Rahe Stress Scale Research Articles

Major Stressful Life Events and the Risk of Pancreatic, Head and Neck Cancers: A Case-Control Study.

Major stressful life events have been shown to be associated with an increased risk of lung cancer, breast cancer and the development of various chronic illnesses. The stress response generated by our body results in a variety of physiological and metabolic changes which can affect the immune system and have been shown to be associated with tumor progression. In this study, we aim to determine if major stressful life events are associated with the incidence of head and neck or pancreatic cancer (HNPC). This is a matched case-control study. Cases (CAs) were HNPC patients diagnosed within the previous 12 months. Controls (COs) were patients without a prior history of malignancy. Basic demographic data information on major stressful life events was collected using the modified Holmes-Rahe stress scale. A total sample of 280 was needed (79 cases, 201 controls) to achieve at least 80% power to detect odds ratios (ORs) of 2.00 or higher at the 5% level of significance. From 1 January 2018 to 31 August 2021, 280 patients were enrolled (CA = 79, CO = 201) in this study. In a multivariable logistic regression analysis after controlling for potential confounding variables (including sex, age, race, education, marital status, smoking history), there was no difference between the lifetime prevalence of major stressful event in cases and controls. However, patients with HNPC were significantly more likely to report a major stressful life event within the preceding 5 years when compared to COs (p = 0.01, OR = 2.32, 95% CI, 1.18-4.54). Patients with head, neck and pancreatic cancers are significantly associated with having a major stressful life event within 5 years of their diagnosis. This study highlights the potential need to recognize stressful life events as risk factors for developing malignancies.

Факторы риска развития психических нарушений у больных рассеянным склерозом

Up to 50% of patients with multiple sclerosis (MS) suffer from mental disorders. The purpose — to study the risk factors for mental disorders development in MS patients. Material and methods. The study group included 315 patients with MS and mental disorders. The control group consisted of 300 MS patients without mental disorders. The diagnosis of MS was established according to the 2017 McDonald criteria. The diagnosis of mental disorders was established in accordance with the ICD-10 criteria. We used Beck Depression Inventory (BDI), Multidimensional Fatigue Inventory (MFI-20), Spielberger State-Trait Anxiety Inventory (STAI), adapted by Khanin, Expanded Disability Status Scale (EDSS), and Holmes and Rahe stress scale. MS progression rate (PR) was calculated using N. A. Malkova (1988) method. Results. The research established a link between mental disorders development and the localization of demyelination foci, with MS PR of at least 0.74 EDSS points per year, and with significant stressful events before MS development. Conclusion. The data obtained can be used to predict the development of mental disorders in MS patients.

Mental health and quality of life of female breast cancer survivors in southeast Serbia

Background/Aim. Quality of life (QoL) is one of the outcome measures for patients with chronic diseases. Mental health issues often impact the QoL of cancer patients. Cancer patients with a good QoL have a longer life expectancy and are able to lead a more productive and social life. The aim of the study was to determine the association of mental health with the QoL, as well as to determine significant predictors of QoL in patients with breast cancer (BC). Methods. The study included 118 patients treated at the Specialized Breast Cancer Department of the Oncology Clinic of the University Clinical Center Nis. The study?s inclusion criteria were the presence of early-stage nonmetastatic BC and completed surgical treatment. The following questionnaires were used: the general sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS), Buss-Perry Aggression Questionnaire, Early Maladaptive Schema questionnaire - short form (SQ-SF), Flanagan?s Quality of Life Scale (QoLS), Holmes and Rahe Stress Scale, Berlin Social Support Scales (BSSS), Health Locus of Control. Results. A statistically significant negative correlation was found with emotional state, i.e., anxiety score, depressiveness score, total stress score, and physical aggression score, while QoL correlated positively with all subscales of the perceived social support (PSS) questionnaire. QoL was significantly different for patients with the following early maladaptive schemas: emotional deprivation, emotional inhibition, and a sense of entitlement/narcissism. Moreover, QoL differed significantly depending on partnership status, the presence of clinically significant anxiety, the presence of hormonesensitive cancer, the presence of human epidermal growth factor receptor 2 (HER2)-positive cancer, and time since diagnosis. Multiple linear regression was performed, and depression and PSS had the highest share. Conclusion. In our study, the presence of depressiveness and PSS were the best predictors of QoL of BC survivors.

КАЧЕСТВО ЖИЗНИ И СТЕПЕНЬ СОПРОТИВЛЯЕМОСТИ СТРЕССОВЫМ ФАКТОРАМ У НАСЕЛЕНИЯ РЕСПУБЛИКИ БЕЛАРУСЬ ПО ДАННЫМ КЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ

Mental health of an individual is one of the priorities of healthcare. Positive dynamics in preventing the development of the disease and providing timely assistance in case of its presence helps to prevent a number of social and economic consequences. The aim of this study is to track the level of dependence of the quality of life on the degree of resistance to stress factors among the adult population of our country. Material and methods. A survey of 1200 respondents from six regions of the Republic of Belarus (regional centres, cities, villages) was conducted. The SF-36 questionnaire (The Short Form-36) and the Holmes and Rahe Stress Scale were used. Data were processed using the Statistica 10.0 program. Conclusions. The assessed indicators of physical functioning, role-physical functioning, general health and physical health component are higher among those who live in large cities. Residents of rural areas have higher indicators of role-emotional functioning, mental health, vitality and mental health component.

Risk factors-related first episode postpartum psychosis among Egyptian women: the role of psychosocial and the biological factors

BackgroundThe risks associated with postpartum psychosis (PP) are poorly recognized in Egyptian women. We aimed to study the role of sociodemographic, psychosocial, obstetric, and biological factors in the occurrence of PP within 4 weeks after delivery in a sample of Egyptian women. We included 60 women with PP and 30 postpartum women without psychosis. All participants underwent a full medical assessment and psychiatric assessment using the Holmes and Rahe Stress Scale, the Brief Psychiatric Rating Scale (BPRS), and hormonal assessment (including estrogen levels and thyroid function tests) were performed for each woman.ResultsThe mean age of pregnancy of women with PP was significantly younger than that of controls (19.2 ± 2.04 years versus 24.37 ± 4.92 years). PP was significantly more common among primipara (73.3%), women who underwent cesarean sections (58.3%) and had thyroid dysfunction. The rates of low birth weight, and premature delivery were significantly higher among women with PP than among those without PP. The mean time-lapse from parturition to the onset of PP symptoms was 6.11 ± 1.62 days. Sleep disturbance, and irritability symptoms were the earliest symptoms of PP in our study. Plasma estrogen levels were significantly correlated with the total BPRS scores in patients with PP (P = 0.001).ConclusionsYoung age, primiparity, low birth weight, cesarean delivery, a rapid drop in the estrogen level and thyroid dysfunction all could contribute to the occurrence of PP.

COVID-19 pandemic experience of diagnostic radiographers: A Singapore survey

IntroductionDiagnostic Radiographers (DR) are the frontline responders during the COVID-19 outbreak, providing essential diagnostic imaging services for screening and monitoring of suspected and confirmed patients. Understanding the experience and perceptions of DR towards the COVID-19 outbreak enables radiography leaders to guide changes in the approach to managing response to future health outbreaks. This study aims to document the experiences of DR in Singapore during the COVID-19 pandemic. MethodsAll DR practising in Singapore institutions were invited to participate in an online survey, disseminated by the Singapore Society of Radiographers (SSR). The survey assessed the attitudes and perceptions of the respondents on the COVID-19 pandemic. The Holmes and Rahe Stress Scale was used to identify the respondents’ life events closely related to the pandemic. Data collection took place from 5 July 2020 to 5 September 2020. ResultsA total of 123 DR responded to the survey, where 89.4% of the respondents had been involved in the imaging of suspected or confirmed COVID-19 patients. Those performing General Radiography had the highest number of cases - 300 cases a month. The fear of transmitting COVID-19 to their family presented as the primary stressor (77.2%), followed by the lack of manpower (73.2%). The global themes that emerged from the study were (1) adapting to change and (2) quality of support. ConclusionRadiology departments in Singapore were able to cope with the high demands of the pandemic in terms of the provision of information, supplies, and physical equipment. However, they were less prepared to handle human factors such as mental health and staff morale. The safety and well-being of staff should not be compromised to reduce staff anxiety while performing their duties. Strategies to improve their ability to adapt to changes and provision of quality support are necessary measures in future pandemic situations.

Assessment of mental health in patients with irritable bowel syndrome

Background. The study of mental health in patients with irritable bowel syndrome (IBS) is a promising area of medicine not only in terms of determining the psychological profile, but can also serve as an alternative in terms of further management and treatment of this group of patients. The purpose of the study was to examine mental health of IBS patients. Materials and methods. 54 patients with IBS were examined in the psychiatric clinic of Gǟvle Hospital in 2019–2021. They were included in group I of the examined patients. The control group (groupII) included 40 healthy individuals. Assessment of the psychological status was determined using the following methods: 1) Psychological Stress Measure PSM-25 by Lemyr-Tessier-Fillion; 2) The Holmes and Rahe Stress Scale; 3) Health Assessment 36-Item Short Form Survey (SF-36 Health Assessment). Results. Despite the fact that physical symptoms (abdominal pain, intestinal spasm, defecatory dysfunction) were the main complaints in the clinical picture of our patients with IBS, it was found that the key factor in exacerbating and maintaining IBS physical symptoms are psychosocial (cognitive and emotional) factors. We evaluated the quality of life and psychological state of the examined patients with IBS. Analyzing the PSM-25 questions answered by patients from group I with IBS (n=54) and from control group II (n=40) on the level of psychological stress, the following results were obtained with gender distribution: 42.9% of female patients of group I had a high level of stress, and 50.0% a medium level of stress; low levels of stress were found in only 7.1% of female patients of group I. After analyzing the level of stress, we assessed stress resistance, as a significant proportion of patients showed high and medium levels of stress. The level of stress was significantly higher in patients with IBS compared with the control group II. According to the survey on the psychological and physical component of health, these scores were also reduced in patients with IBS compared with the control group. Conclusions. High and medium levels of stress, as well as reduced stress resistance, were found in IBS patients, which is more pronounced in male patients. Decreased psychological and physical components of health have been found in IBS patients, indicating a reduction in the quality of life of these patients.

Socio-psychological characteristics of persons who had attempted suicide (Minsk, Belarus)

IntroductionMortality from intentional self-harm is an urgent medical and social problem in most countries of the world. According to the World Health Organization, suicide mortality is the second leading cause of death among young people aged 15-29 years globally. In the Republic of Belarus, this is one of the main causes of death from external causes.ObjectivesTo identify statistically significant social factors and individual characteristics of people who had attempted suicide.MethodsThree patient groups were formed: persons who had suicidal attempt with high probability of death (mainly hanging) (GSAD), persons who had suicidal attempt in other ways (GSAO), and persons who had diagnosed adjustment disorder and did not have suicidal attempts (comparison group CG). The groups consisted of 40, 80 and 40 people, respectively. Socio-demographic data were determined, the level of stress was assessed according to the Holmes and Rahe Stress Scale, depressive symptoms on the Montgomery-Åsberg Depression Rating Scale, individual features were determined using the Eysenck personality questionnaire and the Leonhard-Shmishek personality characteristics questionnaire. The obtained data were analyzed using the Spearman linear correlation coefficient.ResultsStatistical analysis revealed one significant factor interconnected with a high level of motivation for committing suicide - the method of suicide (rₛ=-0.68) and 2 factors were at the significance boundary: the presence of a diagnosis of mental disorder (rₛ=0.28), and the education factor (rₛ=-0.28).ConclusionsThe method of suicide, the presence of a mental disorder and the level of education are the most significant factors interrelated with a pronounced motivation for committing suicide.DisclosureNo significant relationships.

INFLUENCE OF LIFESTYLE ON STRESS MANAGEMENT IN PUBLIC SECTOR HEALTH WORKERS IN SEMI-URBAN AREA – A PRELIMINARY STUDY

Introduction: This research set out to evaluate the effects lifestyle has on stress in primary health care personnel’s working in the public Health sector in a semi urban region of Rivers State, Nigeria, and if possible understand how diet as well as other intrinsic factors might help in the management of stress. Method: The Holmes and Rahe stress scale was administered, as well as other questions in a self-administered questionnaire to test for how Age, diet, food type, physical activity and sleep affected stress on the stress scale. The questionnaire was administered to 53 individuals (8 males and 45 females), with ages between 24-60 and data was evaluated based on several different criteria. Result: A low level stress was found to be higher (37.7%) in the age groups 25-34 and 35-44 (60.0% and 68.8% respectively). Men (87.5%) were found to have moderate to high level stress than the women (57.8%). Respondents with moderate to high levels stress had 50% - 80% chance of major health breakdown within the next 2 years according to the Holmes and Rahe statistical predictor model which saw 35.7% of respondents who slept less than 7 hours a day had high levels of stress than does who slept more than 9 hours at night (28.6%). Regarding exercise, respondents who were inactive (30.8%) to low (43.5%) in terms of minutes per week of physical activity as well as those who were inconsistent (45.5%) with physical activities (in terms of number of times per week) had high levels of stress. Regarding body mass index (BMI) and stress, the risk for health breakdown within 2 years were observed as overweight/obese (64.5%) individuals had moderate to high levels of stress compared to normal (59.1%). Concerning dietary pattern, moderate to high levels stress were observed in semi vegetarian (100%), lacto-Ovo vegetarians (66.9%) and non-vegetarians (61.1%). Blood group was found to influence the way individuals dealt with the stress - with type O positive (68.7%) being the most sensitive, and type AB positive the least sensitive. Conclusion: Effectively knowing and practicing how to eliminate the negative factors of stress and modifying lifestyle especially sleep hours, food, physical activities in male population and the active age group can assure one of better health outcomes by reducing the chances of major health breakdown within 2 years. KEY WORDS: Sleep hours, Exercise, Physical activity, blood group, Diet, stress, Primary Health Workers.

INCREASING STRESS RESISTANCE BY TRANSCRANIAL ELECTRICAL STIMULATION IN PATIENTS AFTER PROSTATE CANCER SURGERY

Anxiety in men often increases during the rehabilitation period after prostate cancer surgery. Moreover, simultaneous development of erectile dysfunction is also observed. This contributes to psycho-emotional stress formation.
 The aim of the study is to evaluate the effect of transcranial electrical stimulation (tES) on stress vulnerability during the rehabilitation period after various types of prostate cancer surgery.
 Materials and Methods. The authors estimated anxiety level and erectile dysfunction in 124 men 6 months after prostate cancer surgery. The patients were divided into groups according to the surgery type: Group 1 (n=24) – high-intensity focused ultrasound (HIFU); Group 2 (n=50) – laparoscopic radical prostatectomy; Group 3 (n=50) – laparotomic radical prostatectomy. Serum concentration of adrenocorticotropic hormone (ACTH), cortisol, adrenaline, interleukins 1 and interleukins 2 (IL-1, IL-2) and stress vulnerability level according to N.V. Kirsheva and N.V. Ryabchikova test, Holmes and Rahe stress scale, S. Cohen and G. Williamson test, and “Prognosis” method was determined twice: before and after tES.
 Results. Erectile dysfunction was detected in 37 patients 6 months after radical prostatectomy (Group 2, n=17; Group 3, n=20). All the patients of Group 1 (HIFU) restored erection. A decrease in stress vulnerability was observed in all patients, regardless of the surgery type and the severity of functional disorders. After tES, a significant decrease in the levels of ACTH, cortisol, IL-1, IL-2 was estimated (p<0.05). According to all tests used, a significant increase in stress vulnerability was noted, regardless of the type of surgery (p<0.001).
 Conclusion. In terms of frequency of functional disorder development during the rehabilitation period, HIFU has advantages over radical prostatectomy, regardless of the surgical approach. Transcranial electrical stimulation 6 months after surgery significantly reduces the level of stress hormones and interleukins in patients’ blood serum; increases stress vulnerability regardless of the surgery type and functional disorders. Moreover, tES can be recommended for all patients after prostate cancer surgery.

An association between chronic life stressors prior to diagnosis of breast cancer.

The clinical course of breast cancer (BC) and survival depend on a wide range of risk factors. From the psychosomatic point of view, BC is one of the most studied type of cancer but there is no evidence available for this relation. Therefore, in the present study we evaluate the impact of chronic life stressors in BC patients. A total of 100 BC patients were invited to participate in an interview, when information about social parameters and emotional changes in the period prior to diagnosis were collected. The emotional changes were evaluated by the Holmes and Rahe's Stress Scale, which analyzes the difficulty required for a person to readjust to society after significant changes in their life. Clinicopathological parameters were obtained from the medical records. For all data, the level of significance adopted was p <0.05. It was observed that 55.2 % of the patients have a medium and 13.8 % were at high risk for disease development related to stressful events in the period prior to the BC diagnosis. The highest stress levels were presented by separated, divorced, or widowed patients compared to married (p <0.01) and single (p = 0.037) patients. The high-risk (HR) group had a lower proportion of positivity for estrogen receptor when compared to the low (LR) and moderate risk (MR) groups (p= 0.001). In addition, a binary logistic regression analysis was performed, and we found that the relationship between the estrogen receptor and the HR of chronic stress was independently associated with the histological type of BC and lymph nodes involvement. The relationship of stressful life experiences and BC is not well established, so our study collaborates with the literature to demonstrate the importance of stress as a factor associated with the development of BC.

Type D Personality and Essential Hypertension in Semarang City, Indonesia: A Primary Healthcare Center-based Case-Control Study

Type D personality is defined as the interaction between negative affectivity (NA) and social inhibition (SI). Hypertension has the highest cases in primary healthcare center (PHC) in Semarang City compared to other non-communicable diseases. This study aims to determine type D personality role on essential hypertension. It was a case-control study conducted at the PHC in Semarang City from January 2020 to March 2021 with 139 cases and 139 controls among 18-60 years old patients. Sample collection was performed by stratified random sampling. The instruments used were the DS-14 scale, structured questionnaire IPAQ-SF, food frequency questionnaire, and the Holmes and Rahe Stress Scale, while data were analyzed using logistic regression. The prevalence of type D personality in the case group (64%; 95%CI: 55.9%-72.1%) was higher than in the control (36.7%; 95%CI: 28.7%-44.7%). Type D personality was discovered to be significantly associated with essential hypertension (OR: 3.07; 95%CI: 1.83-5.16). After other covariates adjustment, the association was still statistically significant (AdjOR: 2.41; 95%CI: 1.32-4.41).

Psychiatric comorbidity and quality of life in patients with dermatological diseases

ObjectiveThe aim of the study was to compare the psychiatric comorbidities in patients with vitiligo with control group considering the burden in their life quality.BackgroundSeveral studies reported high rates of depression and anxiety particularly for specific dermatological diseases such as vitiligo, affecting their life quality.Patients and methodsA total of 30 patients with vitiligo as well as 30 participants as a control group were included. The study was conducted in Neuropsychiatry Department, Menoufia University. Arabic version of the Structured Clinical Interview for psychiatric Disorders 1 based on the Diagnostic and Statistical Manual of Mental Health Disorders, fourth ed., was used for psychiatric diagnosis. Dermatology life quality index was used to assess life quality in patients with vitiligo. Arabic version of the Holmes and Rahe Stress Scale was used to determine stressful life events that might increase risk for illnesses.ResultsA statistically significant difference between the patients with vitiligo and controls was found regarding psychiatric comorbidities (P < 0.001). Only seven (23.3%) patients of vitiligo group were free of psychiatric disorders. Overall, 23 patients of vitiligo group had psychiatric comorbidities versus control group (76.7 vs. 16.7%). Quality of life (QOL) affection was at moderate effect in 16.7%, very large effect in 30%, and extreme large effect in 10%.ConclusionPatients with vitiligo disease were associated with high rates of psychiatric comorbidity. A significant disruption was found in QOL. Screening may be helpful for early diagnosis, improving their QOL.

Stressors are Correlated with the Development of Conversion Disorder Presenting with Non-epileptic Events

Introduction: To study the socio-demographic and psychosocial correlates in patients with conversion disorder presentingwith nonepileptic events and discuss its interventional implication.&#x0D; Materials and Methods: This cross-sectional descriptivestudy was carried out in a tertiary care hospital of BrahmmanBaria Medical College from January 2018 to January2019. 151 consecutive patients with conversion disorder satisfying the inclusion and exclusion criteria were selected. Theywere interviewed using semi-structured socio-demographic profile proforma, Holmes and Rahe stress scale for the explorationof psycho-social stressors. The data were entered on MS excel, analyzed by SPSS-version 16.0.&#x0D; Results: The psychosocialstressors were clearly identified in all patients. Almost ninety five (94.70%, n=143) out of the total 151 subjects hada history of stressors, while in the rest 4.95% no stressors could be established. The commonest stressors were Troubleswith in-laws (26.49%), Death of close family member (11.92%) and Increase in argument with significant others (10.59 %).&#x0D; Conclusion: Significantly higher number of the patients presented with the stressor of troubles with in-laws, when assessedon the Holmes and Rahe Social Readjustment Rating Scale. Detection of exact nature of correlates has immense potentialfor therapeutic as well as preventive field.&#x0D; Medicine Today 2020 Vol.32(2): 134-137

Coping Strategies in Thyroid Diseases

Abstract In the present study, we aimed at evaluating the relationship between the cognitive coping strategies of people with thyroid diseases and the level of stress experienced by them. During the present study we evaluated the coping strategies with Cognitive Emotion Regulation Questionnaire, and the level of stress experienced by them with Holmes and Rahe stress scale. All patients attended an endocrinology outpatient clinic between may-august 2019. 42 thyroid patients (31 with hypothyroidism and 11 with hyperthyroidism), aged 33-69 were selected for this study. The coping strategies used predominantly by thyroid patients are: rumination, positive reappraisal, catastrophizing. The rumination and the level of stress experienced correlated positively. 295 *, p = .044, statistically significant (p&lt;0.05). 58.13% of patients presented stressful events in the year prior onset of thyroid pathology. This finding is important because restructuring less proactive coping strategies through psychotherapies can be an effective alternative or adjuvant way of treating thyroid diseases.

Faktor dominan kejadian konstipasi fungsional pada remaja di Jakarta

Dominant factors of functional constipation among adolescent in JakartaBackground: The impact of functional constipation, including the quality of life decreases, increase the additional health costs that must be incurred, and reduce productivity. Previous research in various places in Indonesia shows that functional constipation is experienced among adolescents, percentages between 24.6-68.5%.Objective: Determine the relationship and dominant factor between gender, fiber intake, fluids intake, consumption of probiotic drinks, physical activity, nutritional status, stress, and nutritional knowledge on the incidence of functional constipation.Methods: The study design was cross-sectional. The number of respondents studied was 150 high-school students from class X and XI. The sample selected by using a total sampling system. Data collected using the Roma III questionnaire of functional constipation, physical activity using the Physical Activity Questionnaire for Adolescent, and stress level using the Holmes and Rahe Stress Scale for students. Nutritional knowledge was obtained by filling out a questionnaire. Food recall 2x24 hours to assess fiber intake, fluid, and probiotic drinks. Measure body weight and height of students to determine nutritional status. Data analyzed using univariate, Chi-Square test for bivariate, and multiple logistic regression tests for multivariate.Results: 75.3% of students had functional constipation, 64.0% less fiber intake,54.0% less fluid intake, 91.3% less physical activity, 62.0% did not consume probiotic drinks, 38.7% were obese and 30.0% lacking in nutrition knowledge. Dominant factor of functional constipation was physical activity (p-value 0.035; OR 3.57; CI 1.09-11.66).Conclusions: Low physical activity can increase the incidence of functional constipation in adolescents at Jakarta.

THE SIGNIFICANCE OF MULTIDISCIPLINARY APPROACH FOR THE INCREASING IN PATIENTS WITH DIABETES MELLITUS 2 TYPE QUALITY OF LIFE LEVEL

Introduction. Diabetes mellitus 2 type has become a global health problem and is by far one of the most common chronic diseases, so there is an urgent need to provide high quality medical and social care to this patient population. It is known that this group of patients is characterized by a number of specific features that distinguish them and create difficulties for physicians in the treatment process.&#x0D; Purpose. Study has been devoted to the comprehensive assessment of affecting factors on the quality of life of patients with type 2 Diabetes Mellitus (T2DM) in relationship with their psychological status indicators and level of compliance.&#x0D; Materials and Methods. Study population consisted of T2DM (n=40) equivalented by the indicators of age, body mass index, blood pressure, laboratory level of blood glucose and glycated hemoglobin (HbA1c). All patients signed a voluntary informed consent before the study. Study data has been collected using informed patients form and 6 validated psychometric scales: Chaban Quality of Life Scale (CQLS), Medication Compliance Scale (MCS), Toronto Alexithymia Scale (TAS-20), Dysfunctional Attitudes Scale (DAS), Depression, Anxiety and Stress Scale (DASS-21)) and Holmes and Rahe Stress Scale (HRSS). Glycemic control has been based on HbA1c results and blood glucose level.&#x0D; Results. Statistically significant difference has been found between the groups of the patients with high, middle and low level of their commitment to therapy according to MCS results. A significant correlation has been found between the following indicators: HbA1c and body mass index of patients with T2DM (p = .19; r = .368) and presence of alexithymia (p = .039; r = - .328). Depending on the level of quality of life with numeral scores of results with other scales: MCS (p = .361; r = .022); DAS (p = .027; r = - .350), stress level (DASS - 21) (p = .038; r = - .339), depression (DASS - 21) (p = .002; r = -. 471) and HRSS (p = .006; r = - .425).&#x0D; Conclusion: Psychological indicators identified by results of research such as, level of: compliance, cognitive distortions, depression, stress resistance and social adaptation — affected quality of life of T2DM patients, as well as indicators of alexithymia, anxiety, and quality of life affected the level of their commitment to treatment. Patients with low level of compliance and quality of life had the increased risk of treatment non-efficiency as a result. Therefore, multidisciplinary approach in the treatment of each individual patient, would potentially improving the adherence and effectiveness of T2DM treatment

2281-PUB: Family Impact Module in NYC: Diabetes vs. Community Sample

Introduction: We previously reported parents of a child with diabetes (CWD) score poorly on the Pediatric Quality of Life (QoL) Family Impact Module (FIM). Use of the FIM in parents of a CWD is limited and comparison to a control group in or similar to NYC has not been explored. The objective of this study is to compare FIM scores between a PCP office and a diabetes center in NYC. Method: Parents of children at a diabetes and PCP office in NYC completed the FIM and Holmes and Rahe Stress Scale (HRSS) to assess stressful events. Results: Parents of 66 CWD (47% Male) and 97 of a child without (45% Male) (controls) enrolled. Compared to controls, CWD were older (median 13.7 vs. 8.3 years; p&amp;lt;0.0001), included more white subjects (86 vs. 63%; p&amp;lt;0.0001) and scored higher on HRSS (median 128.5 vs. 68; p&amp;lt;0.001). Adjusting for age, sex, race, and HRSS, difference in total FIM scores between groups was statistically significant (p=0.002) with higher impact on the CWD group. Statistically significant differences were found in total Parent Health Related QoL (PHRQoL) (p=0.003), physical function (p=0.0009), cognitive function (p&amp;lt;0.0001), communication (p=0.0003), worry (p&amp;lt;0.0001), and daily activity (p=0.04). None were found in total Family Function, emotional or social function, and family relations. Conclusion: Results show NYC parents of a CWD have higher levels of family impact compared to a community sample. They have worse PHRQoL stress, worry, cognitive and physical function, communication, and daily activity. It is unknown why there is no difference between the groups in all subscales. Previously we reported having a CWD has impact on, communication if CWD is male, worry if multiple CWD, and cognitive function if additional illness. HbA1c, age, and disease duration were not predictors. It should be noted, families from a diabetes clinic are given support which may buffer stress and being in NYC may increase stress regardless. Future study must recruit a larger sample, create normative data, and explore other illnesses. Disclosure J. Ilkowitz: None. A. Zeleniuch-Jacquotte: None. B. Lois: None. P.J. Prezioso: None. M. Gallagher: Consultant; Self; Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc.

BIPOLAR AFFECTIVE DISORDER;

Introduction: Bipolar Affective Disorder is a chronic, recurring illness. There is evidenced relationship between life events (particularly adverse interpersonal events) and the onset of bipolar episodes. Objective: To determine the association of different Psychosocial risk factors for relapse in patients with Bipolar Affective Disorder. Study Design: Descriptive cross-sectional study. Setting: Psychiatry Outpatient Department (OPD) of Jinnah Post Graduate Medical Centre (JPMC), Karachi. Period: January 2016 to July 2016). Subjects and Method: Total 146 patients of both genders aged between 18 to 60 years were enrolled in study. Diagnosis of Bipolar Affective Disorder was based on diagnostic criteria of International Classification of Diseases 10th version [ICD-10]. For the identification of psychosocial factors Holmes and Rahe stress scale was used. Results: A total of 146 patients of both genders with average age of 31.44 ± 10.40 years. Among 146 cases, 97 (66.40%) were males and 49(33.60%) were females. Out of 146, 79(54.10%) were married, 61(41.80) were single. Among 146 patients the psychosocial factors were identified individually. The death of spouse, recent marriage, marital separation and death of close family member or friend, pregnancy were the psychosocial factors associated with relapse with p-value of less than 0.05. Conclusion: The psychosocial factors or adverse life events do trigger the course of Bipolar Affective Disorder. The major negative life events such as death of spouse or close family member or friend, the marital issues are predominant.

Psychological adaptation and peculiarities of melatonin synthesis in women with infertility of various genesis

To improve medical care for families suffering from infertility, a comprehensive approach is needed taking into account the psychoemotional state of a woman and the adaptive capabilities of her body.Aim. To determine the presence of psychological adaptation disorders and features of melatonin synthesis in women with infertility of various genesis.Materials and methods. 115 women with infertility (the main group) were under observation. The control group consisted of 90 fertile women who had born children. The presence of sleep disorders (the table by A. M. Veyn), stress level (the Holmes and Rahe Stress Scale), state and trait anxiety (the Ch. D. Spielberger Anxiety Scales, Yu. L. Khanin, 1976) and depression (the Beck Depression Scale) were assessed. The determination of melatonin serum level was performed by the method of enzyme immunoassay (ELISA).Results. Women with infertility are characterized by violations of psychological adaptation, manifested by sleep disorders (67.0 %), increased stress level (47.8 %), increased state anxiety (47.0 %) and depressive states (21.7 %). Significant disorders are observed in women with idiopathic and hormonal infertility, the least pronounced changes – in infertility caused by an immunological factor. Hypomelatoninemia is observed in 36.5 % of women with infertility and in 20.9 % – hypermelatoninemia. Such multidirectional changes indicate desynchronization of melatonin synthesis, and confirm the dysadaptative disorders in infertility. The highest incidence of melatonin secretion abnormalities was observed in hormonal infertility, and the lowest - in immunological infertility. The regulatory role of melatonin in psychological adaptation is confirmed by its level correlation with the corresponding indicators scores: sleep disorders (ρ = -0.51), stress level (ρ = -0.39), state (ρ = -0.37) and trait anxiety (ρ = -0.26), depression level (ρ = 0.22).Conclusions. A high frequency of psychological dysadaptosis in women with infertility, especially with hormonal and idiopathic infertility, and the regulatory role of melatonin have been revealed, which opens the prospects for psychocorrection methods and therapy with melatonin preparations inclusion in the treatment of infertility.