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Diabetes and mental health : graduate thesis
No full textŠećerna bolest globalna je epidemija i jedan od vodećih izazova za javno zdravstvo u današnjem društvu. Njezin razvoj uvelike se povezuje s promjenama u načinu života, kao što su smanjena tjelesna aktivnost, konzumacija visokokalorične hrane te porast učestalosti pretilosti. Rizik od komplikacija šećerne bolesti povećava se s trajanjem bolesti. Mnogi pacijenti ne znaju da boluju od DM dok se ne razviju komplikacije. Kronične komplikacije dijabetesa mogu se podijeliti na mikrovaskularne i makrovaskularne, pri čemu su mikrovaskularne komplikacije češće prisutne od makrovaskularnih. Osim fizičkih posljedica, šećerna bolest kao kronična bolest uvelike utječe i na mentalno zdravlje bolesnika te na smanjenje kvalitete života pojedinca i njegove obitelji. Suočavanje s dijabetesom donosi različite izazove koji se tiču samog dijabetesa, kao što su osjećaj opterećenosti pridržavanjem dijabetičkog režima, zabrinutost zbog budućnosti i mogućih komplikacija, te osjećaj krivnje kada upravljanje bolešću ne ide uspješno. Šećerna bolest kao kronična, doživotna bolest predstavlja složen teret za samonadzor i izazov za svakog pojedinca. Oko trećine ljudi s DM ima psihološke i/ili socijalne probleme koji ometaju njihovu sposobnost samostalnog upravljanja dijabetesom. Osobe koje boluju od DM izložene su većem riziku od distresa uvjetovanog dijabetesom, depresije, anksioznosti i poremećaja prehrane.
Mentalni komorbiditeti šećerne bolesti otežavaju pridržavanje liječenja te kada se pravovremeno ne dijagnosticiraju i ne liječe povećavaju rizik od ozbiljnih posljedica za zdravlje bolesnika.Diabetes is a global epidemic and one of the leading public health issues in contemporary society. Its development is significantly influenced by lifestyle changes associated with reduced physical activity, consumption of high-calorie foods, and the increasing prevalence of obesity. The risk of diabetes complications increases with the duration of the disease. Since many patients are unaware that they have diabetes, numerous individuals already have developed complications by the time they are diagnosed. Chronic complications of diabetes can be divided into microvascular and macrovascular, with microvascular complications being more prevalent than macrovascular ones. Besides physical consequences, diabetes as a chronic illness greatly impacts the mental health of patients and reduces the quality of life for both the individual and their family. Managing diabetes presents various challenges, such as the burden of adhering to diabetic regimes, concerns about the future and potential complications, and feelings of guilt when disease management is unsuccessful. Diabetes, as a lifelong chronic disease, poses a complex burden for self-monitoring and is a challenge for every individual. Approximately one-third of people with diabetes experience psychological and/or social issues that interfere with their ability to manage diabetes independently. Individuals with diabetes are at a higher risk for diabetes-related distress, depression, anxiety, and eating disorders. Mental comorbidities of diabetes complicate adherence to treatment and, when not timely diagnosed and treated, increase the risk of serious health consequences for the patient
Comparison of conservative treatment and operative treatment of anterior cruciate ligament rupture and the results of different operative techniques - a review paper
No full textPrednji križni ligament važan je ligament koljena, često ozlijeđen kod sportaša, najčešće zbog beskontaktne rotirajuće ozljede. Pristup varira ovisno o težini ozljede, aktivnosti bolesnika te dostupnim resursima. Čimbenici koji predviđaju uspješan povratak sportu su simetrično izvedeni test skakanja, mlađa dob, muški spol, profesionalno bavljenje sportom te pozitivni psihološki pogled. Nekompletna ruptura ACL-a se može tretirati neoperativno rehabilitacijom. Odabir grafta kod operativnog pristupa je debatirana tema, gdje čimbenici poput anamneze bolesnika, resursi te edukacija kirurga igraju ulogu. Autograftovi imaju prednost brže integracije, manji rizik ponovne ozljede te nemaju rizik infekcije, dok alograftovi imaju prednost kraćeg trajanja operacije, nemaju problema donorskog mjesta te je moguć pristup raznim veličinama tetiva. Najbolji trenutak za rekonstrukciju ACL-a ovisi o čimbenicima stanja ozlijeđenog koljena poput potpuni opseg kretnji, bez oteknuća i adekvatna snaga. Prerehabilitacija je preporučena, no značajno odgođena rekonstrukcija može povećati rizik za daljnju ozljedu koljena. Kratkoročne komplikacije operativnog pristupa su infekcije i duboka venska tromboza, dok dugoročne komplikacije su OA koljena, artrofibroza, propadanje grafta te ponovna ozljeda. Principi rehabilitacije su dostizanje ciljeva poput potpunog opsega pokreta i adekvatne snage i propriocepcije koji se dostižu vježbama zatvorenog lanca te vježbama specifičnim za sport. Rizik za nastanak OA je multifaktorijalan, po utjecajem čimbenika poput težine primarne traume, konkominantna ozljeda meniskusa, kvaliteta kirurške rekonstrukcije te starost, aktivnost i biomehanika koljena samog bolesnika.The anterior cruciate ligament is an important ligament of the knee, often injured in athletes, most often due to a non-contact pivoting injury. The approach varies depending on the severity of the injury, the activity of the patient, and the available resources. Factors that predict a successful return to sports are a symmetric performance of unilateral hopping exercises, younger age, male gender, playing sports at an elite level, and a positive psychological outlook. Incomplete rupture of the ACL can be treated non-operatively. The choice of graft in the operative approach is a debated topic, where factors such as the patient's history, resources, and the surgeon's education play a role. Autografts have the advantage of faster integration, lower risk of re-injury, and no risk of infection, while allografts have the advantage of a shorter duration of surgery, no donor site problems, and access to various tendon sizes. The best time for ACL reconstruction depends on factors of the condition of the injured knee, like full range of motion, no swelling, and adequate strength. Pre-rehabilitation is recommended, but significantly delayed reconstruction may increase the risk of further knee injury. Short-term complications of the operative approach are infections and deep vein thrombosis, while long-term complications are knee OA, arthrofibrosis, graft failure and re-injury. The principles of rehabilitation are to achieve goals such as full range of motion and adequate strength and proprioception, which are achieved through closed-chain exercises and sport-specific exercises. The risk of OA is multifactorial influenced by factors such as the severity of the primary trauma, concomitant meniscus injury, the quality of the surgical repair, and the age, activity and biomechanics of the patient's own knee
Association of personality disorder and bipolar disorder type I
No full textUdruženost poremećaja osobnosti s bipolarnim poremećajem predstavlja složen fenomen u području mentalnog zdravlja. Bipolarni poremećaj, poznat po cikličkim epizodama manije i depresije, može biti dodatno kompliciran prisustvom poremećaja ličnosti. Poremećaj osobnosti karakteriziraju duboki i trajni obrasci ponašanja, mišljenja i funkcioniranja koji često ometaju međuljudske odnose i svakodnevno funkcioniranje. Kada se ova dva poremećaja udruže, simptomi mogu biti izraženiji, a dijagnostika i terapija složenija što utječe na tijek bolesti i ishode liječenja. Osobe s ovim udruženjem često imaju teže epizode manije i depresije, veći rizik od samoubojstva te poteškoće u održavanju stabilnih interpersonalnih odnosa. Kako bi se uspješno nosili s ovim izazovom, ključno je prilagoditi terapijski pristup potrebama svakog pojedinca. To uključuje kombinaciju farmakoterapije, psihoterapije i psihosocijalne podrške. Osim toga, važno je kontinuirano pratiti i prilagođavati terapiju kako bi se osiguralo da pacijenti dobiju optimalnu podršku i poboljšaju kvalitetu svog života.The comorbidity of personality disorders with bipolar disorder represents a complex phenomenon in the field of mental health. Bipolar disorder, known for its cyclical episodes of mania and depression, can be further complicated by the presence of personality disorders. Personality disorders are characterized by deep and enduring patterns of behavior, thinking, and functioning that often interfere with interpersonal relationships and daily functioning. When these two disorders co-occur, symptoms can be more pronounced, and treatment becomes more complex. Individuals with this comorbidity often experience more severe episodes of mania and depression, a higher risk of suicide, and difficulties in maintaining stable interpersonal relationships. To successfully address this challenge, it is crucial to tailor the therapeutic approach to the needs of each individual. This includes a combination of pharmacotherapy, psychotherapy, and psychosocial support. Additionally, it is important to continuously monitor and adjust treatment to ensure that patients receive optimal support and improve their quality of life
Hepatocellular carcinoma as a complication of liver cirrhosis
No full textHepatocelularni karcinom (HCC) najčešći je tip primarnog raka jetre i često se razvija kao
komplikacija ciroze jetre (1). Ciroza, koja podrazumijeva kronično oštećenje jetre i formiranje
ožiljnog tkiva, značajno povećava rizik za razvoj HCC-a. Glavni uzroci ciroze uključuju
kronični hepatitis B i C, alkoholnu bolest jetre, te nealkoholnu masnu bolest jetre (NAFLD)
(13). Patogeneza HCC-a u kontekstu ciroze uključuje kompleksne mehanizme poput
regenerativne hiperplazije hepatocita, upalnih procesa i oksidativnog stresa, koji mogu
uzrokovati genetičke mutacije i maligne transformacije (20). Simptomi HCC-a često su nejasni
u ranim fazama, uključujući umor, gubitak težine, bol u gornjem dijelu trbuha i žuticu.
Dijagnoza HCC-a obično se postavlja kombinacijom slikovnih metoda (ultrazvuk, CT, MR) i
laboratorijskih testova, uključujući mjerenje alfa-fetoproteina (AFP) u krvi (36). Liječenje ovisi
o stadiju bolesti i može uključivati kirurško uklanjanje tumora, transplantaciju jetre, lokalne
ablacije, transarterijsku kemoembolizaciju i radioembolizaciju, te sistemsku terapiju ciljanim
lijekovima (36, 68). Prognoza HCC-a često je loša zbog kasne dijagnoze i prisutnosti osnovne
ciroze, ali rano otkrivanje i napredne terapijske opcije mogu poboljšati ishod. Redoviti probir
bolesnika s cirozom je ključan za rano otkrivanje HCC-a i povećanje mogućnosti za učinkovito
liječenje.Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and often
develops as a complication of liver cirrhosis. Cirrhosis, which involves chronic liver damage
and the formation of scar tissue, significantly increases the risk of developing HCC. The main
causes of cirrhosis include chronic hepatitis B and C, alcoholic liver disease, and non-alcoholic
fatty liver disease (NAFLD). The pathogenesis of HCC in the context of cirrhosis involves
complex mechanisms such as regenerative hyperplasia of hepatocytes, inflammatory processes,
and oxidative stress, which can cause genetic mutations and malignant transformations. The
symptoms of HCC are often vague in the early stages, including fatigue, weight loss, upper
abdominal pain, and jaundice. The diagnosis of HCC is usually established through a
combination of imaging methods (ultrasound, CT, MRI) and laboratory tests, including the
measurement of alpha-fetoprotein (AFP) in the blood. Treatment depends on the stage of the
disease and may include surgical removal of the tumor, liver transplantation, local ablations,
transarterial chemoembolization, radioembolization, and systemic therapy with targeted drugs.
The prognosis of HCC is often poor due to late diagnosis and the presence of underlying
cirrhosis, but early detection and advanced therapeutic options can improve outcomes. Regular
screening of patients with cirrhosis is crucial for the early detection of HCC and increasing the
chances for effective treatment
Clinical features of patients with anti-synthetase syndrome
No full textAnti-sintetaza sindrom je autoimuna sistemska bolest iz spektra idiopatskih upalnih miopatija. Ovom restrospektivnom studijom na uzorku od 16 ispitanika sa dijagnosticiranim ASS koji su liječeni na Zavodu za reumatologiju i kliničku imunologiju KBC-a Rijeka u periodu od travnja 2018. godine do listopada 2023. godine dokazano je da se bolest dva puta češće javlja u žena nego u muškaraca. Nadalje, ASS se može prvom simptomatologijom javiti u bilo kojoj životnoj dobi, međutim, najviše ispitanika se prezentiralo između 30 i 70 godine života. Od kliničkih karakteristika, najviše ispitanika imalo je prisutan artritis, miozitis i/ili ILD, dok su ”mehaničarske” ruke, Raynaudov fenomen, febrilitet i disfagija, bile su zastupljene u manjeg broja ispitanika. Miozitis se češće javljao u pacijenata s pozitivnim anti-Jo-1 protutijelima, dok se ILD češće javljala u pacijenata s pozitivnim anti-PL-7 protutijelima. Prije postavljanja dijagnoze i uvođenja terapije, većina ispitanika imala je blago povišene vrijednosti upalnih parametara (SE i CRP), blago povišene vrijednosti LDH te znatno povišene vrijednosti CK. Većina ispitanika imala je pozitivno samo jedno protutijelo, dok je samo jedan ispitanik imao pozitivna dva protutijela. Najviše ispitanika bilo je pozitivno na anti-Jo-1 protutijelo, dok su ostali ispitanici imali pozitivno anti-PL-7 ili anti-PL-12 protutijelo. Miozitis se prvenstveno dijagnosticirao na temelju anamneze, fizikalnog pregleda i povišenih vrijednosti CK, dok su EMNG i biopsija mišića provedene u manjeg broja ispitanika. S druge strane, HRCT čini zlatni standard u postavljanju dijagnoze ILD-a. Na HRCT-u su najčešće bili zastupljeni NSIP i UIP uzorak, dok je OP uzorak bio zastupljen u manjeg broja ispitanika. Pacijentima s ASS su kao prva linija liječenja uvedeni GK, a kako bi se s vremenom smanjila doza GK, u terapiju se mogu dodavati MTX, RTX, AZA, MMF i Cs.Anti-synthetase syndrome is an autoimmune systemic disease from the spectrum of idiopathic inflammatory myopathies. This retrospective study on a sample of 16 subjects diagnosed with ASS who were treated at the Department of Rheumatology and Clinical Immunology of CHC Rijeka in the period from April 2018 to October 2023 proved that the disease occurs twice as often in women than in men. Furthermore, ASS can present its first symptoms at any age, however, most subjects presented between 30 and 70 years of age. Of the clinical characteristics, most subjects had arthritis, myositis and/or ILD, while "mechanic" hands, Raynaud's phenomenon, febrility and dysphagia were present in a smaller number of subjects. Myositis occurred more often in patients with positive anti-Jo-1 antibodies, while ILD occurred more often in patients with positive anti-PL-7 antibodies. Before the diagnosis and introduction of therapy, most of the subjects had slightly elevated values of inflammatory parameters (SE and CRP), slightly elevated LDH values, and significantly elevated CK values. Most of the subjects had only one positive antibody, while only one subject had two positive antibodies. Most subjects were positive for anti-Jo-1 antibody, while the rest of the subjects had positive anti-PL-7 or anti-PL-12 antibody. Myositis was primarily diagnosed based on history, physical examination and elevated CK values, while EMNG and muscle biopsy were performed in a smaller number of subjects. On the other hand, HRCT is the gold standard in the diagnosis of ILD. On HRCT, NSIP and UIP patterns were most often represented, while OP pattern was represented in a smaller number of subjects. Patients with ASS are given GK as the first line of treatment, and in order to reduce the dose of GK over time, MTX, RTX, AZA, MMF and Cs can be added to the therapy
Comparison of conservative and surgical treatment of meniscal lesions and results of treatment after meniscectomy
No full textMenisci su vezivno-hrskavične strukture polumjesečastog oblika smještene unutar zglobne šupljine koljena. Imaju izuzetno važnu ulogu u biomehanici koljena, zaštiti zglobne hrskavice i stabilnosti koljena. Lezije meniska predstavljaju najčešću ozljedu koljena te su ujedno i najčešći razlog izvođenja operacijskog zahvata na istom. Dijagnostički postupak lezija meniska sastoji se od anamneze, kliničkog pregleda, kliničkih testova, MRI i artroskopije koljena. Liječenje lezija meniska može biti konzervativno i operativno. Konzervativno liječenje podrazumijeva primjenu fizikalne terapije, redukciju tjelesne mase te promjenu stila života. Operativno liječenje lezija meniska danas se izvodi artroskopski, a podrazumijeva šivanje meniska, parcijalnu ili totalnu meniscektomiju, rekonstrukciju te transplantaciju meniska. Parcijalna i totalna meniscektomija se nastoje izbjeći kada postoji mogućnost šivanja meniska te kad se izvode pokušava se da bude što je više moguće poštedna zbog dokazanog ubrzanog razvoja OA nakon meniscektomije. Šivanje meniska je metoda izbora kod operativnog liječenja lezija meniska u svrhu očuvanja njegove cjelovitosti. Razlikujemo tri metode šivanja meniska, iznutra prema van, izvana prema unutra i sve unutra. Izbor metode šivanja ovisi o vrsti, lokaciji, opsežnosti i izgledu lezije. Rekonstrukcija i transplantacija meniska predstavljaju ugradnju sintetskih biorazgradivih nosača ili kadaveričnog meniska koji zamjenjuju parcijalno ili totalno reseciran menisk. Najčešće korišteni sintetski nosači jesu kolagenski i poliuretanski.Menisci are fibrocartilaginous anatomical structures with a crescent shape located inside the joint cavity, with an emphasis on the knee joint. They play an extremely important role in the biomechanics of the knee, the protection of the articular cartilage and in the stability of the knee. Lesions of the meniscus represent the most common knee injury and are also the most common reason for knee surgery. The diagnostic procedure for meniscal lesions consists of anamnesis, clinical examination, clinical tests, MRI and arthroscopy. Treatment of meniscal lesions can be conservative or operative. Conservative treatment involves the use of physical therapy, weight reduction and lifestyle changes. Operative treatment of meniscal lesions today is performed arthroscopically, and includes meniscal suturing, partial or total meniscectomy, reconstruction and meniscal transplantation. Partial and total meniscectomy are rarely performed today, and when they are performed, these procedures are as sparing as possible due to the proven accelerated development of OA after meniscectomy. Suturing of the meniscus is the method of choice in the operative treatment of meniscus lesions in order to preserve its integrity. There are three main methods of suturing: from the inside out, from the outside in and all in. The choice of suturing method depends on the type, location, extension and appearance of the lesion. Meniscus reconstruction and transplantation represents the installation of synthetic biodegradable supports or cadaveric meniscus that replace a partially or totally resected meniscus. The most commonly used synthetic supports are collagen and polyurethane
Genetics of cardiomyopathies
No full textKardiomiopatije su skupina bolesti srčanog mišića koje mogu dovesti do srčanog zatajenja, aritmija i iznenadne srčane smrti. Genetička osnova kardiomiopatija je značajna, s mnogim slučajevima koji se nasljeđuju autosomno dominantno. Glavne vrste kardiomiopatija na koje utječe genetika uključuju hipertrofičnu kardiomiopatiju (HCM), dilatativnu kardiomiopatiju (DCM), restriktivnu kardiomiopatiju (RCM) i aritmogenu desnu ventrikularnu kardiomiopatiju (ARVC). HCM je često povezana s mutacijama u genima koji kodiraju sarkomerne protein kao što su MYH7 i MYBPC3. Ove mutacije dovode do abnormalnog rasta stanica srčanog mišića i zadebljanja septuma. Nadalje, genetičke mutacije koje utječu na protein citoskeleta, sarkomere i nuklearne ovojnice (npr. TTN, LMNA) često su uključene u DCM. Ove mutacije uzrokuju oslabljenje srčanog mišića i proširenje srčanih komora. Genetički uzroci RCM-a su manje definirani, ali mogu uključivati mutacije u sarkomernim proteinima i onima povezanima sa sistemskim bolestima poput amiloidoze. ARVC često je povezana s mutacijama u dezmosomnim proteinima (npr. PKP2, DSP), što dovodi do zamjene srčanog mišića masnim i vlaknastim tkivom, prvenstveno u desnoj klijetki. Genetičko testiranje igra ključnu ulogu u dijagnozi i liječenju kardiomiopatija. Pomaže u identificiranju osoba koje su u riziku, usmjerava kliničko upravljanje i informira članove obitelji o njihovom potencijalnom riziku. Rana dijagnoza putem genetičkog skrininga omogućava pravovremene intervencije, uključujući promjene životnog stila, lijekove i upotrebu ugradbenih uređaja za prevenciju teških komplikacija. Razumijevanje genetičkih temelja kardiomiopatija otvara vrata personaliziranoj medicini. Liječenje se može prilagoditi na temelju specifičnih genetičkih mutacija, poboljšavajući učinkovitost i ishode. Istraživanja u genskoj terapiji i regenerativnoj medicini daju nadu za buduće mogućnosti liječenja, potencijalno ispravljajući genetičke defekte na molekularnoj razini. Genetika kardiomiopatija je brzo razvijajuće područje koje značajno utječe na dijagnozu, upravljanje i strategije liječenja. Stalna istraživanja su ključna za otkrivanje više o genetičkim mehanizmima uključenim u ove bolesti i za razvoj inovativnih terapija koje mogu poboljšati kvalitetu života pacijenata s ovim izazovnim stanjima.Cardiomyopathies are a group of heart muscle diseases that can lead to heart failure, arrhythmias, and sudden cardiac death. The genetic basis of cardiomyopathies is significant, with many cases being inherited in an autosomal dominant pattern. The main types of cardiomyopathies influenced by genetics include hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM), and arrhythmogenic right ventricular cardiomyopathy (ARVC). HCM is commonly associated with mutations in genes encoding sarcomeric proteins such as MYH7 and MYBPC3. These mutations lead to abnormal cardiac muscle cell growth and thickening of the heart walls. Genetic mutations affecting the cytoskeleton, sarcomere, and nuclear envelope proteins (e.g., TTN, LMNA) are frequently implicated in DCM. These mutations cause weakened heart muscles and enlarged heart chambers. Genetic causes of RCM are less well-defined but can include mutations in sarcomeric proteins and those associated with systemic diseases like amyloidosis. ARVC is often linked to mutations in desmosomal proteins (e.g., PKP2, DSP), leading to replacement of heart muscle with fatty and fibrous tissue, primarily in the right ventricle. Genetic testing plays a crucial role in the diagnosis and management of cardiomyopathies. It helps identify at-risk individuals, guides clinical management, and informs family members about their potential risk. Early diagnosis through genetic screening allows for timely interventions, including lifestyle modifications, medications, and the use of implantable devices to prevent severe complications. Understanding the genetic underpinnings of cardiomyopathies opens the door to personalized medicine. Treatments can be tailored based on specific genetic mutations, improving efficacy and outcomes. Research in gene therapy and regenerative medicine holds promise for future treatment options, potentially correcting genetic defects at the molecular level
Panhypopituitarism caused by a suprasellar germinoma: A case report
No full textBACKGROUND Suprasellar germinomas are rare intracranial tumors frequently associated with permanent endocrine disorders. We present the clinical picture, treatment, and complications of suprasellar germinoma at pediatric age which, besides being life-threatening, has lifelong endocrinological consequences. CASE SUMMARY A 12-year-old female patient was presented having had intensive headaches for three weeks and visual disturbances for six months. An ophthalmological examination revealed bilateral papilledema and a marked loss of vision. Emergency brain magnetic resonance imaging (MRI) showed a suprasellar tumor, involving the infundibulum and the optic chiasm, extending to the third ventricle. Laboratory tests confirmed decreased levels of thyroxine, cortisol, gonadotropins, and insulin-like growth factor 1. Maximal tumor reduction was performed, and immunohistopathology established the diagnosis of suprasellar germinoma. MRI of the spine and cerebrospinal fluid cytology confirmed the localized disease. Adjuvant chemotherapy and radiotherapy were performed according to the SIOP CNS GCT II protocol. A post-treatment MRI showed no residual tumor, but pituitary function had not recovered. Three and a half years after the end of the treatment, the patient is in a complete remission, requiring hormonal replacement therapy, continuous education, and psychological support. CONCLUSION This complex case highlights the importance of timely diagnosis, a multidisciplinary approach, and close follow-up in children with suprasellar germinomas
Meaning of Life in Secondary Abstainers from Alcohol (Abstain From Alcohol and Meaning of Life)
No full textAim: Alcoholism is a major public health problem, and it has not yet been clarified which are the factors that influence the relapse of the disease. Aim of this research is to examine whether there is a connection between meaning of life in secondary abstainers from alcohol and variables (demographic, alcohol consumption and severity of addiction before abstinence) and to determine which variables are predictors of the meaning of life in secundary abstainers. Subjects and methods: The research was conducted in 2019 and 2020 at the County Hospital of Požega, at the Department of Neurology, Psychiatry and Clinical Psychology. 113 adults participated in this research who were diagnosed with alcohol addiction and are currently abstaining from alcohol. Results: Meaning of life in the examined addicts in abstinence is low positively related to the length of abstinence (p = 0.030), low negative with the number of hospitalizations due to alcohol addiction (p = 0.013), moderately negative with the severity of alcohol addiction before abstinence (p < 0.001) and moderately positive with financial status (p < 0.001). Hierarchical regression analysis showed that beeing unmerried (p = 0.021), financial status (p < 0.001) and severity of addiction (p < 0.001) are significant predictors of the meaning of life among abstainers from alcohol. Conclusion: It has been shown that alcoholism affects the meaning of life for alcohol addicts, and that it should be considered at the beginning and during the treatment of alcohol addicts
ChatGPT and other Chatbots in Psychiatry
No full textAim: Artificial intelligence (AI) is making significant inroads into the field of psychiatry, offering new tools and applications. ChatGPT, a specific chatbot, is at the forefront of this digital revolution. AI’s use in psychiatry ranges from identifying psychiatric symptoms, predicting treatment responses, and improving medication adherence to assisting in patient education, monitoring, and bridging gaps in mental health care. Materials and Methods: This review used a literature study method. Results: ChatGPT functions as a clinical decision support tool. It can analyse patient data and provide diagnostic insights, recommend evidence-based treatments, and offer drug information. It has demonstrated proficiency in generating summaries from medical records, saving clinicians time and enabling them to focus on patient care. Additionally, chatbots like ChatGPT serve as therapist assistants, offering emotional support between therapy sessions and potentially conducting psychotherapy. Studies have shown positive outcomes, with chatbots reducing depression, anxiety symptoms, and providing 24/7 availability for crisis situations. Users find them non-judgmental and comfortable for discussing sensitive issues. Despite their potential, chatbots have limitations, such as the risk of incorrect or biased information due to their training data. They lack genuine understanding, creativity, and the ability to clarify user input. Ethical considerations regarding responsibility and data usage are paramount. Conclusion: AI, particularly ChatGPT, holds substantial promise in modern psychiatry, enhancing diagnostics, patient education, monitoring, and therapeutic support. Its integration into everyday psychiatric practice requires careful use, continuous oversight, and ethical considerations. Psychiatrists must become more familiar with AI tools to leverage their benefits in patient care