Disorders In People Research Articles

Association between symptoms of depression and inflammatory parameters in people aged over 90 years

BackgroundOld age is a period of life that presents many health and social challenges, resulting in a greater vulnerability to the development of mental disorders, including depression. There has been a growing interest in the relationship between depression and inflammatory factors, because of its potential clinical and therapeutic implications. Inflammatory processes, which were originally understood as a response to infection and trauma, appear to play an important role in the pathogenesis of depression in the elderly. The aim of the study was to analyse the relationship between the severity of depressive disorders and inflammatory parameters in people over 90 years of age.MethodsThe study was conducted in Poland in 2017. The study population consisted of long-lived individuals, both living at home and staying in residential care homes. The participants were 90 people of both sexes (69 women and 21 men), aged between 90 and 103 years (mean = 92.36; SD = 2.98). The study was conducted using the diagnostic survey method with a questionnaire technique. The Geriatric Depression Scale (GDS) was used to carry out the analysis. The levels of selected inflammatory factors were determined using relevant laboratory tests.ResultsIn the study group, the highest percentage of people had symptoms of moderate depression (n = 36;40%), followed by those without depression (n = 35;38.9%). There was a weak negative correlation between GDS scores and fibrinogen levels (p ≤ 0.05). The logistic regression model showed no significant relationship between inflammatory parameters and the development of depressive disorders.ConclusionsInflammatory parameters do not appear to predict the development of depressive disorders in people over 90 years of age.

Formation mechanisms of mental disorders in people living with HIV

The epidemic of Human Immunodeficiency Virus (HIV) infection affects all social groups of the population. Biopsychosocial stressors directly related to HIV infection, such as stigma, discrimination and shame, side effects of treatment, symptoms of HIV infection, and disclosure of the diagnosis influence the deterioration of mental health of people living with HIV. Stigma and discrimination can prevent the timely seeking of psychiatric help. Social stigmatization of HIV infection may affect their adherence to antiretroviral therapy. The purpose of our study was to study the formation mechanisms of mental disorders in people living with HIV. A comprehensive examination of 118 patients diagnosed with HIV infection between the ages of 22 and 61 was conducted at the Sumy Regional Clinical Medical Center for Socially Dangerous Diseases. During the examination of each patient, a psychiatric examination was carried out, anamnestic data were collected, and questionnaires were used: the Symptom Check List90-Revised psychopathological symptoms questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI). The examined patients were diagnosed with organic mood disorders, depressive disorders, anxiety disorders; disorders related to stress and trauma. The results of the questionnaires confirm the diversity and breadth of clinical symptoms found among those examined. 55.9% of patients had severe symptoms of psychological distress. 55.9% of the examined show symptoms of depression of varying severity. As a result of the study, the main parameters that influence the formation of mental disorders in people living with HIV were formed: socioeconomic factors, which are primarily represented by a low level of education and a fairly high level of unemployment, social isolation and the absence of family support, fear of stigmatization, the presence of harmful habits and stressful events and factors related to the detection of HIV infection. Keywords: antiretroviral therapy, depression, neuroinflammation, psychosocial factors.

Physical healthcare gap among patients with severe mental illness through the COVID-19 pandemic. Preliminary results from a real-world investigation in Lombardy, Italy

IntroductionPatients suffering from mental disorders tend to be less adherent to the recommended therapies. Moreover, the COVID-19 pandemic had a global impact on physical and social well-being, which turned out stronger in the most fragile patients, like those with a mental condition.ObjectivesTo assess whether the COVID-19 pandemic influenced the physical healthcare gap between patients with and without severe mental illness (SMI) treated for chronic conditions.MethodsData were retrieved from Healthcare Utilization Databases of Lombardy region (Italy). Prevalent users of antihypertensive drugs, statins or antidiabetic drugs, receiving healthcare in Lombardy during 2020, were identified. Among them, those with a previous diagnosis of schizophrenic or bipolar disorder were selected and matched with up to 3 patients without any sign of mental disorder by sex, age and number of contacts with the NHS during the previous year. 3 cohorts (not necessarily independent) were formed.High adherence to specific recommended drug therapies and discontinuation during 2020 were evaluated.Association between presence of SMI and high adherence was evaluated by using a log-binomial model (risk ratios, RR with 95% CI); a Cox model (hazard ratios, HR) was used for discontinuation.As comparison, same analyses were performed to the cohorts of prevalent users in 2019, to evaluate the impact of the COVID-19 pandemic. Results were stratified according to the type of mental disorder.Results36'436, 14'136 and 12'597 prevalent users of antihypertensives, statins or antidiabetics respectively were identified, of which 25% with SMI (9'109, 3'536 and 3'152 respectively).During the pandemic period, for all the three cohorts, patients with mental illness had 10% lower probability of being adherent to the recommended drug therapies.The association between SMI and discontinuation was significant and varied among the three cohorts, with HR (95% CI): 1.27 (1.21; 1.33) for antihypertensives users, 1.16 (1.07; 1.26) for antidiabetics users and 1.08 (1.01; 1.16) for statins users.Compared with 2019 the gap remained similar, except for discontinuation of antidiabetics, where the gap diminished from 34% in 2019 to 16% in 2020.No differences between the two mental disorders were found.ConclusionsResults show that suffering from a mental disorder in people with chronic physical conditions affects their adherence to recommended drug therapies. During the pandemic period, the restrictive measures adopted may have led to a better care by family members, counteracting any increase in the gap.The healthcare gap in patients suffering from mental illness remains an unsolved problem of primary importance for public health.Disclosure of InterestNone Declared

Incidence and characterization of aerophagia in dogs using videofluoroscopic swallow studies.

Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or ingested air resulting in gastric distention (>1/3 of end gastric volume). Aerophagia is highlighted during eating and drinking. Videofluoroscopic swallow studies (VFSS) document aerophagia in dogs, but the incidence, clinical signs (CS), and associated disorders are unknown. Identify the incidence of aerophagia, compare CS between dogs with and without aerophagia, and identify associated and predisposing disorders using VFSS. A total of 120 client-owned dogs. Sequential VFSS and associated medical records from dogs presenting to veterinary teaching hospitals at Auburn University and the University of Missouri were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney and chi-squared tests, odds ratios (OR), and multiple logistic regression (P < .05). The incidence (95% confidence interval [CI]) of aerophagia was 40% (31.7-48.9). Dogs with mixed CS (gastrointestinal [GI] and respiratory; P < .001, 58.3%) were more likely to have aerophagia than dogs with exclusively respiratory CS (25%). Aerophagia was significantly more common in brachycephalic dogs (P = .01; 45.8% vs 13.8%), dogs with nonbrachycephalic upper airway obstruction (P < .001; 33.3% vs 4.1%), pathologic penetration and aspiration (P-A) scores (P = .04; 41.6% vs 23.6%), and gagging (P < .001; 25% vs 11.7%). Mixed CS (P = .01), brachycephaly (P < .001), and upper airway obstruction (P < .001) were independent predictors of aerophagia. Aerophagia was common, particularly in dogs with mixed CS. Brachycephalic dogs and dogs with upper airway obstruction are predisposed. Aspiration risk was high, emphasizing overlapping upper aerodigestive pathways.

The presence of personality traits of borderline personality disorder in anorexia nervosa and obesity

IntroductionWhile in eating disorders such as anorexia nervosa, the comorbidity of pathological personality traits is very common, and accordingly the personality traits of borderline personality disorder is considered very frequent and coexisting. The treatment of anorexia nervosa is based primarily on the psychotherapy and work on pathological personality traits even more than the treatment of the syndrome and the consequences of malnutrition itself. That achieves a longer-term and more reliable solution than symptomatic treatment of anorexia nervosa which usually does not bring satisfactory results. On the other hand, in patients with obesity, pathological personality traits, especially those of borderline personality disorder, are still very rarely associated, since obesity is usually not even considered a disorder, but a variation in the population.ObjectivesThe aim of this paper is to investigate the pathological personality traits of borderline personality disorder in people with obesity.Methods Investigating relevant scientific and professional literature from the field of personality pathology and eating disorders.ResultsWhen obesity is related to impulse control disorder in the sense of emotional eating under increased stress according to today’s relevant literature, it can definitely be related to personality traits of borderline personality disorder, i.e. the presence of elements of borderline personality organization and prementalization models. Such an inability to deal with negative emotions such as increased anxiety or rejection sensitivity, which results in overeating and the related feeling of shame that overwhelms the person, regardless of whether he/she/they has any of the certain forms of compulsive behaviour afterwards, can be related to impulsive behaviour and the “all or nothing” way of thoughts. This is also confirmed by cases when certain people have a history of both one and the other disorder. Thus, some people have, for example, malnutrition in adolescence as part of anorexia nervosa, only to have problems with obesity after some time with a healthy body mass.ConclusionsSince pathological personality traits in people with anorexia nervosa and obesity give indications of common characteristics in the form of borderline personality disorder traits, i.e. borderline personality organization and prementalization models in both disorders, future research will certainly shed light on the connection between these eating disorders.Disclosure of InterestNone Declared

The Correlation Between Stigma and Mental Health Disorders in People Living with HIV/AIDS

Stigma remains a significant challenge for people living with HIV/AIDS(PLWHA) despite the advances that have been made in HIV care and treatment. It is known to affect health care outcomes including care seeking habits and medication adherence. In addition to contributing to poor health outcomes, stigma is known to increase the risk of developing mental health disorders. Various researchers have found a correlation between stigma and mental health disorders including depression, anxiety, mental distress, stress, post-traumatic stress disorder (PTSD), and suicidal ideation. The aim of this review is to explore the association between stigma and mental health disorders in PLWHA. It identifies common mental health disorders found in people living with HIV and how these disorders are linked to stigma. The review also identifies how stigma and mental health disorders affect healthcare outcomes of PLWHA. The review concludes by providing a number of measures that can help to end stigma and improve overall health outcomes of PLWHA.&#x0D; Keywords: stigma, HIV-related stigma, HIV/AIDS, mental health disorders, people living with HIV/AIDS

Posttraumatic stress disorder in people with dementia: study protocol

ABSTRACT Background: Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the ‘TRAuma and DEmentia’ interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia. Methods: This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the ‘TRAuma and DEmentia’ interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group. Conclusion: This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities. Trial registration: NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F

Trauma and comorbid post-traumatic stress disorder in people with bipolar disorder participating in the Heinz C. Prechter Longitudinal Study

BackgroundIt is estimated that up to 50 % of people with bipolar disorder (BD) also have comorbid post-traumatic stress disorder (PTSD). However, little is known about the presentation and treatment of people with this comorbidity. MethodsData from 577 individuals diagnosed with bipolar disorder participating in the Heinz C. Prechter Longitudinal Study of BD were explored at baseline, year two and four. Three trauma groups were created: (i) one trauma (n = 75), (ii) multiple traumas (n = 417), and comorbid PTSD (n = 85). Measures of depression, mania, sleep, number of hospitalisations, suicide attempts, and medication use were analysed using regression modelling to determine differences between the three trauma groups. ResultsThere was an increase in depression, mania, and sleep scores and a higher number of hospitalisations in participants with comorbid PTSD compared to those experiencing one trauma. Additionally, increased mania and depression scores were reported in participants experiencing multiple traumas compared to those with one trauma. There was no difference in medication use between those who experienced one trauma compared to those with comorbid PTSD. LimitationsThe trauma groups may include confounding with more participants experiencing PTSD than reported in this study due to screening processes. Additionally, the severity of trauma was not recorded, therefore number of traumas was utilised as a proxy. ConclusionComorbid BD and PTSD is associated with worse symptom scores compared to participants reporting one trauma. Clinical implications include the addition of trauma-informed care to clinical settings to identify PTSD to provide appropriate treatments.

Muscle stiffness indicating mission crew health in space

Muscle function is compromised by gravitational unloading in space affecting overall musculoskeletal health. Astronauts perform daily exercise programmes to mitigate these effects but knowing which muscles to target would optimise effectiveness. Accurate inflight assessment to inform exercise programmes is critical due to lack of technologies suitable for spaceflight. Changes in mechanical properties indicate muscle health status and can be measured rapidly and non-invasively using novel technology. A hand-held MyotonPRO device enabled monitoring of muscle health for the first time in spaceflight (> 180 days). Greater/maintained stiffness indicated countermeasures were effective. Tissue stiffness was preserved in the majority of muscles (neck, shoulder, back, thigh) but Tibialis Anterior (foot lever muscle) stiffness decreased inflight vs. preflight (p < 0.0001; mean difference 149 N/m) in all 12 crewmembers. The calf muscles showed opposing effects, Gastrocnemius increasing in stiffness Soleus decreasing. Selective stiffness decrements indicate lack of preservation despite daily inflight countermeasures. This calls for more targeted exercises for lower leg muscles with vital roles as ankle joint stabilizers and in gait. Muscle stiffness is a digital biomarker for risk monitoring during future planetary explorations (Moon, Mars), for healthcare management in challenging environments or clinical disorders in people on Earth, to enable effective tailored exercise programmes.

Dietary and Metabolic Approaches for Treating Autism Spectrum Disorders, Affective Disorders and Cognitive Impairment Comorbid with Epilepsy: A Review of Clinical and Preclinical Evidence.

Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.

MENTAL HEALTH AND RELATED FACTORS IN PEOPLE DEPREVED OF LIBERTY: INTEGRATIVE REVIEW

The mental health must be understood whit the capacity that each person has to live, produce and enjoy material goods and services, dealing with the stressors of daily life and keeping a level of well-being. People deprived of liberty are characterized with a vulnerable population since before their confinement in the prision environment, then your access to material goods and services is restricted. Like this, knowing the risk factors, scientifically disclosed, for the occurrence of mental disorders in people deprived of liberty translates at the objective created for this integrative review, carried out in june 2023. The indexed terms used for the advanced search were “mental health and prisoners and risk factors”. After applying the inclusion criteria: original or research articles; in full format; available in portuguese, english or spanish; free Access; published in the last 10 years, from 2013 to 2022. And, of the exclused: articles that did not present risk factors for the occurrence of mental disorders or people deprived of liberty as study participants as the object of investigation. A universe of 28 articles was obtained that answer the question: What are the risk factors for the occurrence of mental disorders in people deprived of liberty? The results indicated that of the 20 (100%) articles, 20 (71,42%) point to environmental risk factors, 20 (71,42%) behavioral, and 19 (67,85%) biological. It should be noted that the presentation and interpretation of data occurred in a non-exclusive manner, that is, na article may contain information from more than one of the categories. For environmental risk factors, previous family histories of violence stand out. Among biological ones, the existence prior to imprisonment of signs and symptoms and/or mental disorders. And for behaviorists, the use and abuse of illicit chemical substances is the main factor associated with mental disorders. Among these, anxiety, depression and bipolarity stand out, for wich nursing has different instruments that can be honed and applied. Since, it has gradually been inserted and expanded the field of professional activity in the prison system.

Investigation of electromyography of the masseter and temporal muscles in children with Down syndrome aged 2 to 12 years during maximal voluntary isometric contraction and rest

Background. Muscle weakness and low muscle tone may cause chewing and swallowing disorders in people with Down syndrome. This study investigated the electromyography of the masseter and temporal muscles in children with Down syndrome, aged 2 to 12, during maximal voluntary isometric contraction and rest. Methods. The current descriptive-analytical and case-control study investigated the electromyography frequency indicators of the masseter and temporal muscles at maximum voluntary contraction and resting states in 15 children aged 2 to 12 with Down syndrome and 15 normal children of the same age. Results. The average frequency of the mean and median in the electrical signal of the masseter and temporal muscles on the left and right sides and in two different positions in children with Down syndrome is lower than in normal children. In comparing the average frequency of the mean, except for the left and right temporal muscles in the maximum voluntary isometric contraction and the left master muscle during rest, there is a significant difference in the rest. Also, in comparing the average frequency of the median, except for the left and right temporal muscles in the resting state, there are non-significant differences in the rest of the cases. Conclusion. The average frequency of the electrical signal of the masseter and temporal muscles in children with Down syndrome is lower than that of normal children. Unlike typically developing children, those with Down syndrome struggle with chewing and swallowing. Practical Implications. The data obtained from this study contributes to the enhancement of interventions and treatments for patients with Down syndrome.

The association between visual impairment and mental disorders

To determine the association between visual impairment (VI) and some mental disorders using the general health questionnaire (GHQ) in individuals aged 60 years and above in Tehran, Iran. The present population-based cross-sectional study was conducted on people aged 60 and older in Tehran, Iran using multi-stage cluster sampling. After selecting the samples, examinations including visual acuity measurement, refraction, and slit-lamp biomicroscopy were performed for all participants. The GHQ was used to examine mental disorders. Simple and multiple linear regressions were used to investigate the association between VI and mental disorders. Of the 3740 invitees, 3310 participated in the study (response rate: 88.50%). After applying the exclusion criteria, 2789 individuals were analyzed for this report. Mean score of physical, anxiety, social and depression disorders in people with and without VI was 3.74 ± 2.03, 5.81 ± 2.79, 7.56 ± 1.91, 1.32 ± 1.90, and 3.14 ± 1.76, 4.93 ± 2.71, 8.09 ± 1.99, 0.91 ± 1.38, respectively. The total score of GHQ in participants with and without VI was 18.43 ± 4.75 and 17.07 ± 4.19, respectively. The association between GHQ subscales and total GHQ score with VI by multiple linear regression showed that VI had a statistically significant direct association with physical symptoms (β = 0.37; 95% CI 0.12 to 0.62) and anxiety (β = 0.48; 95% CI 0.16 to 0.81). Nevertheless, depression had a borderline association with VI (β = 0.21; 95% CI − 0.03 to 0.45) and social dysfunction did not have a statistically significant association with VI in the final linear regression model and did not remain in the model. Total GHQ score had a statistically significant association with VI (β = 1.02; 95% CI 0.39 to 1.64) in the presence of covariates. Regarding the association between VI and GHQ components, the physical symptoms had the highest R2 (R2 = 0.159). Patients with VI suffer more from anxiety, depression, and physical symptoms regardless of age, sex, education, and other effective variables. The coincidence of aging with VI and the association of VI with mental disorders emphasizes the importance of a broader view of the elderly and the aging process.

Delayed mental, neurological and somatic disorders associated with COVID-19

Purpose of the study. To assess the nature of health complaints, frequency of occurrence, structure and characteristics of neurological, general somatic and mental disorders in people in the post-COVID period.Materials and methods. The main group (n=1000) was represented by people who had a new coronavirus infection, confirmed by polymerase chain reaction (PCR) SARS-CoV-2, from 18 to 60 years old. As part of the study, an extensive survey of the examined individuals was carried out, aimed at identifying the main psychoneurological and general somatic consequences that developed in the period from 4 weeks to 12 months after COVID-19.Results and discussion. The study included 289 men and 711 women (28.9% and 71.1%, respectively). The average age at the time of the examination was 40.2±11.8 years. More than half of the respondents were of working age, had a permanent job or were studying (72.3%), while 17.9% indicated a high level of physical activity before COVID-19. The majority of respondents suffered from mild COVID-19 (76.6%), in 23.4% of cases the disease was moderate. Among somatic (vegetative) disorders as a consequence of COVID-19, the most common complaints were hair loss (49.5%), fatigue in 77.5% of cases, regardless of workload and type of work, and fluctuations in blood pressure in 50.2% of patients. Women complained more intensely about hair loss (χ2=60.2608, df=9, p&lt;.001), shortness of breath (χ2=17.5025, df=9, p=0.04), interruptions in heart function (χ2=22.7863, df=9, p=0.007).Among the respondents, the most common complaints were emotional disturbances, which determined the picture of anxiety and depressive disorders, as well as cognitive impairments in the form of memory loss (69.5%), concentration, difficulties with long-term attention maintenance (65,5%) and switching from one task to another (60%). With the age of the respondents, fatigue increased in intensity (R=0.2, p&lt;0.05), insomnia (R=0.2, p&lt;0.05), anxiety for health and for their close persons (R=0.2, p&lt;0.05), neurological complaints (widespread muscle pain (R=0.3, p&lt;0.05), pain in the spine (R=0.3, p&lt;0.05), gait disturbances (R=0.2, p&lt;0.05), as well as the intensity of general somatic complaints (urinary disorders (R=0.2, p&lt;0.05), shortness of breath (R=0.2, p&lt;0.05), pain and heaviness in the chest (R=0.2, p&lt;0.05), irregular heartbeat (R=0.2, p&lt;0.05), fluctuations in blood pressure (R=0.2, p&lt;0.05). Clear gender differences in the intensity of post-COVID psychopathological manifestations were revealed. Women complained more strongly about post-COVID high fatigue (χ2=23.8901, df=9, p=0.004), general malaise (χ2=17.9304, df=9, p=0.04) and, accordingly, lower activity and inability to cope with household workload (χ2=22.3384, df=9, p=0.008) compared to men. Women had more severe dysmnestic disorders (χ2=23.0900, df=9, p=0.006) than men. Women were also characterized by having greater anxiety for close persons (χ2=20.5941, df=9, p=0.01) and insomnia (χ2=20.2633, df=9, p=0.02) than men. Post-COVID neurological disorders, despite their lower frequency and intensity of manifestations, caused the most significant difficulties in everyday life and predominated in older people.Conclusion. The clinical picture of post-COVID syndrome is represented by a wide range of somatic and neuropsychiatric disorders, which determines the specifics of patient management after the illness. When assessing long-term disorders, it is advisable to rely on the opinions of specialists as part of an interprofessional expert group, to make decisions on the implementation of a clinical diagnostic algorithm for each patient based on a systematic approach, taking into account specific symptoms or conditions. Preliminary results of our study showed that special attention should be paid to women at the stage of treatment of acute infection and rehabilitation, due to the higher incidence of psychoneurological complications of COVID-19 in them. Given the risks of long-term consequences of COVID-19 and the possibility of reinfection, it is critical to integrate basic and clinical research data to optimize cognitive preservation and quality of life for patients.

Forecasts regarding mental disorders in people in the post-war period

BackgroundIn connection with the onset of difficult times associated with the war, Ukrainians are exposed to traumatic factors for mental health. The research is relevant in connection with the real threat to the mental state of the population in the long term, because this type of disease can be in a latent phase for a long time. ObjectiveThe purpose of the study is to record the specifics of the impact of the war on the psyche of Ukrainian citizens, which also includes the hypothetical post-war situation in the country. MethodsThe method of typological analysis identified six main mental disorders that can be caused by war. As an analysis of the current situation in the country, an appropriate psychodiagnostic technique was selected for each disorder. To predict the future situation in the post-war period, a comparison method was used, based on recording the experience of countries that have passed the stage of ending the conflict. ResultsIt was found that approximately half of the interviewees have signs of post-traumatic stress disorder (PTSD), adjustment disorder, depression, anxiety disorders, and somatoform disorders. But signs of dependence on psychoactive substances were observed in about a quarter of those surveyed. Women were more prone to PTSD, anxiety and somatoform disorders, and men to addiction to psychoactive substances. Risk factors that may cause further complication of the situation with mental illnesses in post-war Ukraine were highlighted. ConclusionThe results of the study are relevant for state and non-state organizations related to activities aimed at psychological or psychiatric assistance to the population.

Cognitive behavioural therapy for social anxiety disorder in people with bipolar disorder: a case series

BackgroundSocial anxiety disorder increases the likelihood of unfavourable outcomes in people with bipolar disorder. Cognitive behavioural therapy (CBT) is the first-line treatment for social anxiety disorder. However, people with bipolar disorder have been excluded from the studies that this recommendation is based on. MethodWe completed a case series to obtain initial data on whether CBT is an acceptable, safe, and effective treatment for social anxiety disorder in people with bipolar disorder.ResultsEleven euthymic participants with bipolar disorder attended up to sixteen treatment and three follow-up sessions of CBT for social anxiety disorder. Participants attended on average 95% of the offered CBT sessions. No adverse events were reported. Participants’ mean score on the Social Phobia Inventory decreased from 46.5 (SD 6.6) before the treatment to 19.8 (SD 11.9) at the end of the sixteen-session intervention and further to 15.8 (SD 10.3) by the end of the 3-month follow-up. This degree of improvement is equivalent to the effect observed in studies of CBT for social anxiety disorder in people without severe mental illness.ConclusionsThis case series provides preliminary evidence that CBT is acceptable, safe, and effective for treating social anxiety disorder in people with bipolar disorder during euthymia. A randomized controlled trial is needed to confirm these findings, and to establish whether treatment for social anxiety disorder improves the course of bipolar disorder.

Mental Health Among Men Who Have Sex with Men Under the Influence of Psychoactive Substances: a Systematic Review

AbstractSex under the influence of psychoactive substances (SUIPS) has gained much attention in the press and scientific literature over the last years, especially among men who have sex with men (MSM). Concerns have thus far been expressed in relation to short-term physical health risks, like contracting bloodborne diseases, like viruses. However, much less is known about long-term mental health consequences of SUIPS, like depression, anxiety, and substance use disorders (SUD). Therefore, we systematically reviewed literature for evidence on mental health complications of SUIPS in MSM. SUIPS was associated with a lower general mental health status, and higher rates of depression, anxiety disorders and suicide ideation in 15 studies, and higher rates of SUD were found among MSM practicing SUIPS in four studies. Motives of SUIPS were increasing sexual performance, fear of rejection, anxiety, and low self-esteem among others. Furthermore, long-term mental health risks, as associated with some of the most frequently reported psychoactive substances in the context of SUIPS, include psychosis and substance dependence. Therefore, the present findings indicate that SUIPS is associated with mental disorders and that they are probably closely intertwined with motives for SUIPS and the long-term effects of using psychoactive substances. This underlines the need to address the presence of mental disorders in people practicing SUIPS, alongside the physical risks.

Potential Advantages of a Well-balanced Nutrition Regimen for People Living with Human Immunodeficiency Virus Type -1

This review underscores the important role of nutrition in enhancing the management of Human Immunodeficiency Virus type 1 (HIV-1). Highlighting the efficacy of dietary interventions, including, the importance of omega-3 fatty acids, vitamins D and B-12, and the Mediterranean diet, we delineate how these beneficial nutritional strategies can improve the effectiveness of combined antiretroviral therapy (cART), mitigate its side effects, and ameliorate metabolic disorders in people living with HIV-1 (PLWH). Our review advocates for the integration and implementation of personalized nutritional assessments into the care plan for PLWH, proposing actionable strategies for healthcare providers in HIV-1 field. Summarizing the current standing of the relevance of the nutritional and well-planned diet recommended for the PLWH and emphasizing on the future research directions, this review establishes a foundation for nutrition as a cornerstone in comprehensive HIV-1 management. Our review aims to improve patients’ health outcomes and overall quality of life for PLWH.

Musculoskeletal Comorbidities among known Diabetes Patients, their Quality of Life, and Healthcare Costs: A Comparative Study From a Tertiary Care Hospital in Uttarakhand.

Diabetes is a chronic disorder with long-term sequelae and multisystem manifestation. Burden of diabetes in on the rise. Presence of other morbidities can not only have a detrimental effect on the disease treatment and recovery course, but also on the financial burden and quality of life. Present study aims to investigate how musculoskeletal conditions affect individuals with diabetes compared to those without the condition. A comparative study was conducted among patients attending the outpatient department of a tertiary care hospital in North India to assess the burden of musculoskeletal disorders in people with and without diabetes. A total of 195 diabetes patients and an equal number of individuals without diabetes were sequentially enrolled from the outpatient department (OPD). Burden of musculoskeletal comorbidities was significantly higher (46.2%) among people with diabetes than the comparison group (25.1%). The overall odds ratio (OR) for comorbidities of musculoskeletal system was 2.5 times higher in diabetes cases as compared to individuals without diabetes. The OR for rheumatoid arthritis, chronic backache, and osteoarthritis was found to be 3.6, 2.9, and 1.7 respectively. Poor quality of life and higher direct cost of treatment were found among diabetes cases with musculoskeletal comorbidities as against those without these comorbidities. Presence of musculoskeletal comorbidity is high among diabetes patients, and it has an impact on the quality of life and treatment cost. Screening for musculoskeletal comorbidities should be included as part of the diabetes complication assessment to allow for early detection and treatment.

Too little or too much nocturnal movements in Parkinson’s disease: A practical guide to managing the unseen

Nocturnal and sleep-related motor disorders in people with Parkinson’s disease (PD) have a wide spectrum of manifestations and present a complex clinical picture. Problems can arise due to impaired movement ability (hypokinesias), e.g. nocturnal hypokinesia or early-morning akinesia, or to excessive movement (hyperkinesias), e.g. end-of-the-day dyskinesia, parasomnias, periodic limb movement during sleep and restless legs syndrome. These disorders can have a significant negative impact on the sleep, daytime functional ability, and overall quality of life of individuals with PD and their carers. The debilitating motor issues are often accompanied by a combination of non-motor symptoms, including pain and cramping, which add to the overall burden. Importantly, nocturnal motor disorders encompass a broader timeline than just the period of sleep, often starting in the evening, as well as occurring throughout the night and on awakening, and are not just limited to problems of insomnia or sleep fragmentation. Diagnosis can be challenging as, in many cases, the ‘gold standard’ assessment method is video polysomnography, which may not be available in all settings. Various validated questionnaires are available to support evaluation, and alternative approaches, using wearable sensors and digital technology, are now being developed to facilitate early diagnosis and monitoring. This review sets out the parameters of what can be considered normal nocturnal movement and describes the clinical manifestations, usual clinical or objective assessment methods, and evidence for optimal management strategies for the common nocturnal motor disorders that neurologists will encounter in people with PD in their clinical practice.