Clinical and Biochemical Correlations of Aggression in Young Patients with Mental Disorders

Abstract

Hyperdopaminergia has been identified at impulsive or psychotic patients, the polymorphism of COMT or other enzymes that metabolize dopamine could be involved. The deficiencies of the serotoninergic system in suicidal behaviour has been mentioned by many studies that indicate the reduction of 5-HT, 5-HIAA in CSF or 5-HTT polymorphism. Young patients with psychotic or depression symptoms manifest, frequently, aggressive and self-harm behaviour. Besides the association between the young age and the aggressivity of the patients with serious mental disorders, our study shows gender differences and this matter is sustained by hormonal factors. The study was conducted at the Gheorghe Preda Psychiatric Hospital in Sibiu. The study comprises 52 patients aged between 18 and 35 who were diagnosed with the diagnosis of Schizophrenia, Bipolar Affective Disorder, Depressive Episode and Major depressive disorder according to the DSM-5 criteria. Evaluation of the severity of psychiatric and depressive symptomathology were assessed with Brief Psychiatric Rating Scale and Beck Depression Inventory; aggression and self-aggression in the patients with Schizophrenia, respectively with Bipolar disorder, depressive episode and Major depression disorder were assessed with Buss Perry Aggression Questionnaire and Suicide Intent Scale. Regarding the severity of aggression in the young patients from our study (Buss Perry scale score), male gender is higher than female gender: higher percentages in males (35% and 10%) than in females (16 and 0%). Determining aggression in schizophrenia is possible due to COMT polymorphism that lead to impulsivity or psychotic symptoms. The study show a significant positive correlation between the severity of symptoms of schizophrenia and aggression. From the analysis of the severity of depression in young patients (SIS score) it is noted that its severity is higher in the female gender. Women had higher scores of moderate depression (58%) and severe (26%) than men (37 and 25%, respectively). This relationships could be possible due to the polymorphism of the gene encoding the 5-HTT serotonin transporter related with serotonin deficiency.The study do not show a significant positive correlation between the severity of the depressive symptomatology and the degree of the suicide intent.

Aggression in schizophrenia, bipolar and major depression disorder

“…Our study showed that the mean score of total aggression and its components in the schizophrenia group was significantly higher than in the comparison group. Duica et al (2018) found a positive and significant correlation between the severity of schizophrenia symptoms and aggression. This study was conducted in hospitalized patients and showed a high level of aggression in hospitalized patients diagnosed with schizophrenia, which is consistent with other studies in this field (Zhu et al, 2016;Ose et al, 2017).…”

Study on the correlation between knee osteoarthritis and anxiety in patients aged over 55

“…In this context we can say that there are changes of neuronal signaling in the spinal cord and brain in the case of a continuous joint nociception, a phenomenon called central sensitization, to which the sensory input is amplified when it reaches nociceptive ways at the medullary level and in the brain, causing the frequency and gravity of pain (30). Therefore, the central sensitization present in an important percentage of people with osteoarthritis (31) is an element of pain gravity (32,33), explaining the difference between the intensity of the pain and the joint structures changes in this condition (34). In the case of the synovitis, certain inflammatory molecules can directly activate the nociceptors in the joint, causing the phenomenon of peripheral sensitization.…”

The quality of life - an indicator for assessing the recovery program in patients diagnosed with degenerative disorders

“…Thus, it was found that obesity, the decrease of the physical activity (7) and the female sex were the factors that decreased the quality of life. Additionally, the patients' educational level, the psychological stress, the depression, the social and inter-family relations (8,9). A study from 2019 (10) on 6472 participants shows that osteoarthritis at the level of the lower limb affects between 10-20% of people over 60 (11) involving economic and social costs (12), but also medical costs increasing by 80-90 % the costs for possible hip or knee prostheses (13,14,15).…”