6 research outputs found
Correlation Between Chronic Somatic Co-morbidities and Prognosis of Major Depressive Disorder
No full textIntroductionDepression and somatic disorders are closely interrelated. Depressed mood is recognized to contribute to the development and progression of wide range of somatic diseases, while at the same time somatic diseases may increase the risk of depression. Co-morbidity research still represents huge research and clinical challenge to contemporary psychiatry and medicine.ObjectivesTo check whether the correlation of NSC and poor prognosis of MDD treatment is merely the consequence of age and duration of illness.MethodsWe investigated a cross-sectional sample consisting of 290 psychiatric diagnosed with MDD. Outcome was the number of psychiatric rehospitalizations (NPR) since the first diagnosis of MDD treatment success. Predictor was NSC. Covariates controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of MDD, CGI-severity of MDD at diagnosis, treatment with antidepressants and anti-psychotics.ResultsAfter adjustment for all confounders, mediation analysis revealed insignificant indirect effects of NSC on NPR through patient's age (P = 0.296) and duration of MDD (P = 0.180). Direct effect of NSC was significant and clinically relevant (P < 0.001). Effect of NSC was significantly moderated by duration of MDD (P = 0.019). NSC and NPR were not significantly associated if MDD lasted for less than a year. The more MDD lasted the stronger was correlation of NSC and NPR.ConclusionCorrelation of NSC and poor prognosis of MDD is not a mere consequence of patient's age and duration of illness. To treat MDD effectively we have to treat simultaneously somatic comorbidities.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec
Comparison of ten-years risk of fatal cardiovascular events calculated by heartscore in diabetic patients with and without post-traumatic stress disorder (PTSD) comorbidity
No full textIntroductionCardiovascular diseases (CVD) are the leading cause of death and disability-adjusted life years lost globally. Recent studies have shown that post-traumatic stress disorder (PTSD) predicts higher risk of cardiometabolic diseases, specifically cardiovascular disease and diabetes type 2.AimsTo assess cardiovascular event risk differences between diabetic patients with and without PTSD comorbidity.ObjectivesTo explore a ten-year risk of fatal CVD events in diabetic patients with and without PTSD; to gain better insight in potential different functioning patterns in these patient subgroups.MethodsWe investigated a cross-sectional sample consisting of 390 psychiatric inpatients and outpatients. Ten-years risk of fatal CVD events calculated by HeartScore, European society of cardiology. Europe high-risk version was used. The risk estimation is made based on: gender, age, smoking, systolic blood pressure and total cholesterol.ResultsBy analysis of covariance, we controlled possible confounding effects of gender, age, education, marital status, number of household members, work status, average monthly income per household member, body mass index (kg/m2), number of somatic comorbidities, number of psychiatric comorbidities, duration of PTSD, clinical global impression scale–severity of PTSD at diagnosis. After the adjustment for all these variables, interaction of PTSD and T2DM was significantly associated with CVD risk (P < 0.001; Eta2 = 0.04).ConclusionA significant fatal CVD event risk differences between diabetic patients with and without PTSD comorbidity were found. Better awareness of possible underlying determinants provides better optimal individual approach planning, likewise effective prevention and control of cardiovascular diseases.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec
Chronic Somatic and Psychiatric Co-morbidities are Associated with Psychiatric Treatment Success; A Nested Cross-sectional Study
No full textIntroductionA rich body of literature dealt with somatic comorbidities of psychiatric illnesses. However, relatively few explored the association of somatic and psychiatric comorbidities with psychiatric treatment success.ObjectiveObjective of this analysis was to explore chronic somatic and psychiatric comorbidities association with the average number of psychiatric re-hospitalisations annually.MethodsThis cross-sectional analysis was done on the baseline data of prospective cohort study “Somatic comorbidities in psychiatric patients” started during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia. We included 798 patients. Outcome was the average number of psychiatric re-hospitalisations annually since the diagnosis. Predictors were number of chronic somatic and psychiatric comorbidities. Covariates that we controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of primary psychiatric illness, CGI–severity at diagnosis, treatment with antidepressants and antipsychotics.ResultsInteraction of somatic and psychiatric comorbidities was the strongest predictor of the average number of psychiatric re-hospitalisations annually (P < 0.001). Mean number of re-hospitalisations annually adjusted for all covariates, was increasing from 0.60 in patients with no chronic comorbidities, up to 1.10 in patients with ≥ 2 somatic and ≥ 2 psychiatric comorbidities.ConclusionSomatic and psychiatric comorbidities are independently associated with the psychiatric treatment success. Further studies should look at possible causal pathways between them, and interdisciplinary treatment of psychiatric patients is urgently needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec
REMISSION AND EMPLOYMENT STATUS IN SCHIZOPHRENIA AND OTHER PSYCHOSES: ONE-YEAR PROSPECTIVE STUDY IN CROATIAN PATIENTS TREATED WITH RISPERIDONE LONG ACTING INJECTION
No full textBackground: While numerous studies have confirmed the efficacy of risperidone long-acting injectable (RLAI) on many clinical
outcomes in patients with schizophrenia, there is no data regarding its influence on employment status.
Subject and methods: This was a 12-month observational study with flexible doses of RLAI on a Croatian population of patients
with schizophrenia and other psychoses. Visits were at baseline and after 1, 3, 6 and 12 months of treatment. Treatment response
was evaluated using Clinical Global Impression of Illness Severity (CGI-S) and Improvement (CGI-I) scales, while remission was
defined by 8 items of Positive and Negative Syndrome Scale (PANSS). Employment status was determined at baseline and at study
endpoint.
Results: A total of 362 patients were included, with a median age of 37 (interquartile range 29-47) years, 63.5 % were males and
67.4% were hospitalised at baseline. Overall 258 (71.3%) patients completed the study. Improvements in CGI-S scores from baseline
were significant (
Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; a cross-sectional study in Croatia
No full textAbstractBackground:Increased physical morbidity in patients with schizophrenia spectrum disorders (SSDs) is well documented. However, much less is known about the association between somatic comorbidities and psychosis treatment outcomes.Subjects and methods:This cross-sectional study, nested within the larger frame of a prospective cohort study, was done in 2016 at Psychiatric Hospital Sveti Ivan, Zagreb, Croatia. Data were collected on a consecutive sample of 301 patients diagnosed with schizophrenia spectrum disorders who achieved a stable therapeutic dosage. Key outcome was the number of psychiatric rehospitalizations since diagnosis of the primary psychiatric illness. Predictors were number of physical and psychiatric comorbidities. By robust regression, we controlled different clinical, sociodemographic, and lifestyle confounding factors.Results:The number of chronic somatic comorbidities was statistically significantly associated with a larger number of psychiatric rehospitalizations, even after the adjustment for number of psychiatric comorbidities and large number of other clinical, sociodemographic, and lifestyle variables.Conclusions:Chronic somatic comorbidities are associated with higher rates of psychiatric rehospitalization independently of psychiatric comorbidities and other clinical, sociodemographic, and lifestyle factors. Therefore, to treat psychosis effectively, it may be necessary to treat chronic somatic comorbidities promptly and adequately. Chronic somatic comorbidities should be considered equally important as the SSD, and should be brought to the forefront of psychiatric treatment and research with the SSD as one entity. The integrative approach should be the imperative in clinical practice.</jats:sec
Somatic comorbidities are associated with poorer treatment outcome in schizophrenia spectrum disorders, independently of psychiatric comorbidities and other clinical factors
No full textIntroductionIncreased somatic morbidities in schizophrenic patients and their association with HRQoL are well documented. Less is known about their association with schizophrenia treatment outcome.ObjectiveTo explore whether the number of somatic comorbidities is associated with poorer psychosis treatment outcome independently of psychiatric comorbidities and other clinical and socio-demographic parameters.AimTo improve understanding of association of somatic morbidities on treatment outcome of schizophrenic patients.MethodsThis nested-cross-sectional study was done during 2016 at Psychiatric hospital Sveti Ivan, Zagreb-Croatia on the sample of 301 patients diagnosed with schizophrenia spectrum disorder. Outcomes were the number of psychiatric rehospitalizations since primary psychiatric diagnosis and the composite of significant improvement measured by CGI-S and the best self-rated health defined as 4th quartile of EQ-5D-5L VAS. Predictors were number of somatic and psychiatric comorbidities. By logistic regression, we controlled socio-demographic and clinical confounders.ResultsHaving two or more somatic comorbidities was significantly associated with the failure to achieve the composite of improvement. The number of somatic comorbidities was significantly associated with increase in psychiatric hospitalizations, even after the adjustment for psychiatric comorbidities and large number of clinical and socio-demographic variables.ConclusionsChronic somatic comorbidities are associated with poorer psychosis treatment outcome independently of psychiatric comorbidities and other factors. Therefore, to treat psychosis effectively it may be essential to treat chronic somatic comorbidities promptly and adequately. The integrative approach should be the imperative in clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec
