Sažetak. Cilj: Shizofreniju karakterizira visoka učestalost ovisnosti o pušenju, kao i visoka učestalost metaboličkog sindroma. Unatoč tome, malo se zna o učinku pušenja na komponente metaboličkog sindroma u toj bolesti. Cilj ovog rada bio je ispitati pridonosi li, i u kojoj mjeri, pojava ovisnosti o pušenju, koncentracijama lipida i glukoze u plazmi te vrijednostima indeksa tjelesne mase (BMI) u skupini hrvatskih pacijenata sa shizofrenijom. Ispitanici i metode: U istraživanju su sudjelovala 263 kronična pacijenta (muškarci/žene: 139/124) s dijagnozom shizofrenije utvrđenom prema DSM-IV klasifikaciji (engl. Diagnostic and statistical manual for mental disorders -DSM-IV). U pušače su klasificirani ispitanici koji puše najmanje jednu cigaretu dnevno u periodu duljem od godine dana, a u nepušače oni koji su popušili manje od 100 cigareta tijekom života. Rezultati: Unatoč visokoj stopi ovisnosti o pušenju (muškarci: 70,5 %; žene: 60,5 %) nije pronađena značajna razlika u koncentracijama lipida i glukoze u plazmi te vrijednostima BMI-ja između muškaraca pušača i nepušača, a u žena su se samo koncentracije triglicerida razlikovale ovisno o pušačkom statusu. Pri tome su pacijentice koje puše imale nešto više vrijednosti triglicerida u usporedbi s pacijenticama nepušačima (1,6 ± 0,7 vs. 1,3 ± 0,5; F = 4,25, P = 0,042). Ipak, multipla regresijska analiza pokazala je da je samo dob značajni prediktor vrijednosti triglicerida u pacijentica (β = 0,41; promjena R 2 = 0,171; P < 0,001), dok je učinak pušenja na koncentracije triglicerida, kao i na ostale ispitane metaboličke parametre, u pacijenata i pacijentica, ostao izvan granica statističke značajnosti (P > 0,05). Zaključak: Na temelju naših rezultata možemo zaključiti da pušenje ne utječe na koncentracije lipida i glukoze u plazmi te vrijednosti BMI-ja niti u pacijenata niti u pacijentica sa shizofrenijom.Ključne riječi: glukoza u plazmi; indeks tjelesne mase; lipidi u plazmi; pušenje; shizofrenija Abstract. Aim: Schizophrenia is associated with a high rate of nicotine dependence as well as with a high prevalence of metabolic syndrome. However, little is known about the influence of smoking on the metabolic syndrome in this illness. In the current study we aim to investigate whether, and to what extent, smoking may contribute to plasma lipid and glucose concentrations and body mass index (BMI) values in Croatian patients with schizophrenia. Patients and methods: Our study comprised 263 chronically ill patients (males/females: 139/124) who met the criteria for schizophrenia, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Smokers were defined as individuals who smoked more than one cigarette each day for more than one year, and nonsmokers were defined as those who had smoked fewer than 100 cigarettes during their lifetime. Results: Although an elevated smoking rate was detected (males: 70.5%; females: 60.5%), we did not observe significant differences in plasma lipid and glucose concentrations and BMI values between male smokers and nonsmo...
Aim: Lack of patient compliance in a general psychiatric ambulatory causes delays in diagnosing as well as in patient treatment efficacy. Method: a 30 year old patient underwent a psychiatric treatment which lasted two yaers. He was treated with a combination of psychopharmacs and psychotheraphy. Results: The patient contacted a psychiatrist for the first time exhibiting the following symptoms: loss of will and interests, weight gain, lowered general mood, avoidance of social contacts. A depressive episode was diagnosed and and antidepressive was introduced to his therapy (fluvoxamine). He did not comply to the therapy assigned nor he attended his scheduled examination. His medicamentous therapy was intensified (fluoxamine, alprazolam, promazine). After six months, the patient returned in company with his family , and his non-compliance with the therapy was revealed. After a sucessfful therapy an improvement in his mental state was noticed. During the last year, he was regular at his examinations and medication, with psychotherapy once a week. Conclusion: Patient compliance is a prerequisite for diagnosing and a successful treatment. Combined treatment methods (psychopharmacotherapy, psychotherapy) with an adherend patient guarantee a good remission.
IntroductionSymptom (from Greek symptoma “anything that has befallen one”) is an each new manifestation by which some disorder is expressed. For the physician, it is a guide to diagnosis itself, and for the patient it is a signal which warns of new conditions of the body and soul or of a disorder.ObjectivesMental disorders are most commonly presented by a group of symptoms, among which the patients often can’t point out the leading one. Anxiety as a symptom can occur in a number of psychiatric entities and it can stimulate differential diagnostic dilemma in daily practice. We will show a 26-year female in which the internal anxiety is the main symptom.AimTo underlined the importance of taking in to account a leading symptom of the disease in the way of establishing the correct diagnosis.MethodsThe psychiatric and psychotherapeutic interviews were performed together with a clinical assessment of mental status and structured clinical interviews (SCID I and SCID II), EEG and psychological testing.Results/conclusionInternal discomfort is a subjective feeling, respectively a symptom which the patient in this case continuously underlined, and which guided us (along with a comprehensive analysis) to a clear diagnosis. Following the choosing of an effective psycho-pharmacological combination, and with the goal of reducing a leading symptom, according to enlarged diagnostic process, we decided to diagnose the Schizoaffective disorders (F 25.2).
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