[The association of quality of life with mental status and sociodemographic data in schizophrenic patients]

AIM

The aim of this study was to assess the mental status and sociodemographic data as well as their influence on the quality of life in schizophrenic patients.

METHODS

SF-36, Soc-29, CDS, PANSS, AIS and sociodemographic questionnaire were given to a cohort of 64 subjects who participated in this study (28 female, 36 male), with age range of 21-58 (Mean 33.4 +/- 10.8). Questionnaires were administered to all patients in partly-remission or remission time.

RESULTS

Patients showed significant positive correlation of summary scales of PCS and MCS with SOC and AIS and negative correlation with depression symptoms estimated by CDS. There were no significant differences in MCS and sociodemographic factors. The values of the PCS were negatively associated with the number of hospitalisations, disease duration time and negative syndromes estimated by PANSS-N.

CONCLUSIONS

Sense of coherence, acceptance of illness and depressive syndromes influence quality of life.

The occurence of mood and anxiety disorders in heart transplant recipients

Fortynine heart transplant recipients were evaluated during the first weeks after orthotopic heart transplantation. Using the ICD-10 (International Classification of Diseases-10th revision) criteria, we studied the incidence of anxiety disorders as well as 17 demographic and medical factors potentially influencing the probability of their occurrence. A smaller 36-person group was evaluated using standard psychopathologic scales for anxiety and mood disorders. Cox regression analysis was used to specify which of 11 demographic and medical factors influenced the time to occurrence of the first episode of a mental disorder. Anxiety episodes occurred in 25 patients, depressive episodes in 27, (hypo)manic in 3, and 12 manifested a slightly elevated mood. The risk of occurrence of anxiety and mood disorders was highest during the first 3 weeks after OHT. "False alarms," namely, calls to the clinic not ending up in transplantation, and coexisting illnesses were related to higher incidences and earlier appearance of anxiety and mood disorders. The risk of occurrence of an anxiety syndrome was greater among older patients. Anxiety syndromes were manifested earlier in patients who underwent transplantation due to ischemic cardiomyopathy than in patients with heart failure caused by other factors. A greater number of false alarms, of long-lasting hospitalizations, and of low mean cyclosporine levels were risk factors for depressive episodes.

[The association of quality of life with mental status and sociodemographic data in patients after total hip replacement]

AIM

The aim of this study was to assess the mental status and sociodemographic data and their influence on the quality of life in patients after total hip replacement.

METHODS

SF-36, Soc-29, HADS, MPI, sociodemographic questionnaire were given to a cohort of 48 subjects who participated in this study (28 female, 20 male), with age range of 54-70 (mean 56). Questionnaires were administered to subjects two weeks before surgery and three months after surgery.

RESULTS

Patients after total hip replacement showed significant improvement in health-related quality of life in the summary scale of PCS and MCS and HADS-D and HADS-A. There were no significant differences in SOC and MPI. The postoperative values of the PCS and the MCS for the whole group of patients correlated positively with the SOC values. Neuroticism (MPI) was also associated with the postoperative functioning in the mental and physical dimensions. Older patients had more likely to have worse score in MCS and PCS before and after surgery.

CONCLUSIONS

Total hip replacement significantly improves patient health and well-being at three months after surgery. Sense of coherence, neurotism and old age influence quality of life.

[The influence of some sociodemographic and clinical factors on depression in women undergoing coronary arteriography]

AIM

The aim of this study was to evaluate the influence of sociodemographic and clinical factors on symptoms of depression in 90 female patients awaiting coronarography.

METHOD

The factor dividing the patients into two groups: those without significant atheromatosis - 48 women and those with coronary atheromatosis - 42 women, was the result of invasive diagnostics of coronary heart disease. BDI (Beck Depression Inventory), HAM-D (Hamilton Depression Rating Scale) and sociodemographic and clinical data questionnaire were used in the study.

RESULTS

It was proved that there was a connection between the appearance of increased parameters of depression and more frequent number of annual visits in the Primary Care or Cardiologic Clinic, higher level of depressiveness and anxiety, fear of obtaining information applying to the necessity of coronarography, lack of hormonal replacement therapy and of support from other people. Additionally, it was noticed that the intensity of symptoms were higher for those less educated, those waiting shorter for coronarography and those with hypertension. There were no statistically significant differences in the estimation of depressive states in both groups, neither in prevalence, nor in the intensity.

CONCLUSION

Patients with increased parameters of depression need special therapies and multidisciplinary care.

[Cardiac syndrome X from a psychosomatic point of view]

The aim of this paper was to explain the idea of cardiac syndrome X, particularly the association between emotional disturbances, somatoform disorder and syndrome X. Cardiac syndrome X is defined by the presence of angina-like chest pain, a positive response to stress testing and angiographically normal coronary arteriogram. It has been shown to occur in approximately 20 - 30 percent of angina patients undergoing cardiac catheterization. Most of the patients with normal angiograms are women especially in perimenopausal age. Syndrome X patients reported more depression, anxiety and somatic concerns than positive angiographic patients. They have high scores on psychological inventories that measure anxiety and depression, and are very prone to somatization. They have better prognosis with death from cardiac causes than patients with coronary heart disease. With regard to female chest pain patients, somatoform disorder can be assumed. At the present time, there is no common agreement on the exact cause of the symptoms associated with syndrome X.

Anxiety and depression and their influence on the quality of life after total hip replacement: preliminary report

Objective. The study investigated health-related quality of life in relation to mental status (anxiety and depression) and demographic factors in patients before and after total hip replacement due to osteoarthrosis. Methods. The SF-36, HADS, socio-demographic data questionnaire was delivered to a group of 184 subjects (108 females, 76 males) at the mean age at the time of surgery of 59 years. Questionnaires were delivered to the subjects 2 weeks before the surgery and 6 months after the operation (by mail). Results. Patients after hip replacement showed significant improvement in health-related quality of life in most domains of SF-36 score and summary scale of PCS (Physical Component Summary Scale) and MCS (Mental Component Summary Scale). They also showed improvement in mental status. Elderly patients were more likely to show worse score in MCS and PCS before and after surgery. BMI (body mass index) was correlated only with preoperative PCS. Mental status was associated with postoperative PCS and MCS. Patients who were satisfied with the results of the surgery showed higher PCS and MCS score. Conclusion. Hip replacement surgery brings significant improvement to the quality of life. Age and mental status of those patients influence markedly their postoperative performance.

Sense of coherence in patients after limb amputation and in patients after spine surgery

Objective. To assess the score of SOC (sense of coherence), BDI (Beck Depression Scale), STAI ( State and Trait Anxiety Inventory) in three examined groups and correlation of SOC score with sociodemographic data, anxiety and depression. Methods. The SOC, BDI, STAI questionnaires were given to 51 patients after limb amputation, 65 patients after vertebral surgery because of chronic back pain and 40 persons in the control group. Results. Patients after limb amputation achieved the same level of SOC score as the control group. Patients who had higher results on the SOC score rarely suffered from phantom pain. Patients after spine surgery had a lower level on the SOC score than the control group. A lower score of SOC was observed in older, unemployed, poorer educated, subjects taking medicine, who did not report improvement after operation. Patients after limb amputation and patients after spinal surgery were more depressed and anxious than healthy people. Conclusion. Patients with higher SOC results, in both examined groups, were less depressed and anxious.

[Personality types in patients after vertebral surgery]

AIM

To compare personality types in patients after vertebral surgery.

METHOD

74 patients after vertebral surgery were examined with the MPI. 22 patients were operated because of injury. 52 patients were operated because of chronic pain back. The control group consisted of 20 healthy people. Maudsley Personality Inventory created by Eysenck, was used to study personality types.

RESULTS

There were no differences in personality types between patients suffering from chronic back pain and patients operated because of injury. Statistically, a significantly higher score in the N scale was noticed in the group with chronic back pain in comparison to patients operated because of injury and in comparison to the control group.

CONCLUSIONS

A higher score in the N scale observed in patients suffering from chronic back pain, may suggest a specific personality type of those patients. Higher level of neuroticism may create some difficulties in the acceptation of the illness and adaptation process. It is necessary to take special psychological care of those patients.

[Sociodemographic factors and their influence on anxiety and depression in patients after limb amputation]

AIM

The aim of this study was to assess the score of HADS and the correlation with sociodemographic factors and personality traits in patients after limb amputation.

METHOD

45 patients after limb amputation due to atherosclerosis and 30 persons from a control group participated in the study. HADS Scale and the Maudsley Personality Inventory created by Eysenck were used in the study. Socidemographic data were collected by means of the Sociodemographic data questionnaire.

RESULTS

In comparison to the control group, patients after limb amputation achieved a higher score in HADS-A and HADS-D and in the N scale of the Maudsley Personality Inventory. Higher levels of anxiety and depression were noticed in patients suffering from phantom limb pain and in patients with neurotic personality traits.

CONCLUSION

Patients after limb amputation need multidisciplinary care because of higher levels of anxiety and depression (especially patients with phantom limb pain and those with neurotic personality traits).

[Sociodemographic data and their influence on anxiety and depression in patients after spine surgery]

AIM

The aim of this study was to assess the score of HADS and the correlation with sociodemographic data in patients after spine surgery.

MATERIAL

40 patients after spine surgery because of low back pain and 20 persons of control group participated in the study.

METHODS

HADS was used in the study. Socidemographic data were collected by means of Socio-demographic data questionnaire.

RESULTS

Patients after spine surgery had worse results in HADS-A and HADS-D in comparison to control group. Men, older, worse-educated, unemployed, reporting more concomitant disease and medicine taking patients were more depressed. Anxiety correlated with age, education, tacking medicine and improvement after surgery.

CONCLUSION

Patients after spine surgery need multidisciplinary care because of higher level of anxiety and depression.

[Selected aspects relative to somatoform disorders]

This article addresses somatoform disorders, which remain a challenging problem in contemporary psychiatry. Inadequate responses to stressors play a significant role in their development. The term "somatoform disorders" refers to illnesses that were previously termed "psychosomatic". This article defines disorders according to the ICD-10 classification while highlighting important differences between this and the DSM-IV classification. The article reviews expert opinions concerning somatoform disorders, particularly in regard to somatization, hypochondriasis and autonomic dysfunction in these conditions. Attention is drawn to the relationship between somatoform disorders and other psychiatric conditions including depression, anxiety disorders and personality disorders as well as to actual non-psychiatric illnesses. The influence of cultural background, sex and age is discussed. Difficult clinical conditions such as fibromyalgia and Münchhausen syndrome are also considered.

[Sense of coherence in alcohol dependent males treated in departments of alcohol detoxication and rehabilitation--initial report]

The aim of this study was a comparison of the sense of coherence in the group of alcohol dependent male patients, with and without selecting psychosocial effects of alcoholism. The examined group consisted of 55 males treated in departments of alcohol detoxication and rehabilitation in Mental Hospital in Toszek. The SOC--29 scale by Antonovsky was used in order to estimate the sense of coherence and specific questionnaire was used to show selecting psychosocial effects of alcoholism. SOC level was significantly higher in the group of men without psychosocial consequences of alcohol dependence.