophrenia, Schizo-affective disorder or Persistent delusional disorder. The following variables were considered: demographic parameters (at onset and at present), clinical and evolutional aspects (including the number of relapses and the diagnostic stability) and psychopathological parameters regarding the variety of psychotic symptoms and the patient’s interpretation of Schneider’s first rank symptoms. The symptomatology was assessed using a method derived from the SCAN instrument and the data were analyzed qualitatively.
Differences between the subjects’ experiences of first rank symptoms in relation to paranoid delusions and religious delusions were observed. The subjects experiencing religious delusions often interpreted the first rank symptoms as being common, normal experiences.
In religious delusion, Schneider’s first rank symptoms are accepted and interpreted by the patient as common actions of supernatural beings, especially in schizo-affective episodes, being different from the interpretation of these symptoms when in relation to paranoid delusions.
In patients receiving long acting injectable (LAI) antipsychotics, the risk of medication side effects needs serious attention.
The study objective is to determine in which measure co-morbid psychiatric symptoms influence the presence of the metabolic syndrome (MS).
Patients receiving LAI antipsychotics have a history of medication non-adherence, with recurrences and partial remissions. The aim of the study is to assess the contribution of residual psychiatric symptoms in the development of the MS in these patients.
The study includes two samples of psychotic remitted subjects, one including patients on olanzapine LAI and the other one patients receiving risperidone LAI for at least six months. The presence of co-morbid symptoms was assessed with BPRS. The International Federation of Diabetes diagnostic criteria for the MS were used. The following information was analyzed: medication, gender, fasting glycemia, lipid profile, waist circumference, blood pressure, and psychiatric symptoms.
The study included 28 patients, 15 (53.6%) on olanzapine LAI, and 13 (46.4%) on risperidone LAI. 15 patients were women and 13 men. 11 (39.2%) patients were diagnosed with MS. The whole sample presented higher scores at the following BPRS items: anxiety, somatic concern, and motor retardation.
Symptoms such as anxiety, somatic concern, and motor retardation may contribute to the development of the MS. 39% of the subjects presented the criteria of the MS.
Early diagnosis of schizophrenia is often delayed in first-episode psychosis and this could be viewed as an obstacle for a proper therapeutic approach and optimal clinical management.
Our main objective was to identify baseline socio-demographic variables in first-episode psychosis which are associated with an increased likelihood of diagnosing schizophrenia in the second episode of psychosis. As a secondary objective we aimed to assess the diagnostic stability between first and second episode psychosis.
Material and methods
Data belonging to 100 patients that were twice admitted in Timisoara Psychiatric Clinic, between 2010 and 2015, for two distinct and consequent episodes of psychosis, were analyzed. The first admittance had to coincide with first episode psychosis.
Logistic binary regression showed that a younger mean age (OR = 0.90; 95% CI = 0.85–0.95), a more unfavorable professional status (OR = 3.75; 95% CI = 1.10–12.74) and a lesser quality of social support (OR = 3.47; 95% CI = 1.11–10.82) at the onset of the first episode of psychosis were associated with an increased likelihood for a subsequent diagnosis of schizophrenia.
Identifying an initial socio-demographical profile with a high predictive value for a subsequent outcome towards schizophrenia should encourage using this diagnosis starting with the first episode of psychosis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
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