IntroductionDiabetes mellitus (DM) is associated with chronic complications and comorbidities. Psychopathology and personality changes (PCh) are also found in DM. Some authors suggest organic PCh. The aim of our study was to access DM associated PCh and their relations with DM complications, glycemic control (GC) and family history for DM (FH).Material and methodsWe examined 47 patients with DM type 2 (64.65 ± 9.78 years old; 14 males, 33 females; 24 with and 23 without FH, 20 with good, 15 with poor and 12 with very poor GC). All of them underwent somatic and neurological examinations. Blood count and biochemistry, urine analysis, brain computer tomography, electroneurography, electrocardiography and neuropsychological battery were applied. PCh were accessed by Minnesota Multiphasic Personality Inventory.ResultsThe most frequent PCh were hypochondriasis (Hs, 77%), hysteria (Xy, 74%) and schizoidia (Se; 77%); hypomania was low in 60%; 30% showed low psychasthenia and 49% low psychopatia. High paranoia had 23% and low–15%. Poor GC was associated with cognitive impairment (CI) and high Hs, Xy and Se. Patients with high Hs, Xy and Se showed more frequent diabetic complications (retinopathy, polyneuropathy and nephropathy), comorbidities and CI than those without, even after correction for age, therapy and DM duration. FH was risk factor for PCh.ConclusionsPatients with DM show specific PCh. High scoring on Hs, Xy and Se scales are associated with poor GC, chronic DM complications, comorbidities and CI. FH is risk factor for PCh.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction: Suicide is a major public health problem but factors determining suicide risk are still unclear. Studies in this field in Bulgaria are limited, especially on a regional level.Methods: By a cross-sectional design, we accessed the medical records of all psychiatric patients committed suicide over a 10-year period (2009–2018) in one major administrative region of Bulgaria. A statistical analysis was performed of the association between age of suicide as an indirect yet measurable expression of the underlying suicidal diathesis and a number of socio-demographic and clinical characteristics.Results: Seventy-seven of 281 suicides (28%) had psychiatric records. Most common diagnoses were mood disorders (44%), followed by schizophrenia (27%), anxiety disorders (10%), substance use disorders (9%) and organic conditions (8%). Male gender, single/divorced marital status, early illness onset, co-occurring substance misuse and lower educational attainment (for patients aged below 70) were significantly associated with earlier age of suicide whereas past suicide attempts and psychiatric hospitalizations, comorbid somatic conditions and unemployment showed insignificant association. Substantial proportion of patients (60%) had contacted psychiatric service in the year preceding suicide, with nearly half of these encounters being within 30 days of the accident.Conclusion: Severe mental disorders are major suicide risk factor with additional contribution of certain socio-demographic and illness-related characteristics. Monitoring for suicidality must be constant in chronic psychiatric patients. Registration of suicide cases in Bulgaria needs improvement in terms of information concerning mental health. More studies with larger samples and longitudinal design are needed to further elucidate distal and proximal suicide risk factors.
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