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Background/Aim. Chest pain of no heart origin resembles angina and when none medical reason is found, the patients are referred to psychiatrist for further assessment. The aim of this reserch was to determine psychological characteristics of the patients with non-coronary chest pain (NCCP), difference compared to the coronary patients and the predictive value of those parameters for NCCP. Methods. Fourty consecutively recruited patients without a diagnose of heart disease (NCCP group) were examined and compared to 45 coronary patients (C group). For psychiatric diagnose, the Mini-International Neuropsychiatric Interview (MINI) was used. Psychological symptoms were assessed by the Symptom Checklist-90-Revised (SCL-90R), exposure to life events was scored by the Holms &Rahe Scale and levels of anxiety and depressiveness by the Back Anxiety Inventory and Back Depression Inventory. The statistical analysis was done by using the software package SPPS17. The Student's-t test and χ 2-test were used for estimating more difference between groups while ANOVA determined parameters associated with NCCP. Results. The NCCP patients were younger (33.40 ± 5.43 vs. 48.37 ± 6.43, p < 0.001), more anxious (20.47 ± 11.93 vs. 9.63 ± 3.86, p < 0.001), had more exposure to life events (102.03 ± 52.22 vs. 46.5 ± 55.08, p < 0.001) and were more distressed (41.37 ± 7.70 vs. 29.37 ± 5.67, p < 0.001), while coronary patients were more depressed and hostile. The regression analysis indicated that elevation in anxiety score for 1 point, means 25% of a higher chance [odds ratio (OR) = 1.25; 95% confidence interval (CI): 1.10-1.41] and elevation in the Life events score, means 2% of a higher chance that subject belonged to the NCCP group (OR = 1.02; 95% CI: 1.01-1.03). The younger subjects were more likely to have non-cardiac chest pain (OR = 0.58, 95% CI: 0.42-0.80). Conclusion. The results suggested that the patients with NCCP had none associated psychiatric disorder, but showed higher distress level, more exposure to negative life events and moderate anxiety level. Psychological help could be of a benefit to prevent possible psychiatric issues in young people with non-cardiac chest pain.
Background/Aim. Depersonalization is considered to be the third leading symptom in psychiatric morbidity. The aim of this study was to investigate the correlation of depersonalization and different patterns of suicidal behaviour in patients suffering from depresssive disorder. Methods. The study included 119 depressed patients divided into two groups: the first group consisted of depressed patients with clinically manifested depersonalization according to the Cambridge Depresonalisation Scale presented score ≥ 70, and the second group consisted of the patients whithout clinically manifested depersonalization symptomatology, or, it was on the subsyndromal level. Subsequently, these two groups were compared regarding the suicidality indicators. Results. According to the Scale for Suicide Ideation of Beck, the depressed patients with depersonalization had statistically significantly higher scores regarding suicidal ideation, both active and passive, more often manifested suicidal desire, suicidal planning and overall suicidality (p < 0.000). Positive ideation, as a protective factor, was reduced in this group (p < 0.000). These patients had more previous suicide attempts (p < 0.001) and family history of suicides (p = 0.004). The depressed patients with depersonalization had 8 times more often active suicidal desire, 11 times more often passive suicidal desire and 5 times more often suicidal planning compared to patients without depersonalization. Conclusion. Suicidal potential, manifested in various patterns of suicidal behaviour among the patients suffering from depressive disorder with clinically manifested depersonalization is prominent. It is necessary to pay particular attention to depersonalization level during diagnostic and treatment procedure of the depressed patients having in mind that it may be associated with high suicidal potential.
Kratak sadr`aj: Sve je vi{e dokaza da su kortikalne }elije mozga obolelih od shizofrenije osetljive na apoptozu. Kako je apoptoza aktivna od rane faze intrauterinog `ivota, va`an mehanizam u modelovanju organizma tokom razvoja, mogla bi biti uklju~ena u patogenezu shizofrenije. U cilju testiranja ove hipoteze odre|ivana je aktivnost kaspaze-3, kolorimetrijskom metodom, u mononuklearnim }elijama periferne krvi kod 30 obolelih od shizofrenije i 30 zdravih osoba sli~ne starosti i pola. Shodno pove}anoj osetljivosti na apoptozu, aktivnost kaspaze-3 u limfocitima obolelih od shizofrenije je zna~ajno ve}a (0,111±0,055 mmol/mg proteina, p<0,05) u pore|enju sa vrednostima kontrolne grupe (0,086±0,030 mmol/mg proteina). Najvi{a aktivnost je dobijena u grupi bolesnika sa skoro podjednako izra`enom pozitivnom i negativnom simptomatologijom (0,159±0,096 mmol/mg proteina) i bila je zna~ajno vi{a (p<0,05) od vrednosti grupe sa relativnom predominacijom pozitivnih simptoma (0,100±0,029 mmol/mg proteina). Nije na |e na zna~ajna razlika u aktivnosti kaspaze-3 izme|u boles nika tretiranih tipi~nim (0,124±0,071 mmol/mg proteina) odnosno atipi~nim (0,104±0,039 mmol/mg proteina) antipsihoticima. Prema na{im saznanjima ovo su prvi rezul tati koji pokazuju da je aktivnost kaspaze-3 zna~ajno pove }ana u nativnim }elijama obolelih od shizofrenije {to uka zuje na disregulaciju apoptoti~nog mehanizma u ovoj bolesti.
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