Behavioral Characteristics Of Patients Research Articles

The Link between Major Depressive Disorder & Chronic Coronary Syndrome - A Literature Review

Depression is prevalent among patients with coronary artery disease and has significant consequences. Occurrence of depression after a new diagnosis of stable angina is common and affects nearly 1 in 5 individuals. There have been several biological mechanisms by which depression may be related to coronary artery disease. As compared with nondepressed patients, those with depression have increased catecholamine levels,elevated resting heart rate, and decreased heart rate variability. . Behavioral characteristics of patients with depression include poor medication adherence, lower exercise tolerance,physical inactivity, poor dietary habits,and tobacco use. Although depression and its impact have been well documented in post-MI patients, much less is known about its significance in patients with chronic coronary syndrome(CCS).Despite the fact that CCS is the most common manifestation of coronary artery disease,sothere is a huge gap in the field of knowledge correlating CCS and depression. University Heart Journal 2023; 19(1): 26-30

Effects of psychological characteristics of patients with hypertension on their adherence to treatment. Analysis of clinical cases

Objective — to acquaint cardiologists and family medicine doctors with modern treatment approaches that take into account the psychological characteristics of patients. The professional activity of therapeutic doctors is to a large extent (especially in comparison with surgical and anesthesiology specialties) related to the need to develop communication skills, since patients differ not only in clinical features, but also in psychological traits that are revealed in the process of diagnosis and treatment. The authors performed the analysis of four clinical cases with a detailed description of socio‑demographic and behavioral characteristics of patients who ask for a cardiologist’s consultation for the purpose of correcting drug treatment. In addition to the analysis of complaints, anamnesis and data from laboratory and instrumental examinations, typical problems of communication with «difficult» patients have been described and practical recommendations were provided. Four variants of the possible behavior of patients are presented, determined by their psychological characteristics and manifested during communication with doctors of a therapeutic profile. The following psychotypes were chosen as «classical»: «expressive», «directive», «analytical» and «friendly». For the first two, a characteristic feature is the presence of a high level of authority in the process of communicating with interlocutors, and for the last two — a low level. Also, «analytical» and «directive» personalities are marked by a significantly higher degree of self‑control compared to «expressive» and «friendly». Doctors mostly come into contact with patients who combine the features of two psychotypes with the dominance of one of them. Physicians’ understanding of the therapeutic profile of patients’ psychological characteristics will allow understanding their expectations and improving adherence to pharmacotherapy.

Illness perception in patients with chronic migraine: cognitive, emotional and behavioral aspects

In patients with chronic migraine (CM), the illness perception includes three main aspects: cognitive (thoughts, beliefs, attitude towards pain), emotional (mood) and behavioral (pain coping strategies). The patient’s perception affects the course of CM, the prognosis and personality of the patient, so its assessment, understanding and correction underlie a multidisciplinary approach to treatment. Objective : to evaluate the cognitive, emotional and behavioral characteristics of patients with CM. Material and methods . The study included 200 patients with CM (63 men and 137 women), mean age 33.1±7.1 years. All patients were interviewed and tested to assess their clinical, cognitive, emotional and behavioral characteristics. Results . High levels of indicators such as catastrophizing of symptoms (84%), autonomic sensations (89%), intolerance to bodily sensations (71%), overestimation of the severity of symptoms (91%), and bodily weakness (68%) were revealed. All patients had misconceptions about the causes of headache, the majority (80%, n=160) had misconceived negative ideas about the prognosis. Almost all patients had high situational (95%, n=190) and personal (90%, n=180) anxiety, depressive symptoms of varying severity (95%, n=190). Non-adaptive pain coping strategies prevailed: avoidance coping style (87%, n=174); emotion-oriented coping (76%, n=152). In a group of 20 patients significant (p<0.05) associations were found between catastrophizing of symptoms, autonomic sensations, overestimating the severity of symptoms, anxiety and depression, and coping strategies. Conclusion . In most patients with CM, the illness perception includes negative and misconceived ideas about headache, clinically expressed symptoms of anxiety and depression, and maladaptive coping strategies. Significant relationships were found between cognitive, emotional, and behavioral characteristics, which emphasizes the validity and positive perspective of using the cognitive-behavioral model of pain in CM treatment.

STI testing and subsequent clinic attendance amongst test negative asymptomatic users of an internet STI testing service; one-year retrospective study.

To explore the characteristics of online STI test users, and assess the frequency and factors associated with subsequent service use following a negative online STI test screen in individuals without symptoms. One-year retrospective study of online and clinic STI testing within a large integrated sexual health service (Umbrella in Birmingham and Solihull, England) between January and December 2017. A multivariable analysis of sociodemographic and behavioural characteristics of patients was conducted. Sexual health clinic appointments occurring within 90 days of a negative STI test, in asymptomatic individuals who tested either online or in clinic were determined. Factors associated with online STI testing and subsequent clinic use were determined using generalized estimating equations and reported as odds ratios (OR) with corresponding 95% confidence intervals (CI). 31 847 online STI test requests and 40 059 clinic attendances incorporating STI testing were included. 79% (25020/31846) of online STI test users and 49% (19672/40059) of clinic STI test takers were asymptomatic. Online STI testing was less utilised (p<0.05) by men who have sex with men (MSM), non-Caucasians and those living in neighborhoods of greater deprivation. Subsequent clinic appointments within 90 days of an asymptomatic negative STI test occurred in 6.2% (484/7769) of the online testing group and 33% (4960/15238) for the clinic tested group. Re-attendance following online testing was associated with being MSM (aOR 2.55[1.58 to 4.09]-MSM vs Female) and a recent prior history of STI testing (aOR 5.65[4.30 to 7.43] 'clinic tested' vs 'No' recent testing history). Subsequent clinic attendance amongst online STI test service users with negative test results was infrequent, suggesting that their needs were being met without placing an additional burden on clinic based services. However, unequal use of online services by different patient groups suggests that optimised messaging and the development of online services in partnership with users are required to improve uptake.

Психологические и поведенческие особенности больных с фармакорезистентной эпилепсией

INTRODUCTION: Pharmacoresistant epilepsy (PRE) is diagnosed in 30% of all patients with epilepsy, causing disorders in psychological and social well-being, as well as the development of intrapersonal conflicts and psychological defense mechanisms. The psychotraumatic role of the epilepsy diagnosis is deepened by restrictions in the daily and professional activities of patients. AIM: To analyze the psychological and behavioral characteristics of patients with PRE compared with patients with successfully controlled seizures. MATERIALS AND METHODS: We studied 60 patients diagnosed with epilepsy aged 20 to 75 years, who were divided to 2 groups: 30 patients with pharmacoresistant epilepsy and 30 patients with successfully controlled seizures. The following psychometric methods were used in the study: Eysenck's test; Strelau test; Freiburg Multivariate Personality Inventory (FPI); Toronto alexithymic scale; T. Bant's scale of manipulative attitude; test ‘Tendency to self-destruction’; test of intrapersonal conflicts by V. Lauterbach; questionnaire ‘Types of behavior in conflict’ by K. Thomas – R. Kilman. Statistical differences between the groups were assessed using non-parametric statistics; differences were considered significant at p &lt; 0.05. RESULTS: The patients with PRE showed a higher level of anxiety and alexithymia, a lower level of spontaneous and reactive aggression and tranquility compared to the patients of the control group. Patients with PRE show a higher tendency to manipulative behavior and a lower tendency to self-destructive behavior than patients with successful seizure control. The spectrum of intrapersonal conflicts in patients with PRE is represented by an imbalance between the needs for dominance, achievements, independence and passive avoidance, submission, unrealized opportunities. In interpersonal conflicts, these patients are prone to avoidant behavior, while patients in the control group demonstrate the flexibility of behavior using all possible behavioral strategies. In general, patients with PRE have psychological and behavioral characteristics typical of patients with epilepsy, but expressed to a greater extent. However, in patients with PRE, we found a lower level of aggression and a lower tendency to self-destructive behavior than in patients with successfully controlled seizures, which can be explained by the compensating impact of persistent seizures on high aggressiveness, as well as a behavioral strategy that manifests itself in low compliance with a simultaneous tendency to manipulative behavior when interacting with a doctor. CONCLUSION: The conducted study revealed psychological and behavioral features of patients with PRE, causing significant psychological and social maladaptation requiring correction by medical professionals and psychologists. The research of the psychological characteristics of patients with epilepsy seems promising to us for optimizing an individual treatment strategy.

Verbal and Behavioral Characteristics of Patients with Right Hemisphere Damage : Results of the Discourse Analysis Rating Scales

Verbal and Behavioral Characteristics of Patients with Right Hemisphere Damage : Results of the Discourse Analysis Rating Scales

Sociodemographic, clinical and epidemiological characteristics of the men with HIV infection and syphilis in St. Petersburg

The purpose statement is to analyze the socio-demographic, clinical, epidemiological, and behavioral characteristics of patients with only HIV infection and those co-infected with HIV and Tr. pallidum, which are under supervision in St. Petersburg GBUZ «Center for the Prevention and Control of AIDS and Infectious Diseases».Material and methods. The data of outpatient cards of 588 patients who were registered in the dispensary at the St. Petersburg Central Clinical Center in the period from 2018 to 2020 were studied, and the data of the cards of males (435 people) were selected. Patients were divided into two groups: with HIV monoinfection (198 people) and with a combination of HIV infection and syphilis (237 people).Results. Patients co-infected compared with HIV-only patients were less likely to have higher education, were less likely to be married, were diagnosed with HIV infection more often at self-report and during routine examination, there were more men who hade sex with men (homosexual), and bisexual men. Co-infected patients were less likely to have used drugs in the present or in the past and were primarily infected with HIV through sexual contact. They were diagnosed mainly with early forms of syphilis. In patients with coinfection, concomitant diseases of the kidneys, cardiovascular, endocrine systems were often detected, and a high comorbidity with chronic hepatitis B was also noted.Conclusion. The identified socio-demographic, clinical, epidemiological and behavioral characteristics of men with HIV + syphilis coinfection indicate the need for more active work aimed at popularizing barrier contraception among men, especially MSM and prone to bisexual contacts; when syphilis is detected in HIV-infected patients, conduct a thorough examination of all organs and systems, extraordinary for the presence of viral hepatitis.

Fuzzy Cluster Analysis and Prediction of Psychiatric Health Data Based on BPNN

PMH (psychiatry/mental health) is affected by many factors, among which there are numerous connections, so the prediction of PMH is a nonlinear problem. In this paper, BPNN (Back Propagation Neural Network) is applied to fuzzy clustering analysis and prediction of PMH data, and the rules and characteristics of PMH and behavioral characteristics of people with mental disorders are analyzed, and various internal relations among psychological test data are mined, thus providing scientific basis for establishing and perfecting early prevention and intervention of mental disorders in colleges and universities. Artificial neural network is a mathematical model of information processing, which is composed of synapses similar to the structure of brain neurons. The fuzzy clustering analysis and data prediction ability of optimized PMH data are obviously improved. Applying BPNN to the fuzzy clustering analysis and prediction of PMH data, analyzing the rules and characteristics of PMH and the behavioral characteristics of patients with mental disorders, can explore various internal relations among psychological test data, and provide scientific basis for establishing early prevention and intervention of mental disorders.

Психологические и поведенческие характеристики пациентов с лекарственно-индуцированной головной болью

Study Objective: To evaluate the characteristics of patients with medication-overuse headache (MOH) for their further treatment. Study Design: Prospective study. Materials and Methods. Within 12 months, 120 patients (12 men and 108 women, mean age of men — 46.3 ± 3.54 years, of women — 41.3 ± 9.5 years) with primary headache and MOH were followed up. Participants were divided into two groups depending on the diagnosis: group I (n = 44) — patients with chronic forms of primary headache without MOH, group II (n = 76) — patients with chronic forms of primary headache and MOH. The patients filled out special questionnaires for their characterization. Study Results. The study compared groups according to the frequency of taking various types of analgesic drugs. Patients with MOH took pain medications: non-steroidal anti-inflammatory drugs — 15 (19.7%), triptans — 38 (50%), combined drugs — 23 (30.3%); 46 patients chose analgesic drug/s based on the speed of effect, and the preferred characteristics of the drugs were the availability (n = 25) and complete relieve pain (n = 19). The most of participants chose pain medications based on a doctor's recommendation; 44 (57.9%) of MOH patients tried to cancel them on their own, but failed. In people with MOH, the most common behavioral strategies were: taking painkillers to prevent headaches due to fear of pain (34.2%); refusal to discontinue the drug due to fear of increased pain even in the presence of side effects (22.4%); frequent practice of escalating the amount and dose of symptomatic agents in conditions of catastrophic pain (21.1%). The characteristics of our patients and their emotional and behavioral features showed that a more detailed study of these characteristics and features is necessary to develop a further treatment plan. Conclusion. When treating patients with MOH show that a complex approach to a comprehensive analysis of the state of physical and emotional health is needed. The characteristics of our patients once again prove the importance of a dialogue between a doctor and a patient to improve the effectiveness of treatment. A significant role in preventive methods implemented through educational programs are important for improving the quality of their lives. Keywords: medication-overuse headache, chronic primary headache, migraine, tension type headache, behavioral characteristics of patients with chronic headache, educational programs in management of patients with headache.

Development of a questionnaire to identify ocular torticollis

Ocular disease is one of the causes of abnormal head positioning. Conventionally, the behavioral characteristics of ocular torticollis patients are different from those of non-ocular torticollis patients, though research addressing the significance of this difference is yet limited. This prospective, cross-sectional study aims to develop a questionnaire based on the clinical features in children with abnormal head posture being ocularly assessed. Children aged ≥ 6 months who visited our rehabilitation medicine clinic with a chief complaint of abnormal head posture were included. Patients with apparent orthopedic and neurological diseases were excluded. A 10-item questionnaire was developed to analyze the behavioral characteristics of patients. The patients were divided into ocular and non-ocular torticollis groups according to ophthalmologic examination results. Thirty-four and 13 patients were assigned to the non-ocular torticollis and ocular torticollis groups, respectively. Five questions were finally selected and the questionnaire was scored as the sum of the scores for the each questions (yes = 1 point, no = 0 point). The median (interquartile range) score of the ocular torticollis group (3.0 (3.0-4.0)) was significantly higher than that of the non-ocular torticollis group (2.0 (1.0-3.0); p = 0.000).Conclusion: Our parent-reported torticollis assessment questionnaire may be useful for screening ocular torticollis. What is known: • Ocular disease is one of the various causes of abnormal head positioning. • The behavioral characteristics of patients with ocular torticollis are different from those of patients with non-ocular torticollis; research on this matter is limited. What is new: • We delveloped a questionnaire to differentiate ocular and postural torticollis and the score of the questionnaire was different between patients with or without ocular disease. • The questionnaire based on behavioral characteristics may help screening and determining the need of ophthalmic evaluation in patients with torticollis.

Collective Psychology and Behavioral Characteristics of Patients with Inflammatory Bowel Disease: A Single Cohort Study

Background: We previously treated patients with inflammatory bowel disease (IBD) using color therapy as part of projective psychotherapy and found differences in preferred colors selected in an imagined stressful situation between patients with ulcerative colitis (UC) and those with Crohn’s disease (CD). In this study, we investigated differences in color selection among UC patients, CD patients, and healthy volunteers (HVs). More precisely, formal analysis using a projective technique was performed to evaluate their emotional characteristics when coping with stress, and egogram analysis was performed to investigate their collective psychological characteristics and behavioral characteristics as social selves. Methods: Eighty-three HVs, 70 UC patients, and 71 CD patients were shown a sheet displaying images of bottles each containing 2 horizontally separated compartments filled in the same color or different colors. The preferred colors selected under imagined psychological stress (loneliness) were analyzed using a projection approach to investigate the emotional characteristics of the inner self. The Tokyo University Egogram New Version II (TEG^®II) was then used to analyze collective psychological characteristics and behavioral characteristics as social selves in the HV, UC, and CD groups. Results: Comparison of all 3 groups with the χ² test showed that more participants chose calm colors in the CD group than in the HV and UC groups, while more participants chose stimulating colors in the UC group than in the CD group (p < 0.01). Analysis of TEG^®II results with one-way analysis of variance and then with the Tukey-Kramer multiple comparison test revealed differences in collective psychological characteristics and behavioral characteristics in all 3 groups. Comparing scores for 5 types of ego states (Critical Parent, Nurturing Parent, Adult, Free Child, and Adapted Child) revealed that more participants in the CD group had a low Critical Parent score than in the HV group (p < 0.05). More participants in the IBD group had a low Nurturing Parent score than in the HV group (CD vs. HV, p < 0.01; UC vs. HV, p < 0.05). Significantly more participants in the UC group had a higher Adult score than in the HV or CD group (each p < 0.01). Conclusions: The psychological characteristics of patients with IBD differ depending on the type of disease (i.e., CD vs. UC). Management based on such differences should be provided for patients with each disease type.

Medical Comorbidity of Nocturnal Enuresis in Children.

Introduction:The purpose of this study was to evaluate the characteristics of patients with nocturnal enuresis (NE).Methods:We enrolled 403 children with NE referred to the Services of Pediatrics, Campus Bio-Medico University Hospital of Rome between June 2013 and July 2018. We excluded 2 children, respectively, with renal agenesis and chromosomopathy.Results:Of the 401 patients, 101 girls (25.2%) and 300 boys (74.8%), aged 5–16 years; mean age at first visit 8.8 ± 2.44 years. During the physical examination, we asked the patients and their parents specific questions to identify signs and symptoms of voiding disorders and comorbid conditions. In addition, we evaluated family history and behavioral characteristics of patients. In this study, NE was heredity in the 31.2% of cases. We found urogenital abnormalities in 15.7% of cases, constipation in 14.5% of cases, innocence heart murmur in 21.4% of cases and parasomnias in a good percentage of cases, especially snoring (13.7%), restless sleep (5.7%), somniloquy (23.7%) and bruxism (14.7%).Conclusions:Our experience demonstrates that there are a lot of comorbidities that are associated with NE and can influence the prognosis and the response to the therapy in these children.

\u201cFactors associated with non-small cell lung cancer treatment costs in a Brazilian public hospital\u201d

BackgroundThe present study estimated the cost of advanced non-small cell lung cancer care for a cohort of 251 patients enrolled in a Brazilian public hospital and identified factors associated with the cost of treating the disease, considering sociodemographic, clinical and behavioral characteristics of patients, service utilization patterns and survival time.MethodsEstimates were obtained from the survey of direct medical cost per patient from the hospital’s perspective. Data was collected from medical records and available hospital information systems. The ordinary least squares (OLS) method with logarithmic transformation of the dependent variable for the analysis of cost predictors was used to take into account the positive skewness of the costs distribution.ResultsThe average cost of NSCLC was US$ 5647 for patients, with 71% of costs being associated to outpatient care. The main components of cost were daily hospital bed stay (22.6%), radiotherapy (15.5%) and chemotherapy (38.5%). The OLS model reported that, with 5% significance level, patients with higher levels of education, with better physical performance and less advanced disease have higher treatment costs. After controlling for the patient’s survival time, only education and service utilization patterns were statistically significant. Individuals who were hospitalized or made use of radiotherapy or chemotherapy had higher costs. The use of these outpatient and hospital services explained most of the treatment cost variation, with a significant increase of the adjusted R2 of 0.111 to 0.449 after incorporation of these variables in the model. The explanatory power of the complete model reached 62%.ConclusionsInequities in disease treatment costs were observed, pointing to the need for strategies that reduce lower socioeconomic status and population’s hurdles to accessing cancer care services.

Psychological and somatic distress in Chinese outpatients at general hospitals: a cross-sectional study

BackgroundOur study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the different distress patterns.MethodsThis multicenter cross-sectional study was conducted at ten outpatient departments at Chinese general hospitals. The somatic symptom severity scale (PHQ-15), the nine-item depression scale (PHQ-9), and the seven-item anxiety scale (GAD-7) were employed to classify patients in terms of four distress patterns.ResultsA total of 491 patients were enrolled. Among them, the proportion of patients with high psychological distress was significantly higher within those with high somatic distress (74.5% vs. 25.5%, p < .001). Patients with psychological distress alone and mixed distress were significantly younger and with lower monthly family income, while the proportion of female patients (80.9%) was highest in the somatic distress group. Patients with mixed distress had the most negative cognitive and behavioral characteristics [highest health anxiety (5.0 ± 1.9), lowest sense of coherence (35.5 ± 10.0), the worst doctor–patient relationship from both patients’ (36.0 ± 7.3) and doctors’ perspectives (23.3 ± 7.0)], as well as most impaired quality of life (41.6 ± 7.4 and 31.9 ± 10.3). In addition, compared with patients with somatic distress alone, those with psychological distress alone had lower sense of coherence, worse doctor–patient relationship, and more impaired mental quality of life, but less doctor visits. Discriminant analysis showed that gender, mental quality of life, health anxiety, sense of coherence, and frequent doctor visits were significant indicators in identifying patients with different distress patterns.ConclusionsOur study found that (1) psychological distress was not rare in the Chinese general hospital outpatients, especially in those with high somatic distress; (2) patients with psychological distress alone sought less help from doctors, despite their severe psychosocial impairment; and (3) gender, health anxiety, sense of coherence, mental quality of life, and frequent doctor visits could help to identify different distress patterns.

Transferring psychiatric specialist services to local authorities—Characteristics of the patients involved

Background: To obtain more co-ordinated services, better co-operation between the services and more efficient use of resources, a pilot project for transferring some district psychiatric centres (DPCs) to large municipalities is planned by the Norwegian government. Systematic knowledge about the patients involved is needed when clinical needs and standards, funding, and political agendas are discussed. This study identifies the clinical, socio-demographic, and behavioural characteristics of patients who need services from both the municipality and the DPC.Method: A national mapping of patients in specialist mental health services was conducted in 2012/2013, including 65% of all inpatients (n = 2358) and 60% of all outpatients (n = 23 124). The need for services was assessed by each patient’s clinician.Results: It was found that 74% of inpatients and 43% of outpatients needed one or more services from the municipality, usually involving housing, mental health treatment/therapy, or economic support according to their clinicians. These were typically patients with severe mental illness, young inpatients, older outpatients and persons with low education and weak social networks. Only small differences in the need for municipal services were found between patients in hospitals and DPCs.Conclusions: Many of the patients in specialist mental health services, especially the inpatients, needed services from municipal social and health services. Because these patients had the most severe mental illnesses and were the most socially deprived, a stronger integration of service levels would potentially benefit these patients most. The pilot project should be evaluated to identify the consequences for patients, staff, quality of services, and costs of transferring services to a lower system level.

Cognitive and behavioral characteristics of patients with a clinical diagnosis of Alzheimer&apos;s disease (AD) and a past history of traumatic brain damage

Cognitive and behavioral characteristics of patients with a clinical diagnosis of Alzheimer&apos;s disease (AD) and a past history of traumatic brain damage

Spatial analysis of HIV infection and associated individual characteristics in Burundi: indications for effective prevention.

BackgroundAdequate resource allocation is critical in the battle against HIV/AIDS, especially in Africa. The determination of the location and nature of HIV services to implement must comply with the geographic, social and behavioral characteristics of patients. We therefore investigated the spatial heterogeneity of HIV prevalence in Burundi and then assessed the association of social and behavioral characteristics with HIV infection accounting for the spatial heterogeneity.MethodsWe used data from the 2010 Demographic and Health Survey. We analyzed these data with a geostatistical approach (which takes into account spatial autocorrelation) by i) interpolating HIV data using the kernel density estimation, ii) identifying the spatial clusters with high and low HIV prevalence using the Kulldorff spatial scan statistics, and then iii) performing a multivariate spatial logistic regression.ResultsOverall HIV prevalence was 1.4 %. The interpolated data showed the great spatial heterogeneity of HIV prevalence (from 0 to 10 %), independently of administrative boundaries. A cluster with high HIV prevalence was found in the capital city and adjacent areas (3.9 %; relative risk 3.7, p < 0.001) whereas a cluster with low prevalence straddled two southern provinces (0 %; p = 0.02). By multivariate spatial analysis, HIV infection was significantly associated with the female sex (posterior odds ratio [POR] 1.36, 95 % credible interval [CrI] 1.13-1.64), an older age (POR 1.97, 95 % CrI 1.26-3.08), the level of education (POR 1.50, 95 % CrI 1.22-1.84), the marital status (POR 1.86, 95 % CrI 1.23-2.80), a higher wealth index (POR 2.11, 95 % CrI 1.77-2.51), the sexual activity (POR 1.76, 95 % CrI 1.04-2.96), and a history of sexually transmitted infection (POR 2.03, 95 % CrI 1.56-2.64).ConclusionsOur study, which shows where and towards which populations HIV resources should be allocated, could help national health policy makers develop an effective HIV intervention in Burundi. Our findings support the strategy of the Joint United Nations Programme on HIV/AIDS (UNAIDS) for country-specific, in-depth analyses of HIV epidemics to tailor national prevention responses.

Establishing a Good Dentist‐Patient Relationship: Skills Defined from the Dental Faculty Perspective

The importance of developing good dentist-patient relationships has been well documented, but previous studies have focused on social techniques, not considering the psychological and behavioral characteristics of patients, and have used definitions and instruments that were not dental-specific. Therefore, the aims of this study were to propose a definition of dentist-patient relationship skills, derived from dental faculty members' criteria and informed by Emotional Intelligence concepts, and to propose a preliminary dental-specific, face-valid, and reliable self-assessment instrument. The study was conducted in three phases. Phases I and II defined dentist-patient relationship competence through literature analysis and semi-structured interviews with expert key informants, establishing the outcome skills. In Phase III, the instrument was constructed and piloted. Communication skills and basic psychological tools resulted in core topics for use in practice. The definition both specifies and broadens social interactions in dentistry by including dental faculty members' criteria and topics such as psychological tools and pre-, intra-, and postoperative topics appropriate for use during consultation, examination, and treatment. The instrument was found suitable, reasonable, and accessible with a Cronbach's alpha level of 0.95. Future studies are needed to confirm the definition, as well as the instrument's validity, reliability, transference, and sensitivity to the dental educational environment.

PERSONAL DETERMINANTS OF BEHAVIOR ASSOCIATED WITH HEALTH IN INDIVIDUALS WITH DIFFERENT RISK OF DEVELOPING METABOLIC SYNDROME

Objective. To study personal characteristics affecting health behavior in individuals with different risk of metabolic syndrome (MS).Design and methods. We examined 138 respondents (aged 20–62 years) with the use of the medical examination, interview, observation and personality questionnaires (coping style, locus of control, alexithymia), and personality and behavioral characteristics of patients with different risk of MS were identiied. Results. Subjects with MS and single components of MS are characterized by emotional eating behavior, lack of sleep, lack of exercise, alexithymia, more external locus of control, avoidant coping strategies. The study showed a signiicant role of internal attitudes in the formation of health-promoting eating behavior, and the correlation between coping style and characteristics of eating behavior and smoking. Conclusion. The data support the importance of corrective measures aimed at changing not only the lifestyle, but also personal attitudes, and behavioral patterns that have an impact on health.

Distinct clinical and pathological characteristics of frontotemporal dementia associated with C9ORF72 mutations

The identification of a hexanucleotide repeat expansion in the C9ORF72 gene as the cause of chromosome 9-linked frontotemporal dementia and motor neuron disease offers the opportunity for greater understanding of the relationship between these disorders and other clinical forms of frontotemporal lobar degeneration. In this study, we screened a cohort of 398 patients with frontotemporal dementia, progressive non-fluent aphasia, semantic dementia or mixture of these syndromes for mutations in the C9ORF72 gene. Motor neuron disease was present in 55 patients (14%). We identified 32 patients with C9ORF72 mutations, representing 8% of the cohort. The patients' clinical phenotype at presentation varied: nine patients had frontotemporal dementia with motor neuron disease, 19 had frontotemporal dementia alone, one had mixed semantic dementia with frontal features and three had progressive non-fluent aphasia. There was, as expected, a significant association between C9ORF72 mutations and presence of motor neuron disease. Nevertheless, 46 patients, including 22 familial, had motor neuron disease but no mutation in C9ORF72. Thirty-eight per cent of the patients with C9ORF72 mutations presented with psychosis, with a further 28% exhibiting paranoid, deluded or irrational thinking, whereas <4% of non-mutation bearers presented similarly. The presence of psychosis dramatically increased the odds that patients carried the mutation. Mutation bearers showed a low incidence of motor stereotypies, and relatively high incidence of complex repetitive behaviours, largely linked to patients' delusions. They also showed a lower incidence of acquired sweet food preference than patients without C9ORF72 mutations. Post-mortem pathology in five patients revealed transactive response DNA-binding protein 43 pathology, type A in one patient and type B in three. However, one patient had corticobasal degeneration pathology. The findings indicate that C9ORF72 mutations cause some but not all cases of frontotemporal dementia with motor neuron disease. Other mutations remain to be discovered. C9ORF72 mutations are associated with variable clinical presentations and pathology. Nevertheless, the findings highlight a powerful association between C9ORF72 mutations and psychosis and suggest that the behavioural characteristics of patients with C9ORF72 mutations are qualitatively distinct. Mutations in the C9ORF72 gene may be a major cause not only of frontotemporal dementia with motor neuron disease but also of late onset psychosis.