There is little information describing the trajectories of depression and anxiety symptomatology in the context of coronary heart disease (CHD), and their comparison according to sociodemographic and disability measures, cardiac risk factors, and health care costs.

Using a primary care cohort of 803 patients with a diagnosis of CHD, a latent class growth curve model was developed to study the distinct trajectories of depression and anxiety symptoms (using the hospital anxiety and depression scale) over a 3-year period comprised of 7 distinct follow-up points. Multinomial regression analysis was then conducted to study the association between latent classes, baseline risk factors, and total health care costs across time.

The 5-class model yielded the best combination of statistical best-fit analysis and clinical correlation. These classes were as follows: “stable asymptomatic” (n = 558), “worsening” (n = 64), “improving” (n = 15), “chronic high” (n = 55), and “fluctuating symptomatology” (n = 111). The comparison group was the “stable asymptomatic” class. The symptomatic classes were younger and had higher proportion of women, and were also associated with non-white ethnicity, being a current smoker, and having chest pain. Other measures of disease severity, such as a history of myocardial infarction and comorbidities, were not associated with class membership. The highest mean total health care costs across the 3 years were the “chronic high” and “worsening” class, with the lowest being the “improving” and “stable low” classes. The total societal costs for patients in the “chronic high” and “worsening” class were significantly higher, as compared to the “stable low” class.

The authors have not supplied their declaration of competing interest.

Patients with schizophrenia deal with many risk factors that make them more susceptible to infections. However, knowledge about incidence and the nature of infections among people with schizophrenia is scarce.

To investigate the occurrence and risk factors for severe infections in schizophrenia patients.

– to determine incidence rates of infections among young adults with schizophrenia;

– to define risk factors for infections.

Population-based nationwide cohort study with selection of all individuals born in Denmark between 1975–1990 and follow-up period from 1995–2013 was conducted. Data from the Danish Psychiatric Central Register and the Danish National Hospital Registry were used. A Poisson regression was chosen to estimate incidence rate ratios of infections and to explore the associations of different risk factors like sex, age, substance abuse and medical co-morbidity with the rates of infections.

922,564 individuals born between 1975–1990 were included in the study. Overall, 3520 women and 5479 men were identified with schizophrenia. In percentages, 36% with schizophrenia had infectious diseases compared to 25% of background population. Some of severe infections like HIV (0.23% vs 0.05%), sepsis (0.72% vs 0.27%), hepatitis (1.4% vs 0.22%) skin infections (12% vs 6.2%)and tuberculosis (0.12% vs 0.06%) were highly increased in persons with schizophrenia, whereas smaller differences were found regarding CNS infections (0.5% vs 0.4%) and gastrointestinal infections (8.7% vs 6.2%).

The preliminary data results suggest, that individuals with schizophrenia have higher prevalence of all types of severe infectious compared to the background population.

The authors have not supplied their declaration of competing interest.

Anxiety and depression disorders are common in patients with chronic pain. Studies using clinical interviews in patients with chronic pain report prevalence rates ranging between 30–54% for depression and 17–29% for anxiety. This is the first study using contacts with a hospital psychiatric ward to investigate prevalence of depression and anxiety in patients with chronic pain.

Estimate the prevalence of anxiety and depression in patients with chronic pain referred for interdisciplinary treatment.

To increase the knowledge about mental disorders and chronic pain in secondary health care.

All chronic pain patients referred to and treated at an interdisciplinary pain clinic at Odense university hospital, Denmark from 1 Jan 2005–13 Nov 2015 were included as participants. The Danish National Patient Register was used to collect information on contacts with a hospital psychiatric ward 10-year prior to the first contact at the pain clinic due to depression (ICD-10: F32-F33) and/or anxiety (ICD-10: F40-F41).

In total, 7204 patients (64% women; mean age: 48.2) were included. Altogether, 17.8% (95% CI: 16.9–18.7) of patients had contact to a psychiatric ward. The prevalence of unipolar depression were: 6.1% (95% CI: 5.5–6.6) and anxiety: 2.1% (95% CI: 1.8–2.5), while 0.7% (95% CI: 0.5–0.9) had both depression and anxiety.

The prevalence rates of depression and anxiety noted in this study were lower than those reported in previous studies. A hospital-based diagnosis seems likely to be less frequent than interview-based measures, yet, might have a higher validity due to the clinician-based assessment.

The authors have not supplied their declaration of competing interest.

Alcoholic anorexia (AA), being one of prevalent narcology diseases, up to now has not been studied in psychosomatics and psychopathology paradigm.

To identify multifactorial pathopsychological, psychopathological, nervous, alimentary, toxicological constituents of AA pathogenesis.

Twenty-four patients with alcohol dependence (males aged 29–37) have been studied. Diagnosis was objectified by psychosomatic, pathopsychological complex international valid tests and rating, adequate for investigation design, laboratory, electrophysiology, biochemical, ultrasound and other methods.

AA was accompanied with mental and physical post-intoxication exhaustion, asthenizing, tremor, dissomnia, depression, pre-delirium signs. Psychosomatic concept was proposed for reasonable identification of intranosological AA clinical forms in narcological clinical course. Anorectic dipsomaniac conditions are explained pathogenetically with psychosomatic mechanisms of deviant addictive craving behaviour as pathopsychological target and patient's intentional complete or partial refuse food consumption in favour of real in time more quick and brutal attainment of alcoholic drunkenness (Ebrietas Alcogolica). This anorexia fabula draws AA closer to Anorexia Nervosa and mostly reflects compulsive obsession with alcohol use. Pathopsychological, psychosomatic, neurogenous mechanisms of alcoholic anorexia of drinking bout early stages are transformed gradually to post-intoxication alimentary, nervous, psychic exhaustion. Meanwhile, АА is valid for alcohol withdrawal syndrome diagnosis and plays situation relapsing role in alcoholizing prolongation.

Alcoholic anorexia is starting to declare even at early stages of alcoholic addiction formation. It is more illustrative in periodically recurrent and exaggerating drinking bouts when dynamic intestinal obstruction risk is high. Findings obtained ground alcoholic anorexia attribution to urgent conditions with necessary integrated relieving therapy and secondary prevention.

The authors have not supplied their declaration of competing interest.

According to literature, the patients with severe mental disorder have higher cardiovascular disease risk than the normal population.

The current study based on the assumption that elevated inflammatory markers may be related to cardiovascular disease risk in psychiatric patient population.

This study is aimed to define the relation between the inflammatory reactant, C-reactive protein levels and 10-year risk of coronary heart disease according to Framingham risk score (FRS).

A total of 204 patients (106 female–98 male) who admitted to the psychiatric service between March and November 2015 and diagnosed with major depression, bipolar disorder and psychotic disorder were included in the study. Participants were evaluated by their gender, age, body mass index, waist circumference, high density lipoprotein levels, total cholesterol levels, systolic and diastolic blood pressures, diabetes comorbidity and CRP levels.

Ten-year risk of cardiovascular disease was found significantly higher at males than females (P < 0.001). There was no correlation between the FRS and the CRP levels which is an acute phase reactant and a contributer of atherogenesis (P = 0.763). However, mean values of CRP levels were determined as 0.59 ± 0.07 mg/dL for females and 0.56 ± 0.07 mg/dL for males. These levels are both high compared to the normal value which is up to 0.34 mg/dL. There was also a remarkable correlation between FRS scores and waist circumference (P = 0.012).

Framingham risk score can be used to detect cardiovascular disease risk and can be helpful in management of pharmacotherapy of the high-risk population.

The authors have not supplied their declaration of competing interest.

Increased coexistence of psychiatric symptoms in patients with alcohol abuse/addiction is highlighted in the literature. Equally high is the coexistence of physical illnesses due to the harmful effects of alcohol.

To record the profile and the characteristics of individuals with psychiatric/somatic co-morbidity who attend the psychiatric emergency department/(PED) of the largest psychiatric hospital in Greece.

A total of 1058 individuals, with a mean age of 44.4 years, were identified having alcohol problems in a five-year time period (2010–2015) in the context of the PED, while the majority of them was found to have psychiatric co-morbidity. The most common diagnosis was psychotic syndromes (24.2%), followed by affective (23.8%), personality (12.5%), and somatoform and anxiety disorders (6.3%). About 3% of the sample presented acute alcohol poisoning or severe withdrawal symptoms, coexistence with severe somatic disease and organic mental disorders. More than a third (37%) of them had to be hospitalized, while the involuntary hospitalization rates (21%) were higher than the voluntary ones (16%). Finally, 13.65% suffered from co-morbid somatic diseases with need of immediate emergency and hospital care.

The abuse and/or dependence of alcohol are largely associated with the coexistence of psychiatric and physical diseases. The psychiatric and physical co-morbidity, as regards attendance and hospitalization–involuntary and voluntary–, present a higher rate in men (86%) and mainly affects people of productive age. Additional data are needed to explore detailed factors that could contribute to a better design of more appropriate services for patients with alcohol use disorders.

The authors have not supplied their declaration of competing interest.

Eating disorders (ED) and personality disorders (PD) are often interplayed in every-day clinical practice. Less is known on patient's emotional deregulation and impulsivity.

To investigate whether clinical features of ED and PD correspond to a specific impulsivity and emotional background pattern.

ED, PD, impulsivity and emotional regulation.

A group of outpatients with ED (n = 39) was compared to a group of healthy controls (n = 40) by means of semi-structured interviews and standardized questionnaires (BIS-11, DERS, Eat-26, SCID-II and STAI), in order to evaluate association between clinical features (ED and PD) and altered impulsivity or/and emotion regulation.

Seventy-five percent of ED cases matched also diagnostic criteria for PD. Cluster B diagnoses occurred more frequently in Bulimia Nervosa (BN) and Binge eating disorders (BED) whereas Cluster C PD was strongly associated with restrictive anorexia (AN-R) (P < 0.001). BIS-11 scores were significantly higher in cluster B as compared to cluster C PD (P = 0.019). People with PD have a significantly higher DERS score compared to people without (P < 0.001). Mean DERS scores were similar in BN, BED and AN Binge purging (AN-BP) but lower in AN-R (P < 0.001).

ED is an iceberg top, of a three-step ladder. The intermediate step is built of personality traits and disorders forging the variety of ED clinical expressions. The hidden base of iceberg is represented by both the emotional (de)regulation and the level of impulsivity. Therapies focused on the base of this iceberg are needed for a clinical resolution of eating symptoms.

The authors have not supplied their declaration of competing interest.

Stroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.

The databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.

Antidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.

Antidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.

The authors have not supplied their declaration of competing interest.

Potentially inappropriate prescribing, is highly prevalent among older patients hospitalized with major psychiatric illness. Inappropriate use of psychotropic medications in elderly patients has become a focus of concern.

To determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), according to STOPP-START, Beers and PRISCUS criteria applied by CheckTheMeds®.

To identify potentially IP, PPo and the prevalence of contraindications, interactions and precautions in older patients hospitalized with major psychiatric illness.

Retrospective cross-sectional study with patients over 65 discharged from the Psychiatric acute unit of the university hospital of La Princesa (Madrid) between January 2013 and October 2015 was conducted. The CheckTheMeds® program was used to identify IP.

A total of 104 elders–74 females and 30 males–were included, with a mean age of 76 years (range: 65–91). An average of 5.73 (range: 1–16) was prescribed drugs at discharge. The Ip results STOPP 81.73% (n = 85), START 43.26% (n = 45), Beers 94.23% (n = 98) y PRISCUS 40.38% (n = 42). Contraindications were described in the 21.15% of the patients, precautions in 83.65% and interactions in 83.65%. Psychotropic drugs were the most often inappropriate prescribed medicaments.

Prescribing omissions are twice as prevalent as IP in the elderly. Currently, inappropriate prescription of psychotropic agents is very common for the elderly. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilization and cost and nonpharmacological interventions, should be thoroughly explored.

The authors have not supplied their declaration of competing interest.

Relevance of consultation liaison psychiatry is conditioned by trend of steady rise of psychosomatic disorders and insufficient development of supplied forms and methods of medical care to patients with this pathology.

To study incidence rate of psychosomatic disorders in primary health care, to develop algorithm of medical care.

A total of 2010 patients of the primary health care unit were examined. Methods used: clinical-psychopathological, clinical-dynamic, questionnaire screening, statistical (factor analysis).

Mental disorders, co-morbid with physical pathology, constituted 3.9% of the contingent with predominance of psychosomatic disorders–15.6 per 10,000 of the population. Respective from clinical-dynamic structure of psychosomatic disorders three groups of patients were distinguished: in need for consultation by a psychiatrist (22.9%); for course treatment by psychiatrist and subsequent observation by physicians (28%); and for systematic therapy and observation by psychiatrist (49.1%). Patients with psychosomatic disorders addressed general medicine network 1–2 years after onset of mental disorder and 6.4 ± 1.2 years after diagnostics of somatic pathology. Patients had predominantly cardiovascular (37.7%; P < 0.05), respiratory (20.5%), and gastrointestinal diseases (20.9%). Exacerbation of psychosomatic disorder was reliably interrelated with psychotraumatic situation and exacerbation of physical pathology. Introduced algorithm of psychiatric consultation consisted of:

– evaluation of mental and physical status;

– distinguishing the nosological groups;

– choice of therapy;

– formation of groups of observation (risk groups in need for course therapy, systematic therapy).

Consultation liaison psychiatry in general medical institution allows widening accessibility of psychiatric care and makes its provision more cost-effective.

The authors have not supplied their declaration of competing interest.

The pathogenesis of dissatisfaction of the own appearance in patients without obvious abnormalities is still unexplored. The aim of the study was to investigate the structure of psychopathological disorders in patients without evident appearance abnormalities seeking for surgical or cosmetological correction.

Study sample has included 227 women (average age: 35.8 ± 4.9 years) and 54 men (average age: 30.9 ± 5.7 years)–patients of plastic surgery and cosmetology clinic. The study used clinical psychopathological and follow-up methods of examination.

We have found the heterogeneous spectrum of mental disorders in this group of patients: overvalued dysmorphophobia was diagnosed in 26%, anxiety-phobic disorders–23.1%, obsessive-compulsive disorders–in 11%, depression–in 32%, delusional disorders–in 7.5% of patients.

The results of our study show that the phenomenon of dissatisfaction with the appearance without obvious cosmetic defects manifests in the course of wide spectrum of mental disorders. The follow-up shows no improvement and even worsening of patients’ mental state after cosmetological or surgical treatment. Decision about possibility and extent of the operation should be based on the analysis of patient's mental state and motive for reference to aesthetic medicine specialist.

The authors have not supplied their declaration of competing interest.

In the palliative care setting, accurate identification of depression is important to allow delivery of appropriate treatments.

– 1. To assess rates of depression in palliative care inpatients using the CSDD, comparing with formal clinical diagnosis based on diagnostic and statistical manual of mental disorders (DSM-IV) criteria;

– 2. To identify items of the CSDD that most distinguish depressive illness in a palliative care setting.

We measured rates of depression in patients admitted into a palliative care inpatient unit with the CSDD. DSM-IV clinical diagnosis of major depressive disorder (MDD) was achieved using all available clinical information by an experienced independent rater. We calculated Cohen's Kappa to measure concordance between the CSDD and DSM-IV diagnosis.

We assessed 142 patients (56.3% male; mean age: 69.6 years), the majority of which had a cancer diagnosis (93.7%). 18.3% (n = 26) met DSM-IV criteria for MDD, while 12% scored ≥6 on the CSDD with 15 cases of depression common to these two methods (K = 0.65). Discriminant analysis identified five CSDD items that were especially distinguishing of MDD; sadness, loss of interest, pessimism, lack of reactivity to pleasant events and appetite loss. An abbreviated version of the CSDD, based on these 5 items, proved highly accurate in identifying DSM-IV MDD (AUC = 0.94), with sensitivity of 89% and specificity of 84% at a cut-off score ≥2.

There was good level of concordance between the CSDD and DSM-IV diagnosis of MDD. We identified five depressive symptoms that are especially discriminating for depression in palliative care patients.

The authors have not supplied their declaration of competing interest.

Anti-HCV treatments are moving away from interferon-alpha towards DAAs, associated with fewer side effects, better tolerability, and better PROs.

To describe neuropsychiatric symptoms and PROs during DAAs treatment in a group of HCV+ patients.

Forty outpatients, scheduled for DAAs treatment, were assessed at enrolment (T0), 4 weeks (T1), at the end of treatment (EOT) and after 12 weeks of follow up (F-UP), by means of MDRS, HAM-D, HAM-A, MRS, Y-BOCS and SF-36. Afterwards the sample was divided into two groups as a function of a positive psychiatric history (19) and compared with each other.

Total sample mean scores between W0 and F-UP were compared and an improving trend was observed in all administered scales. An SF-36 items analysis showed a statistically significant difference in emotional role functioning between W0 vs EOT and EOT vs F-UP, in change in overall health status between W0 vs EOT and W0 vs F-UP.A multivariate logistic regression analysis showed that a positive psychiatric history was not associated with an improvement in vitality of 4.3 (minimal clinically important difference). Comparing the two groups, no significant fluctuations in SF-36 scores were founded and major deviations score increases were recorded in patients with a psychiatric history in all scales.

Our real world data shows that new regimens do not seem to be associated with psychiatric side effects and conversely a clinical improvement compared to baseline was found, suggesting an immediate gain in PROs over the treatment period, particularly the psychiatric subgroup.

The authors have not supplied their declaration of competing interest.

Essential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today, scientists discover more and more patients whose BP values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.

To study the role emotion dysregulation in the pathogenesis of EH.

A projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchernko, Pervichko). At the second stage of the study, the simulation of emotional stress with the aspiration level modelling was carried out. The level of state anxiety, BP values and levels of catecholamines, renin and angiotonin I were taken before and after the experiment. Eighty-five patients with “hypertension at work” (mean age: 45.9 ± 2.8), 85 patients with “classical” EH (mean age: 47.4 ± 4.5 years) and 82 healthy subjects (mean age: 44.9 ± 3.1) took part in the study.

“Hypertension at work” patients significantly more frequently than patients from the second group and healthy subjects are more prone to rumination, disasterization and repression of their emotions. They will seldom employ the strategy of subjective-objective interactive transformations; their edibility to actualize new meanings in traumatic situations is diminished. We showed that emotion regulation strategies in “hypertension in the work” patients were ineffective in overcoming the emotional tension and created the conditions for chronization of high blood pressure, and could be considerded as the central link in pathogenesis of stress-induced hypertension.

The results contributes to enrich our understanding of etiology and pathogenesis of EH.

The authors have not supplied their declaration of competing interest.

Inflammatory bowel diseases (IBD) in adolescents are chronic medical conditions with a substantial influence on the well-being of the family members.

Total of 27 adolescents suffered from IBD, and 39 healthy adolescents completed questionnaires ADOR (parenting styles assessed by teenagers), KidScreen-10 (quality of life), SAD (Scale of Anxiety in Children), and CDI (Children's Depression Inventory). Their parents completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), and Pediatrics Quality of Life Family Impact Module (PedsQL).

The parental styles of mothers and fathers of IBD adolescents and the parents of healthy controls were without statistically significant differences except for the fathers’ positive parental style, which was significantly higher in the fathers of controls. There were no statistically significant differences between IBD children and the healthy controls in the quality of life assessed. However, the parents’ quality of life of ill children was statistically significantly lower than of the parents of the controls. The mothers of IBD adolescents were significantly more anxious and the fathers more depressed than the parents of the healthy controls, but there was no difference in the levels of anxiety or depression between IBD adolescents and the controls. Positive parental style of parents of IBD children positively correlated with the quality of life of adolescents. Positive parental style of the fathers correlated negatively with the state and trait children's anxiety and negatively correlated with severity of childhood depression.

The parents of the adolescents with IBD represent important group for psychosocial support.

The authors have not supplied their declaration of competing interest.

Psychiatric morbidity in epilepsy is high, with prevalence rates of up to 50%, being higher in treatment-refractory cases. This co-morbidity worsen the quality of life. Psychiatric comorbidities are hampered by atypical presentations or disorders, which do not appear in the DSM-IV or ICD.

To describe the psychiatric morbidity in a group of patients with refractory-epilepsy.

To provide evidence of the high morbidity and show the prevalence of the different psychiatric disorders.

We cross-sectional assessed psychiatric disturbances in resistant-epileptic patients using SCID for DSM-IV and clinical interview for epileptic specific psychiatric conditions. We grouped psychiatric disturbances into six clusters:

– affective disorders;

– anxiety disorders;

– psychotic disorders;

– eating disorders;

– conduct disorder;

– substance use disorder.

We also considered epilepsy specific conditions as Interictal Psychotic Disorder (IPI) and Interictal Dysphoric Disorder (IDD) characterized by 3/8 symptoms: depressive mood, anergia, pain, insomnia, fear, anxiety, irritability, and euphoric mood.

The sample consist on 153 patients, with a mean age of 37. In total, 42.5% were males. One or more axis I diagnoses was seen in 38% of the patients. The most common condition was IDD (27.1%), followed by affective disorders (22%), anxiety disorders (15.3%), psychotic disorders (4%) and drug use (2%). There were no patients with eating or conduct disorders or IPI.

Psychiatric morbidity is frequent in resistant-epilepsy. Despite 38% of patients suffered from at least one axis I diagnoses, IDD was the most prevalent condition and not included in SCID interview.

The authors have not supplied their declaration of competing interest.

Cannabinoid hyperemesis syndrome (CHS), is characterized by recurrent episodes of severe nausea and intractable vomiting, preceded by chronic use of cannabis. A pathognomonic characteristic is compulsive bathing in hot water. The resolution of the problem occurs when cannabis use is stopped. However, patients are often reluctant to discontinue cannabis. Treatment with anti-emetic medication is ineffective. Case series suggested haloperidol as a potential treatment. Other antipsychotics as olanzapine has been used as anti-emetic treatment in chemotherapy.

To describe three cases of patients with CHS whom showed a successful response to olanzapine, even when, haloperidol had failed.

To present an alternative treatment for CHS which can offer benefits over haloperidol.

We present three cases of patients who suffered from CHS and were admitted to emergency department. All patients were treated with olanzapine after conventional anti-hemetic treatment failure. One patient was also unsuccessfully treated with haloperidol.

All three patients showed a good response to olanzapine treatment. Different presentations were effective: velotab and intramuscular. Their nausea, vomits and agitation were ameliorated. They could be discharge after maintained remission of symptoms.

Olanzapine should be considered as an adequate treatment for CHS. Its suitable receptorial profile, its availability in different routes of administration and its side effects profile could offer some benefits over haloperidol.

The authors have not supplied their declaration of competing interest.

Growing evidence has been collected over the complex, intertwined pathophysiological connection among subclinical cardiovascular (CV) disease, i.e. atherosclerosis, systemic low pro-inflammatory states and psychiatric disorders/symptomatology (anxiety, depression), with controversial results.

Aim of this study was to investigate the possible link between subclinical CV risk factors (atherosclerosis), depressive symptoms, and inflammation.

Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, attending colonoscopy after positive faecal occult blood test, negative medical history for cancer. Collected data: blood pressure, glycaemia, lipid profile, waist circumference, BMI, PCR (C reactive protein), LPS (bacterial lipopolysaccharide), ultrasound carotid intima-media thickness (c-IMT). Psychometric tests: HADS, TCI, IMSA, SF36. Statistical analysis performed with STATA13.

The 54 patients enrolled were equally distributed by gender. CV risk factors were common in the study population, with 33 patients (61.11%) with hypertension, 14 (25.93%) with hyperglycaemia, 20 (37.4%) with hypertriglyceridemia, 19 (35.19%) with low HDL and 64.81% with overweight. High levels of PCR were found in 24 subjects (44.44%). Right c-IMT was increased in 26.41% of the sample, and 11.32% had an atheromatous plaque. Left c-IMT was increased in 24.53% of patients, with a plaque in 7.55% of them. Clinically relevant depressive symptoms were found in the 18.87% of the sample and were statistically significantly associated with PCR (OR = 28.63; P = 0.01).

Evidence contributing to the so-called “inflammation theory” of depression and supporting the association between mood and CV disorders was here collected, supporting the need for a multidisciplinary approach to the diagnosis and treatment of such conditions, assuming a clinically-translated PNEI (psycho-neuro-endocrino-immunological) perspective.

The authors have not supplied their declaration of competing interest.

Metabolic syndrome (MetS) is defined by metabolic and cardio-vascular impairments and is frequently associated with anxiety and depressive disorders. Both MetS and anxiety-depressive syndromes feature similar systemic inflammatory alterations. Inflammation of the large bowel is also a key factor for the development of colorectal cancer (CRC).

To measure the prevalence of MetS and symptoms of anxiety and depression among patients undergoing colonoscopy.

Cross-sectional study. Patients undergoing colonoscopy aged 40 or more, with negative history for neoplasia or inflammatory bowel disease, were enrolled. Data collected: colonoscopy outcome, presence/absence of MetS (IDF and ATP III criteria), presence/absence of depressive and anxiety symptoms assessed with HADS.

The sample was made up of 53 patients (female 24, 45.3%). Mean age was 60.66 ± 9.08. At least one adenoma was found to 23 patients (43.3%). Prevalence of MetS ranged from 34% to 36% (ATP III and IDF criteria, respectively). Prevalence of depressive and anxiety symptoms was 20% and 33%, respectively.

Prevalence of MetS, anxiety and depressive symptoms among patients undergoing colonoscopy was higher than in the general population.

The authors have not supplied their declaration of competing interest.

Several studies have shown an association between the Short-Form 36 (SF36) scores and anxiety-depressive symptoms, suggesting that depression in particular could reduce Quality of Life (QoL) to the same, and even greater, extent than chronic non-communicable diseases, such as diabetes and hypertension.

To explore the relationship among QoL and anxiety, depressive and anxiety-depressive symptoms in an outpatient sample.

Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, without history for cancer, attending colonoscopy after positive faecal occult blood test. Collected data: blood pressure, blood glucose, lipid profile. Psychometric test: Hospital Anxiety and Depression Scale (HADS). QoL was assessed with SF36. Statistics performed with STATA13.

54 patients enrolled (27 females). Sixteen patients (30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive symptoms and five (9.4%) for anxiety-depressive symptoms. The perceived QoL was precarious in twelve subjects (22.2%): eight (15.9%) had low score (≤ 42) at “Mental Component Summary” (MCS) subscale, three (5.7%) at the “Mental Health” item and one patient (1.9%) at the “Vitality” one. At the multiple regression analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive symptoms (OR = 11.16; P = 0.02) were associated with MCS.

The association emerging from the present study between depressive/anxiety symptoms and the MCS component of SF36 is consistent with available literature. Study design and small sample size do not allow to generalize results, that need further studies to be confirmed.

The authors have not supplied their declaration of competing interest.