A sound mind in a sound body? The role of cooperation between medical specialists and patients with comorbid mental and somatic disorders

Introduction

Treatment of accompanying somatic disorders in patients with schizophrenia is a crucial issue, as those people die about 25 years earlier, compared with the general population. Moreover, premature death in this group of patients is more often caused by comorbidities than by suicide. It is worth emphasizing that cardiovascular disease itself in people with schizophrenia accounts for as much as 23% of causes of death, followed by suicides and drug toxicity. The paper presents a description of a 65-year-old patient diagnosed with schizophrenia, alcohol addiction, metabolic syndrome, and cardiac arrhythmia.

Objectives

To determine the impact of cooperation between medical specialists and a psychiatric patient on the treatment effect.

Methods

A case of a patient treated in a day ward is described. A literature search was made in the PubMed database.

Results

A patient after exacerbations of mental illness, often preceded by a return to alcohol use, tends to discontinue both psychiatric drugs and those prescribed for somatic diseases. Due to the diagnosed atrial fibrillation, sudden discontinuation of cardiac medications significantly increases the risk of life-threatening somatic complications, including stroke.

Conclusions

Diagnostic and therapeutic management in the treatment of psychiatric and somatic diseases with concurrent addiction to psychoactive substances requires interdisciplinary cooperation of medical specialists with the patient to achieve a successful outcome. Summarizing, in treatment, we must always look at the patient as a whole. Aside from caring for the mental state, the physical condition along with the possibility of cooperation on the part of the patient remains essential.

Disclosure

No significant relationships.

Comparative analysis of non-motor symptoms in patients with Parkinson's Disease and atypical parkinsonisms

OBJECTIVES

After being diagnosed with idiopathic Parkinson's Disease (IPD) or Atypical Parkinsonism (AP) patients often tend to present non-motor symptoms (NMS). The aim of the study was to explore the differences between occurrence of non-motor symptoms presented by patients with IPD and AP, including sleep, autonomic, psychotic and affective disorders.

MATERIALS AND METHOD

The study included 219 patients (184 with IPD, and 35 with AP) hospitalized between 2016 and 2019 in the Department of Neurology of the Medical University of Silesia. Non-motor symptoms were evaluated using patients' medical chart reviews and NMS questionnaire. The clinical advancement of the disease was assessed using UPDRS part III, and modified Hoehn-Yahr scale (HY).

RESULTS

There were no statistically significant differences between both IPD and AP groups within the parameters of sex, age, HY and UPDRS III OFF scales. Non-motor symptoms were presented significantly often (p = 0.003) in AP patients (n = 32, 91.4 %), then in patients with IPD (n = 122, 66.3 %). Sleep disorders were significantly more prevalent in patients with idiopathic Parkinson's disease (n = 92, 50 %) than in patients with atypical parkinsonism (n = 8, 22.86 %, p = 0.0031). However, autonomic and psychotic disorders didn't show statistically significant differences in both groups.

CONCLUSION

Non-motor symptoms are frequent in both IPD and AP which makes them an integral part of both diseases. Patients with AP are more likely to present non-motor symptoms in general, but rarely they complain of sleep disorders.